PEDI EXAM 1--TEST BANK QUESTION COPY Flashcards
(141 cards)
1
Q
- To avoid complications, the nurse will teach the child with a genetic disorder to maintain penicillin prophylaxis if the child has been diagnosed with:
A
sickle-cell disease
2
Q
Which parent comment shows understanding of the cause of the child’s genetic condition in such a way that the nurse can document that no further teaching about the cause is needed?
A
“My child has this disease because the code in the genes just changed, and it is no one’s fault.”
3
Q
A couple is evaluated in the genetics clinic, and the male is found to be a carrier of an X-linked dominant disorder. The couple asks the nurse what this means in regard to their future children. The nurse’s response will include the information that:
A
All girls born to the family will be affected.
4
Q
A mother trying to understand karyotyping for Down syndrome, trisomy 21, asks the nurse, “What does a karyotype of a normal cell nucleus show?” You would inform her that a karyotype shows a representation of all ___________ chromosomes that a normal cell nucleus contains.
A
Answer: 46
5
Q
The nurse in the genetics clinic is helping mothers understand the causes of their children’s genetic disorders. The nurse will explain how monosomy from nondisjunction during meiosis caused the disorder in the child with:
A
Classic Turner’s syndrome.
6
Q
A parent asks about the differences between the manifestations of cystic fibrosis in his child and in another child with this disease. The parent should be taught that different gene alterations within one particular gene can result in a wide variation in patient manifestations. Correct understanding of teaching is proved when a parent states, “A mutation in one area of the CFTR gene on chromosome 7 accounts for more than 300 variations of severity in:
A
“Mucus production.”
7
Q
- A family has had all five of their children born with a genetic disorder. The disorder is inherited as autosomal dominant. If this is not a statistical rarity, the likelihood would be that:
A
One parent has both chromosomes with the affected gene
8
Q
During a sports physical, a client is found to have myopia, long digits, tall stature, an arm span greater than his height, scoliosis, and a hollow chest. The nurse should suspect:
A
Marfan’s syndrome.
9
Q
When a parent reports multiple male miscarriages, the nurse should confer with the health care provider about a possible genetics referral for which type of conditions
A
X-linked recessive conditions
10
Q
The nurse is discussing genetic referral with the parents of children being seen in the pediatric clinic. The child who would benefit from a genetic referral is the child whose family has a history of:
A
Cleft lip and/or cleft palate, diaphragmatic hernia, or cataract
11
Q
A nurse is reviewing the charts of children in the pediatric units to determine which parents would benefit from referral to the genetics clinic. The nurse recognizes that the parents of children with genetic and chromosomal disorders would benefit most from this referral. Therefore, the nurse refers the parents of the: (Select all that apply.)
A
Child diagnosed at age 6 with cystic fibrosis.
Child with Fanconi’s syndrome being treated for anemia.
12
Q
The nurse in the genetics clinic is working with families undergoing testing for genetic disease. If the initial testing is positive, more extensive testing is required to confirm:
A
newborn screening.
13
Q
During genetic testing, one parent is found to have a chromosomal abnormality without any physical or mental disability; however, the offspring inherit physical and/or mental disability. During patient education, the nurse explains that the type of individual who can have a chromosomal abnormality without any disability but can cause his offspring to receive chromosomal alterations and disability is the parent with:
A
Dominant-gene structural chromosomal balanced translocations
14
Q
Which statement by a pregnant woman indicates correct understanding of autosomal recessive inheritance teaching when both husband and wife have one sickle-cell trait gene?
A
“Regardless of whether this baby carries the gene, my next child still has a 50% chance of carrying the trait.”
15
Q
Parents of a baby who died shortly after birth from a genetic disorder have been referred to a genetics clinic. The physician has explained to the parents why the referral was made. Which statement by the parents indicates that they understand the reason for the referral?
A
“The genetics clinic will give us the information we need to decide whether we want to try again.”
16
Q
Advances in genetic screening provide information with high levels of certainty about genetic disorders a fetus might have. Which of the following is an ethical implication of these advances?
A
The nurse must be aware of his own personal feelings about the actions taken after the screening tests are completed.
17
Q
. It is more common for children with genetic disorders to live longer. What impact does this have on health care delivery for the nurse providing care for these children?
A
Nurses must be familiar with increasing numbers of genetic disorders and the care these children require.
