Wong Essentials of Pediatric Nursing, 10th Edition Test Bank

<< Williams Basic Nutrition & Diet Therapy, 14e (LPN Threads) 14th Edition by Staci Nix Test Bank Addiction Treatment 4th Edition by Katherine Test Bank >>
Product Code: 222
Availability: In Stock
Price: $24.99
Qty:     - OR -   Add to Wish List
Add to Compare

Wong Essentials of Pediatric Nursing, 10th Edition Test Bank

Description

WITH ANSWERS
Wongs Essentials of Pediatric Nursing, 10th Edition Test Bank

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

Hockenberry: Wongs Essentials of Pediatric Nursing, 10th Edition

 

MULTIPLE CHOICE

 

  1. A nurse is selecting a family theory to assess a patients family dynamics. Which family theory best describes a series of tasks for the family throughout its life span?
a. Interactional theory
b. Developmental systems theory
c. Structural-functional theory
d. Duvalls developmental theory

 

 

ANS:  D

Duvalls developmental theory describes eight developmental tasks of the family throughout its life span. Interactional theory and structural-functional theory are not family theories. Developmental systems theory is an outgrowth of Duvalls theory. The family is described as a small group, a semiclosed system of personalities that interact with the larger cultural system. Changes do not occur in one part of the family without changes in others.

 

DIF:    Cognitive Level: Understand          REF:   p. 17

TOP:   Integrated Process: Nursing Process: Assessment

MSC:  Area of Client Needs: Health Promotion and Maintenance

 

  1. Which family theory explains how families react to stressful events and suggests factors that promote adaptation to these events?
a. Interactional theory
b. Developmental systems theory
c. Family stress theory
d. Duvalls developmental theory

 

 

ANS:  C

Family stress theory explains the reaction of families to stressful events. In addition, the theory helps suggest factors that promote adaptation to the stress. Stressors, both positive and negative, are cumulative and affect the family. Adaptation requires a change in family structure or interaction. Interactional theory is not a family theory. Interactions are the basis of general systems theory. Developmental systems theory is an outgrowth of Duvalls theory. The family is described as a small group, a semiclosed system of personalities that interact with the larger cultural system. Changes do not occur in one part of the family without changes in others. Duvalls developmental theory describes eight developmental tasks of the family throughout its life span.

 

DIF:    Cognitive Level: Understand          REF:   p. 16

TOP:   Integrated Process: Nursing Process: Assessment

MSC:  Area of Client Needs: Health Promotion and Maintenance

 

  1. Which is the term for a family in which the paternal grandmother, the parents, and two minor children live together?
a. Blended
b. Nuclear
c. Binuclear
d. Extended

 

 

ANS:  D

An extended family contains at least one parent, one or more children, and one or more members (related or unrelated) other than a parent or sibling. A blended family contains at least one stepparent, step-sibling, or half-sibling. The nuclear family consists of two parents and their children. No other relatives or nonrelatives are present in the household. In binuclear families, parents continue the parenting role while terminating the spousal unit. For example, when joint custody is assigned by the court, each parent has equal rights and responsibilities for the minor child or children.

 

DIF:    Cognitive Level: Remember           REF:   p. 18

TOP:   Integrated Process: Nursing Process: Planning

MSC:  Area of Client Needs: Health Promotion and Maintenance

 

  1. A nurse is assessing a familys structure. Which describes a family in which a mother, her children, and a stepfather live together?
a. Blended
b. Nuclear
c. Binuclear
d. Extended

 

 

ANS:  A

A blended family contains at least one stepparent, step-sibling, or half-sibling. The nuclear family consists of two parents and their children. No other relatives or nonrelatives are present in the household. In binuclear families, parents continue the parenting role while terminating the spousal unit. For example, when joint custody is assigned by the court, each parent has equal rights and responsibilities for the minor child or children. An extended family contains at least one parent, one or more children, and one or more members (related or unrelated) other than a parent or sibling.

 

DIF:    Cognitive Level: Understand          REF:   p. 18

TOP:   Integrated Process: Nursing Process: Assessment

MSC:  Area of Client Needs: Health Promotion and Maintenance

 

  1. Parents of a firstborn child are asking whether it is normal for their child to be extremely competitive. The nurse should respond to the parents that studies about the ordinal position of children suggest that firstborn children tend to:
a. be praised less often.
b. be more achievement oriented.
c. be more popular with the peer group.
d. identify with peer group more than parents.

 

 

ANS:  B

Firstborn children, like only children, tend to be more achievement oriented. Being praised less often, being more popular with the peer group, and identifying with peer groups more than parents are characteristics of later-born children.

 

DIF:    Cognitive Level: Apply                  REF:   p. 29

TOP:   Integrated Process: Nursing Process: Implementation

MSC:  Area of Client Needs: Health Promotion and Maintenance

 

  1. The nurse is teaching a group of new parents about the experience of role transition. Which statement by a parent would indicate a correct understanding of the teaching?
a. My marital relationship can have a positive or negative effect on the role transition.
b. If an infant has special care needs, the parents sense of confidence in their new role is strengthened.
c. Young parents can adjust to the new role easier than older parents.
d. A parents previous experience with children makes the role transition more difficult.

