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Test Bank Pediatric Nursing Caring Children Families 3rd Potts
CHAPTER 1: OVERVIEW OF PEDIATRIC NURSING
1. Which of the following major problems results from the denial of preventive services (such as prenatal care, dental care, and immunizations) to any given population?
a. spiraling costs for emergency medical services
b. health maintenance organizations losing money
c. extensive waiting lists for clinic health care services
d. closing of small community hospitals
2. Poverty rates are highest in which of the following types of families?
a. two-parent c. adoptive
b. single-parent d. foster
3. Which of the following factors most increases the prevalence of illnesses such as asthma and anemia, as well as respiratory and gastrointestinal infections?
a. household smokers c. poverty
b. family history of these illnesses d. education
4. The children who are at greatest risk of infant death are born:
a. to mothers under age 18 c. to fathers and mothers over age 40
b. into families in poverty d. into families with alcohol problems
5. The chance that a child will have to repeat a grade in school or be placed in special education classes:
a. is the same for the general population, regardless of circumstances
b. depends mainly on the quality of the schools and the teachers
c. increases a small amount for each year the child lives in poverty
d. depends mainly on whether the child has moved during the school year
6. The fastest-growing segment of the homeless population consists of which of the following groups?
a. alcoholics refusing treatment c. single males
b. mentally ill people d. families with children
7. Which of the following groups of people disproportionately represents the homeless population?
a. African Americans c. Hispanics
b. Caucasians d. Asians
8. A teacher confers with the school psychologist and the school nurse about a child who has poor attention span, aggressive behaviors, delayed speech, and shyness, and who tends to withdraw. This child often falls asleep in class, saying he is not sleeping at night. Which of the following situations or conditions is most likely to cause or contribute to the behavior exhibited by this child?
a. sharing a room with a sibling
b. attention deficit disorder with hyperactivity
9. Psychological problems most often identified among homeless children are:
a. conduct disorder
b. oppositional defiant disorder
c. depression, anxiety, and behavioral problems
d. personality problems and difficulty with authority figures
10. Because of their age, children are most likely to gain access to a firearm in:
a. the home or the home of a friend or relative
b. a pawn shop
c. a local gun dealer or a gun and knife show
d. a sports store
CHAPTER 2: LEGAL AND ETHICAL ISSUES
1. When the nurse is dealing with a specific and actual legal problem involving a child or adolescent, which of the following actions is most important for the nurse to take?
a. Consult with legal counsel who is familiar with the laws in the state where the problem occurred.
b. Select an attorney who appears to be sympathetic to pediatric clients, who has had success in similar cases, and who is willing to work with the nurse.
c. Contact the nursing school where he or she graduated to see if it has free legal counsel.
d. Wait to see if the problem will resolve itself without further action on the part of the nurse.
2. Nurse Practice Acts, Mandatory Reporting Laws, and Good Samaritan Acts are examples of laws affecting nurses. Which of the following is the source for such laws and acts?
a. constitutional law c. state laws and regulations
b. federal law and regulations d. case law
3. Which of the following factors is not necessary to review when obtaining informed consent?
a. risks of the procedure c. alternatives to the procedure
b. benefits of the procedure d. cost of the procedure
4. In the majority of cases, pediatric clients are asked to give their consent or permission before receiving a procedure or treatment. This process is referred to as which of the following terms?
a. inclusion c. consideration
b. assent d. co-permission
5. The major benefit of getting assent from a child is which of the following?
a. having the assurance of not being sued
b. enhancing the self-esteem of the child
c. lessening the controlling nature of caregivers
d. obtaining the childs cooperation and lessening the trauma
6. If a health care facility or health care provider treats a client without proper consent, and legal action follows, the facility or provider would most likely be:
a. charged with failure to render optimum care to the client
b. charged with assault and held liable for any damages
c. fined severely for not following state regulations
d. denied Medicare- and Medicaid-approved status
7. A family is involved in an automobile accident. The father, who is unconscious, and his 14-year-old son, who has suffered life-threatening injuries, are transported by ambulance to the hospital. The hospital staff attempt to contact the mother; however, they learn from the housekeeper that the mother is out of the country and not reachable by phone. Which of the following actions would be most reasonable and prudent on the part of the hospital staff?
a. Obtain informed consent from the child, if possible, and with or without it, provide life-saving procedures.
b. Get a court order from a judge in case the family later has objections to some of the care, such as the use of blood products.
c. Have the housekeeper give informed consent.
d. Locate another relative and get informed consent.
8. A nurse is working in the emergency room when a child is brought in with injuries and a history that suggests sexual abuse. The child is not cooperative. Which of the following reasons presents the best rationale for waiting until the child is cooperative, instead of restraining and forcing the child to submit to the examination?
a. The hospital staff would likely be charged with abuse.
b. One of the parents may object to restraint if both have not signed informed consent, especially if they are divorced.
c. Forcing participation may damage the childs ability to give testimony in a criminal case.
d. Forced examination may not provide accurate results.
9. Although the age varies among states, the majority of states define a minor as being a person under the age of:
a. 16 c. 18
b. 17 d. 21
10. Most states permit a child under age 18 to consent to certain types of care without parental or guardian notification or consent. The types of care that most often do not require the consent or notification of the parents or guardian include:
a. minor surgery c. contraception
b. liposuction d. psychiatric care
CHAPTER 3: THE CHILD IN CONTEXT OF THE FAMILY
1. When the nurse treats families as context, the emphasis is on which of the following?
a. extended family c. community
b. nuclear family d. individual
2. Sociologists define the family as a group of people:
a. with blood ties, adoption, guardianship, or marriage
b. with a focus on perpetuating the species
c. who are living together
d. who have strong emotional ties
3. Which of the following definitions best matches the U.S. Bureau of Census definition of family?
a. everyone in a household regardless of relationship
b. father, mother, and children
c. a group of two or more people related by birth, marriage, or adoption and residing together
d. a household of only those related by marriage(s) or birth, which would include extended family
4. Nurses using a contemporary definition should identify a clients family by asking which of these questions?
a. Who do you consider to be your family?
b. Are your parents and siblings living?
c. Are you married and do you have any children?
d. Who lives with you in your household?