18
Q
While being comforted in the Emergency Department, the 7-year-old sibling of a pediatric trauma victim blurts out to the nurse, “It’s all my fault! When we were fighting yesterday, I told him I wished he was dead!” The nurse, realizing that the child is experiencing magical thinking, should respond by:
A
Reassuring the child that it is normal to get angry and say things that we do not mean, but that we have no control over whether an accident happens.
19
Q
The nurse talking with the parents of a toddler who is struggling with toilet training reassures them their child is demonstrating a typical developmental stage that Erikson described as:
A
“Autonomy vs. shame and doubt.”
20
Q
Utilizing Bronfenbrenner’s ecologic theory of development, the nurse caring for a child would discuss the parents’ work environment as part of an assessment of that child’s:
A
exosystem
21
Q
The parents of a 1-month-old infant are concerned that their baby seems different from their other child, and ask the nurse if this is normal. The nurse informs them that it is normal for babies to have different temperaments, and that according to the “temperament theory” of Chess and Thomas, one of the characteristics of the “slow-to-warm-up” child is that he:
A
Initially reacts to new situations by withdrawing.
22
Q
While in the pediatrician’s office for their child’s 12-month well-child exam, the parents ask the nurse for advice on age-appropriate toys for their child. Based on the child’s developmental level, the nurse should suggest which types of toys? Select all that apply.
A
toys that can pop apart & go back together
jack in the box toys
push and pull toys
23
Q
While assessing the development of a 9-month-old infant, the nurse asks the mother if the child actively looks for toys when they are placed out of sight. The nurse is determining whether the infant has developed:
A
object permanence
24
Q
While planning a lecture on healthy lifestyle choices for a high school class, the school nurse should be aware that which of the following statements is most supported by current research?
A
Children with lower self-efficacy scores have been associated with more frequent violent behaviors than have children with higher self-efficacy scores
25
A nurse is assessing language development in all the infants presenting at the doctor’s office for well-child visits. The child who would be expected to be verbalizing the words “dada” and “mama” is the child between the ages of:
9-12 months
26
While counseling the parents of a 6½-month-old infant, the most appropriate toy for the nurse to suggest would be a:
Soft, fluid-filled ring that can be chilled in the refrigerator.
27
Two 3-year-olds are playing in a hospital playroom together. One is working on a puzzle, while the other is stacking blocks. The mother of one of the children scolds them for not sharing their toys. The nurse counsels this mother that this is normal developmental behavior for this age, and the term for it is:
parallel play
28
A neonatal nurse who encourages parents to hold their baby and provides opportunities for kangaroo care most likely is demonstrating concern for which aspect of the infant’s psychosocial development?
attachment
29
While trying to inform a 5-year-old girl about what will occur during an upcoming CT scan, the nurse notices that the child is engaged in a collective monologue, talking about a new puppy. The nurse’s best response would be:
“You must be so excited to have a new puppy! They are so much fun. Now let me tell you again about going downstairs in a wheelchair to a special room.”
30
The mother of a 6-year-old boy who has recently had surgery for the removal of his tonsils and adenoids complains that he has begun sucking his thumb again. The nurse caring for the child should assure the mother that this is a normal response for a child who has undergone surgery, and that it is a coping mechanism that children use called:
regression
31
Prior to giving an intramuscular injection to a 2½-year-old child, the most appropriate statement by the nurse would be:
“It is all right to cry, I know that this hurts. After we are done, you can go to the box and pick out your favorite sticker.”
32
A 14-year-old with cystic fibrosis suddenly becomes noncompliant with the medication regime. The intervention by the nurse that would most likely improve compliance would be to
Set up a meeting with some older teens with cystic fibrosis who have been managing their disease effectively.
33
While the nurse is admitting a pediatric patient, the mother blurts out, “I think this hospital is the most disorganized, inefficient place I have ever been in!” The most therapeutic response for the nurse to make would be:
“It sounds like you are upset with the care your child has received. Is that correct?”
34
A nurse notices a client sitting at the edge of the chair, tapping her fingers, fidgeting, and blinking her eyes frequently. In planning this client’s care, the nurse should take into account that this client is most likely displaying nonverbal cues of:
Anxiety.
35
While caring for an adolescent with cystic fibrosis, the nurse would best demonstrate friendliness and interest by the nonverbal behavior of:
Sitting at eye level and leaning forward while speaking with the client.
36
An 8-year-old child states, “Whenever I have to stop playing my video game to take my medicine, I get very mad!” The most appropriate response for the nurse to make would be:
“You are telling me that you get mad. Tell me what you mean by mad.”
