Chapter 01: Perspectives of Pediatric Nursing 2 Chapter 02: Social, Cultural, Religious, a, Exercises of Nursing

Chapter 01: Perspectives of Pediatric Nursing 2 Chapter 02: Social, Cultural, Religious, and Family Influences on Child Health Promotion

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TB/Test Bank - Wong's Nursing Care of Infants and Children (11e by Hockenberry)
No index entries found.
Table of
Contents
Table of Contents
1
Chapter 01: Perspectives of Pediatric Nursing 2
Chapter 02: Social, Cultural, Religious, and Family Influences on Child Health
Promotion
18
Chapter 03: Hereditary Influences on Health Promotion of the Child and Family 36
Chapter 04: Communication, Physical, and Developmental Assessment of the
Child and Family
54
Chapter 05: Pain Assessment and Management in Children 76
Chapter 06: Childhood Communicable and Infectious Diseases 94
Chapter 07: Health Promotion of the Newborn and
Family Chapter 08: Health Problems of the Newborn
Chapter 09: The High-Risk Newborn and Family
Chapter 10: Health Promotion of the Infant and
Family Chapter 11: Health Problems of the Infant
Chapter 12: Health Promotion of the Toddler and Family
Chapter 13: Health Promotion of the Preschooler and
Family Chapter 14: Health Problems of Early Childhood
Chapter 15: Health Promotion of the School-Age Child and
Family Chapter 16: Health Problems of the School-Age Child
Chapter 17: Health Promotion of the Adolescent and Family
Chapter 18: Health Problems of the Adolescent
Chapter 19: Family-Centered Care of the Child with Chronic Illness or
Disability Chapter 20: Family-Centered Palliative Care
Chapter 20: Impact of Cognitive or Sensory Impairment on the Child
and Family Chapter 21: Family-Centered Care of the Child During
Illness and Hospitalization Chapter 22: Pediatric Nursing Interventions
and Skills
Chapter 23: The Child with Fluid and Electrolyte
Imbalance Chapter 24: The Child with Renal Dysfunction
Chapter 25: The Child with Gastrointestinal
Dysfunction Chapter 26: The Child with Respiratory
Dysfunction Chapter 27: The Child with
Cardiovascular Dysfunction
Chapter 28: The Child with Hematologic or Immunologic
Dysfunction Chapter 29: The Child with Cancer
Chapter 30: The Child with Cerebral Dysfunction
Chapter 31: The Child with Endocrine
Dysfunction Chapter 32: The Child with
Integumentary Dysfunction
Chapter 33: The Child with Musculoskeletal or Articular
Dysfunction Chapter 34: The Child with Neuromuscular or
Muscular Dysfunction
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No index entries found.