5. The major goal of the nurse using Neumans nursing theory would be to:
a. assist the individual to identify helpful and antagonistic family members
b. help keep the family structure stable within its environment
c. enhance interactions between all extended family and the individual
d. minimize ineffective communication between family and society
6. Kings open systems theory viewed the family as:
a. the future through birthing of children
b. both hostile and helpful in ever-changing dynamics
c. a social system that influences the growth and development of individuals
d. a family system where children can be nurtured and build a strong sense of identity
7. Which of the following statements best represents a major belief in Kings open systems theory?
a. Nurses are partners with families.
b. Families are self-sufficient.
c. Individuals are more important than families.
d. Family is viewed only as context.
8. The major goal of nursing in Roys adaptation model is to:
a. help an individual adapt and integrate into the larger society
b. promote adaptation and minimize ineffective responses
c. help the individual adapt to maturational crises
d. assist the family in adapting to interpersonal difficulties
9. One of the five functions in the structural-functional theory of family is affective, which refers to the:
a. general mood of the family
b. way feelings are addressed or not addressed in the family
c. family meeting the needs for love and belonging of each member
d. face or outer picture that the family shows to the outside world
10. The nurse can best gain a perspective about a family value system by:
a. gaining an understanding of how a family distributes its resources
b. asking family members what they most value
c. assessing church membership and membership in community organizations
d. interviewing employers, friends, and neighbors of the family
CHAPTER 4: COMMUNITY AND HOME HEALTH NURSING
1. The largest percentage of community health nurses work in:
a. state and local health departments c. school health nursing
b. U.S. Department of Veterans Affairs d. home health
2. Which of the following best represents the focus of the community health nurse?
a. health promotion and disease prevention
b. curing people who are chronically ill
c. working with those who do not have health insurance
d. optimal functioning of the family
3. While community health nurses focus on the individual or the family, which of the following do they also have as their final objective?
a. the well-being of the extended family c. the financial well-being of the family
b. the well-being of the community d. the well-being of the chronically ill
4. The community health nurse is coordinating all the services needed by a child who has a chronic illness and is staying at home: physical therapy, tutoring, occupational therapy, respite care, as well as financial resources for the caregivers. This activity best represents which of the following legitimate roles for the community health nurse?
a. case manager c. collaborator
b. advocate d. consultant
5. You are the community health nurse working with a single mother who has small children. You have helped the mother get on the Women, Infants, and Children (WIC) program. She receives coupons from this program to get food for her children, but she often fails to use the coupons, saying she is embarrassed to take charity. Which of the following responses from you would most likely succeed in getting her to use the coupons?
a. Its really not charity. You have paid taxes and will pay more taxes some day when you have a job.
b. If you dont take the help, someone else less deserving will.
c. If I were in your shoes, I would use the coupons and be glad of having them.
d. It is important to give your children nutritious meals so they will grow, and this is a way to provide them.
6. Children with chronic illnesses, chronic conditions, or disabilities are often referred by community health nurses to which of the following programs to receive help with health care services?
a. NSAID Title I c. CSHCN Title V
b. WECM d. WIC
7. Medicaid optional services most often include such things as:
a. enhanced hospital coverage for intensive care
b. housekeeping and maintenance services
c. eyeglasses and speech, hearing, and dental care
d. income for household expenses if time is lost on the job
8. Healthy People 2010 national health objectives added some new focus areas, two of which are:
a. starting kindergarten and the reading initiative earlier to ensure reading by age 6
b. increasing small motor skills in children and reducing the incidence of behavioral problems in children
c. involving fathers sooner in prenatal care and making certain they have an opportunity to be present at birth
d. medical products safety and adding children to the maternal and infant safety area
9. In the prevention of firearm-related injuries, the public health or community health nurse needs to:
a. routinely inquire about the presence of firearms in the home and do a firearms safety assessment
b. report all firearms seen on home visits to local child protective agencies so that agency can do a follow-up
c. let families know he or she is opposed to keeping firearms in the home and insist they be removed
d. schedule the family members (including the children in the home) for a gun safety clinic
10. Which of the following tasks do community health nurses most often carry out in their work?
a. administrating mammograms and teaching routine breast self-exams
b. screening for venereal diseases and on-site microscopic analysis of samples from persons suspected of having these diseases
c. assisting in obtaining serum lead levels and administering developmental assessments
d. administering sonograms of the heart, bladder, uterus, or other organs as ordered by the patients public health care practitioner
CHAPTER 5: SCHOOL NURSING
1. Which of the following nurses convinced the New York Board of Health to place a nurse in the school system, thus establishing school nursing?
a. Dorothea Dix c. Esther Lucille Brown
b. Lillian Wald d. Anne Goodrich
2. The first school nurse in the United States in 1902 was:
a. Lavinia Dock c. Lina Rogers
b. Mary Adelaide Nutting d. Isabelle Hampton Robb
3. What major accomplishment occurred as the result of the work of the first school nurse in the United States?
a. The number of children excluded from school dropped significantly.
b. The incidence of whooping cough decreased by 50%.
c. The number of playground accidents dropped significantly.
d. The number of immunized children increased by 50%.
4. The original role of the school nurse was:
a. identifying, educating, and following up on communicable diseases
b. developing, teaching, and evaluating a comprehensive health curriculum
c. home health visits to the ill child
d. assisting the classroom teacher with hygiene teaching
5. During the 1920s the school nurse role expanded to include:
a. classroom teaching on how to deal with bomb threats and set up bomb shelters
b. prevention of injury during natural disasters such as tornadoes or hurricanes
c. identification of physical defects in children and making referrals to correct the defects
d. identification of children with alcohol and other drug problems and proper referrals
6. At one point in the history of school nursing, staffing was cut back and tasks were delegated to teachers and other school personnel. This occurred during which time period?
a. the Vietnam War c. the 1890s
b. early 1900s d. World War II
7. What minimum educational preparation is recommended for school nurses by both the American Nurses Association and the American School Health Association?
a. licensed practical nurse certificate c. baccalaureate degree
b. associate degree in nursing d. masters degree
8. What factor in the 1970s played a major part in the changing role of the school nurse and prompted the need for additional education and expertise for school nurses?
a. passage of the Education for All Handicapped Children Act
b. greater numbers of children entering the school system
c. the fact that teachers stopped teaching the health curriculum
d. changes in the Medicaid laws affecting children
9. What federal act requires that all states provide appropriate education at no cost and in the least- restrictive environment to children with handicaps?