 

 

ANS:  A

If parents are supportive of each other, they can serve as positive influences on establishing satisfying parental roles. When marital tensions alter caregiving routines and interfere with the enjoyment of the infant, then the marital relationship has a negative effect. Infants with special care needs can be a significant source of added stress. Older parents are usually more able to cope with the greater financial responsibilities, changes in sleeping habits, and reduced time for each other and other children. Parents who have previous experience with parenting appear more relaxed, have less conflict in disciplinary relationships, and are more aware of normal growth and development.

 

DIF:    Cognitive Level: Understand          REF:   p. 17

TOP:   Integrated Process: Nursing Process: Evaluation

MSC:  Area of Client Needs: Health Promotion and Maintenance

 

  1. When assessing a family, the nurse determines that the parents exert little or no control over their children. What is this style of parenting called?
a. Permissive
b. Dictatorial
c. Democratic
d. Authoritarian

 

 

ANS:  A

Permissive parents avoid imposing their own standards of conduct and allow their children to regulate their own activity as much as possible. The parents exert little or no control over their childrens actions. Dictatorial or authoritarian parents attempt to control their childrens behavior and attitudes through unquestioned mandates. They establish rules and regulations or standards of conduct that they expect to be followed rigidly and unquestioningly. Democratic parents combine permissive and dictatorial styles. They direct their childrens behavior and attitudes by emphasizing the reasons for rules and negatively reinforcing deviations. They respect the childs individual nature.

 

DIF:    Cognitive Level: Remember           REF:   p. 20

TOP:   Integrated Process: Nursing Process: Diagnosis

MSC:  Area of Client Needs: Health Promotion and Maintenance

 

  1. When discussing discipline with the mother of a 4-year-old child, the nurse should include which instruction?
a. Children as young as 4 years old rarely need to be punished.
b. Parental control should be consistent.
c. Withdrawal of love and approval is effective at this age.
d. One should expect rules to be followed rigidly and unquestioningly.

 

 

ANS:  B

For effective discipline, parents must be consistent and must follow through with agreed-on actions. Realistic goals should be set for this age group. Parents should structure the environment to prevent unnecessary difficulties. Requests for behavior change should be phrased in a positive manner to provide direction for the child. Withdrawal of love and approval is never appropriate or effective. Discipline strategies should be appropriate to the childs age, temperament, and severity of the misbehavior. Following rules rigidly and unquestioningly is beyond the developmental capabilities of a 4-year-old.

 

DIF:    Cognitive Level: Apply                  REF:   p. 20

TOP:   Integrated Process: Teaching/Learning

MSC:  Area of Client Needs: Health Promotion and Maintenance

 

  1. Which is most characteristic of the physical punishment of children, such as spanking?
a. Psychological impact is usually minimal.
b. Children rarely become accustomed to spanking.
c. Childrens development of reasoning increases.
d. Misbehavior is likely to occur when parents are not present.

 

 

ANS:  D

Through the use of physical punishment, children learn what they should not do. When parents are not around, it is more likely that children will misbehave because they have not learned to behave well for their own sake, but rather out of fear of punishment. Spanking can cause severe physical and psychological injury and interfere with effective parent-child interaction. Children do become accustomed to spanking, requiring more severe corporal punishment each time. The use of corporal punishment may interfere with the childs development of moral reasoning.

 

DIF:    Cognitive Level: Understand          REF:   p. 20

TOP:   Integrated Process: Teaching/Learning

MSC:  Area of Client Needs: Health Promotion and Maintenance

 

  1. A 3-year-old girl was adopted immediately after birth. The parents have just asked the nurse how they should tell the child that she is adopted. Which guidelines concerning adoption should the nurse use in planning a response?
a. Telling the child is an important aspect of their parental responsibilities.
b. The best time to tell the child is between ages 7 and 10 years.
c. It is not necessary to tell the child who was adopted so young.
d. It is best to wait until the child asks about it.

 

 

ANS:  A

It is important for the parents not to withhold information about the adoption from the child. It is an essential component of the childs identity. There is no recommended best time to tell children. It is believed that children should be told young enough so they do not remember a time when they did not know. It should be done before the children enter school to keep third parties from telling the children before the parents have had the opportunity.

 

DIF:    Cognitive Level: Understand          REF:   p. 22

TOP:   Integrated Process: Teaching/Learning

MSC:  Area of Client Needs: Health Promotion and Maintenance

 

  1. A parent of a school-age child is going through a divorce. The parent tells the school nurse the child has not been doing well in school and sometimes has trouble sleeping. The nurse should recognize this as which implication?
a. Indication of maladjustment
b. Common reaction to divorce
c. Lack of adequate parenting
d. Unusual response that indicates need for referral

 

 

ANS:  B

Parental divorce affects school-age children in many ways. In addition to difficulties in school, they often have profound sadness, depression, fear, insecurity, frequent crying, loss of appetite, and sleep disorders. This is not an indication of maladjustment, suggestive of lack of adequate parenting, or an unusual response that indicates need for referral in school-age children after parental divorce.