37
Students are observing a staff nurse who is empathic with the child undergoing chemotherapy. The students observe the nurse interplaying the internalized feelings of the child and the child’s experiences or fantasies. The students recognize that the nurse, while fully absorbed in the identity of the child, still identifies himself as a separate personality. The student who correctly understands empathy recognizes the phase of empathy as:
incorporation
38
In order to prepare a 6-year-old client for an intravenous catheter insertion, the nurse’s best response would be:
“It is okay to cry. I know that this hurts.”
39
During a well-child visit, a frustrated mother complains that her 2-year-old’s only response anymore is “no,” and asks for help. The most appropriate advice for the nurse to give this mother would be to:
Offer the toddler choices.
40
The nurse caring for a 9-year-old child with extensive burns needs to prepare the child for going to whirlpool therapy for the first time. The most effective response to promote communication with this child would be:
“Some of the children I have worked with before have told me that the thing they worried most about was how much it would hurt them.”
41
A nurse working with Japanese-American adolescents should be aware of nonverbal communication patterns in their culture. While working with these clients, the nurse should:
Shake their hands upon greeting them.
42
In order to effectively instruct the parents of a newly diagnosed diabetic child on home care, the most important factor for the nurse to consider while implementing the teaching plan would be:
The level of stress that the parents are experiencing secondary to their child’s diagnosis.
43
A nurse is working with a child who is a pediatric trauma victim. The nurse is planning nursing interventions to facilitate rapport and effective communication with this child and family. The nursing intervention that is least likely to establish effective, therapeutic communication with the child and family is:
Inviting the family out to a movie to decrease its anxiety
44
The nurse caring for a Chinese-American child should be aware that which nonverbal communication patterns are acceptable to use when giving information to the child’s father? Select all that apply.
Avoiding direct eye contact when listening
Distant personal space is preferred.
He prefers not to be touched by strangers.
45
While assessing an 8-month-old infant, the best strategy for the nurse to use to promote communication with the infant would be to:
Use touch, patting and cuddling the infant.
46
A non–Spanish-speaking nurse is working with a 7-year-old client who is able to speak English, but whose family speaks only Spanish. The nurse needs to give discharge instructions regarding the client’s oral antibiotics. There are no Spanish-speaking interpreters available presently, but one will be able to come in about one hour. The nurse’s most appropriate intervention would be:
To have the parents wait until an interpreter can be found to translate the discharge instructions.
47
While the nurse is bathing a 7-year-old child, the child states, “I get so sad when my mom leaves.” The response that ignores the importance of the child’s feelings is:
“Your mother has to take care of your brothers and sisters too. She will be back tomorrow.”
48
During the newborn examination, the nurse assesses the infant for signs of developmental dysplasia of the hip. A finding that would strongly indicate this disorder would be:
Asymmetric thigh and gluteal folds.
49
The nurse is taking a health history from the family of a 3-year-old child. The statement or question by the nurse that would be most likely to establish rapport and elicit an accurate response from the family is:
“Tell me about the concerns that brought you to the clinic today.”
50
During an examination, a nurse asks a 5-year-old child to repeat his address. The nurse most likely is evaluating:
Remote memory.
51
A nurse working in the newborn nursery notes that an infant is having frequent episodes of apnea lasting 10–15 seconds without any changes in color or decreases in heart rate. The most appropriate intervention would be to:
Continue to observe the infant, and call the physician if the apnea lasts longer than 20 seconds.
52
A new mother is worried about a “soft spot” on the top of her newborn infant’s head. The nurse informs her that this is a normal physical finding called the anterior fontanel. The mother understands further teaching when she states that “It will close on its own when my infant is:
“12–18 months of age.”
53
The nurse is completing a physical examination of a 4-year-old child. The best position in which to place the child for assessment of the genitalia would be:
Frog-leg position.
54
The nurse is assessing a 10-year-old child for cognitive development. The question by the nurse that best determines cognitive development would be:
“What classes are you taking, and what are your grades in them?”
55
A very concerned 14-year-old boy presents to the clinic because of an enlargement of his left breast. Except for the breast enlargement, the rest of the history and physical was reported as normal. The most appropriate intervention for the nurse to implement next would be to inform the child that:
This is a normal finding in adolescent males, and that the breast tissue generally regresses by the time of full sexual maturity.