Table of

Contents

Table of Contents

Chapter 01: Perspectives of Pediatric Nursing 2

Chapter 02: Social, Cultural, Religious, and Family Influences on Child Health

Promotion

Chapter 03: Hereditary Influences on Health Promotion of the Child and Family 36

Chapter 04: Communication, Physical, and Developmental Assessment of the

Child and Family

Chapter 05: Pain Assessment and Management in Children 76

Chapter 06: Childhood Communicable and Infectious Diseases 94

Chapter 07: Health Promotion of the Newborn and

Family Chapter 08: Health Problems of the Newborn

Chapter 09: The High-Risk Newborn and Family

Chapter 10: Health Promotion of the Infant and

Family Chapter 11: Health Problems of the Infant

Chapter 12: Health Promotion of the Toddler and Family

Chapter 13: Health Promotion of the Preschooler and

Family Chapter 14: Health Problems of Early Childhood

Chapter 15: Health Promotion of the School-Age Child and

Family Chapter 16: Health Problems of the School-Age Child

Chapter 17: Health Promotion of the Adolescent and Family

Chapter 18: Health Problems of the Adolescent

Chapter 19: Family-Centered Care of the Child with Chronic Illness or

Disability Chapter 20: Family-Centered Palliative Care

Chapter 20: Impact of Cognitive or Sensory Impairment on the Child

and Family Chapter 21: Family-Centered Care of the Child During

Illness and Hospitalization Chapter 22: Pediatric Nursing Interventions

and Skills

Chapter 23: The Child with Fluid and Electrolyte

Imbalance Chapter 24: The Child with Renal Dysfunction

Chapter 25: The Child with Gastrointestinal

Dysfunction Chapter 26: The Child with Respiratory

Dysfunction Chapter 27: The Child with

Cardiovascular Dysfunction

Chapter 28: The Child with Hematologic or Immunologic

Dysfunction Chapter 29: The Child with Cancer

Chapter 30: The Child with Cerebral Dysfunction

Chapter 31: The Child with Endocrine

Dysfunction Chapter 32: The Child with

Integumentary Dysfunction

Chapter 33: The Child with Musculoskeletal or Articular

Dysfunction Chapter 34: The Child with Neuromuscular or

Muscular Dysfunction

Chapter 01: Perspectives of Pediatric Nursing

MULTIPLE CHOICE

  1. The clinic nurse is reviewing statistics on infant mortality for the United States versus other countries. Compared with other countries that have a population of at least 25 million, the nurse makes which determination? a. The United States is ranked last among 27 countries. b. The United States is ranked similar to 20 other developed countries. c. The United States is ranked in the middle of 20 other developed countries. d. The United States is ranked highest among 27 other industrialized countries. ANS: A Although the death rate has decreased, the United States still ranks last in infant mortality among nations with a population of at least 25 million. The United States has the highest infant death rate of developed nations. DIF: Cognitive Level: Remembering TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
  2. Which is the leading cause of death in infants younger than 1 year in the United States? a. Congenital anomalies b. Sudden infant death syndrome c. Disorders related to short gestation and low birth weight d. Maternal complications specific to the perinatal period ANS: A Congenital anomalies account for 20.1% of deaths in infants younger than 1 year compared with sudden infant death syndrome, which accounts for 8.2%; disorders related to short gestation and unspecified low birth weight, which account for 16.5%; and maternal complications such as infections specific to the perinatal period, which account for 6.1% of deaths in infants younger than 1 year of age. DIF: Cognitive Level: Remembering MSC: Client Needs: Health Promotion and Maintenance
  3. What is the major cause of death for children older than 1 year in the United States? a. Heart disease

among different ethnic groups, and the causes of unintentional deaths vary with age and gender. DIF: Cognitive Level: Applying TOP: Integrated Process: Teaching/Learning MSC: Client Needs: Health Promotion and Maintenance

  1. What do mortality statistics describe? a. Disease occurring regularly within a geographic location b. The number of individuals who have died over a specific period c. The prevalence of specific illness in the population at a particular time d. Disease occurring in more than the number of expected cases in a community ANS: B Mortality statistics refer to the number of individuals who have died over a specific period. Morbidity statistics show the prevalence of specific illness in the population at a particular time. Data regarding disease within a geographic region, or in greater than expected numbers in a community, may be extrapolated from analyzing the morbidity statistics. DIF: Cognitive Level: Remembering MSC: Client Needs: Health Promotion and Maintenance
  2. The nurse should assess which age group for suicide ideation since suicide in which age group is the third leading cause of death? a. Preschoolers b. Young school age c. Middle school age d. Late school age and adolescents ANS: D Suicide is the third leading cause of death in children ages 10 to 19 years; therefore, the age group should be late school age and adolescents. Suicide is not one of the leading causes of death for preschool and young or middle school-aged children. DIF: Cognitive Level: Understanding TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
  3. Parents of a hospitalized toddler ask the nurse, What is meant by family-centered care? The nurse should respond with which statement?

