(Test Bank) Pediatric Nursing The Critical Components of Nursing Care

Rudd,Kocisko, 2

Nursing

Test Bank

2nd Edition

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Test Bank for Pediatric Nursing The Critical Components of Nursing Care, The downloadable file consists of 305 pages, and the total size of the file is 4.89 MB. Purchase now only for highly discounted price.

Author(s): Rudd, Kocisko

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Study Note Preview

Pediatric Nursing The Critical Components of Nursing Care 2nd Edition Rudd Test Bank Chapter 1. Issues and Trends in Pediatric Nursing MULTIPLE CHOICE 1. A nurse is reviewing changes in healthcare delivery and funding for pediatric populations. Which current trend in the pediatric setting should the nurse expect to find? a. Increased hospitalization of children b. Decreased number of uninsured children c. An increase in ambulatory care d. Decreased use of managed care ANS: C One effect of managed care is that pediatric healthcare delivery has shifted dramatically from the acute care setting to the ambulatory setting. The number of hospital beds being used has decreased as more care is provided in outpatient and home settings. The number of uninsured children in the United States continues to grow. One of the biggest changes in healthcare has been the growth of managed care. DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: Nursing Process Step: Planning MSC: Safe and Effective Care Environment 2. A nurse is referring a low -income family with three children under the age of 5 years to a program that assists with supplemental food supplies. Which program should the nurse refer this family to? a. Medicaid b. Medicare c. Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program d. Women, Infants, and Children (WIC) program ANS: D WIC is a federal program that provides supplemental food supplies to low-income women who are pregnant or breast -feeding and to their children until the age of 5 years. Medicaid and the Medicaid Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program provides for well -child examinations and related treatment of medical problems. Children in the WIC program are often referred for immunizations, but t hat is not the primary focus of the program. Public Law 99 -457 provides financial incentives to states to establish comprehensive early intervention services for infants and toddlers with, or at risk for, developmental disabilities. Medicare is the program for Senior Citizens. DIF: Cognitive Level: Application REF: p. 7 OBJ: Nursing Process Step: Implementation MSC: Health Promotion and Maintenance 3. In most states, adolescents who are not emancipated minors must have parental permission before: a. treatment for drug abuse. b. treatment for sexually transmitted diseases (STDs). c. obtaining birth control. d. surgery. ANS: D An emancipated minor is a minor child who has the legal competence of an adult. Legal counsel may be consulted to verify the status of the emancipat ed minor for consent purposes. Most states allow minors to obtain treatment for drug or alcohol abuse and STDs and allow access to birth control without parental consent. DIF: Cognitive Level: Application REF: p. 12 OBJ: Nursing Process Step: Planning MSC: Safe and Effective Care Environment 4. A nurse is completing a clinical pathway for a child admitted to the hospital with pneumonia. Which characteristic of a clinical pathway is correct? a. Developed and implemented by nurses b. Used primarily in the pediatric setting c. Specific time lines for sequencing interventions d. One of the steps in the nursing process ANS: C Clinical pathways measure outcomes of client care and are developed by multiple healthcare professionals. Each pathway outlines specific time lines for sequencing interventions and reflects interdisciplinary interventions. Clinical pathways are used in multiple settings and for clients throughout the life span. The steps of the nursing process are assessment, diagnosis, planning, implement ation, and evaluation. DIF: Cognitive Level: Comprehension REF: p. 6 OBJ: Nursing Process Step: Planning MSC: Safe and Effective Care Environment 5. When planning a parenting class, the nurse should explain that the leading cause of death in children 1 to 4 years of age in the United States is: a. premature birth. b. congenital anomalies. c. accidental death. d. respiratory tract illness. ANS: C Accidents are the leading cause of death in children ages 1 to 19 years. Disorders of short gestation and unspecified low birth weight make up one of the leading causes of death in neonates. One of the leading causes of infant death after the first month of life is congenital anomalies. Respiratory tract illnesses are a major cause of morbidity in children. DIF: Cognitive Level: Application REF: p. 9 OBJ: Nursing Process Step: Implementation MSC: Safe and Effective Care Environment 6. Which statement is true regarding the quality assurance or incident report? a. The report assures the legal department that there is no problem. b. Reports are a permanent part of the clients chart. c. The nurses notes should contain the following: Incident