a. Handicapped Persons Environmental Act
b. Individuals with Disabilities Education Act (IDEA)
c. Childrens Educational Act (CEA)
d. Handicapped Childrens Act
10. Included in the school nurses role is the provision of direct services and indirect services. Which of the following activities best exemplifies the indirect services that school nurses provide?
a. gastrostomy feedings c. community referrals
b. ventilator care d. clean intermittent catheterizations
CHAPTER 6: THEORETICAL APPROACHES TO THE GROWTH AND DEVELOPMENT OF CHILDREN
1.Maturation refers to changes that are due to:
a. major life experiences c. illness
b. genetic inheritance d. injury
2.Cephalocaudal development proceeds in which direction?
a. head downward
b. foot to midsection, followed by head to midsection
c. toe to head
d. extremities in toward the tailbone section of the body
3.Development that proceeds from the inside out is called by which of the following terms?
a. internal-external c. proximodistal
b. inner-outer d. cellular-epidermal
4.Infants start grasping with the whole hand, and as they develop they begin to use just the fingers. This development is an example of which of the following types of development?
a. cephalocaudal c. anterior-posterior
b. proximodistal d. internal-external
5.When comparing the development of a number of children, you would expect which aspect of developmental change to be the same in all the children?
a. basic sequence of changes c. length of each change
b. onset of each change d. response
6.When children learn new developmental skills, the new skills:
a. take longer to learn than earlier skills c. predominate over older skills
b. cause the child anxiety d. are a minor focus compared to old skills
7.When comparing the way infants react to pain with the way older children respond to pain, you will find that:
a. there is little difference between the way infants and children respond to pain
b. infants respond with their whole body while children can localize the pain
c. children will cry more and infants will withdraw more
d. infants will refuse to nurse during pain while children will continue to eat
8.A mother is comparing her child with the neighbors child who is the same age. The mother is concerned that her child does not have as advanced language skills as the neighbor child. The nurse assesses the child and determines the language skills are within the range of normal. This nurse would advise the mother that:
a. speech develops more rapidly in children with siblings
b. the development of language skills varies greatly in children
c. some childrens talents lie in areas other than language skills
d. the child needs to have a battery of psychological tests
9.The nurse is working with the caregivers of a child who is 2-1/2 years old. The nurse advises the caregivers that it is important for the child to know what it feels like to have a wet diaper. This advice was given because of which rationale?
a. The nurse is acting on an old wives tale and has no rationale.
b. Children need to know the connection between being wet and being changed by a caregiver.
c. Children have to be able to tell a caregiver they are wet before they can be successfully toilet trained.
d. This is an important sensory experience for maximum development of brain potential.
10.In the nature versus nurture controversy about human development, the nature view sees development as mainly influenced by which of the following factors?
a. genetic c. culture
b. environmental d. chance
CHAPTER 7: GROWTH AND DEVELOPMENT OF THE NEWBORN
1.The neonatal or newborn period of life is defined as the first:
a. 24 hours c. 7 days
b. 48 hours d. 28 days
2.In fetal circulation, most blood will bypass the fetal lungs via the:
a. inferior vena cava c. foramen ovale
b. ductus venosus d. ductus arteriosus
3.When the fetus makes the transition to becoming a newborn and extrauterine life begins, there occurs a series of changes, including decreased pulmonary vascular resistance, increased pulmonary blood flow, increased pressure of the left atrium, decreased pressure of the right atrium, and closure of which of the following structures?
a. foramen ovale c. inferior vena cava
b. ductus venosus d. superior vena cava
4.After a long labor, the mother is concerned about the swelling of her babys scalp. The newborn is 24 hours old. The nurse palpates the scalp and finds swelling that extends across the suture lines. In addition to explaining the probable cause of the swelling and the time of resolution, the nurse explains that the term for this condition is:
a. cephalhematoma c. molding
b. caput succedaneum d. crepitation
5.The umbilical cord, which connects the fetus to the placenta, contains:
a. one vein and one artery c. one artery and two veins
b. two veins and two arteries d. two arteries and one vein
6.The nurse instructing the mother on how to care for the umbilical cord of the newborn would direct the mother to:
a. wash the cord only with warm water and gently dry it
b. apply 70% isopropyl alcohol or hydrogen peroxide to the base next to the skin and to the cord with each diaper change
c. use a solution of baby shampoo and water on the cord, rinse, and dry carefully
d. wash the cord with a solution of Ivory soap and water, dry, air for 30 minutes, and apply triple antibiotic ointment after baths and diaper changes
7.The nurse instructs the caregivers of a newborn to notch the diapers or fold them in such a way as to expose the cord. The major purpose of exposing the cord is to:
a. allow visualization at all times c. remind the caregivers to do cord care
b. keep the diaper from rubbing the cord d. provide air circulation for the cord
8.The nurse is assessing neonatal reflexes. As the nurse moves the neonates head slowly to the right or left, the eyes move more slowly than the head and do not immediately adjust to the position of the head. This reflex is called:
a. cats eye c. dolls eye
b. head lag reflex d. eye delay
9.The rooting reflex of an infant disappears at approximately how many months of age?
a. 1 c. 4
b. 2 d. 6
10.The stomach capacity of the newborn is approximately how many mL?
a. 30 c. 60
b. 40 d. 80
CHAPTER 8: GROWTH AND DEVELOPMENT OF THE INFANT
1.The age range for an infant is defined as which of the following time spans?
a. newborn to 3 months c. 1 month to 1 year
b. newborn to 6 months d. 3 months to 15 months
2.The most rapid growth period in a persons life is during which of the following periods?
a. infancy c. latency
b. early childhood d. adolescence
3.The approximate weight gain for babies in the first 6 months of life is:
a. 1/2 pound per month c. 1-1/2 pounds per month
b. 1 pound per month d. 2 pounds per month
4.The approximate increase in height for babies is how many inches per month in the first 6 months of life?
a. 1/4 c. 1
b. 1/2 d. 1-1/2
5.A mother asks the nurse when a soft spot on the babys head will close. The best response by the nurse is which of the following responses?
a. It will close in about a year.
b. There are two soft spots called the anterior and posterior fontanels, which will close by the time the baby is about a year old.
c. It will close in 6 months.
d. The soft spot you are talking about will close by 12 to 18 months of age. Another soft spot will close by 2 months.