 

DIF:    Cognitive Level: Apply                  REF:   p. 24

TOP:   Integrated Process: Teaching/Learning

MSC:  Area of Client Needs: Psychosocial Integrity

 

  1. A mother brings 6-month-old Eric to the clinic for a well-baby checkup. She comments, I want to go back to work, but I dont want Eric to suffer because Ill have less time with him. The nurses most appropriate answer would be which statement?
a. Im sure hell be fine if you get a good babysitter.
b. You will need to stay home until Eric starts school.
c. You should go back to work so Eric will get used to being with others.
d. Lets talk about the child care options that will be best for Eric.

 

 

ANS:  D

Lets talk about the child care options that will be best for Eric is an open-ended statement that will assist the mother in exploring her concerns about what is best for both her and Eric. Im sure hell be fine if you get a good babysitter, You will need to stay home until Eric starts school, and You should go back to work so Eric will get used to being with others are directive statements. They do not address the effect of her working on Eric.

 

DIF:    Cognitive Level: Apply                  REF:   p. 27

TOP:   Integrated Process: Communication and Documentation

MSC:  Area of Client Needs: Psychosocial Integrity

 

  1. Which term best describes a group of people who share a set of values, beliefs, practices, social relationships, law, politics, economics, and norms of behavior?
a. Race
b. Culture
c. Ethnicity
d. Social group

 

 

ANS:  B

Culture is a pattern of assumptions, beliefs, and practices that unconsciously frames or guides the outlook and decisions of a group of people. A culture is composed of individuals who share a set of values, beliefs, and practices that serve as a frame of reference for individual perceptions and judgments. Race is defined as a division of humankind possessing traits that are transmissible by descent and are sufficient to characterize it as a distinct human type. Ethnicity is an affiliation of a set of persons who share a unique cultural, social, and linguistic heritage. A social group consists of systems of roles carried out in groups. Examples of primary social groups include the family and peer groups.

 

DIF:    Cognitive Level: Remember           REF:   p. 29

TOP:   Integrated Process: Nursing Process: Assessment

MSC:  Area of Client Needs: Psychosocial Integrity

 

  1. Which term best describes the emotional attitude that ones own ethnic group is superior to others?
a. Culture
b. Ethnicity
c. Superiority
d. Ethnocentrism

 

 

ANS:  D

Ethnocentrism is the belief that ones way of living and behaving is the best way. This includes the emotional attitude that the values, beliefs, and perceptions of ones ethnic group are superior to those of others. Culture is a pattern of assumptions, beliefs, and practices that unconsciously frames or guides the outlook and decisions of a group of people. A culture is composed of individuals who share a set of values, beliefs, and practices that serves as a frame of reference for individual perception and judgments. Ethnicity is an affiliation of a set of persons who share a unique cultural, social, and linguistic heritage. Superiority is the state or quality of being superior; it does not include ethnicity.

 

DIF:    Cognitive Level: Understand          REF:   p. 30

TOP:   Integrated Process: Nursing Process: Assessment

MSC:  Area of Client Needs: Psychosocial Integrity

 

MULTIPLE RESPONSE

 

  1. Dunst, Trivette, and Deal identified the qualities of strong families that help them function effectively. Which qualities are included? (Select all that apply.)
a. Ability to stay connected without spending time together
b. Clear set of family values, rules, and beliefs
c. Adoption of one coping strategy that always promotes positive functioning in dealing with life events
d. Sense of commitment toward growth of individual family members as opposed to that of the family unit
e. Ability to engage in problem-solving activities
f. Sense of balance between the use of internal and external family resources

 

 

ANS:  B, E, F

A clear set of family rules, values, and beliefs that establishes expectations about acceptable and desired behavior is one of the qualities of strong families that help them function effectively. Strong families also are able to engage in problem-solving activities and to find a balance between internal and external forces. Strong families have a sense of congruence among family members regarding the value and importance of assigning time and energy to meet needs. Strong families also use varied coping strategies. The sense of commitment is toward the growth and well-being of individual family members, as well as the family unit.

 

DIF:    Cognitive Level: Understand          REF:   p. 19

TOP:   Integrated Process: Nursing Process: Diagnosis

MSC:  Area of Client Needs: Health Promotion and Maintenance

 

  1. A nurse is conducting a teaching session on the use of time-out as a discipline measure to parents of toddlers. Which are correct strategies the nurse should include in the teaching session? (Select all that apply.)
a. Time-out as a discipline measure cannot be used when in a public place.
b. A rule for the length of time-out is 1 minute per year.
c. When the child misbehaves, one warning should be given.
d. The area for time-out can be in the family room where the child can see the television.
e. When the child is quiet for the specified time, he or she can leave the room.