report filed and copy placed in chart. d. This report is a form of documentation of an event that may result in legal action. ANS: D An incident report is a warning to the legal department to be prepared for potential legal action; it is not a part of the clients chart or nurse documentation. DIF: Cognitive Level: Knowledge REF: p. 14 OBJ: Nursing Process Step: Implementation MSC: Safe and Effective Care Environment 7. Which client situation fails to meet the first requirement of informed consent? a. The parent does not understand the physicians explanations. b. The physician gives the parent only a partial list of possible side effects and complications. c. No parent is available and the physician asks the adolescent to sign the consent form. d. The infants teenage mother signs a consent form because her parent tells her to. ANS: C The first requirement of informed consent is that the person giving consent must be competent. Minors are not allowed to give consent. An understanding of information, full disclosure, and voluntary consent are requirements of informed consent, but none of these is the first requirement. DIF: Cognitive Level : Comprehension REF: p. 12 OBJ: Nursing Process Step: Implementation MSC: Safe and Effective Care Environment 8. A nurse assigned to a child does not know how to perform a treatment that has been prescribed for the child. What should the nurses first action be? a. Delay the treatment until another nurse can do it. b. Make the childs parents aware of the situation. c. Inform the nursing supervisor of the problem. d. Arrange to have the child transferred to another unit. ANS: C If a nurse is not competent to perform a particular nursing task, the nurse must immediately communicate this fact to the nursing supervisor or physician. The nurse could endanger the child by delaying the intervention until another nurse is available. Telling the childs parents would most likely increase their anxiety and will not resolve the difficulty. Transfer to another unit delays needed treatment and would create unnecessary disruption for the child and family. DIF: Cognitive Level: Application REF: p. 11 OBJ: Nursing Process Step: Impleme ntation MSC: Safe and Effective Care Environment 9. A nurse is completing a care plan for a child and is finishing the assessment phase. Which activity is not part of a nursing assessment? a. Writing nursing diagnoses b. Reviewing diagnostic reports c. Collecting data d. Setting priorities ANS: D Setting priorities is a part of planning. Writing nursing diagnoses, reviewing diagnostic reports, and collecting data are parts of assessment. DIF: Cognitive Level: Comprehension REF: p. 19 OBJ: Nursing Process Step: Planning MSC: Physiological Integrity 10. Which patient outcome is stated correctly? a. The child will administer his insulin injection before breakfast on 10/31. b. The child will accept the diagnosis of type 1 diabetes mellitus before discharge. c. The parents will understand how to determine the childs daily insulin dosage. d. The nurse will monitor blood glucose levels before meals and at bedtime. ANS: A The outcome is stated in client terms, with a measurable verb and a time frame for action. The verb accept is difficult to measure. The goal of accepting a diagnosis before hospital discharge is unrealistic. Outcomes should be stated in client terms. Nursing actions are determined after outcomes are developed in the implementation phase of the nursing process. DIF: Cognitive Level: Application REF: p. 20 OBJ: Nursing Process Step: Planning MSC: Safe and Effective Care Environment MULTIPLE RESPONSE 1. A nurse is reviewing the nursing care plan for a hospitalized child. Which statements are collaborative problems? Select all that apply. a. Risk for injury b. Potential complication of seizure disorder c. Altered nutrition: Less than body requirements d. Fluid volume deficit e. Potential complication of respiratory acidosis ANS: B, E In addition to nursing diagnoses, which describe problems that respond to independent nursing functions, nurses must also deal with problems that are beyond the scope of independent nursing practice. These are sometimes termed collaborative problems physiological complica tions that usually occur in association with a specific pathological condition or treatment. The potential complications of seizure disorder and respiratory acidosis are physiological complications that will require physician collaboration to treat. Risk f or injury, altered nutrition, and fluid volume deficit will respond to independent nursing functions. DIF: Cognitive Level: Application REF: p. 20 OBJ: Nursing Process Step: Planning MSC: Safe and Effective Care Environment 2. Which nursing activities do not meet the standard of care? Select all that apply. a. Failure to notify a physician about a childs worsening condition b. Calling the supervisor about staffing concerns c. Delegating assessment of a new admit to the Unlicensed Assistive Personnel (UAP) d. Asking the Unlicensed Assistive Personnel (UAP) to take vital signs e. Documenting that a physician was unavailable and the nursing supervisor was notified ANS: A, C A nurse who fails to notify a physician about a childs worsening condition and delegating the assessment of a new admit to a UAP do not meet the standard of care. Calling the supervisor about staffing concerns, asking the UAP to take vital signs, and documenting that a physician could not be reached and the nursing supervisor was notified all meet the standard of care. Chapter 2. Standards of Practice and Ethical Considerations Multiple Choice 1. Leah is a new graduate nurse and has questions about her scope of practice. The best place to review would be: 1. The code of ethics. 