a. Family-centered care reduces the effect of cultural diversity on the family. b. Family-centered care encourages family dependence on the health care system. c. Family-centered care recognizes that the family is the constant in a childs life. d. Family-centered care avoids expecting families to be part of the decision-making process. ANS: C The three key components of family-centered care are respect, collaboration, and support. Family-centered care recognizes the family as the constant in the childs life. The family should be enabled and empowered to work with the health care system and is expected to be part of the decision-making process. The nurse should also support the familys cultural diversity, not reduce its effect. DIF: Cognitive Level: Applying TOP: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance

  1. The nurse is describing clinical reasoning to a group of nursing students. Which is most descriptive of clinical reasoning? a. Purposeful and goal directed b. A simple developmental process c. Based on deliberate and irrational thought d. Assists individuals in guessing what is most appropriate ANS: A Clinical reasoning 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. DIF: Cognitive Level: Applying TOP: Integrated Process: Teaching/Learning MSC: Client Needs: Health Promotion and Maintenance
  2. Evidence-based practice (EBP), a decision-making model, is best described as which? a. Using information in textbooks to guide care b. Combining knowledge with clinical experience and intuition c. Using a professional code of ethics as a means for decision making

ANS: A

When teaching parents of school-age children about childhood health problems, the nurse should include information about childhood obesity because it is the most common problem among children and is associated with type 2 diabetes. Teaching parents about ways to prevent obesity is important to include. Immunization rates differ depending on the childs race and ethnicity; dental caries continues to be a common chronic disease in childhood; and mental health problems are seen in children as young as school age, not just in adolescents. DIF: Cognitive Level: Applying TOP: Integrated Process: Teaching/Learning MSC: Client Needs: Health Promotion and Maintenance

  1. The nurse is planning care for a hospitalized preschool-aged child. Which should the nurse plan to ensure atraumatic care? a. Limit explanation of procedures because the child is preschool aged. b. Ask that all family members leave the room when performing procedures. c. Allow the child to choose the type of juice to drink with the administration of oral medications. d. Explain that EMLA cream cannot be used for the morning lab draw because there is not time for it to be effective. ANS: C The overriding goal in providing atraumatic care is first, do no harm. Allowing the child a choice of juice to drink when taking oral medications provides the child with a sense of control. The preschool child should be prepared before procedures, so limiting explanations of procedures would increase anxiety. The family should be allowed to stay with the child during procedures, minimizing stress. Lidocaine/prilocaine (EMLA) cream is a topical local anesthetic. The nurse should plan to use the prescribed cream in time for morning laboratory draws to minimize pain. DIF: Cognitive Level: Applying MSC: Client Needs: Health Promotion and Maintenance
  2. Which situation denotes a nontherapeutic nursepatientfamily relationship? a. The nurse is planning to read a favorite fairy tale to a patient. b. During shift report, the nurse is criticizing parents for not visiting their child. c. The nurse is discussing with a fellow nurse the emotional draw to a certain patient. d. The nurse is working with a family to find ways to decrease the familys dependence on health care providers. ANS: B

Criticizing parents for not visiting in shift report is nontherapeutic and shows an underinvolvement with the parents. Reading a fairy tale is a therapeutic and age appropriate action. Discussing feelings of an emotional draw with a fellow nurse is therapeutic and shows a willingness to understand feelings. Working with parents to decrease dependence on health care providers is therapeutic and helps to empower the family. DIF: Cognitive Level: Analyzing MSC: Client Needs: Psychosocial Integrity