56
A nurse caring for a 9-year-old notices some swelling in the child’s ankles. The nurse presses against the ankle bone for five seconds, then releases the pressure, noticing a markedly slow disappearance of the indentation. Due to these physical findings, the nurse would be most concerned with assessing:
Urine output
57
The nurse is caring for an infant diagnosed with “failure to thrive.” The nurse observes the physician taking blood pressures in all four extremities, and recognizes that the congenital cardiac defect suspected is:
Coarctation of the aorta.
58
A 7-year-old presents to the clinic with an exacerbation of asthma symptoms. On physical exam, the nurse would expect which of the following findings? Select all that apply.
wheezing
decreased vocal resonance
decreased tactile fremitus
59
While inspecting a 5-year-old child’s ears, the nurse notes that the right pinna protrudes outward, and that there is a mass behind the right ear. In light of these findings, the vital sign parameter that the nurse would be most concerned with would be:
Temperature.
60
While assessing a 10-month-old African-American infant, the nurse notices that the sclerae have a yellowish tint. Which organ system would the nurse suspect as having an ongoing disease process?
Gastrointestinal
61
While teaching the parents of a newborn about infant care and feeding, the nurse instructs the parents to:
Delay supplemental foods until the infant is 4–6 months old.
62
A nurse is talking to the mother of an exclusively breastfed African-American 3-month-old infant who was born in late fall. The nurse would want to make sure that this child is receiving:
Vitamin D.
63
While teaching parents of a newborn about normal growth and development, the nurse informs them that their child’s weight should:
Double by 5 months of age.
64
The nurse is teaching the parents of a 4-month-old infant about good feeding habits. The nurse emphasizes the importance of holding the baby during feeding and not letting the infant go to sleep with the bottle, as this is most likely to increase the incidence of both dental caries and:
Otitis media.
65
The mother of a premature infant born at 32 weeks’ gestation expresses the desire to breastfeed her child. An appropriate suggestion by the nurse would be:
””You should begin pumping by six hours postpartum to ensure adequate milk production.”
66
The mother of a 2-year-old is concerned because her child does not seem interested in eating. The child is drinking about 5–6 cups of whole milk per day and 1 cup of fruit juice. When the weight-to-height percentile is calculated, the child is in the 90–95th percentile. What would be the best advice for the nurse to give this mom?
Change from whole milk to 2% milk and decrease milk consumption to 3–4 cups per day and the fruit juice to one-half cup per day, offering water if the child is still thirsty in between.
67
A vegetarian adolescent has been placed on iron supplementation secondary to a diagnosis of iron-deficiency anemia. To increase the absorption of iron, the nurse would instruct the teen to take the supplement with:
Orange juice.
68
The nurse has been completing a nutritional assessment with an 18-month-old. The comment by the parent that would prompt the nurse to provide the parent with further education is:
“We take the meat out of the freezer and then allow it to thaw on the counter for 2–3 hours before cooking it thoroughly.”
69
During a 4-month-old’s well-child checkup, the nurse discusses introduction of solid foods into the infant’s diet and concerns for foods commonly associated with food allergies. Therefore, the parents are instructed to delay until after 1 year of age the introduction of:
Strawberries, eggs, and wheat.
70
While teaching a health promotion class to a group of parents of children in a Head Start class, the nurse informs the parents that the most common preventable chronic infectious disease in U.S. children is:
Dental decay.
71
The parents of a 2½-year-old are concerned about their child’s finicky eating habits. While counseling the parents, the nurse would accurately make which statements? Select all that apply.
“The child is experiencing physiologic anorexia, which is normal for this age group.”
“It is more appropriate to assess a toddler’s nutritional demands over a 1-week period rather than a 24-hour one.”
“The toddler should drink 16–24 ounces of milk daily.”
72
A 6-year-old recently diagnosed with asthma also has a peanut allergy. The nurse instructs the family not only to avoid peanuts, but also to check food label ingredients carefully for peanut products and to make sure dishes and utensils are adequately washed prior to food preparation. The mother asks why this is specific for her child. The nurse should reply that in comparison with other children, this child has a higher risk for:
Anaphylaxis.
73
During a well-child physical, a 16-year-old girl has a normal history and physical except for an excessive amount of tooth enamel erosion, a greater-than-normal number of filled cavities, and calluses on the back of her hand. Her body mass index is in the 50–75th percentile for her age. The nurse would be most concerned about:
Bulimia nervosa.