 

 

ANS:  B, C, E

A rule for the length of time-out is 1 minute per year of age; use a kitchen timer with an audible bell to record the time rather than a watch. When the child misbehaves, one warning should be given. When the child is quiet for the duration of the time, he or she can then leave the room. Time-out can be used in public places and the parents should be consistent on the use of time-out. Implement time-out in a public place by selecting a suitable area or explain to children that time-out will be spent immediately on returning home. The time-out should not be spent in an area from which the child can view the television. Select an area for time-out that is safe, convenient, and unstimulating but where the child can be monitored, such as the bathroom, hallway, or laundry room.

 

DIF:    Cognitive Level: Apply                  REF:   p. 21

TOP:   Integrated Process: Teaching/Learning

MSC:  Area of Client Needs: Health Promotion and Maintenance

 

  1. Divorced parents of a preschool child are asking whether their child will display any feelings or behaviors related to the effect of the divorce. The nurse is correct when explaining that the parents should be prepared for which types of behaviors? (Select all that apply.)
a. Displaying fears of abandonment
b. Verbalizing that he or she is the reason for the divorce
c. Displaying fear regarding the future
d. Ability to disengage from the divorce proceedings
e. Engaging in fantasy to understand the divorce

 

 

ANS:  A, B, E

A child 3 to 5 years of age (preschool) may display fears of abandonment, verbalize feelings that he or she is the reason for the divorce, and engage in fantasy to understand the divorce. He or she would not be displaying fear regarding the future until school age, and the ability to disengage from the divorce proceedings would be characteristic of an adolescent.

 

DIF:    Cognitive Level: Apply                  REF:   p. 24

TOP:   Integrated Process: Nursing Process: Implementation

MSC:  Area of Client Needs: Teaching and Learning

 

COMPLETION

 

  1. A nurse is admitting a child, in foster care, to the hospital. The nurse recognizes that foster parents care for the child _____ hours a day. (Record your answer as a whole number.)

 

ANS:

24

 

The term foster care is defined as 24-hour substitute care for children outside of their own homes.

 

DIF:    Cognitive Level: Understand          REF:   p. 27

TOP:   Integrated Process: Nursing Process: Assessment

MSC:  Area of Client Needs: Health Promotion and Maintenance

 

Chapter 10: Health Problems of Infants

Hockenberry: Wongs Essentials of Pediatric Nursing, 10th Edition

 

MULTIPLE CHOICE

 

  1. Recent studies indicate that a deficiency of which vitamin correlates with increased morbidity and mortality in children with measles?
a. A
b. C
c. Niacin
d. Folic acid

 

 

ANS:  A

Vitamin A deficiency is correlated with increased morbidity and mortality in children with measles. This vitamin deficiency also is associated with complications from diarrhea, and infections are often increased in infants and children with vitamin A deficiency. No correlation exists between vitamin C, niacin, or folic acid and measles.

 

DIF:    Cognitive Level: Remember           REF:   p. 331

TOP:   Integrated Process: Nursing Process: Assessment

MSC:  Area of Client Needs: Physiologic Integrity

 

  1. Which vitamin is recommended for all women of childbearing age to reduce the risk of neural tube defects such as spina bifida?
a. A
b. C
c. Niacin
d. Folic acid

 

 

ANS:  D

The vitamin supplement that is recommended for all women of childbearing age is a daily dose of 0.4 mg of folic acid. Folic acid taken before conception and during pregnancy can reduce the risk of neural tube defects by 70%. No correlation exists between vitamins A, C, or folic acid and neural tube defects.

 

DIF:    Cognitive Level: Remember           REF:   p. 331

TOP:   Integrated Process: Nursing Process: Assessment

MSC:  Area of Client Needs: Physiologic Integrity

 

  1. A nurse is assessing a child with kwashiorkor disease. Which assessment findings should the nurse expect?
a. Thin wasted extremities with a prominent abdomen
b. Constipation
c. Elevated hemoglobin
d. High levels of protein

 

 

ANS:  A

The child with kwashiorkor has thin, wasted extremities and a prominent abdomen from edema (ascites). Diarrhea (persistent diarrhea malnutrition syndrome) not constipation commonly occurs from a lowered resistance to infection and further complicates the electrolyte imbalance. Anemia and protein deficiency are common findings in malnourished children with kwashiorkor.

 

DIF:    Cognitive Level: Understand          REF:   p. 332

TOP:   Integrated Process: Nursing Process: Assessment

MSC:  Area of Client Needs: Physiologic Integrity

 

  1. A nurse is preparing to accompany a medical missions team to a third world country. Marasmus is seen frequently in children 6 months to 2 years in this country. Which symptoms should the nurse expect for this condition?
a. Loose, wrinkled skin
b. Edematous skin
c. Depigmentation of the skin
d. Dermatoses

 

 

ANS:  A

Marasmus is characterized by gradual wasting and atrophy of body tissues, especially of subcutaneous fat. The child appears to be very old, with loose and wrinkled skin, unlike the child with kwashiorkor, who appears more rounded from the edema. Fat metabolism is less impaired than in kwashiorkor; thus, deficiency of fat-soluble vitamins is usually minimal or absent. In general, the clinical manifestations of marasmus are similar to those seen in kwashiorkor with the following exceptions: With marasmus, there is no edema from hypoalbuminemia or sodium retention, which contributes to a severely emaciated appearance; no dermatoses caused by vitamin deficiencies; little or no depigmentation of hair or skin; moderately normal fat metabolism and lipid absorption; and a smaller head size and slower recovery after treatment.

