Child Health Nursing Partnering with Children & Families 3rd Edition by Jane W. Ball Ruth C. Bindler Kay J. Cowen Test Bank

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Child Health Nursing Partnering with Children & Families 3rd Edition by Jane W. Ball Ruth C. Bindler Kay J. Cowen Test Bank

Description

Ball, Child Health Nursing, 3/E
Chapter 12
Question 1
Type: MCSA
A nurse observes the parent-child interaction during the six-year-old well-child checkup and notes that the parent speaks harshly to the child and uses negative remarks when speaking with the nurse. Which statement by the nurse would be most beneficial?
1. Addressing the child, the nurse says, Are you unhappy when Mommy talks to you like this?
2. I am going to refer you for counseling, because your interactions with your child seem so negative.
3. Perhaps you should leave the room so that I can speak with your child privately.
4. Lets talk privately. Lets discuss ways you can speak to your child in a positive tone.
Correct Answer: 4
Rationale 1: The nurse should not ask the child if she is unhappy with the parent.
Rationale 2: It is not appropriate to refer them to counseling without a discussion with the parent.
Rationale 3: Because the child is only six years old, it would be difficult to ask the parent to leave the room. If the nurse wants to speak with the child alone, the nurse perhaps would escort the child to another area and speak briefly with the child.
Rationale 4: The best approach to this encounter would be for the nurse to discuss concerns with the parent privately, because the nurse wants to help the parent develop a good relationship with the child. The child should not be a part of this conversation.
Global Rationale:

Cognitive Level: Applying
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 12-4

Question 2
Type: MCSA
Which of these aspects of developmental health supervision should be included in each health care visit of young children?
1. Discussions of discipline with the parents
2. Toilet training guidelines
3. Referrals to community agencies
4. Patient and family education
Correct Answer: 4
Rationale 1: Discipline, while important to the care of children, is age-specific and not part of the main developmental plan.
Rationale 2: Toilet training is age-specific and does not need to be part of developmental health visits.
Rationale 3: Although referrals to community agencies may be a component of some health care visits, they should not be included in every visit.
Rationale 4: The main recommendations for developmental health supervision of young children include assessment, education, intervention, and care coordination. This standard framework should be used as guidelines for each health care visit.
Global Rationale:

Cognitive Level: Applying
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 12-1

Question 3
Type: MCSA
A nurse obtains a nutritional health history from a 10-year-old child. Which of these food selections, if consumed on a regular basis, should lead the nurse to become concerned about the need for improving oral hygiene?
1. Fluoridated water
2. Sorbet and yogurt
3. Peanuts and peanut butter crackers
4. Gummy bears and licorice
Correct Answer: 4
Rationale 1: Fluoridated water has been shown to decrease the incidence of dental caries.
Rationale 2: Foods such as sorbet and yogurt do not stick to the teeth and are not considered foods that increase dental caries.
Rationale 3: Foods such as peanut butter and peanut butter crackers are good sources of nutrients and not associated with increased dental caries.
Rationale 4: Items such as gummy bears and licorice stick to the teeth and lead to dental caries.
Global Rationale:

Cognitive Level: Analyzing
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 12-2

Question 4
Type: MCSA
A nine-year-old child who has been followed in the same pediatric health care home since birth has come in for a well-child visit. A nurse who measures the height and weight of the child documents 35th percentile for height and 90th percentile for weight. How should the nurse interpret these data?
1. The child is obese and needs dietary counseling.
2. The child is beginning a growth spurt.
3. As soon as the child begins the adolescent growth spurt, the height and weight measurements will normalize.
4. The parents are most likely below the 50th percentile for height and weight.
Correct Answer: 1
Rationale 1: These data show that the child is disproportionate in height and weight. This childs weight is very high in comparison with height. The child would appear obese. Dietary history and counseling are the first steps. This child also might need an endocrine evaluation.
Rationale 2: This is not a growth spurt, since height is what is referred to by the term growth spurt.
Rationale 3: The statement about the adolescent growth spurt is incorrect for this age child.
Rationale 4: No assumptions about the parents can be made from the data presented.
Global Rationale:

Cognitive Level: Analyzing
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 12-2