74
A 6-year-old child has been newly diagnosed with cystic fibrosis. During discharge teaching, the nurse is instructing the parents on nutritional requirements specifically related to the child’s decreased ability to absorb fats. The nurse teaches the family that the child will need supplementation with vitamins that are fat-soluble, such as:
Vitamin K.
75
An adolescent is being seen in the clinic to discuss health promotion behaviors. What should the nurse include in the evaluation of the plan?
Effectiveness of the plan, and methods to expand and sustain successful approaches
76
The nurse is preparing to see an adolescent patient to assess relationships with others. What should the nurse do when conducting this assessment?
Provide time alone with both the adolescent and the parents
77
An adolescent is visiting the clinic for the first time. What should the nurse keep in mind when attending to this patient?
The nurse should explain procedures and introduce personnel to adolescents.
78
An adolescent comes to the clinic because of a concern with a skin lesion, and is accompanied by a parent. When the adolescent is called back to the exam room, the parent comes with the adolescent. What approach by the nurse would be most appropriate?
Reassure the parent that you will talk with her about any of her concerns and questions.
79
A 17-year-old female presents at a nurse practitioner’s office and requests a signature for work papers. The nurse reviews her chart and notes that the last physical examination was within the year. In addition to providing the signature for the work papers, the nurse should use this visit as:
A health supervision opportunity
80
A school nurse is performing annual height and weight screening. The nurse notes that three females who are close friends each lost 15 pounds over the past year. The priority nursing action is to:
Obtain a nutritional history for each of these adolescents.
81
A nurse is planning to present a lecture/discussion on health maintenance to adolescents in their high school health class. The nurse will include which topic in the presentation information?
Limiting refined sugar and high-fat intake
82
A 15-year-old female adolescent’s body mass index (BMI) is 27.5. The adolescent’s height is 5 feet, 2 inches, and she weighs 160 pounds. The girl’s menses began when she was 12 years old. School performance has been spotty. The priority client teaching would be related to:
1. Nutritional intake.
83
An adolescent reports the following: “I get up at 6 a.m., attend early-morning band classes three times each week, play sports for two hours each day after school, and homework takes me three hours each night. I always feel tired.” The priority history question is:
How many hours of sleep do you get each night?
84
The school nurse performs screenings on all students in the high school. One student tells the nurse that since starting high school, she is constantly tired and moody. Which of these should the nurse investigate further?
1. Sleep deprivation
85
During an annual physical, the adolescent reports typical food intake to the nurse. Which requires further assessment by the nurse?
1. “I have fried eggs and soda for breakfast.”
86
The nurse is teaching a class of adolescent students the importance of physical exercise. Which statement by a student needs further discussion?
“I don’t need to exercise. I am healthy, unlike my mother, who has diabetes.”
87
The nurse is giving a group of adolescents a lecture on sex education. After the lecture, one adolescent asks the nurse for advice regarding being pressured by a boyfriend to have sex. Which response by the nurse is most appropriate?
“Continue with your plan of not having sex right now.”
88
The nurse is having an informal talk with a group of adolescent at a health fair. Which statement requires follow up by the nurse?
“I wish I had a different body.”
89
A teenager is accompanied by his mother to the annual physical examination. The nurse is aware of privacy issues related to the teenager. While the mother is in the room, which topic should the nurse avoid?
Cigarette smoking
90
The nurse working in the clinic includes an adolescent history in every client intake interview. Which of these issues should the nurse address when the parents are not present?
Possible domestic violence
91
An obese adolescent who adamantly denies sexual activity has a positive pregnancy test. Which of the following statements would be most appropriate for the nurse to make to this adolescent?
1. “Let’s discuss some activities that you have done within the past few months that could possibly lead to pregnancy.”
92
A mother reports that her adolescent daughter is always late. The mother states, “She was born late, and has been late every day of her life.” Which response should the nurse make to this mother?
1. “Setting specific alarms and then reinforce the value of being ‘on-time’ may be helpful strategies to assisting her to be more of an ‘on-time’ individual.”
93
The school nurse performs screenings on all students in the high school. In addition, the nurse will perform selected screenings on individual teenagers. When planning the screenings for the year, the nurse will include which screening for all teenagers?
1. Scoliosis
94
A nursing history on a 17-year-old female reveals that the adolescent takes a multivitamin with 0.5 mg of fluoride each day and one with 0.4 mg of folic acid each day. What concern should the nurse bring to the attention of the physician?