  1. The nurse is aware that which age group is at risk for childhood injury because of the cognitive characteristic of magical and egocentric thinking? a. Preschool b. Young school age c. Middle school age d. Adolescent ANS: A Preschool children have the cognitive characteristic of magical and egocentric thinking, meaning they are unable to comprehend danger to self or others. Young and middle school-aged children have transitional cognitive processes, and they may attempt dangerous acts without detailed planning but recognize danger to themselves or others. Adolescents have formal operational cognitive processes and are preoccupied with abstract thinking. DIF: Cognitive Level: Understanding TOP: Nursing Process: Assessment MSC: Client Needs: Safe and Effective Care Environment
  2. The school nurse is assessing children for risk factors related to childhood injuries. Which child has the most risk factors related to childhood injury? a. Female, multiple siblings, stable home life b. Male, high activity level, stressful home life c. Male, even tempered, history of previous injuries d. Female, reacts negatively to new situations, no serious previous injuries ANS: B Boys have a preponderance for injuries over girls because of a difference in behavioral characteristics, a high activity temperament is associated with risk-taking behaviors, and stress predisposes children to increased risk taking and self-destructive behaviors. Therefore, a male child with a high activity level and living in a stressful environment has the highest number of risk factors. A girl with several siblings and a stable home life is low risk. A boy with previous injuries has two risk factors, but an even temper is not a risk factor for injuries. A

a. Strong evidence from unbiased observational studies b. Evidence from randomized clinical trials showed inconsistent results c. Consistent evidence from well-performed randomized clinical trials d. Evidence for at least one critical outcome from randomized clinical trials had serious flaws ANS: B Evidence from randomized clinical trials with important limitations indicates that the evidence is of moderate quality. Strong evidence from unbiased observational studies and consistent evidence from well-performed randomized clinical trials indicates high quality. Evidence for at least one critical outcome from randomized clinical trials that has serious flaws indicates low quality. DIF: Cognitive Level: Remembering MSC: Client Needs: Safe and Effective Care Environment

  1. An adolescent patient wants to make decisions about treatment options, along with his parents. Which moral value is the nurse displaying when supporting the adolescent to make decisions? a. Justice b. Autonomy c. Beneficence d. Nonmaleficence ANS: B Autonomy is the patients right to be self-governing. The adolescent is trying to be autonomous, so the nurse is supporting this value. Justice is the concept of fairness. Beneficence is the obligation to promote the patients well-being. Nonmaleficence is the obligation to minimize or prevent harm. DIF: Cognitive Level: Analyzing MSC: Client Needs: Health Promotion and Maintenance
  2. The nurse manager is compiling a report for a hospital committee on the quality of nursing- sensitive indicators for a nursing unit. Which does the nurse manager include in the report? a. The average age of the nurses on the unit b. The salary ranges for the nurses on the unit c. The education and certification of the nurses on the unit

d. The number of nurses who have applied but were not hired for the unit ANS: C Nursing-sensitive indicators reflect the structure, process, and outcomes of nursing care. For example, the number of nursing staff, the skill level of the nursing staff, and the education and certification of nursing staff indicate the structure of nursing care. The average age of the nurses, salary range, and number of nurses who have applied but were not hired for the unit are not nursing-sensitive indicators. DIF: Cognitive Level: Applying TOP: Integrated Process: Communication and Documentation MSC: Client Needs: Safe and Effective Care Environment MULTIPLE RESPONSE

1. Which responsibilities are included in the pediatric nurses promotion of the health and well-being of children? (Select all that apply.) a. Promoting disease prevention b. Providing financial assistance c. Providing support and counseling d. Establishing lifelong friendships e. Establishing a therapeutic relationship f. Participating in ethical decision making ANS: A, C, E, F The pediatric nurses role includes promoting disease prevention, providing support and counseling, establishing a therapeutic relationship, and participating in ethical decision making; a pediatric nurse does not need to establish lifelong friendships or provide financial assistance to children and their families. Boundaries should be set and clear. DIF: Cognitive Level: Applying MSC: Client Needs: Health Promotion and Maintenance 2. The nurse is conducting a teaching session for parents on nutrition. Which characteristics of families should the nurse consider that can cause families to struggle in providing adequate nutrition? (Select all that apply.) a. Homelessness b. Lower income c. Migrant status

d. Spending off-duty time with patients and families e. Asking questions if families are not participating in care ANS: A, B, D Actions that show overinvolvement include buying clothes for patients, showing favoritism toward a patient, and spending off-duty time with patients and families. Focusing on technical aspects of care is an action that indicates underinvolvement, and asking questions if families are not participating in care indicates a positive action. DIF: Cognitive Level: Analyzing MSC: Client Needs: Health Promotion and Maintenance