6.Birth weights differ with ethnic backgrounds. Which of the following babies are typically the largest at birth, compared to the others?
a. European American c. Chinese
b. Native American d. Japanese
7.A mother asks you when her baby will be able to pick up and hold toys. You would explain to her that in order to be able to willingly grasp an object such as a toy, the baby must first:
a. have the ability to release the object c. lose the involuntary grasp reflex
b. double the birth weight d. be able to sit up
8.Gross motor development is best exemplified by the ability to:
a. use the muscles of the hands to grasp toys
b. maintain balance, postural control, and locomotion
c. use the facial muscles to smile, cry, and frown
d. open the hand, look at the fingers, and place them in the mouth
9.The mother asks the nurse when her baby will be able to hold his head up. The best response by the nurse is that the baby will be able to hold his head up at:
a. 3 months
b. 4 months and also use the forearms for support
c. 6 months, if the baby is not overfed and overweight
d. 7 months
10.A mother notices that her 6-month-old child grasps things such as a spoon in her palms. This mother asks when her daughter will be able grasp a spoon between the thumb and fingers. She has been trying to teach the child this skill without success. The best response by the nurse would be:
a. The pincer grasp will be mastered at about 8 months. It would be best to let the child grasp the spoon with the palm, as it is too early for the pincer grasp.
b. Have your child play with an older child who uses the pincer grasp, and your baby will likely pick up the skill from the other child in a short while.
c. Keep working and teaching. The baby will soon pick this skill up if you just keep pushing.
d. Lets do some developmental testing to see in what other areas your baby is behind in development.
CHAPTER 9: GROWTH AND DEVELOPMENT OF THE TODDLER
1.The period of toddlerhood is from 12 months to:
a. 15 months c. 24 months
b. 18 months d. 36 months
2.During the toddler stage, a child will gain approximately how many pounds per year?
a. 1 c. 5
b. 3 d. 7
3.Growth rate slows for toddlers due to which of the following causes?
a. decline in appetite and erratic eating habits
b. hormonal changes, especially a decline in growth hormone
c. increased activity levels burning more calories
d. sleep problems resulting in less sleep per night
4.Most toddlers can climb stairs by how many months?
a. 10 c. 15
b. 12 d. 18
5.Until myelination of the spinal cord is completed, the child will:
a. have some difficulty in walking
b. have difficulty kicking a ball forward without losing balance
c. experience transitory paresthesia of the legs
d. have diminished feeling from the waist down
6.All of a childs deciduous teeth usually erupt by how many months of age?
a. 15 c. 24
b. 18 d. 30
7.The nurse is assessing a toddler of 18 months to see what skills the child has for dressing himself. The nurse expects to find that a toddler of this age can do which of the following tasks?
a. put on his shoes c. remove his own shoes
b. tie his own shoelaces d. tie others shoelaces
8.Caregivers ask the nurse at what age their 1-year-old will be able to ride a tricycle. The most accurate response by the nurse would be which of the following?
a. 13 months c. 18 months
b. 16 months d. 24 months
9.The usual eating patterns of toddlers are to:
a. eat a lot in the morning and taper off by night
b. vary widely in amount eaten and in foods liked and disliked from day to day
c. eat consistently the same amount and type of food day by day
d. eat only one preferred food at every meal day after day
10.Which of the following best describes the term physiologic anorexia?
a. period of decreased appetite as a result of decreased caloric need
b. refusing to eat in order to get secondary gains from behavior
c. not eating, which brings a variety of changes in body function
d. changes in appetite due to fluctuating eating habits
CHAPTER 10: GROWTH AND DEVELOPMENT OF THE PRESCHOOLER
1.The nurse on the pediatric unit is working with the recreational and developmental specialists to plan some activities for the children. One activity is a card game, in which the participant is required to sort into piles cards picturing like objects. The nurse realizes that children of which of the following age groups have just begun to have this capacity?
a. 3 years c. 4 years
b. 3-1/2 years d. 6 years
2.The difference in vocabulary between the 3-year-old child and the 4-year-old child is:
a. 150 versus 400 words c. 300 versus 800 words
b. 200 versus 500 words d. 900 versus 1,500 words
3.A mother is concerned about her preschool child running into the street without looking. The nurse would advise this mother that for preschoolers:
a. verbal reminders of established limits and looking before crossing are effective
b. fear of punishment is the only thing that works to prevent this behavior
c. an adult must be with the preschool child at all times
d. children this age seldom run into the street without looking unless chasing a ball
4.Which of the following ages might be a more opportune time for the birth of an additional sibling, because at this age the child is less jealous of a younger sibling?
a. 1 c. 3
b. 2 d. 4
5.Which of the following statements might a preschool child most likely make when questioned as to why something is right or wrong?
a. Because my mother says so.
b. Because there are rules about this.
c. Because its in the Ten Commandments.
d. I just know it is so.
6.A preschooler knows she should not ram her tricycle into the garage door at home, but she does this at a friends house. What is the most logical reason for this difference in behavior at home and at the friends house?
a. The preschooler values her own house more than she values the house of a playmate.
b. The childs mother is much stricter and supervises children much more closely than the playmates mother.
c. A young preschool child may have difficulty applying known rules to a different situation.
d. There is a higher level of frustration when outside her own home and play territory.
7.A nurse is instructing the mother of a 3-year-old about diet. The nurse will recommend that the mother look at the amount of fat in the childs diet and ensure that the fat in the diet is:
a. at least 40% c. less than 15%
b. around 10% d. no more than 30%
8.The nurse practitioner is presenting the mother of a preschooler with a bottle of vitamins. The nurse most importantly needs to instruct the mother to do which of the following things?
a. Give the vitamins with sips of milk.
b. Give preschoolers half a vitamin and grade-school children a whole vitamin.
c. Store the vitamins in a locked cabinet that the child cannot access.
d. Teach the child how to be independent and self-administer the vitamins.