The presence of fluoride in the multivitamin
95
An adolescent who recently moved to a new school in a different town presents to an ambulatory care center and describes the following: “I have no friends in my new school, and I no longer want to go to college. I know I will be lonely there, too.” Which of the following takes priority when speaking with the adolescent?
Promoting healthy mental health outcomes
96
An adolescent reports participating in an exercise program at school each Wednesday throughout the school year. Further history reveals that the adolescent does not participate in any other physical activities. Which of these outcomes is consistent with these data?
1. The adolescent is not meeting the recommendations of the Healthy People 2010 initiative.
97
The nurse has just completed a thorough assessment of an adolescent in the clinic who has begun dating and is now withdrawn. Which diagnosis is appropriate for the adolescent and family?
Rape-Trauma Syndrome related to date rape
98
The nurse is speaking with a group of adolescents about what can happen when having unprotected sex. The nurse understands that to communicate effectively with teens, she must:
1. Allow for discussion, and bring peers who have had experience related to the topic being discussed.
99
What would be the best way for the nurse to teach adolescents regarding health promotion and health maintenance?
1. Have the adolescents identify a personal health goal.
100
Prior to accepting an assignment as a home health nurse, the nurse must realize that:
The family is in charge
101
Children receive most of their health care in community settings. Which is an example of nursing care provided in a community setting?
1. Surgery and diagnostic testing procedures in ambulatory surgical settings
102
Which is an appropriate function for the pediatric nurse to assume in an office or health center?
1. Identifying children in need of urgent care or isolation
103
The role of the nurse in the school setting can include:
Providing health assessment of infants of mothers enrolled in school
104
A child is being discharged after an extended hospitalization. Prior to discharge from a hospital, home health care nurses should assess which aspect of the home setting?
1. Readiness of the home for the discharged patient
105
A 16-year-old client has a long leg cast secondary to a fractured femur. To effectively facilitate the adolescent’s return to school, the school nurse should:
Meet with teachers and administrators at the school to make sure that entrances and classrooms are wheelchair-accessible
106
The community health nurse is planning an education session for recently hired teachers at a child-care center. It is most important that the nurse teach the staff:
1. Principles of infection control
107
Prior to her return to school, an individualized health plan (IHP) will be developed for the child who has:
Been newly diagnosed with insulin-dependent diabetes mellitus
108
A child with a history of asthma is actively wheezing. Which is the best initial action by the nurse?
Have the child use his metered-dose inhaler
109
The telephone triage nurse receives a call from a parent who states that her 18-month-old is making a crowing sound when he breathes and is hard to wake up. Which is the nurse’s priority action?
Advise the parent to hang up and call 911
110
The number of serious injuries of children in a community has doubled in the past year. Based on this information, the most appropriate community nursing diagnosis is:
Knowledge, Deficient related to injury prevention in children
111
Which should the nurse take into consideration when working with families in a home?
1. Family member preferences for involvement in the care of the child
112
When a child is returning to school after an absence and needs medication or other therapies during school hours, who should be involved in the child’s health plan?
School administrators
113
Which role would the school nurse least likely pursue?
Providing referrals to students because of tardiness to school
114
The school nurse is seeing a 5-year-old child who requires oxygen and tube-feeding. The nurse evaluates the child as:
1. Medically fragile.
115
Specific functions of the pediatric nurse in primary care include which task(s)?
1. Assisting with physician examinations and performing diagnostic tests
116
An important goal for pediatric nurses in the office or health care setting is:
1. Develop a positive relationship with the child and family.
117
Camp nurses can function:
1. Independently.
118
A major goal of home health care nurses working with families is:
Promoting or restoring the child’s health
119
A child who is dependent on a ventilator is being discharged from the hospital. Prior to discharge, the home health nurse discusses development of an emergency plan of care with the family. Which is the most essential part of the plan?
1. Acquisition of a backup generator
120
Which aspect of an Emergency Medical Services system is most indicative that EMS providers are prepared to provide emergency care to children?
Staff education related to assessment and treatment of children of all ages
121
Which of the following should be considered in disaster preparedness for children with special needs?
The utility company needs advance notification when a child is technology-assisted, to provide emergency power
122
Which of the following should the nurse encourage families to include when developing a disaster plan?
Having an adequate supply of medication, equipment, and supplies
123
The nurse is caring for an 8-year-old child who has been in a car accident, has a head injury, and is in the ICU. The nurse sees the child pulling on the IV line. What action should the nurse take?