 

DIF:    Cognitive Level: Understand          REF:   p. 332

TOP:   Integrated Process: Nursing Process: Assessment

MSC:  Area of Client Needs: Physiologic Integrity

 

  1. Rickets is caused by a deficiency in:
a. vitamin A.
b. vitamin C.
c. vitamin D and calcium.
d. folic acid and iron.

 

 

ANS:  C

Fat-soluble vitamin D and calcium are necessary in adequate amounts to prevent the development of rickets. No correlation exists between vitamins A, C, folic acid, or iron and rickets.

 

DIF:    Cognitive Level: Remember           REF:   p. 330

TOP:   Integrated Process: Nursing Process: Assessment

MSC:  Area of Client Needs: Physiologic Integrity

 

  1. A nurse is preparing to administer an oral iron supplement to a hospitalized infant. Which should not be given simultaneously with the iron supplement?
a. Milk
b. Multivitamin
c. Fruit juice
d. Meat, fish, poultry

 

 

ANS:  A

Many foods interfere with iron absorption and should be avoided when the iron is consumed. These foods include phosphates found in milk, phytates found in cereals, and oxalates found in many vegetables. Multivitamins may contain iron; no contraindication exists to taking the two together. Vitamin Ccontaining juices enhance the absorption of iron. Meat, fish, and poultry do not have an effect on absorption.

 

DIF:    Cognitive Level: Understand          REF:   p. 331

TOP:   Integrated Process: Nursing Process: Implementation

MSC:  Area of Client Needs: Physiologic Integrity

 

  1. Parents report that they have been giving a multivitamin to their 1-year-old infant. The nurse counsels the parents that which vitamin can cause a toxic reaction at a low dose?
a. Niacin
b. B6
c. D
d. C

 

 

ANS:  C

Hypervitaminosis of vitamin D presents the greatest problem because this fat-soluble vitamin is stored in the body. Vitamin D is the most likely of all vitamins to cause toxic reactions in relatively small overdoses. The water-soluble vitamins, primarily niacin, B6, and C, can also cause toxicity but not at the low dose that occurs with vitamin D.

 

DIF:    Cognitive Level: Understand          REF:   p. 331

TOP:   Integrated Process: Teaching/Learning

MSC:  Area of Client Needs: Physiologic Integrity

 

  1. The nurse is helping parents achieve a more nutritionally adequate vegetarian diet for their child. Which is most likely lacking in their particular diet?
a. Fat
b. Protein
c. Vitamins C and A
d. Complete protein

 

 

ANS:  D

The vegetarian diet can be extremely healthy, meeting the overall nutrition objectives for Healthy People. Parents should be taught about food preparation to ensure that complete proteins are available for growth. When parents use a strict vegetarian diet, likelihood exists of inadequate protein for growth and calories for energy. Fat and vitamins C and A are readily available from vegetable sources. Plant proteins are available. Foods must be combined to provide complete proteins for growth.

 

DIF:    Cognitive Level: Understand          REF:   p. 331

TOP:   Integrated Process: Teaching/Learning

MSC:  Area of Client Needs: Physiologic Integrity

 

  1. Which describes marasmus?
a. Deficiency of protein with an adequate supply of calories
b. Not confined to geographic areas where food supplies are inadequate
c. Syndrome that results solely from vitamin deficiencies
d. Characterized by thin, wasted extremities and a prominent abdomen resulting from edema (ascites)

 

 

ANS:  B

Marasmus is a syndrome of emotional and physical deprivation. It is not confined to geographic areas were food supplies are inadequate. Marasmus is a deficiency of both protein and calories. It is characterized by gradual wasting and atrophy of body tissues, especially of subcutaneous fat. The child appears very old, with flabby and wrinkled skin.

 

DIF:    Cognitive Level: Remember           REF:   p. 332

TOP:   Integrated Process: Nursing Process: Assessment

MSC:  Area of Client Needs: Physiologic Integrity

 

  1. Although infants may be allergic to a variety of foods, the most common allergens are:
a. fruit and eggs.
b. fruit, vegetables, and wheat.
c. cows milk and green vegetables.
d. eggs, cows milk, and wheat.

 

 

ANS:  D

Milk products, eggs, and wheat are three of the most common food allergens. Ingestion of these products can cause sensitization and, with subsequent exposure, an allergic reaction. Eggs are a common allergen, but fruit is not. Wheat is a common allergen, but fruit and vegetables are not. Cows milk is a common allergen, but green vegetables are not.

