Chapter 1 - Perspectives of Pediatric Nursing Flashcards
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.
a. The United States is ranked last among 27 countries.
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.
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
a. Congenital anomalies
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
What is the major cause of death for children older than 1 year in the United States?
a. Heart disease
b. Childhood cancer
c. Unintentional injuries
d. Congenital anomalies
c. Unintentional injuries
Unintentional injuries (accidents) are the leading cause of death after age 1 year through adolescence. The leading cause of death for those younger than 1 year is congenital anomalies, and childhood cancers and heart disease cause a significantly lower percentage of deaths in
children older than 1 year of age.
In addition to injuries, what are the leading causes of death in adolescents ages 15 to 19 years?
a. Suicide and cancer
b. Suicide and homicide
c. Drowning and cancer
d. Homicide and heart disease
b. Suicide and homicide
Suicide and homicide account for 16.7% of deaths in this age group. Suicide and cancer account for 10.9% of deaths, heart disease and cancer account for approximately 5.5%, and homicide and heart disease account for 10.9% of the deaths in this age group.
The nurse is planning a teaching session to adolescents about deaths by unintentional injuries. Which should the nurse include in the session with regard to deaths caused by injuries?
a. More deaths occur in males.
b. More deaths occur in females.
c. The pattern of deaths does not vary according to age and sex.
d. The pattern of deaths does not vary widely among different ethnic groups.
a. More deaths occur in males.
The majority of deaths from unintentional injuries occur in males. The pattern of death does vary greatly among different ethnic groups, and the causes of unintentional deaths vary with age and
gender
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
b. The number of individuals who have died over a specific period
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.
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
d. Late school age and adolescents
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
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.
c. Family-centered care recognizes that the family is the constant in a childs life.
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.
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
a. Purposeful and goal directed
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.
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
d. Gathering all evidence that applies to the childs health and family situation
b. Combining knowledge with clinical experience and intuition
EBP helps focus on measurable outcomes; the use of demonstrated, effective interventions; and questioning what is the best approach. EBP involves decision making based on data, not all evidence on a particular situation, and involves the latest available data. Nurses can use textbooks to determine areas of concern and potential involvement.
Which best describes signs and symptoms as part of a nursing diagnosis?
a. Description of potential risk factors
b. Identification of actual health problems
c. Human response to state of illness or health
d. Cues and clusters derived from patient assessment
d. Cues and clusters derived from patient assessment
Signs and symptoms are the cues and clusters of defining characteristics that are derived from a patient assessment and indicate actual health problems. The first part of the nursing diagnosis is the problem statement, also known as the human response to the state of illness or health. The identification of actual health problems may be part of the medical diagnosis. The nursing
diagnosis is based on the human response to these problems. The human response is therefore a component of the nursing diagnostic statement. Potential risk factors are used to identify nursing care needs to avoid the development of an actual health problem when a potential one exists
The nurse is talking to a group of parents of school-age children at an after-school program about childhood health problems. Which statement should the nurse include in the teaching?
a. Childhood obesity is the most common nutritional problem among children.
b. Immunization rates are the same among children of different races and ethnicity.
c. Dental caries is not a problem commonly seen in children since the introduction of fluoridated water.
d. Mental health problems are typically not seen in school-age children but may be diagnosed in adolescents.
a. Childhood obesity is the most common nutritional problem among children.
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.
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.
c. Allow the child to choose the type of juice to drink with the administration of oral medications.
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.
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
b. During shift report, the nurse is criticizing parents for not visiting their child.
Criticizing parents for not visiting in shift report is nontherapeutic and shows an under involvement 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.
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
a. Preschool
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.
