Chapter 1
Question 1
Question 1
Type: MCSA
The nurse in a pediatric acute care unit is assigned the following tasks. Based on
recognition that the action defined requires training beyond the preparation of a registered
nurse, the nurse would refuse to:
1. Diagnose a six-year-old with diversional activity deficit related to placement in
isolation.
2. Listen to the concerns of an adolescent about being out of school for a lengthy surgical
recovery.
3. Diagnose an eight-year-old with acute otitis media and prescribe an antibiotic.
4. Provide information to a mother of a newly diagnosed four-year-old diabetic about
local support group options.
Correct Answer: 3
Rationale 1: Nursing diagnoses are a responsibility of the nurse in an acute care unit.
Rationale 2: Listening to concerns is within the expectations of a nurse in an acute care
unit.
Rationale 3: Advanced practice nurse practitioners perform assessment, diagnosis, and
management of health conditions. The role of the pediatric nurse includes providing
nursing assessment, direct nursing care interventions, client and family education at
developmentally appropriate levels, client advocacy, case management, minimization of
distress, and enhancement of coping.
Rationale 4: Providing information about support groups is within the expectations of the
nurse in an acute care unit.
Global Rationale:
Cognitive Level: Applying
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
,Learning Outcome: 1-1
Question 2
Type: MCSA
Despite the availability of Children's Health Insurance Programs (CHIP), many eligible
children are not enrolled. The nursing intervention that can best help eligible children to
become enrolled is:
1. Educating the family about the need for keeping regular well-child visit appointments.
2. Assessing details of the family's income and expenditures.
3. Limiting costly, unnecessary duplication of services through case management.
4. Advocating for the child by encouraging the family to investigate CHIP eligibility.
Correct Answer: 4
Rationale 1: While it is the nurse's responsibility to educate the family, this intervention
is not what will best help eligible children to become enrolled.
Rationale 2: Financial assessment is more commonly the function of a social worker.
Rationale 3: The case management activity mentioned will not provide a source of
funding.
Rationale 4: In the role of an advocate, a nurse advances the interests of the child by
suggesting that the family investigate CHIP eligibility.
Global Rationale:
Cognitive Level: Analyzing
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 1-1
Question 3
Type: MCSA
A nurse is examining different nursing roles. Which best illustrates an advanced practice
nursing role?
,1. A clinical nurse specialist with whom other nurses consult for her expertise in caring
for high-risk children
2. A clinical nurse specialist working as a staff nurse on a medical-surgical pediatric unit
3. A registered nurse who is the circulating nurse in surgery
4. A registered nurse who is the manager of a large pediatric unit
Correct Answer: 1
Rationale 1: A clinical nurse specialist with whom other nurses consult for expertise in
caring for high-risk children would define an advanced practice nursing role. Advanced
practice nurses have specialized knowledge and competence in a specific clinical area
and have earned a master's degree.
Rationale 2: A clinical nurse specialist working as a staff nurse on a medical-surgical
pediatric unit might have the qualifications for an advanced practice nursing staff but is
not working in that capacity.
Rationale 3: A registered nurse who is a circulating nurse in surgery is defined as a
professional nurse and has graduated from an accredited program in nursing and
completed the licensure examination.
Rationale 4: A registered nurse who is the manager of a large pediatric unit is defined as
a professional nurse and has graduated from an accredited program in nursing and
completed the licensure examination.
Global Rationale:
Cognitive Level: Analyzing
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 1-1
Question 4
Type: MCSA
The role of the registered nurse as a nurse educator is to:
1. Provide primary care for healthy children.
2. Assist the family in making informed decisions by providing information about the
pros and cons of the treatment plan.
, 3. Assist the primary care nurse with procedures requiring advanced practice skills.
4. Communicate with the hospitalized school-aged child’s classroom teacher to assist the
child in achieving classroom goals.
Correct Answer: 2
Rationale 1: The nurse educator does not provide primary care for healthy children.
Rationale 2: The educator works with the family toward the goal of making informed
choices through education and explanation.
Rationale 3: The nurse educator does not assist with procedures requiring advance
practice skills.
Rationale 4: The nurse educator is concerned with teaching the child and parents health
care practices related to the child’s condition.
Global Rationale:
Cognitive Level: Applying
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 1-1
Question 5
Type: MCSA
A 7-year-old child has been admitted for acute appendicitis. The parents are questioning
the nurse about expectations during the child's recovery. Which information tool would
be most useful in answering a parent's questions about timing of key events?
1. Healthy People 2020
2. National clinical practice guidelines
3. Child mortality statistics
4. Critical clinical pathways
Correct Answer: 4
Rationale 1: Healthy People 2020 contains objectives set by the U.S. government to
improve the health and reduce the incidence of death in the twenty-first century.