 

DIF:    Cognitive Level: Remember           REF:   p. 333

TOP:   Integrated Process: Nursing Process: Assessment

MSC:  Area of Client Needs: Physiologic Integrity

 

  1. Cows milk allergy (CMA) is diagnosed in a 6-month-old infant. Which should the nurse recommend as a substitute formula?
a. Nutramigen
b. Goats milk
c. Similac
d. Enfamil

 

 

ANS:  A

Treatment of CMA is elimination of cows milkbased formula and all other dairy products. For infants fed cows milk formula, this primarily involves changing the formula to a casein hydrolysate milk formula (Pregestimil, Nutramigen, or Alimentum). Goats milk (raw) is not an acceptable substitute because it cross-reacts with cows milk protein, is deficient in folic acid, has a high sodium and protein content, and is unsuitable as the only source of calories. Cows milk protein is contained in both Enfamil and Similac.

 

DIF:    Cognitive Level: Apply                  REF:   p. 336

TOP:   Integrated Process: Teaching/Learning

MSC:  Area of Client Needs: Physiologic Integrity

 

  1. A nurse is teaching parents about prevention and treatment of colic. Which should the nurse include in the teaching plan?
a. Avoid use of pacifiers.
b. Eliminate all second-hand smoke contact.
c. Lay infant flat after feeding.
d. Avoid swaddling the infant.

 

 

ANS:  B

To prevent and treat colic, teach parents that if household members smoke, avoid smoking near infant; preferably confine smoking activity to outside of home. A pacifier can be introduced for added sucking. The infant should be swaddled tightly with a soft, stretchy blanket and placed in an upright seat after feedings.

 

DIF:    Cognitive Level: Apply                  REF:   p. 336

TOP:   Integrated Process: Teaching/Learning

MSC:  Area of Client Needs: Physiologic Integrity

 

  1. A parent of an infant with colic tells the nurse, All this baby does is scream at me; it is a constant worry. What is the nurses best action?
a. Encourage parent to verbalize feelings.
b. Encourage parent not to worry so much.
c. Assess parent for other signs of inadequate parenting.
d. Reassure parent that colic rarely lasts past age 9 months.

 

 

ANS:  A

Colic is multifactorial, and no single treatment is effective for all infants. The parent is verbalizing concern and worry. The nurse should allow the parent to put these feelings into words. An empathic, gentle, and reassuring attitude, in addition to suggestions about remedies, will help alleviate the parents anxieties. The nurse should reassure the parent that he or she is not doing anything wrong. Colic is multifactorial. The infant with colic is experiencing spasmodic pain that is manifested by loud crying, in some cases up to 3 hours each day. Telling the parent that it will eventually go away does not help him or her through the current situation.

 

DIF:    Cognitive Level: Apply                  REF:   p. 342

TOP:   Integrated Process: Teaching/Learning

MSC:  Area of Client Needs: Psychosocial Integrity

 

  1. Parent guidelines for relieving colic in an infant include:
a. avoiding touching abdomen.
b. avoiding using a pacifier.
c. changing infants position frequently.
d. placing infant where family cannot hear the crying.

 

 

ANS:  C

Changing the infants position frequently may be beneficial. The parent can walk holding the child face down and with the childs chest across the parents arm. The parents hand can support the childs abdomen, applying gentle pressure. Gently massaging the abdomen is effective in some children. Pacifiers can be used for meeting additional sucking needs. The child should not be placed where monitoring cannot be done. The child can be placed in the crib and allowed to cry. Periodically, the child should be picked up and comforted.

 

DIF:    Cognitive Level: Apply                  REF:   p. 342

TOP:   Integrated Process: Teaching/Learning

MSC:  Area of Client Needs: Physiologic Integrity

 

  1. Clinical manifestations of failure to thrive caused by behavioral problems resulting in inadequate intake of calories include:
a. avoidance of eye contact.
b. an associated malabsorption defect.
c. weight that falls below the 15th percentile.
d. normal achievement of developmental landmarks.

 

 

ANS:  A

One of the clinical manifestations of nonorganic failure to thrive is the childs avoidance of eye contact with the health professional. A malabsorption defect would result in a physiologic problem, not behavioral. Weight (but not height) below the 5th percentile is indicative of failure to thrive. Developmental delays, including social, motor, adaptive, and language, exist.

 

DIF:    Cognitive Level: Understand          REF:   p. 337

TOP:   Integrated Process: Nursing Process: Assessment

MSC:  Area of Client Needs: Physiologic Integrity

 

  1. Which is an important nursing consideration when caring for an infant with failure to thrive?
a. Establish a structured routine and follow it consistently.
b. Maintain a nondistracting environment by not speaking to child during feeding.
c. Place child in an infant seat during feedings to prevent overstimulation.
d. Limit sensory stimulation and play activities to alleviate fatigue.

 

 

ANS:  A

The infant with failure to thrive should have a structured routine that is followed consistently. Disruptions in other activities of daily living can have a great impact on feeding behaviors. Bathing, sleeping, dressing, playing, and feeding are structured. The nurse should talk to the child by giving directions about eating. This will help the child maintain focus. Young children should be held while being fed, and older children can sit at a feeding table. The child should be fed in the same manner at each meal. The child can engage in sensory and play activities at times other than mealtime.