Place soft wrist restraints on the child
124
The nurse is taking care of a school-age child with 50% burns to the head and upper part of the body. The nurse recognizes that the most significant stressors for children of this age with life-threatening illness are: (Select all that apply.)
1. Separation from family.
2. Loss of self-control.
3. Painful and invasive procedures.
4. Fear of the medical team.
125
3. The nurse is preparing a child for a procedure. Which of the following age groups of children benefits most from being talked to, soothed, and touched during and after the procedure?
1. Toddlers
126
4. An adolescent with cystic fibrosis is intubated with an endotracheal tube. The most appropriate nursing diagnosis is:
Powerlessness (Moderate) related to inability to speak to or communicate with friends.
127
A 16-year-old boy has a stiff neck, a headache, a fever of 103°Fahrenheit, and purpuric lesions on his legs. He is admitted to the hospital for treatment of suspected meningococcemia. Although the adolescent’s physical needs take priority at the present time, the nurse can expect which of the following to be the most significant psychological stressor for this adolescent?
Separation from friends and permanent changes in appearance
128
The nurse is caring for a child who has sickle-cell anemia and is in a painful crisis. The most effective nursing intervention for this child would be:
Administering pain medication
129
A school bus carrying children in grades K–12 crashed into a ravine. The critically injured children were transported by ambulance and admitted to the pediatric intensive care unit (PICU). The nurse is concerned about calming the frightened children. The most effective nursing intervention to achieve this goal is which of the following?
Call the children’s parents to come into the PICU.
130
The nurse is taking care of a toddler who is admitted to the hospital for the first time. Which approach should the nurse take when approaching the child?
Make the initial approach with the parent present
131
A 6-year-old child is in the pediatric intensive care unit (PICU) with a fractured femur and head trauma. The child was not wearing a helmet while riding his new bicycle on the highway, and collided with a car. The nurse can expect which of the following nursing diagnoses for the parents of this child?
Family Coping: Compromised, related to the critical injury of the child
132
The nurse is taking care of an adolescent who was admitted following an automobile accident. Which of the following should the nurse know in caring for this client?
1. Adolescents are concerned with privacy and independence.
133
In caring for a child with a life-threatening illness, the nurse should anticipate the parent’s reaction to the child illness. Which of the following should the nurse anticipate the parent will experience? Select all that apply.
1. Shock and disbelief
2. Anger and guilt
3. Deprivation and loss
4. Anticipatory waiting
5. Readjustment and mourning
134
A child is admitted to the PICU following an accident. The nurse is speaking with the parents regarding preparing siblings to visit. What should the nurse include in the conversation with the parents? Select all that apply.
1. Describe how the sibling looks.
1. Describe the hospital environment.
1. Discourage the siblings from visiting.
135
A 10-year-old child is transported to the Emergency Department by ambulance from the scene of a car accident. He is alert and oriented X 3; his pulse, respirations, and blood pressure are stable; and his neck and back are immobilized on a backboard. The nurse sees no obvious bleeding. The child states, “I can’t feel or move my legs.” What injury is most likely?
Spinal cord injury
136
The parents of a 2-year-old child who sustained severe head trauma from falling out of a second-story window are arguing in the pediatric intensive care unit (PICU) and are blaming each other for the child’s accident. The best nursing diagnosis for this family is:
1. Family Coping: Compromised, related to the child’s critical injury
137
15. The Emergency Department nurse receives a 3-year-old child who was hit by a car. The nurse’s priority intervention is which of the following?
1. Assess airway, breathing, and circulation
138
16. The nurse caring for a child who is sedated, unconscious, and on a mechanical ventilator can expect to include which of the following nursing interventions in the nursing care plan?
Maintenance of intravenous (IV) hydration
139
The nurse is planning a new parent education class for a group of adoptive parents. Which of the following is a priority topic for the class?
Accident prevention
140
The nurse is working with a 3-year-old child in Bryant’s traction for a fractured femur. A pain assessment scale such as the Oucher Scale can be useful to the nurse caring for this child because use of a pain assessment scale:
Provides continuity and consistency in assessing and monitoring the child’s pain
141
A newborn is admitted to the neonatal intensive care unit (NICU). The parents are concerned because they cannot stay for long hours to visit. Which statement made by the nurse is most appropriate?
“Parents often feel this way; you can call any time to see how your baby is doing.”