9.The biggest predictor of a childs risk of developing obesity in adulthood is which of the following factors?
a. parental obesity c. amount of time spent sleeping
b. living in the country d. two-caregiver household
10.To help a preschooler sleep at night, the nurse will recommend to the caregivers that they:
a. avoid milk drinks at bedtime
b. have the child watch television until he or she falls asleep
c. read a bedtime story and establish a firm bedtime
d. provide soda or coffee with milk at bedtime
CHAPTER 11: GROWTH AND DEVELOPMENT OF THE SCHOOL-AGED CHILD
1.A parent asks the pediatric nurse, How tall is the average 6-year-old boy, and how much does the average 6-year-old boy weigh? After advising the parent that each child is unique and growth is affected by many factors, the nurse would give the average height and weight for a 6-year-old boy as:
a. 36 inches tall and 37 pounds c. 50 inches tall and 54 pounds
b. 46 inches tall and 45 pounds d. 60 inches tall and 63 pounds
2.When working with school-aged children, the nurse should keep in mind that these children will increase their weight by how many pounds per year?
a. 1-2 c. 5-6
b. 3-4 d. 7-8
3.The nurse in the pediatric clinic measures a 9-year-old childs height and finds that the child has grown 4 inches in 1 year. The nurse will discuss this increase in height with the caregivers, keeping in mind that an increase of 4 inches in 1 year, when compared to the usual increase for a school-aged child, is:
a. just below average c. slightly above average
b. average d. double the average
4.The school nurse is talking with a group of parents about the growth and development of their school-aged children. A parent asks the nurse, Just what are growing pains? Which of the following is the best response?
a. The bones hurt when calcium builds up and the bones are stretching out in length.
b. When the long bones are growing faster than the attached muscle, pain can occur.
c. The nerves are chemically irritated when the bones are elongating in growth.
d. As the bones get longer, the skin has to grow and stretch and this hurts.
5.A parent asks the school nurse to explain there children usually feel growing pains. The nurse explains that the discomfort is usually in the:
a. toes, feet, and ankles c. hip and pelvis
b. knees, calves, and thigh d. fingers, wrists, and elbows
6.The pediatric nurse is working with the parents of a school-aged child who has growing pains. The nurse recommends that the parents try which of the following as comfort measures?
a. sandal-type shoes without enclosed toes or backs
b. ice packs, cold showers, and no heat
c. analgesics, gentle massage, and warm baths
d. exercise, hot packs, and herbal teas
7.When parents select or approve physical activities for their children, they most need to select activities according to the:
a. interests of the child
b. abilities of the child
c. childs potential for improvement
d. childs potential for building lifelong skills
8.The nurse working on the pediatric unit checks the apical pulse of a school-aged child and finds a rate of 95 beats per minute while the child is lying in bed. The best action on the part of the nurse is to:
a. Chart the apical pulse of 95 as it is in the normal range.
b. Recheck the apical pulse for a full minute, as it is somewhat high.
c. Call the pediatrician.
d. Have another nurse recheck the apical pulse.
9.The pediatrician is doing a routine physical exam on a school-aged child and tells the parents that their child has an innocent heart murmur. The parents ask the nurse what this means. The best answer is:
a. The mitral valve is not closing tightly and some blood is getting through when the heart is not contracting.
b. If the childs heart is not overworked for the next few years, this problem will cure itself.
c. This is a minor congenital anomaly and is nothing to worry about as it will cause no problems.
d. This is the sound of blood normally flowing through the heart and is not associated with any heart problem.
10.Parents ask the nurse if their child will always have this innocent heart murmur. Which of the following is the best answer?
a. Yes, this murmur will not disappear and your child will have it throughout life.
b. No, this murmur will no longer be heard when your child becomes an adolescent.
c. Most children are lucky and the murmur goes away after a year or two.
d. This murmur will usually be cured with a period of rest, diet, and medication.
CHAPTER 12: GROWTH AND DEVELOPMENT OF THE ADOLESCENT
1.Adolescence is broken down into how many distinct periods?
a. two c. four
b. three d. five
2.Puberty is best defined as the:
a. beginning of adolescence
b. state of development then reproduction first is possible and the adolescent growth spurt starts
c. period between childhood and adulthood in which a person matures and readies for adult life
d. time then thinking changes to include abstraction and the consideration of others viewpoints
3.The nurse is forking with a prepubescent adolescent. The family asks the nurse to explain then the adolescent will go through puberty. The nurses response will be based on the idea that the age then puberty begins:
a. varies individually
b. is about the same for all females
c. is slightly different for males and females
d. depends on the persons culture
4.A 12-year-old adolescent boy who was hospitalized with complications of diabetes is concerned that his 9-year-old sister is taller than he is and asks the nurse why he is so short compared to his sister. The nurses best response would be:
a. When we get your diabetes under control, you may see yourself having a major growth spurt.
b. You may have inherited the genetic makeup for being short, while your sister got the tall genes.
c. Since she does not have diabetes, she is able to take in more food and put her food intake to maximum use.
d. Girls may begin their growth spurt as early as age 7-1/2, while boys typically start a growth spurt by age 13.
5.An adolescent girl who has experienced menarche asks the nurse how much she will grow before she reaches her full height. The nurses best response is to explain that once menarche has occurred, maximum growth will:
a. have already been achieved c. occur within 2 years
b. rarely be more than 2 more inches d. often take a spurt of 4 or 5 inches
6.Which of the following best describes the term peak weight velocity (PWV)?
a. the total amount of time it takes for an adolescent to reach his or her greatest weight
b. the top of a graph of peaks and valleys of weight gain and weight loss
c. the period of greatest growth in weight during the adolescent growth spurt
d. the speed of weight gain to the maximum weight to date, after any weight loss
7.During a routine physical examination, the health care practitioner mentions that an adolescent girl has asymmetrical breasts. The girl is too embarrassed to ask the doctor about this, but she also notices one breast seems bigger than the other. She asks the school nurse: Why is one of my breasts bigger than the other? What is wrong? The best response by the nurse is which of the following?
a. You have not achieved full growth. The smaller breast will eventually grow and they will be the same size.
b. Many women have asymmetrical breasts. It is not unusual for one breast to be slightly larger.
c. Dont worry too much about this, as the health care practitioner will surely order a mammogram.
d. This condition will correct itself after you have experienced menarche.