 

DIF:    Cognitive Level: Apply                  REF:   p. 337

TOP:   Integrated Process: Nursing Process: Implementation

MSC:  Area of Client Needs: Physiologic Integrity

 

  1. What is an important nursing responsibility when dealing with a family experiencing the loss of an infant from sudden infant death syndrome (SIDS)?
a. Explain how SIDS could have been predicted and prevented.
b. Interview parents in depth concerning the circumstances surrounding the childs death.
c. Discourage parents from making a last visit with the infant.
d. Make a follow-up home visit to parents as soon as possible after the childs death.

 

 

ANS:  D

A competent, qualified professional should visit the family at home as soon as possible after the death and provide the family with printed information about SIDS. An explanation of how SIDS could have been predicted and prevented is inappropriate. SIDS cannot be prevented or predicted. Discussions about the cause will only increase parental guilt. The parents should be asked only factual questions to determine the cause of death. Parents should be allowed and encouraged to make a last visit with their child.

 

DIF:    Cognitive Level: Apply                  REF:   p. 343

TOP:   Integrated Process: Nursing Process: Implementation

MSC:  Area of Client Needs: Psychosocial Integrity

 

  1. Which is an appropriate action when an infant becomes apneic?
a. Shake vigorously
b. Roll head side to side
c. Hold by feet upside down with head supported
d. Gently stimulate trunk by patting or rubbing

 

 

ANS:  D

If the infant is apneic, the infants trunk should be gently stimulated by patting or rubbing. If the infant is prone, turn onto the back. The infant should not be shaken vigorously, the head rolled side to side, or held by the feet upside down with the head supported. These can cause injury.

 

DIF:    Cognitive Level: Apply                  REF:   p. 349

TOP:   Integrated Process: Nursing Process: Implementation

MSC:  Area of Client Needs: Physiologic Integrity

 

  1. To prevent plagiocephaly, the nurse should teach parents to:
a. place infant prone for 30 to 60 minutes per day.
b. buy a soft mattress.
c. allow infant to nap in the car safety seat.
d. have infant sleep with the parents.

 

 

ANS:  A

Prevention of positional plagiocephaly may begin shortly after birth by implementing prone positioning or tummy time for approximately 30 to 60 minutes per day when the infant is awake. Soft mattresses or sleeping with parents (co-sleeping) are not recommended because they put the infant at a higher risk for a sudden infant death incident. To prevent plagiocephaly, prolonged placement in car safety seats should be avoided.

 

DIF:    Cognitive Level: Apply                  REF:   p. 348

TOP:   Integrated Process: Teaching/Learning

MSC:  Area of Client Needs: Physiologic Integrity

 

  1. An infant has been pronounced dead from sudden infant death syndrome (SIDS) in the emergency department. Which is an appropriate question to ask the parents?
a. Did you hear the infant cry out?
b. Why didnt you check on the infant earlier?
c. What time did you find the infant?
d. Was the head buried in a blanket?

 

 

ANS:  C

During a SIDS incident, if the infant is not pronounced dead at the scene, he or she may be transported to the emergency department to be pronounced dead by a physician. While they are in the emergency department, the parents are asked only factual questions, such as when they found the infant, how he or she looked, and whom they called for help. The nurse avoids any remarks that may suggest responsibility, such as Why didnt you go in earlier? Didnt you hear the infant cry out? Was the head buried in a blanket?

 

DIF:    Cognitive Level: Apply                  REF:   p. 347

TOP:   Integrated Process: Nursing Process: Implementation

MSC:  Area of Client Needs: Psychosocial Integrity

 

  1. An infant experienced an apparent life-threatening event (ALTE) and is being placed on home apnea monitoring. Parents have understood the instructions for use of a home apnea monitor when they state?
a. We can adjust the monitor to eliminate false alarms.
b. We should sleep in the same bed as our monitored infant.
c. We will check the monitor several times a day to be sure the alarm is working.
d. We will place the monitor in the crib with our infant.

 

 

ANS:  C

The parents should check the monitor several times a day to be sure the alarm is working and that it can be heard from room to room. The parents should not adjust the monitor to eliminate false alarms. Adjustments could compromise the monitors effectiveness. The monitor should be placed on a firm surface away from the crib and drapes. The parents should not sleep in the same bed as the monitored infant.

 

DIF:    Cognitive Level: Apply                  REF:   p. 349

TOP:   Integrated Process: Teaching/Learning

MSC:  Area of Client Needs: Physiologic Integrity

 

  1. What should the nurse suggest to the parents of an infant who has a prolonged need for middle-of-the-night feedings?
a. Decrease daytime feedings.
b. Allow child to go to sleep with a bottle.
c. Offer last feeding as late as possible at night.
d. Put infant to bed after asleep from rocking.

 

 

ANS:  C

To manage an infant who has a prolonged need for middle-of-the-night feedings parents should be taught to offer last feeding as late as possible at night. Parent should increase daytime feeding intervals to 4 hours or more (may need to be done gradually), offer no bottles in bed, put to bed awake and when child is crying, check at progressively longer intervals each night; reassure child but do not hold, rock, take to parents bed, or give bottle or pacifier.