5. Which are included in the evaluation step of the nursing process? (Select all that apply.) a. Determination if the outcome has been met b. Ascertaining if the plan requires modification c. Establish priorities and selecting expected patient goals d. Selecting alternative interventions if the outcome has not been met e. Determining if a risk or actual dysfunctional health problem exists ANS: A, B, D Evaluation is the last step in the nursing process. The nurse gathers, sorts, and analyzes data to determine whether (1) the established outcome has been met, (2) the nursing interventions were appropriate, (3) the plan requires modification, or (4) other alternatives should be considered. Establishing priorities and selecting expected patient goals are done in the outcomes identification stage. Determining if a risk or actual dysfunctional health problem exists is done in the diagnosis stage of the nursing process. DIF: Cognitive Level: Understanding MSC: Client Needs: Health Promotion and Maintenance 6. Which should the nurse teach to parents regarding oral health of children? (Select all that apply.) a. Fluoridated water should be used. b. Early childhood caries is a preventable disease. c. Dental caries is a rare chronic disease of childhood. d. Dental hygiene should begin with the first tooth eruption. e. Childhood caries does not happen until after 2 years of age.

ANS: A, B, D

Oral health instructions to parents of children should include use of fluoridated water and dental hygiene beginning with the first tooth eruption. In addition, early childhood caries is a preventable disease and should be included in the teaching session. Dental caries is a common, not rare, chronic disease of childhood. Childhood caries may begin before the first birthday. DIF: Cognitive Level: Applying TOP: Integrated Process: Teaching/Learning MSC: Client Needs: Health Promotion and Maintenance

  1. The school nurse is explaining to older school children that obesity increases the risk for which disorders? (Select all that apply.) a. Asthma b. Hypertension c. Dyslipidemia d. Irritable bowel disease e. Altered glucose metabolism ANS: B, C, E Overweight youth have increased risk for a cluster of cardiovascular factors that include hypertension, altered glucose metabolism, and dyslipidemia. Irritable bowel disease and asthma are not linked to obesity. DIF: Cognitive Level: Applying TOP: Integrated Process: Teaching/Learning MSC: Client Needs: Health Promotion and Maintenance 8. The nurse is reviewing the Healthy People 2020 leading health indicators for a child health promotion program. Which are included in the leading health indicators? (Select all that apply.) a. Decrease tobacco use. b. Improve immunization rates. c. Reduce incidences of cancer. d. Increase access to health care. e. Decrease the number of eating disorders.

The nursing process is a method of problem identification and problem solving that describes what the nurse actually does. Match each step of the nursing process with its definition. a. Assessment b. Diagnosis c. Outcomes identification d. Planning e. Implementation f. Evaluation

  1. Problem identification
  2. Expected patient goals
  3. Purposeful collection of data
  4. Development of a care plan
  5. Determines if the outcome was met
  6. Interventions are put into action
  7. ANS: B DIF: Cognitive Level: Understanding TOP: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance
  8. ANS: C DIF: Cognitive Level: Understanding TOP: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance
  9. ANS: A DIF: Cognitive Level: Understanding TOP: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance
  10. ANS: D DIF: Cognitive Level: Understanding TOP: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance
  11. ANS: F DIF: Cognitive Level: Understanding TOP: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance
  12. ANS: E DIF: Cognitive Level: Understanding TOP: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance Ethical dilemmas arise when competing moral considerations underlie various alternatives. Match each competing moral value with its definition. a. Autonomy

