Test bank for Wong's Nursing Care of Infants and Children 11th Edition by
Hockenberry | Complete | Chapter 1-34 2024/2025
MULTIPLE RESPONSE
1. What findings should the nurse expect to observe in a 7-month-old infant with Werdnig-Hoffman disease?
(Select all that apply.)
a. Noticeable scoliosis
b. Absent deep tendon reflexes
c. Abnormal tongue movements
d. Failure to thrive
e. Prominent pectus excavatum
f. Significant leg involvement ANS: B, C, D
Clinical manifestations of Werdnig-Hoffman disease in an infant include absent deep tendon reflexes, abnormal tongue
movements, and failure to thrive. Scoliosis, prominent pectus excavatum, and significant leg involvement are findings observed in
a child with intermediate spinal muscular atrophy.
DIF: Cognitive Level: Understanding
,Test bank for Wong's Nursing Care of Infants and Children 11th Edition by
Hockenberry | Complete | Chapter 1-34 2024/2025
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
2. The nurse is teaching the family with a child with cerebral palsy (CP) strategies to prevent constipation. What should
the nurse include in the teaching session? (Select all that apply.)
a. Increase fluid intake.
b. Increase fiber in the diet.
c. Administer stool softeners daily as prescribed.
d. Increase the amount of dairy products in the diet.
e. Allow the child to decide when to try to have a bowel movement.
ANS: A, B, C
A variety of factors, including decreased mobility, decreased fluid intake, a fear of toileting, poor positioning on the toilet, and
lack of fiber intake may be responsible for constipation for a child with CP. Stool softeners, laxatives, and a bowel management
program may be required to prevent chronic constipation. The child should be placed on the toilet or encouraged to have a bowel
movement at the same time each day. Dairy products can cause constipation.
DIF: Cognitive Level: Applying
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
3. What functional goal should the nurse expect for a child who has a C7 spinal cord injury? (Select all that apply.)
a. Able to drive automobile with hand controls
b. Complete independence within limitations of a wheelchair
c. Can roll over in bed, sit up in bed, and eat independently
d. Requires some assistance in transfer and lower extremity dressing
e. Ambulation with bilateral long braces using four-point or swing-through crutch gait ANS: B, C, D
A child with a C7 spinal cord injury can expect to be completely independent within the limitations of a wheelchair, can roll over
in bed, sit up in bed, and eat independently, and will require some assistance in transfer and lower extremity dressing. The ability
to drive an automobile with hand controls is a functional goal for a T1 to T10 spinal cord injury. Ambulation with bilateral long
braces using four-point or swing- through crutch gait is a functional goal for a T10 to L2 injury.
,Test bank for Wong's Nursing Care of Infants and Children 11th Edition by
Hockenberry | Complete | Chapter 1-34 2024/2025
DIF: Cognitive Level: Understanding
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
4. What functional goal should the nurse expect for a child who has a T1 to T10 spinal cord injury?(Select all that
apply.)
a. May be braced for standing
b. Able to drive automobile with hand controls
c. Can manage adapted public transportation
d. Some able to use regular public transportation
e. Ambulates well, often with short leg braces with or without cane ANS: A, B, C
A child with a T1 to T10 spinal cord injury may be braced for standing, is able to drive an automobile with hand controls, and can
manage adapted public transportation. The ability to use regular public transportation and ambulation with bilateral long braces
using four-point or swing-through crutch gait are functional goals for individuals with a T10 to L2 injury.
DIF: Cognitive Level: Understanding
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
5. The nurse is preparing to admit a 7-year-old child with ataxic cerebral palsy. What clinical manifestations of ataxic
cerebral palsy should the nurse expect to observe? (Select all that apply.)
a. Wide-based gait
b. Rapid, repetitive movements performed poorly
c. Slow, twisting movements of the trunk or extremities
d. Hypertonicity with poor control of posture, balance, and coordinated motion
e. Disintegration of movements of the upper extremities when the child reaches for objects ANS: A, B, E
Clinical manifestations of ataxic cerebral palsy include a wide-based gait; rapid, repetitive movements performed poorly; and
disintegration of movements of the upper extremities when the child reaches for objects Slow, twisting movements of the trunk
are seen with dyskinetic cerebral palsy, and hypertonicity with poor control of posture, balance, and coordinated motion are seen
with spastic cerebral palsy.