8.During adolescence, estrogen causes which of the following changes in the female?
a. epiphyseal maturation, which in turn inhibits long bone growth
b. the greatest widening of the hips she will experience in her lifetime
c. the greatest peaking of sexual interest in preparation for sexual life
d. nesting instinct, with a desire to find a life mate and have a family
9.Which hormone causes breast changes, including enlargement and darkening of the nipple?
a. progesterone c. estrogen
b. luteinizing hormone d. adrenocorticotropic hormone (ACTH)
10.Eccrine and apocrine glands mature during adolescence. These glands cause:
a. increased interest in sexuality and finding a mate
b. a darkening and toughening of the skin in males
c. the breasts to enlarge and the nipples to darken
d. increased amounts of, and a distinct odor to, perspiration
CHAPTER 13: CHILD AND FAMILY COMMUNICATION
1.Which of the following factors is most important in determining the success of relationships used in delivering care?
a. transference and countertransference c. personality of the participants
b. effective communication d. type of illness of the client
2.The major components of the communication process are:
a. message, sender, channel, receiver, and feedback
b. facial expression, tone of voice, and gestures
c. verbal, written, and nonverbal
d. speaker, listener, and reply
3.Barriers to communication include:
a. open-ended questions c. encouragement
b. preconceived ideas d. selective reflection
4.In order to make verbal communication more effective, the nurse will:
a. be brief, clear, and relevant in speech c. avoid speaking slowly
b. use a consistent tone, never varying it d. use medical terms
5.The tone and pitch of the voice, volume, inflection, speed, grunts, and other vocalizations are referred to by which of the following terms?
a. third element c. paraverbal clues
b. ancillary speech d. enhancements
6.Informal communication takes place then individuals talk and is best described by saying the participants:
a. are relaxed
b. are involved in a preexisting informal relationship
c. have no particular agenda or protocol
d. talk with slang words
7.Touch is one of the most important communicative behaviors that nurses use; however, nurses must keep in mind which of the following facts before using touch?
a. Everyone likes to be touched, but most prefer a light touch on the upper body.
b. Touch can have many different meanings to different children and their families.
c. Touch needs to be used very sparingly and only then necessary and asked for.
d. The opposite gender almost always interprets touch as having a sexual meaning.
8.Most communication is:
a. verbal c. nonverbal
b. spatial d. ineffective
9.You are the nurse preparing to meet with a client for the first time. You realize that before effective communication can take place, you must:
a. share personal information about yourself
b. develop trust and rapport with the client
c. set some rules of communication with the client
d. clarify your purpose in talking with the client
10.You are the nurse trying to get a child to take his medication. The child refuses to take the medicine, saying, I hate this medicine because it tastes yucky. Your best response is:
a. Your daddy and mommy will be upset if you dont take this medicine. Your health care practitioner will be upset with you too.
b. You will not get well if you dont take this medicine. It is good for you and will make you well again.
c. Good boys and girls always take their medicine. If you are a good little child, you will take your medicine and Santa will bring you a present.
d. I understand that the medicine does not taste good and you dont want to take it, but I am so proud of you then you take it and you can be proud of yourself.
CHAPTER 14: PEDIATRIC ASSESSMENT
1.When infants are born prematurely, the chronological age on the growth chart:
a. is the same as for other children after 6 months
b. is not accurate, and a special chart for preemies must be used
c. must be corrected subtracting weeks or months of prematurity until age 18 months old
d. must be corrected until age 18, subtracting the period of prematurity from the age
2.When you are the nurse taking the health history of a child, the historian is most likely going to be an adult. Which of the following questions would be the most important to ask before admitting or treating the child?
a. What is the birth date of the child?
b. Who is the legal guardian?
c. What is your relationship to the child?
d. What problems occurred during pregnancy?
3.The nurse is talking with the caregivers about a childs developmental and health history. The child interrupts to add something and the caregivers direct the child to be quiet. The nurses best course of action would be based mostly on which of the following ideas?
a. Caregivers have the right to govern their own children.
b. Children are not as accurate as caregivers in the recall of developmental and health histories.
c. Children need to be included in their own health care as much as possible, considering age and development.
d. The caregivers are the decision makers in terms of care and will be paying for the cost of the care.
4.A mother tells you that her 4-year-old child has begun to have night waking and has started thumb sucking again. Otherwise the child seems very healthy. From this brief history, your immediate response is:
a. It is normal for preschool-aged children to go through some short periods of regression.
b. What changes have happened in your family or with your child?
c. Is there any possibility of pinforms or some other type of parasite that your child might have?
d. You need to call your pediatrician right away and get a complete physical on this child.
5.When obtaining a childs past health history, the nurse would ask questions aimed at getting pertinent information, beginning with the:
a. Apgar score and birth itself c. labor and delivery
b. postnatal period d. prenatal period
6.When taking the health history of a child whose family is at the poverty level and has no insurance, you discover that the child has been seen in the emergency room of the hospital ten times in the last 6 months. During the interview, you would first try to find out from the family if:
a. they use the emergency room for episodic health care or if the child has a regular health care provider
b. there is a history of child or spousal abuse or incestuous relationships in the family
c. the child has a chronic health problem with acute exacerbations presenting an emergency situation
d. the child is hyperactive or has a history of inattention to safety and suffers accidents on a regular basis
7.Which of the following questions or statements is most important during the health history interview of the family seeking care for a toddler?
a. What does your child prefer to eat?
b. When did your child say the first word?
c. Tell me about the toilet training and how that is going.
d. Tell me how you have childproofed your home.
8.A mother asks the nurse to tell her the normal amount of milk a bottle-feeding infant takes in per day in the first month after birth. The nurses answer would be that an infant at this age would take up to:
a. 32 ounces c. 56 ounces
b. 46 ounces d. 64 ounces
9.During a talk with the nurse, the mother of a 6-month-old baby says that she gets her to go to sleep by giving her a bottle of milk to suck on until she falls asleep. The nurses best response would be:
a. You need to be watching your baby on a monitor or there the baby cannot see you.
b. Be sure you prop the bottle well and the babys head is slightly elevated.
c. Letting a child fall asleep with a bottle of milk or other liquid containing sugar will cause cavities.
d. Your baby is old enough to hold her own bottle, and this builds independence and self-esteem.
