Chapter 26: 21st Century Pediatric Nursing Nursing School Test Banks

Chapter 26: 21st Century Pediatric Nursing

MULTIPLE CHOICE

1. From a worldwide perspective, infant mortality in the United States:

a.

Is the highest of the other developed nations.

b.

Lags behind five other developed nations.

c.

Is the lowest infant death rate of developed nations.

d.

Lags behind most other developed nations.

ANS: A

Although the death rate has decreased, the United States still ranks last among nations with the lowest infant death rates. The United States has the highest infant death rate of developed nations.

PTS: 1 DIF: Cognitive Level: Knowledge REF: 723

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

2. The major cause of death for children older than 1 year is:

a.

Cancer.

c.

Unintentional injuries.

b.

Infection.

d.

Congenital abnormalities.

ANS: C

Unintentional injuries (accidents) are the leading cause of death after age 1 year through adolescence. Congenital anomalies are the leading cause of death in those younger than 1 year and are less significant in this age group. There have been major declines in deaths attributed infection as a result of improved therapies. Cancer is the second leading cause of death in this age group.

PTS: 1 DIF: Cognitive Level: Comprehension REF: 723

OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance

3. In addition to injuries, the leading causes of death in adolescents ages 15 to 19 years are:

a.

Suicide, cancer.

c.

Homicide, heart disease.

b.

Homicide, suicide

d.

Drowning, cancer.

ANS: B

In this age group the leading cause of death is accidents, followed by homicide and suicide. Other causes of death include cancer and heart disease.

PTS: 1 DIF: Cognitive Level: Knowledge REF: 723

OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance

4. The leading cause of death from unintentional injuries in children is:

a.

Poisoning.

c.

Motor vehiclerelated fatalities.

b.

Drowning.

d.

Fire- and burn-related fatalities.

ANS: C

Motor vehiclerelated fatalities comprise the leading cause of death in children, as either passengers or pedestrians. Poisoning is the ninth leading cause of death.

Drowning is the second leading cause of death. Fire- and burn-related fatalities are the third leading cause of death.

PTS: 1 DIF: Cognitive Level: Knowledge REF: 719

OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance

5. Which of the following is descriptive of deaths caused by unintentional injuries?

a.

More deaths occur in males.

b.

More deaths occur in females.

c.

The pattern of deaths varies widely in Western societies.

d.

The pattern of deaths does not vary according to age and sex.

ANS: A

Most deaths from unintentional injuries occur in males. The pattern of death caused by unintentional injuries is consistent in Western societies. Causes of unintentional deaths vary with age and gender.

PTS: 1 DIF: Cognitive Level: Comprehension REF: 720

OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance

6. The type of injury a child is especially susceptible to at a specific age is most closely related to:

a.

Physical health of the child.

b.

Developmental level of the child.

c.

Educational level of the child.

d.

Number of responsible adults in the home.

ANS: B

The childs developmental stage determines the type of injury that is likely to occur. The childs physical health may facilitate his or her recovery from an injury. Educational level is related to developmental level, but it is not as important as the childs developmental level in determining the type of injury. The number of responsible adults in the home may affect the number of unintentional injuries, but the type of injury is related to the childs developmental stage.

PTS: 1 DIF: Cognitive Level: Comprehension REF: 721

OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance

7. Which statement regarding childhood morbidity is the most accurate?

a.

Morbidity does not vary with age.

b.

Morbidity is not distributed randomly.

c.

Little can be done to improve morbidity.

d.

Unintentional injuries do not have an effect on morbidity.

ANS: B

Morbidity is not distributed randomly in children. Increased morbidity is associated with certain groups of children, including children living in poverty and those who were low birth weight. Morbidity does vary with age. The types of illnesses in children are different for each age group. Morbidity can be decreased with interventions focused on groups with high morbidity and on decreasing unintentional injuries, which also affect morbidity.

PTS: 1 DIF: Cognitive Level: Comprehension REF: 724

OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance

8. Which statement is most descriptive of pediatric family-centered care?

a.

It reduces the effect of cultural diversity on the family.

b.

It encourages family dependence on the health care system.

c.

It recognizes that the family is the constant in a childs life.

d.

It avoids expecting families to be part of the decision-making process.

ANS: C

The key components of family-centered care are for the nurse to support, respect, encourage, and embrace the familys strength by developing a partnership with the childs parents. Family-centered care recognizes the family as the constant in the childs life. The nurse should support the cultural diversity of the family, not reduce its effect. The family should be enabled and empowered to work with the health care system and to be part of the decision-making process.

PTS: 1 DIF: Cognitive Level: Comprehension REF: 725

OBJ: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance

9. The nurse is preparing staff in-service education about atraumatic care for pediatric patients. Which intervention should the nurse include?

a.

Prepare the child for separation from parents during hospitalization by reviewing a video.

b.

Prepare the child before any unfamiliar treatment or procedure by demonstrating on a stuffed animal.

c.

Help the child accept the loss of control associated with hospitalization.

d.

Help the child accept pain that is connected with a treatment or procedure.