DIF: Cognitive Level: Applying
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
, Test bank for Wong's Nursing Care of Infants and Children 11th Edition by
Hockenberry | Complete | Chapter 1-34 2024/2025
6. What are some of the associated disabilities seen with cerebral palsy? (Select all that apply.)
a. Visual impairment
b. Hearing impairment
c. Speech difficulties
d. Intellectual impairment
e. Associated heart defects ANS: A, B, C, D
Some of the disabilities associated with CP are visual impairment, hearing impairment, behavioral problems, communication and
speech difficulties, seizures, and intellectual impairment. Additional sensory deficits such as hypersensitivity, hyposensitivity, and
balance difficulties may occur in children with CP.
DIF: Cognitive Level: Understanding
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
7. The nurse is preparing to admit a 5-year-old with spina bifida cystica that was below the second lumbar vertebra.
What clinical manifestations of spina bifida cystica below the second lumbar vertebra should the nurse expect to
observe? (Select all that apply.)
a. No motor impairment
b. Lack of bowel control
c. Soft, subcutaneous lipomas
d. Flaccid, partial paralysis of lower extremities
e. Overflow incontinence with constant dribbling of urine ANS: B, D, E
The clinical manifestations of spina bifida cystica below the second lumbar vertebra include lack of bowel control, flaccid, partial
paralysis of lower extremities, and overflow incontinence with constant dribbling of urine. No motor impairment occurs with
spina bifida cystica that was below the third lumbar vertebra, and soft, subcutaneous lipomas occur with spina bifida occulta.
DIF: Cognitive Level: Applying
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
8. The nurse is preparing to admit a 2-year-old child with spina bifida occulta. What clinical manifestations of spina
bifida occulta should the nurse expect to observe? (Select all that apply.)
Hockenberry | Complete | Chapter 1-34 2024/2025
MULTIPLE RESPONSE
1. What findings should the nurse expect to observe in a 7-month-old infant with Werdnig-Hoffman disease?
(Select all that apply.)
a. Noticeable scoliosis
b. Absent deep tendon reflexes
c. Abnormal tongue movements
d. Failure to thrive
e. Prominent pectus excavatum
f. Significant leg involvement ANS: B, C, D
Clinical manifestations of Werdnig-Hoffman disease in an infant include absent deep tendon reflexes, abnormal tongue
movements, and failure to thrive. Scoliosis, prominent pectus excavatum, and significant leg involvement are findings observed in
a child with intermediate spinal muscular atrophy.
DIF: Cognitive Level: Understanding
,Test bank for Wong's Nursing Care of Infants and Children 11th Edition by
Hockenberry | Complete | Chapter 1-34 2024/2025
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
2. The nurse is teaching the family with a child with cerebral palsy (CP) strategies to prevent constipation. What should
the nurse include in the teaching session? (Select all that apply.)
a. Increase fluid intake.
b. Increase fiber in the diet.
c. Administer stool softeners daily as prescribed.
d. Increase the amount of dairy products in the diet.
e. Allow the child to decide when to try to have a bowel movement.
ANS: A, B, C
A variety of factors, including decreased mobility, decreased fluid intake, a fear of toileting, poor positioning on the toilet, and
lack of fiber intake may be responsible for constipation for a child with CP. Stool softeners, laxatives, and a bowel management
program may be required to prevent chronic constipation. The child should be placed on the toilet or encouraged to have a bowel
movement at the same time each day. Dairy products can cause constipation.