10.In the health history interview, the nurse asks the caregivers if they give their 4-month-old baby honey. If the answer is yes, the nurse would do some teaching to:
a. reinforce the caregivers for supplying this added source of immunity
b. let the caregivers know that honey is helpful then the infant has vomiting and diarrhea
c. inform the caregivers of the dangers of botulism from honey until the infant is 1 year old
d. advise the caregivers not to give more than 4 ounces of honey per day
CHAPTER 15: INFECTIOUS DISEASES
1.Which of the following factors or conditions were responsible, in the first third of the 20th century, for the high incidence of infant and childhood mortality?
a. lack of medical doctors c. sudden infant death syndrome
b. infectious diseases d. high-fat diets
2.Which of the following phrases about infectious diseases is always true?
a. They are contagious from person to person.
b. They can be stopped by consistent and adequate handwashing.
c. They are caused by pathogenic organisms in the body.
d. They can be eradicated by vaccinating people around the world.
3.Which of the following best describes the reservoir, one of six factors in the chain of infection?
a. living and nonliving places there pathogens can survive without multiplication
b. a pool of water there mosquitoes can breed and thus more quickly spread infection
c. the stomach, which holds a large number of pathogens for a significant amount of time
d. any area there a stable amount of water is present
4.Which of the following best describes a vector?
a. the point at which an infection entering the body intersects with an infection leaving the body
b. the area of initial bite or contact by the disease-bearing animal or insect
c. a person or animal who is infected with an organism but does not have the disease
d. an animal or insect that carries the infectious organism from one host to another
5.The nurse working with a pediatrician in the doctors office setting knows it is a top priority to properly clean all surfaces and toys touched by the children who come to the office, or make certain they have been properly cleaned, because of which of the following reasons?
a. Organisms tend to enter the body through the mouth.
b. Many organisms remain viable from hours up to several weeks on surfaces.
c. The nurse has a responsibility to stop the spread of HIV in the office setting.
d. Failure to ensure thorough cleansing can result in malpractice for the nurse.
6.A child comes to see the pediatrician and breaks out the next day in the characteristic lesions of chickenpox. The nurse working in this pediatric clinic knows that:
a. this is not a problem, as the child was not contagious before the skin lesions erupted
b. only children physically touched by the child who developed chickenpox were exposed
c. all the children in the doctors office that day need to be quarantined and isolated
d. the doctor needs to see and evaluate all the children who were in the office and exposed
7.The school nurse is working with teenaged parents and their babies in a high school program designed to keep these parents in school and to teach them how to care for their children. The nurse teaches the mothers to change diapers on:
a. a soft towel that can be washed as needed
b. a washable surface that is disinfected after each use
c. upholstered furniture that can be wiped off
d. a changing station with a cushioned cover
8.Which of the following best describes the term vertical transmission?
a. oral intake of germs that go through the body and are secreted rectally
b. when the person contracts the disease or infection while awake and standing
c. droplet infection that drops downward into the respiratory tract
d. the process of transmitting a disease from one generation to another
9.Infections that can be transmitted through vertical transmission are:
a. influenza, meningitis, and varicella
b. rubella, herpes, and human immunodeficiency virus
c. staphylococci, streptococci, and Escherichia coli
d. hepatitis B and C and Rickettsia rickettsii
10.Which of the following groups of children are susceptible to infections from staphylococci and Escherichia coli?
a. adolescents c. toddlers
b. preschoolers d. newborns
CHAPTER 16: CARE OF CHILDREN WHO ARE HOSPITALIZED
1.Prior to the late 1950s governing parents visiting their hospitalized child were:
a. very liberal, allowing unlimited visitation and rooming-in
b. limited to the waking hours only
c. very restrictive and often limited to only weekly visits or visits of a few hours each day
d. limited to one parent only, allowing that parent unlimited visiting
2.Which of the following documents described polices and practices in the care of hospitalized children and how detrimental were these to child development and recovery? (This document brought about change in visiting rules for parents visiting their hospitalized child.)
a. Platt Report of 1959 c. Lysaught report of 1970
b. Brown Report of 1948 d. Patients Bill of Rights
3.Which of the following nurses was the first to systematically study how children and parents cope with hospitalization and to document the effectiveness of nursing in allaying and managing the fears and concerns of children?
a. Florence Erickson c. Gladys Sellew
b. Dorothy Marlow d. Florence G. Blake
4.Which of the following is the predominant goal of nurses caring for children?
a. Find out what is wrong with a child, and fix it as efficiently as is possible.
b. Identify the strengths of children, and enhance their growth in the midst of stress and intrusions.
c. Get the child and family well enough to go to the least-restrictive environment.
d. Spare the family as much trauma and psychological distress as is humanly possible.
5.Which of the following do nurses need to do first then preparing for nursing care of children in a clinical setting?
a. memorize Eriksons life tasks
b. study Piagets theories of growth and development
c. examine their own thoughts and feelings about caring for children and families in the hospital and the roles and responsibilities of nurses in pediatric nursing
d. find out the physicians protocols, and familiarize themselves with these protocols as well as with the policy and procedure manuals of the hospital and unit
6.The nurse, working on a pediatric unit of a hospital, is assigned to care for several children with varying needs. One child was admitted solely for tests, another for management of diabetes, one for heart surgery, and one with a terminal illness. In planning time and attention to the children, the nurse makes it a priority to take into consideration which of the following factors?
a. severity of the reason for hospitalization
b. age and intelligence of the child
c. perceptions and interpretations of the experience by the child
d. parents emotional, physical, and financial needs
7.Which of the following statements best describes stress-point nursing?
a. The nurse uses a chart and a pointer to go through the steps of the procedure.
b. All procedures and treatments are reduced to 10 steps or points to help explain them to the child undergoing them.
c. Each step of a procedure fits into a star-shaped diagram with the steps outlined on the points of the star.
d. The treatment or procedure is described in a sequential manner, exploring how it might feel, and the procedure or treatment is rehearsed.