Question 5
Type: MCSA
The nurse is visiting with a school-age child in the clinic. The child states to the nurse, Friends are giving me cigarettes to smoke. What is the best response by the nurse?
1. Tell them no, dont do it again, and dont tell anyone.
2. Smoking occasionally will not hurt you.
3. Show the child a model of lungs with smoke damage then have the child try to breathe through a straw.
4. Explain to the child the risks associated with smoking.
Correct Answer: 3
Rationale 1: The school-age child wants to be like his peers and wont just tell friends no without a justification.
Rationale 2: Smoking occasionally will hurt the childs health, so this response is inappropriate.
Rationale 3: When teaching about smoking, providing a model of lungs and having the child breathe through a straw demonstrate the effects of airway narrowing. This makes the effects much more realistic.
Rationale 4: A school-age child will not remember or really care about hearing the risks of smoking.
Global Rationale:

Cognitive Level: Applying
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 12-7

Question 6
Type: MCSA
A six-year-old child is being seen by the nurse for well-child checkup. The parent tells the nurse that they live on a farm and their water supply is from a well. Which should be the nurses main concern about the childs oral care?
1. Use of teeth whitener
2. Use of fluoride
3. Use of mouthwash
4. How many teeth have been lost
Correct Answer: 2
Rationale 1: Teeth whitener is not mentioned in the scenario, and while the nurse would be concerned if a six-year-old was using it, fluoride use is more important.
Rationale 2: Many changes occur in the mouth during school-age years, necessitating periodic examination. Inquire about use of fluoride if the water supply is not fluoridated. Well water does not contain fluoride.
Rationale 3: Mouthwash use in a six-year-old is not as important as asking about fluoride use.
Rationale 4: Asking about the number of teeth lost is not as important as finding out whether fluoride is in use.
Global Rationale:

Cognitive Level: Applying
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 12-3

Question 7
Type: MCSA
The nurse is caring for a young child in the clinic. The mother tells the nurse the child sleepwalks every night. Which statement by the nurse is appropriate?
1. Are you concerned the child is not getting enough sleep?
2. What time does your child go to bed at night?
3. What do you know about children who sleepwalk?
4. Is the child experiencing any stress at home?
Correct Answer: 4
Rationale 1: The nurse is more concerned about the reason the child is sleepwalking, not about the amount of sleep the child is getting.
Rationale 2: The nurse is concerned about the reason the child is sleepwalking, not about the childs nighttime routine.
Rationale 3: It is not necessary to ask this question of this mother at this time. It is more important to determine why the child is sleepwalking.
Rationale 4: Sleepwalking and sleep talking sometime occur in school-age children, but they usually decrease as the child nears adolescence. Children who have stress at home, such as parental fighting, ill family members, or inadequate food and shelter, often have increased incidence of sleepwalking.
Global Rationale:

Cognitive Level: Applying
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 12-3

Question 8
Type: MCSA
While teaching the parent of school-age children about self-esteem, the nurse instructs the parents to:
1. Limit the amount of compliments given to the child.
2. Point out the childs deficiencies in a nice way while providing suggestions for improvement.
3. Establish the goals they want the child to achieve at a predetermined time.
4. Build on the childs strengths and talents.
Correct Answer: 4
Rationale 1: Complimenting a childs strengths is important to increase self-esteem.
Rationale 2: In trying to build self-esteem in a child, it is important to talk about the childs abilities.
Rationale 3: Setting goals for the child to reach at a selected time could lead to disappointment if they are not reached on time. This will result in a drop in self-esteem.
Rationale 4: Parents play an important part in fostering the childs self-esteem. Building on the childs strengths and talents and always pointing out the childs abilities will increase the childs self-esteem.
Global Rationale:

Cognitive Level: Applying
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 12-5

Question 9
Type: MCSA
While teaching the parents of a school-age child about coping with divorce, the nurse instructs the parents to:
1. Explain to the child why their marriage fell apart, being sure to identify each partners role in the divorce.
2. Be sure the child understands the divorce is not the childs fault.
3. Spend less time with the child so he doesnt feel the tension between the parents.
4. Allow the child to stay with only one parent until the divorce becomes final.
Correct Answer: 2
Rationale 1: It is not appropriate for the parents to discuss marital concerns with the child.
Rationale 2: Divorce is a common, stressful event for school-age children. While parents are engaged in their own stresses, they might benefit from help to plan for ways to lessen the strain on the children. They can make sure the child understands that the divorce is not the childs fault and is only related to the parents relationship with each other.
Rationale 3: The parents should spend more time with the child, not less, when experiencing a divorce.
Rationale 4: Staying with only one parent will alienate the child from the opposite parent and is not an appropriate instruction.
Global Rationale:

Cognitive Level: Applying
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 12-5

Question 10
Type: MCSA
The parents of a school-age child report that they allow their child to eat anything because the child is a picky eater. Which is the best response the nurse should make to the parent?
1. Continue to allow this, because he eventually will begin to eat properly.
2. Can you try allowing this to continue but only every other day?
3. I think you must not be good role models, so lets talk about your eating habits.
4. Lets talk about what types of food are consumed when your child chooses.
Correct Answer: 4
Rationale 1: The child will never eat properly if the parents do not teach this behavior.
Rationale 2: Eating only the food the child wants, even every other day, does not teach appropriate and healthy food habits.
Rationale 3: Stating that the parents are not good role models will only make the parents defensive, and therefore it is inappropriate.
Rationale 4: Seeking to find a more positive way of influencing the eating behavior in this age group is most appropriate.
Global Rationale:

Cognitive Level: Applying
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 12-2

Question 11
Type: MCSA
The school health nurse is evaluating the home environments of several children as they relate to child safety. Which of these activities places a child at greatest risk for bodily harm?
1. The parents consume alcohol on a daily basis.
2. The child is permitted to participate, unsupervised, in target practice with a revolver.
3. The child is a latchkey child.
4. The parents are in a methadone program.
Correct Answer: 2
Rationale 1: Inappropriate behaviors, such as drug and alcohol use or past use, also place the child at risk, but the use of firearms carries the greatest risk.
Rationale 2: Of all the activities mentioned, playing with guns is the greatest risk for injury.
Rationale 3: A latchkey child needs special attention, but in the current situation, unsupervised gun use is the greatest risk.
Rationale 4: Inappropriate behaviors, such as drug and alcohol use or past use, also place the child at risk, but the use of firearms carries the greatest risk.
Global Rationale:

Cognitive Level: Analyzing
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 12-3

Question 12
Type: MCSA
The school nurse is teaching a class about safety. The nurse will teach the children that they should wear protective athletic gear when participating in selected activities. Which of these activities requires protective athletic gear?
1. Gymnastics
2. Swimming
3. Skateboarding
4. Basketball
Correct Answer: 3
Rationale 1: Like all sports, gymnastics requires safety precautions, but it does not require personal protective equipment.
Rationale 2: All children should know how to swim, but personal protective equipment is not required to participate in swimming.
Rationale 3: Skateboarding is considered a contact sport, so it requires use of personal protective equipment, including a helmet, gloves, and elbow and knee pads.
Rationale 4: Basketball is not considered a contact sport. No personal protective equipment is required.
Global Rationale:

Cognitive Level: Applying
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 12-5

Question 13
Type: MCSA
The nurse asks the parent during a clinic visit about the nutritional intake of her eight-year-old child. The mother tells the nurse she leaves early for work and her teen sibling takes care of the meals. What response by the nurse regarding nutrition is appropriate?
1. Provide information about healthy meals and snacks that are easy for school-age children and teens to prepare.
2. Provide a meal plan for the mother to take to her daughter.
3. Provide sample recipes for the mother.
4. Provide coupons for the mother when going to the grocery store.
Correct Answer: 1
Rationale 1: Provide information about healthy snacks to keep at home, ways to improve calcium intake, and the importance of getting at least five fruit/vegetable servings daily.
Rationale 2: Providing a meal plan is not going to help ensure that the child has healthy meals.
Rationale 3: Sample recipes will not help the mother ensure that her child has healthy meals.
Rationale 4: Coupons will not help the mother ensure that healthy foods are available for her child.
Global Rationale:

Cognitive Level: Analyzing
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 12-7