DIF: Cognitive Level: Applying
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
3. What functional goal should the nurse expect for a child who has a C7 spinal cord injury? (Select all that apply.)
a. Able to drive automobile with hand controls
b. Complete independence within limitations of a wheelchair
c. Can roll over in bed, sit up in bed, and eat independently
d. Requires some assistance in transfer and lower extremity dressing
e. Ambulation with bilateral long braces using four-point or swing-through crutch gait ANS: B, C, D
A child with a C7 spinal cord injury can expect to be completely independent within the limitations of a wheelchair, can roll over
in bed, sit up in bed, and eat independently, and will require some assistance in transfer and lower extremity dressing. The ability
to drive an automobile with hand controls is a functional goal for a T1 to T10 spinal cord injury. Ambulation with bilateral long
braces using four-point or swing- through crutch gait is a functional goal for a T10 to L2 injury.
,Test bank for Wong's Nursing Care of Infants and Children 11th Edition by
Hockenberry | Complete | Chapter 1-34 2024/2025
DIF: Cognitive Level: Understanding
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
4. What functional goal should the nurse expect for a child who has a T1 to T10 spinal cord injury?(Select all that
apply.)
a. May be braced for standing
b. Able to drive automobile with hand controls
c. Can manage adapted public transportation
d. Some able to use regular public transportation
e. Ambulates well, often with short leg braces with or without cane ANS: A, B, C
A child with a T1 to T10 spinal cord injury may be braced for standing, is able to drive an automobile with hand controls, and can
manage adapted public transportation. The ability to use regular public transportation and ambulation with bilateral long braces
using four-point or swing-through crutch gait are functional goals for individuals with a T10 to L2 injury.
DIF: Cognitive Level: Understanding
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
5. The nurse is preparing to admit a 7-year-old child with ataxic cerebral palsy. What clinical manifestations of ataxic
cerebral palsy should the nurse expect to observe? (Select all that apply.)
a. Wide-based gait
b. Rapid, repetitive movements performed poorly
c. Slow, twisting movements of the trunk or extremities
d. Hypertonicity with poor control of posture, balance, and coordinated motion
e. Disintegration of movements of the upper extremities when the child reaches for objects ANS: A, B, E
Clinical manifestations of ataxic cerebral palsy include a wide-based gait; rapid, repetitive movements performed poorly; and
disintegration of movements of the upper extremities when the child reaches for objects Slow, twisting movements of the trunk
are seen with dyskinetic cerebral palsy, and hypertonicity with poor control of posture, balance, and coordinated motion are seen
with spastic cerebral palsy.
DIF: Cognitive Level: Applying
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
, Test bank for Wong's Nursing Care of Infants and Children 11th Edition by
Hockenberry | Complete | Chapter 1-34 2024/2025
6. What are some of the associated disabilities seen with cerebral palsy? (Select all that apply.)
a. Visual impairment
b. Hearing impairment
c. Speech difficulties
d. Intellectual impairment
e. Associated heart defects ANS: A, B, C, D
Some of the disabilities associated with CP are visual impairment, hearing impairment, behavioral problems, communication and
speech difficulties, seizures, and intellectual impairment. Additional sensory deficits such as hypersensitivity, hyposensitivity, and
balance difficulties may occur in children with CP.
DIF: Cognitive Level: Understanding
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
7. The nurse is preparing to admit a 5-year-old with spina bifida cystica that was below the second lumbar vertebra.
What clinical manifestations of spina bifida cystica below the second lumbar vertebra should the nurse expect to
observe? (Select all that apply.)
a. No motor impairment
b. Lack of bowel control
c. Soft, subcutaneous lipomas
d. Flaccid, partial paralysis of lower extremities
e. Overflow incontinence with constant dribbling of urine ANS: B, D, E
The clinical manifestations of spina bifida cystica below the second lumbar vertebra include lack of bowel control, flaccid, partial
paralysis of lower extremities, and overflow incontinence with constant dribbling of urine. No motor impairment occurs with
spina bifida cystica that was below the third lumbar vertebra, and soft, subcutaneous lipomas occur with spina bifida occulta.
DIF: Cognitive Level: Applying
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
8. The nurse is preparing to admit a 2-year-old child with spina bifida occulta. What clinical manifestations of spina
bifida occulta should the nurse expect to observe? (Select all that apply.)