8.The nurse places a unique cartoon character on the outside and inside of a childs door. The hospital has a picture of a different animal for each floor of the hospital, and these pictures are posted in the elevators. Each section of the pediatric unit has a different theme and walls of a different color. These actions on the part of the nurse and the hospital are designed to:
a. reduce anxiety and help children and others feel secure that they will not get lost and that they have a place of their own
b. remind everyone that this is a pediatric unit for children who have special needs and is not a unit for adults
c. cheer the children up and help them laugh to reduce tension in their lives
d. help establish a personality for the hospital, the floors, the unit, and the room of the child who is hospitalized
9.Nurses caring for a pediatric client can most strengthen a childs sense of security by:
a. providing a unit and hospital handbook of rules and posting the dos and donts on the walls there children can see them
b. letting the children know then they will be leaving, who will be caring for them, and then they will be back, and saying good-bye then they leave
c. giving the children enough toys, games, and stuffed animals to play with
d. telling the children then meals will be and what the menu will be for each meal as well as then they will have nothing by mouth (NPO) and for how long
10.The pediatric nurse in the hospital finds one of her clients crying because Daddy just left. Which of the following actions by the nurse would most help the child to feel more secure?
a. holding the child, talking about then Dad will return, and looking at Dads picture
b. looking at the clock, talking about the amount of time before Dad returns, and drawing a clock with that time
c. distracting the child by playing a game that requires a lot of concentration
d. giving the child a cuddly blanket and a cuddly stuffed animal to hold until Dad returns
CHAPTER 17: CHRONIC CONDITIONS
1.Which of the following best describes the term disability?
a. unable to work at 100% of the ability of the average person in the society
b. functional limitation preventing or interfering with the ability to perform age-expected activities
c. a condition in which a person is prevented by limitations from doing the work he or she needs to do
d. having a part of the body that functions at 75% or less of its ability
2.The term chronic condition typically refers to a medical state or degree of health that exists for a minimum of how many months?
a. 3 c. 9
b. 6 d. 12
3.The nurse assessing a child with a chronic illness evaluates the trajectory. The nurse is trying to find out:
a. how fast the child can move
b. how long the child has had the illness
c. whether the condition will get better, worse, or stay the same
d. who else in the family has this condition
4.A child has a disability that is not visible to others. Research has shown that children with a condition that is less visible to others will:
a. frequently have more difficulty adjusting to the condition than those with a more visible disability
b. have the same amount of difficulty adjusting to the condition as people with a visible disability
c. often forget for long periods of time that they have a disability since it is not visible
d. seek more attention from significant others compared to people with a more visible disability
5.The deficit-orientation model of chronic conditions assumes that people with chronic conditions are:
a. lacking important aspects of life
b. lacking in sufficient finances to receive adequate medical services
c. intellectually impaired
d. unable to function in society
6.Using the deficit-orientation model of chronic conditions, clinicians assessing the client would look for:
a. unusual strengths and talents c. abnormalities and problems
b. personality traits d. financial problems and debts
7.The deficit-orientation model of chronic conditions tends to see which of the following as the expert?
a. the client c. the professional(s)
b. the clients family d. the evidence-based literature
8.The health-orientation model of disability tends to be critical of:
a. people who are disabled
b. professionals making negative appraisals
c. the family of the person who is disabled
d. healthy persons who ignore people who are disabled
9.The ordinary model of chronic conditions differs from other models because in this model, people with chronic conditions view themselves as:
a. leading ordinary lifestyles
b. wanting to be more ordinary
c. somewhat extraordinary compared to others
d. experiencing conditions similar to those experienced by many other individuals
10.The health-orientation model of chronic conditions portrays the relationship between client and professional as a:
a. partnership c. patient-client relationship
b. contract d. teacher-learner relationship
CHAPTER 18: PAIN MANAGEMENT
1.When it comes to pain management in infants and children, the majority of health care professionals are still under the impression that infants and children:
a. need one-half the pain medication that adults need
b. need about the same amount of pain medication as adults, adjusted for their body weight
c. do not have pain or suffer less pain than adults
d. have a lot more pain than adults
2.Which of the following statements best describes acute pain?
a. discomfort lasting 3 to 5 days and due to a specific cause such as surgery or injury
b. discomfort that comes on suddenly and lasts less than 8 hours
c. a sharp hurting in a specific location that comes and goes suddenly
d. any hurting that is not considered long-lasting by the individual experiencing it
3.A mother tells the nurse that her child has experienced pain lasting for long periods of time with the pain coming and going. The nurse would describe this pain in her assessment as which of the following kinds of pain?
a. acute pain c. strange pain
b. moderate pain d. chronic pain
4.Nociceptors are best described as nerve receptors specific to which of the following?
a. inflammation c. pressure
b. pain d. sprain
5.Which of the following factors has the most influence on how long pain lasts and how intense it is?
a. the persons past experience with pain
b. how much pain medication the person takes at one time
c. the release of chemical mediators such as substance P
d. the persons history of pain medication use and tolerance to medications
6.Which of the following theories is currently in use to explain how pain impulses travel and are interpreted in the body?
a. classic gate control theory c. electrical impulse theory
b. sodium ion theory d. hormonal rise theory
7.A number of research studies have shown that there is an improvement in postoperative morbidity and mortality then:
a. alpha stimulation is applied for at least 30 minutes before and after surgery
b. infants and children receive general anesthesia and postoperative pain management
c. vitamin C is given to infants and children for a week before and a week after surgery
d. fathers hold and touch their infants before and after surgery
8.As a nurse you must explore your beliefs about medication for infants and children because research has shown which of the following?
a. Nurses are likely to over\-medicate and undermedicate children under their care.
b. Nurses tend to believe that medication will harm children more than help them.
c. It takes a lot of exploration of beliefs before a nurse can be consistent in the administration of pain medication regardless of race, gender, religion, or social status.
d. Educational level, personal pain experience, and number of years in practice influence the nurse in the decision to medicate or not medicate a child in pain.
9.A general rule that nurses can use in deciding whether an intervention or procedure would hurt a child is to ask which of the following questions?
a. Would this hurt an adult? If the answer is yes, then it would hurt a child.
b. Ask the child: Do you think this will hurt a lot, some, or not at all?
c. Ask the mother: Do you think this procedure or intervention will hurt your child?
d. Has this child had this procedure or intervention in the past? If so, what was the pain history?
10.Which of the following statements best describes the term tolerance?
a. the ability to take a particular medication without feeling worse after taking it
b. being able to take a medication even if it does have adverse side effects
c. the need to use increasing doses of a medication over time to achieve the desired result
d. putting up with taking various medications even then you do not feel they are necessary
CHAPTER 19: MEDICATION ADMINISTRATION
1.Infants and children are especially at risk for adverse reactions to medications, including age-specific adverse reactions and ineffective treatment, for which of the following reasons?
a. Drug companies make less money on pediatric clients than on other ages, so they do less
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