Question 14
Type: MCSA
The nurse and a young mother are discussing ways to best prepare children for starting school. What would be the best suggestion for the nurse to make?
1. Teach the child the alphabet and how to count.
2. Encourage the mother to tell the child how much she will miss the child while the child is at school.
3. Help the child relate to other adults and separate from the mother by planning play dates and short stays with sitters.
4. Plan for an older child to accompany the child and introduce the child to the teacher on the first day of school.
Correct Answer: 3
Rationale 1: These are skills the child will learn in school. The nurse is more concerned about psychological preparation for starting school.
Rationale 2: By telling the child how lonely she will be while the child is at school, the mother will make the child feel guilty about abandoning her.
Rationale 3: The ability to separate from the mother is key to an easy transition to school.
Rationale 4: An older child is not the person to accompany the child. It is appropriate to visit the classroom and meet the teacher prior to the first day of school.
Global Rationale:

Cognitive Level: Applying
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 12-6

Question 15
Type: MCSA
The teacher reports to the nurse that despite adequate intelligence, a child is not performing well in school. The nurses initial assessments would include:
1. Talking with the child to determine if there are family stressors, such as divorce, that are interfering with the childs performance.
2. Conducting a vision and hearing screening.
3. Determining if there is conflict between the child and the teacher.
4. Observing the child in the classroom to see interactions between the child and others.
Correct Answer: 2
Rationale 1: Although this can be a contributor to poor school performance, this is not the initial assessment.
Rationale 2: Vision and hearing difficulties should be ruled out before other causes are investigated.
Rationale 3: This would not be the initial consideration but would be evaluated later if other causes could not be found.
Rationale 4: This can be beneficial in determining school issues but is not the initial assessment.
Global Rationale:

Cognitive Level: Analyzing
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 12-3

Question 16
Type: MCSA
A six-year-old child is being seen in the clinic for a well-child visit. The child is visibly nervous and fearful of the nurse and the nurses actions. The nurse should:
1. Ask the parent to leave the examination room as this is probably the cause of the childs nervousness.
2. Assure the child that you will not hurt her.
3. Say to the child: Tell me why you are so nervous.
4. Explain to the child what you are doing in terms the child can understand. Explain the equipment and, when possible, let the child handle the equipment first.
Correct Answer: 4
Rationale 1: The six-year-old child usually is most comfortable when the parent remains in the examination room.
Rationale 2: This is a promise the nurse may not be able to keep. Lab tests and immunizations may be a part of the health visit.
Rationale 3: Explaining feelings and why they are present can be very difficult for adults as well as children. Small children will have even more difficulty in expressing their feelings.
Rationale 4: This activity will help allay the childs fears.
Global Rationale:

Cognitive Level: Applying
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 12-5

Question 17
Type: MCMA
During a summer healthy child visit, the mother tells the nurse that when school starts, she will be going back to work. The mother expresses her concern that her child will be a latchkey kid. Which suggestions will the nurse make to help maintain the childs safety and comfort?
Standard Text: Select all that apply.
1. During the summer, leave the child home alone for short periods of time.
2. Ensure that an adult will always be available by phone.
3. Allow the childs close friend to stay with the child so that he will not be alone.
4. Plan some activities that can serve as distractions for the child while alone.
5. Ensure that the child knows how and when to call 911.
Correct Answer: 1,2,4,5
Rationale 1: This is appropriate to give the child time to become accustomed to being alone in the home.
Rationale 2: This provides back-up for the child should a situation arise that the child cannot handle
Rationale 3: Because there is no adult present, it is not a good idea to have another child present in the home.
Rationale 4: This will keep the child busy with safe activities and reduce the attraction of unsafe activities.
Rationale 5: Children must know not only how to call 911 but also when it is appropriate to call.
Global Rationale:

Cognitive Level: Applying
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 12-6

Question 18
Type: MCMA
An 11-year-old child tells the nurse that she is having trouble falling asleep at night. What recommendations will the nurse make?
Standard Text: Select all that apply.
1.
Drink a cup of warm tea at nighttime to induce sleep.
2. Try to follow a nighttime routine.
3. Avoid sleeping late in the morning or taking a nap.
4. Exercise 30 minutes before bedtime to tire the body out.
5. Darken the room at bedtime.
Correct Answer: 2,5
Rationale 1: Tea contains caffeine and should be avoided at bedtime.
Rationale 2: A nighttime routine warns the body that bedtime is approaching and will help the body prepare to rest.
Rationale 3: When you cant sleep at night, the tendency is to sleep until noon the next day or take a nap in the afternoon. Both activities will inhibit sleep the following night.
Rationale 4: Exercising immediately before going to bed will stimulate the body and keep the child awake.
Rationale 5: Light in the room can interfere with a deep sleep.
Global Rationale:

Cognitive Level: Applying
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 12-6

Question 19
Type: MCSA
The teacher has referred a 10-year-old boy to the school nurse. The school nurse knows that the child is an only child with a single mother who works full time and is going to school. Which additional finding would the nurse identify as putting the child at risk for mental health issues?
1. The child is well nourished, wears glasses, and wears clothing styles that matches the other boys in his class.
2. The boy has a grandmother, aunts, and several cousins living nearby.
3. The family attends church on a regular basis.
4. The child is not involved in community social activities and does not play sports. The child states he plays video games at home after school.
Correct Answer: 4
Rationale 1: These findings indicate no risk factors and are normal for the age.
Rationale 2: This finding indicates the family is probably not isolated and has social support.
Rationale 3: This finding indicates spiritual support.
Rationale 4: This finding indicates the possibility of social isolation and leads the nurse to gather more data.
Global Rationale:

Cognitive Level: Analyzing
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 12-3

Question 20
Type: MCSA
During a well-child visit, the mother tells the nurse that her 11-year-old child is having problems controlling his temper. The mother states that when he gets mad, he often destroys things including his own possessions. The child recently smashed his bicycle, and the mother wonders how she should handle him. The nurse would suggest:
1. Spanking him when he displays this behavior because he knows better.
2. Not replacing the bike and explaining to him that when he breaks something, it will not be replaced.
3. When the child gets angry, the mother will need to yell at the child in order for the child to hear her response.
4. Discussing the childs behavior with the pediatrician so that the child can be placed on mood-altering medications.
Correct Answer: 2
Rationale 1: Spanking often makes the child angrier and does not teach the child acceptable behavior.
Rationale 2: This illustrates the natural consequence of his behavior.
Rationale 3: This will only accelerate the childs anger.
Rationale 4: The child needs to learn to control his anger instead of controlling his anger through the use of medications.
Global Rationale:

Cognitive Level: Applying
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 12-7

Question 21
Type: SEQ
As children grow and develop, their interests and activities change. Place the following childhood activities in order from interests of a 5-year-old to interests of a 12-year-old.
Standard Text: Click and drag the options below to move them up or down.
Choice 1. Hass-defined hobbies such as model building, building with wood, needlepoint
Choice 2. Colors in coloring book, mostly staying inside the lines
Choice 3. Learns to ride a two-wheel bicycle without training wheels; reads first readers
Choice 4. Belongs to the basketball team or cheerleading squad at school
Correct Answer: 2,3,1,4
Rationale 1: These activities require skill and coordination, more advanced skills common among the 9- to 10-year-olds.
Rationale 2: This is the earliest skill and common to the five-year-old child.
Rationale 3: This is common in children around six to eight years old.
Rationale 4: Schools do not have organized sporting teams until middle school.
Global Rationale:

Cognitive Level: Analyzing
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 12-1

Question 22
Type: MCSA
The nurse in the well-child clinic is concerned with injury prevention and includes topics appropriate to the age and behaviors of the child. Which injury prevention topics would be appropriate to prevent hearing loss?
1. The five-year-old child should wear ear plugs when swimming to prevent otitis media.
2. The 12-year-old child should restrict noise levels when listening to music through earphones.
3. The bike helmet for a seven-year-old should be carefully fitted to prevent damage to the ear canal.
4. The nine-year-old child should avoid sports activities that involve cheering crowds to prevent hearing loss.
Correct Answer: 2
Rationale 1: Ear plugs are not considered necessary unless the child has myringotomy tubes.
Rationale 2: Preteens like to listen to loud music, which can damage the hearing.
Rationale 3: A poorly fitting helmet would be uncomfortable and the child would not wear it, but it is not related to hearing loss.
Rationale 4: The noise level at sporting events would not be of sufficient level or duration to damage hearing.
Global Rationale:

Cognitive Level: Analyzing
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 12-7

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