 

DIF:    Cognitive Level: Apply                  REF:   p. 349

TOP:   Integrated Process: Nursing Process: Implementation

MSC:  Area of Client Needs: Psychosocial Integrity

 

  1. A nurse is preparing to feed a 12-month-old infant with failure to thrive. Which intervention should the nurse implement?
a. Provide stimulation during feeding.
b. Avoid being persistent during feeding time.
c. Limit feeding time to 10 minutes.
d. Maintain a face-to-face posture with the infant during feeding.

 

 

ANS:  D

The nurse preparing to feed an infant with failure to thrive should maintain a face-to-face posture with the infant when possible. Encourage eye contact and remain with the infant throughout the meal. Stimulation is not recommended; a quiet, unstimulating atmosphere should be maintained. Persistence during feeding may need to be implemented. Calm perseverance through 10 to 15 minutes of food refusal will eventually diminish negative behavior. Although forced feeding is avoided, strictly encouraged feeding is essential. The length of the feeding should be established (usually 30 minutes); limiting the feeding to 10 minutes would make the infant feel rushed.

 

DIF:    Cognitive Level: Apply                  REF:   p. 342

TOP:   Integrated Process: Nursing Process: Implementation

MSC:  Area of Client Needs: Physiologic Integrity

 

  1. A nurse is teaching a parent of an infant about treatment of seborrhea dermatitis (cradle cap). Which should the nurse include in the instructions?
a. Shampoo every three days with a mild soap.
b. The hair should be shampooed with a medicated shampoo.
c. Shampoo every day with an antiseborrheic shampoo.
d. The loosened crusts should not be removed with a fine-toothed comb.

 

 

ANS:  C

When seborrheic lesions are present, the treatment is directed at removing the crusts. Parents are taught the appropriate procedure to clean the scalp. Shampooing should be done daily with a mild soap or commercial baby shampoo; medicated shampoos are not necessary, but an antiseborrheic shampoo containing sulfur and salicylic acid may be used. Shampoo is applied to the scalp and allowed to remain on the scalp until the crusts soften. Then the scalp is thoroughly rinsed. A fine-tooth comb or a soft facial brush helps remove the loosened crusts from the strands of hair after shampooing.

 

DIF:    Cognitive Level: Apply                  REF:   p. 346

TOP:   Integrated Process: Teaching/Learning

MSC:  Area of Client Needs: Physiologic Integrity

 

MULTIPLE RESPONSE

 

  1. After the introduction of the Back to Sleep campaign in 1992, an increased incidence has been noted of which of the following pediatric disorders? (Select all that apply.)
a. SIDS
b. Torticollis
c. Failure to thrive
d. Apnea of infancy
e. Plagiocephaly

 

 

ANS:  B, E

Plagiocephaly is a misshapen head caused by the prolonged pressure on one side of the skull. If that side becomes misshapen, facial asymmetry may result. The sternocleidomastoid muscle may tighten on the affected side, causing torticollis. SIDS has decreased by more than 40% with the introduction of the Back to Sleep campaign. Apnea of infancy and failure to thrive are unrelated to the Back to Sleep campaign.

 

DIF:    Cognitive Level: Understand          REF:   p. 346

TOP:   Integrated Process: Nursing Process: Assessment

MSC:  Area of Client Needs: Physiologic Integrity

 

  1. A nurse is conducting education classes for parents of infants. The nurse plans to discuss sudden infant death syndrome (SIDS). Which risk factors should the nurse include as increasing an infants risk of a sudden infant death syndrome incident? (Select all that apply.)
a. Breastfeeding
b. Low Apgar scores
c. Male sex
d. Birth weight in the 50th or higher percentile
e. Recent viral illness

 

 

ANS:  B, C, E

Certain groups of infants are at increased risk for SIDS: low birth weight, low Apgar scores, recent viral illness, and male sex. Breastfed infants and infants of average or above average weight are not at higher risk for SIDS.

 

DIF:    Cognitive Level: Understand          REF:   p. 336

TOP:   Integrated Process: Teaching/Learning

MSC:  Area of Client Needs: Health Promotion and Maintenance

 

  1. An infant has been diagnosed with cows milk allergy. What are the clinical manifestations the nurse expects to assess? (Select all that apply.)
a. Pink mucous membranes
b. Vomiting
c. Rhinitis
d. Abdominal pain
e. Moist skin

 

 

ANS:  B, C, D

An infant with cows milk allergy will possibly have vomiting, rhinitis, and abdominal pain. The mucous membranes may be pale due to anemia from blood lost in the GI tract, and the skin will be itchy with the possibility of atopic dermatitis.

 

DIF:    Cognitive Level: Understand          REF:   p. 346

TOP:   Integrated Process: Nursing Process: Assessment

MSC:  Area of Client Needs: Physiologic Integrity

 

  1. Which interventions should the nurse implement when caring for a family of a sudden infant death syndrome (SIDS) infant? (Select all that apply.)
a.

Write a review

Your Name:


Your Review: Note: HTML is not translated!

Rating: Bad           Good

Enter the code in the box below:



 

Once the order is placed, the order will be delivered to your email less than 24 hours, mostly within 4 hours. 

If you have questions, you can contact us here