Chapter 22: Health Care Adaptations for the
Child and Family
Leifer: Introduction to Maternity and Pediatric Nursing, 9th Edition
MULTIPLE CHOICE
1. A 4-year-old child asks tearfully if the IM injection will hurt. What is the nurse‘s most effective
response?
a. “No. It is over before you know it.”
b. “Yes. It will sting a little.”
c. “No. Would you like to see the syringe?”
d. “Yes. Your mom and I are going to hold you to help you be still.”
ANS: B
Truthful answers will give a child a realistic expectation and help establish trust in the nurse.
DIF: Cognitive Level: Application REF: p. 518 OBJ: 11
TOP: Preparation for an IM Injection KEY: Nursing Process Step:
Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
2. Where is the best site for giving an IM injection to a 15-month-old child?
a. Ventrogluteal muscle
b. Dorsogluteal muscle
c. Deltoid muscle
d. Vastus lateralis muscle
ANS: D
The vastus lateralis muscle is free of major blood vessels and nerves and can be used in
children of any age.
DIF: Cognitive Level: Application REF: p. 517 OBJ: 11
TOP: Administering Injections KEY: Nursing Process Step: Planning
, MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
3. What factor does the nurse explain affects the infant‘s physiological response to medications?
a. Faster metabolism in the liver
b. Slower intestinal transit
c. Immature kidney function
d. Increased secretion of hydrochloric acid
ANS: C
Immature kidney function prevents effective excretion of drugs from the body in infants less
than 1 year of age.
DIF: Cognitive Level: Comprehension REF: p. 514 OBJ: 4
TOP: Physiological Responses to Medication
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
4. What intervention should the nurse implement after topical administration of hydrocortisone
cream to the buttocks and abdomen of an infant?
a. Diaper the infant snugly with a disposable diaper.
b. Cover the area with a transparent dressing.
c. Apply a cloth diaper.
d. Place the infant on a plastic pad, undiapered.
ANS: C
Plastic coverings increase the absorption of drugs. The diaper should be cloth, or the infant
should be left undiapered on a cloth pad.
DIF: Cognitive Level: Application REF: p. 514 OBJ: 2
TOP: Rapid Absorption of Drug KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Reduction of Risk
5. Which observation on entering the hospital room lets the nurse know that there is a need for the
parents to receive safety education to prevent unintentional injury?
a. The blanket is not tucked into the mattress.
b. Diapers and wipes are stacked at the foot of the crib.
Child and Family
Leifer: Introduction to Maternity and Pediatric Nursing, 9th Edition
MULTIPLE CHOICE
1. A 4-year-old child asks tearfully if the IM injection will hurt. What is the nurse‘s most effective
response?
a. “No. It is over before you know it.”
b. “Yes. It will sting a little.”
c. “No. Would you like to see the syringe?”
d. “Yes. Your mom and I are going to hold you to help you be still.”
ANS: B
Truthful answers will give a child a realistic expectation and help establish trust in the nurse.
DIF: Cognitive Level: Application REF: p. 518 OBJ: 11
TOP: Preparation for an IM Injection KEY: Nursing Process Step:
Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
2. Where is the best site for giving an IM injection to a 15-month-old child?
a. Ventrogluteal muscle
b. Dorsogluteal muscle
c. Deltoid muscle
d. Vastus lateralis muscle
ANS: D
The vastus lateralis muscle is free of major blood vessels and nerves and can be used in
children of any age.
DIF: Cognitive Level: Application REF: p. 517 OBJ: 11
TOP: Administering Injections KEY: Nursing Process Step: Planning
, MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
3. What factor does the nurse explain affects the infant‘s physiological response to medications?
a. Faster metabolism in the liver
b. Slower intestinal transit
c. Immature kidney function
d. Increased secretion of hydrochloric acid
ANS: C
Immature kidney function prevents effective excretion of drugs from the body in infants less
than 1 year of age.
DIF: Cognitive Level: Comprehension REF: p. 514 OBJ: 4
TOP: Physiological Responses to Medication
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
4. What intervention should the nurse implement after topical administration of hydrocortisone
cream to the buttocks and abdomen of an infant?
a. Diaper the infant snugly with a disposable diaper.
b. Cover the area with a transparent dressing.
c. Apply a cloth diaper.
d. Place the infant on a plastic pad, undiapered.
ANS: C
Plastic coverings increase the absorption of drugs. The diaper should be cloth, or the infant
should be left undiapered on a cloth pad.
DIF: Cognitive Level: Application REF: p. 514 OBJ: 2
TOP: Rapid Absorption of Drug KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Reduction of Risk
5. Which observation on entering the hospital room lets the nurse know that there is a need for the
parents to receive safety education to prevent unintentional injury?
a. The blanket is not tucked into the mattress.
b. Diapers and wipes are stacked at the foot of the crib.