b. Nonmaleficence c. Beneficence d. Justice

  1. The obligation to promote the patients well-being
  2. The obligation to minimize or prevent harm
  3. The patients right to be self-governing
  4. The concept of fairness
  5. ANS: C DIF: Cognitive Level: Understanding TOP: Integrated Process: Caring MSC: Client Needs: Health Promotion and Maintenance
  6. ANS: B DIF: Cognitive Level: Understanding TOP: Integrated Process: Caring MSC: Client Needs: Health Promotion and Maintenance
  7. ANS: A DIF: Cognitive Level: Understanding TOP: Integrated Process: Caring MSC: Client Needs: Health Promotion and Maintenance
  8. ANS: D DIF: Cognitive Level: Understanding TOP: Integrated Process: Caring MSC: Client Needs: Health Promotion and Maintenance

adapt to a different culture group. Cultural sensitivity, a component of culturally competent care, is an awareness of cultural similarities and differences. DIF: Cognitive Level: Understanding MSC: Client Needs: Psychosocial Integrity

  1. Which term best describes the sharing of common characteristics that differentiates one group from other groups in a society? a. Race b. Culture c. Ethnicity d. Superiority ANS: C Ethnicity is a classification aimed at grouping individuals who consider themselves, or are considered by others, to share common characteristics that differentiate them from the other collectivities in a society, and from which they develop their distinctive cultural behavior. Race is a term that groups together people by their outward physical appearance. Culture is a pattern of assumptions, beliefs, and practices that unconsciously frames or guides the outlook and decisions of a group of people. A culture is composed of individuals who share a set of values, beliefs, and practices that serve as a frame of reference for individual perception and judgments. Superiority is the state or quality of being superior; it does not apply to ethnicity. DIF: Cognitive Level: Understanding TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
  2. After the family, which has the greatest influence on providing continuity between generations? a. Race b. School c. Social class d. Government ANS: B Schools convey a tremendous amount of culture from the older members to the younger members of society. They prepare children to carry out the traditional social roles that will be expected of them as adults. Race is defined as a division of humankind possessing traits that are transmissible by descent and are sufficient to characterize race as a distinct human type; although race may have an influence on childrearing practices, its role is not as significant as that of schools. Social class refers to the familys economic and educational levels. The social class of a family may change between generations. The government establishes parameters for children, including amount of schooling, but this is usually at a local level. The school culture has the most significant influence on continuity besides family.

DIF: Cognitive Level: Remembering TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity

  1. The nurse is planning care for a patient with a different ethnic background. Which should be an appropriate goal? a. Adapt, as necessary, ethnic practices to health needs. b. Attempt, in a nonjudgmental way, to change ethnic beliefs. c. Encourage continuation of ethnic practices in the hospital setting. d. Strive to keep ethnic background from influencing health needs. ANS: A Whenever possible, nurses should facilitate the integration of ethnic practices into health care provision. The ethnic background is part of the individual; it should be difficult to eliminate the influence of ethnic background. The ethnic practices need to be evaluated within the context of the health care setting to determine whether they are conflicting. DIF: Cognitive Level: Applying MSC: Client Needs: Psychosocial Integrity
  2. The nurse discovers welts on the back of a Vietnamese child during a home health visit. The childs mother says she has rubbed the edge of a coin on her childs oiled skin. The nurse should recognize this as what? a. Child abuse b. Cultural practice to rid the body of disease c. Cultural practice to treat enuresis or temper tantrums d. Child discipline measure common in the Vietnamese culture ANS: B This is descriptive of coining. The welts are created by repeatedly rubbing a coin on the childs oiled skin. The mother is attempting to rid the childs body of disease. Coining is a cultural healing practice. Coining is not specific for enuresis or temper tantrums. This is not child abuse or discipline. DIF: Cognitive Level: Understanding TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
  3. A Hispanic toddler has pneumonia. The nurse notices that the parent consistently feeds the child only the broth that comes on the clear liquid tray. Food items, such as Jell-O, Popsicles, and juices, are left. Which statement best explains this? a. The parent is trying to feed the child only what the child likes most.