ANS: B

Preparing the child for any unfamiliar treatments, controlling pain, allowing privacy, providing play activities for expression of fear and aggression, providing choices, and respecting cultural differences are components of atraumatic care. In providing atraumatic care, the separation of child from parents during hospitalization is minimized. The nurse should promote a sense of control for the child. Preventing and minimizing bodily injury and pain are major components of atraumatic care.

PTS: 1 DIF: Cognitive Level: Application REF: 724

OBJ: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance

10. Which statement best describes the process of critical thinking?

a.

It is a simple developmental process.

b.

It is purposeful and goal directed.

c.

It is based on deliberate and irrational thought.

d.

It assists individuals in guessing what is most appropriate.

ANS: B

Critical thinking is a complex, developmental process based on rational and deliberate thought. When thinking is clear, precise, accurate, relevant, consistent, and fair, a logical connection develops between the elements of thought and the problem at hand.

PTS: 1 DIF: Cognitive Level: Comprehension REF: 727

OBJ: Nursing Process: Planning

MSC: Client Needs: Safe and Effective Care Environment

11. A clinic nurse is planning a teaching session about childhood obesity prevention for parents of school-age children. The nurse should include which associated risk of obesity in the teaching plan?

a.

Type I diabetes

c.

Celiac disease

b.

Respiratory disease

d.

Type II diabetes

ANS: D

Childhood obesity has been associated with the rise of type II diabetes in children. Type I diabetes is not associated with obesity and has a genetic component. Respiratory disease is not associated with obesity, and celiac disease is the inability to metabolize gluten in foods and is not associated with obesity.

PTS: 1 DIF: Cognitive Level: Application REF: 719

OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance

12. Which is now referred to as the new morbidity?

a.

Limitations in the major activities of daily living

b.

Unintentional injuries that cause chronic health problems

c.

Discoveries of new therapies to treat health problems

d.

Behavioral, social, and educational problems that alter health

ANS: D

The new morbidity reflects the behavioral, social, and educational problems that interfere with the childs social and academic development. It is also referred to a pediatric social illness. Limitations in major activities of daily living and unintentional injuries that result in chronic health problems are included in morbidity data. Discovery of new therapies would be reflected in changes in morbidity data over time.

PTS: 1 DIF: Cognitive Level: Knowledge REF: 719

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

13. Which action by the nurse demonstrates use of evidence-based practice (EBP)?

a.

Gathering equipment for a procedure

b.

Documenting changes in a patients status

c.

Questioning the use of daily central line dressing changes

d.

Clarifying a physicians prescription for morphine

ANS: C

The nurse who questions the daily central line dressing change is ascertaining whether clinical interventions result in positive outcomes for patients. This demonstrates evidence-based practice (EBP), which implies questioning why something is effective and whether a better approach exists. Gathering equipment for a procedure and documenting changes in a patients status are practices that follow established guidelines. Clarifying a physicians prescription for morphine constitutes safe nursing care.

PTS: 1 DIF: Cognitive Level: Application REF: 727

OBJ: Nursing Process: Evaluation

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

14. A nurse is planning a class on accident prevention for parents of toddlers. Which safety topic is the priority for this class?

a.

Appropriate use of car seat restraints

b.

Safety crossing the street

c.

Helmet use when riding a bicycle

d.

Poison control numbers

ANS: A

Motor vehicle accidents (MVAs) continue to be the most common cause of death in children older than 1 year; therefore, the priority topic is appropriate use of car seat restraints. Safety crossing the street and bicycle helmet use are topics that should be included for preschool parents but are not priorities for parents of toddlers. Information about poison control is important for parents of toddlers and would be a safety topic to include but is not the priority over the appropriate use of car seat restraints.

PTS: 1 DIF: Cognitive Level: Application REF: 719

OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance

MULTIPLE RESPONSE

15. The nursing process is a method of problem identification and problem solving that describes what the nurse actually does. The five steps include (Select all that apply):

a.

Assessment.

b.

Diagnosis.

c.

Planning.

d.

Documentation

e.

Implementation.

f.

Evaluation

ANS: A, B, C, E, F

The accepted model is assessment, diagnosis, planning, implementation, and evaluation. The diagnosis phase is separated into two steps: nursing diagnosis and outcome identification. Although documentation is not one of the five steps of the nursing process, it is essential for evaluation. The nurse can assess, diagnose and identify problems, plan, and implement without documentation; however evaluation is best performed with written evidence of progress toward outcomes.

PTS: 1 DIF: Cognitive Level: Knowledge REF: 728-729

OBJ: Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation

MSC: Client Needs: Health Promotion and Maintenance

16. Which behaviors by the nurse indicate a therapeutic relationship with children and families? (Select all that apply.)

a.

Spending off-duty time with children and families

b.

Asking questions if families are not participating in the care

c.

Clarifying information for families

d.

Buying toys for a hospitalized child

e.

Learning about the familys religious preferences

ANS: B, C, E

Asking questions if families are not participating in the care, clarifying information for families, and learning about the familys religious preferences are positive actions and foster therapeutic relationships with children and families. Spending off-duty time with children and families and buying toys for a hospitalized child are negative actions and indicate overinvolvement with children and families that is nontherapeutic.

PTS: 1 DIF: Cognitive Level: Comprehension REF: 726

OBJ: Nursing Process: Evaluation MSC: Client Needs: Psychosocial Integrity

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