2. The standards of practice and professional performance. 3. The NCLEX exam. 4. The state licensing body. ANS : 2 Feedback 1. Applies to the accountability and protection for the public 2. Benchmark for quality and accountability to provide professional guidance 3. This is the basic exam, but it does not give guidance on this matter. 4. The state has rules and regulations, but it is not the source for overall professional accountability and guidance. 2. The Code of Ethics for Nurses is characterized by all of the following except: 1. It serves as a guide to empower individuals. 2. It upholds ethics, principles, rights, duties and virtues. 3. It is a private statement for nurses only. 4. It is a public statement for nurses and their patients. ANS: 3 Feedback 1. Part of the Code of Ethics 2. Part of the Code of Ethics 3. The Code of Ethics is not a private statement. It is for the public and nurses. 4. Part of the Code of Ethics 3. A nurse has discussed the plan of care, asked for parental input, and has spoken with the doctor about the needs of the family and patient. This nurse is exhibiting which characteristics of therapeutic relationships in pediatric medicine? 1. Goals, mutual respect/trust, and advocacy 2. Empowerment, sympathy, and empathy 3. Goals, advocacy, and sympathy 4. Respect/trust, disengagement, and sympathy ANS: 1 Feedback 1. The nurse is demonstrating all characteristics listed. 2. The nurse is not demonstrating sympathy or empathy for the patient. 3. The nurse is not demonstrating sympathy for this family. 4. The nurse is not disengaging or providing sympathy for the family. 4. A primary source for the standards of practice for pediatric nurses is: 1. Pediatric Nursing Scope and Standards of Practice . 2. Code of Ethics. 3. Nightingales Pledge. 4. None of the above. ANS: 1 Feedback 1. Reflects key themes and trends that are relevant to our time and to all pediatric health care settings, which provide the framework for the emergence of specific standards. 2. The Code of Ethics in Nursing provides a foundation for nurses and empowers them as well. 3. The pledge was part of the early Hippocratic Oath. 4. One answer is correct. 5. Sarah is a 4 -year-old patient with cystic fibrosis. She has been having increased hospitalizations and prefers to have Leah as her nurse as an inpatient. Leah has been assign ed to care for a different set of patients today, yet Sarahs mother insists on having Leah as their nurse. Which action would be best for Leah to take with Sarah and her mother? 1. Ignore the situation. 2. Speak to Sarah and her mother to discuss the importance of having another nurse, who also knows the case, care for her. 3. Let Sarahs mother and Sarah voice their reasoning for wanting Leah, and then explain the need for Leah to have a different assignment. 4. Let the charge nurse deal with the situation. ANS: 3 Feedback 1. Ignoring the situation does not demonstrate therapeutic communication. 2. Speaking with the family is important, but letting the family voice their concerns is important as well. 3. The dialogue between the patient and nurse can enhance trust and understanding so the patient can understand the situation. 4. The charge nurse may be part of the conversation, but it is important for Leah to speak too. 6. Which of the following situations would be considered a therapeutic communication challenge in pediatric nursing? 1. 1. A street -smart teenager 2. 2. A noncompliant patient and family 3. 3. A culture that the nurse has not been previously exposed to 4. 4. All of the above ANS: 4 Feedback 1. Considered a therapeutic communication challenge in pediatric nursing 2. Considered a therapeutic communication challenge in pediatric nursing 3. Considered a therapeutic communication challenge in pediatric nursing 4. All fit the criteria 7. The purpose of a Child Life Department for Family -Centered Care is: 1. To prepare the child for procedures. 2. To offer time to be a kid. 3. To provide the staff with information about child development. 4. To be the liaison between the hospital and the school system for a child. 5. 1, 2, 4 ANS: 5 Feedback 1. Preparation is an important element in caring for a child. It helps reduce anxiety and promotes a trusting relationship. 2. Playtime allows a child to cope and fosters self-expression, which reduces stress. 3. CLD is knowledgeable in child development and is present to support the child and the family, not the staff. 4. CLD provides a working relationship between the hospital and school for patients who are in the hospital long term. 5. Preparation is an important element in caring for a child. It helps reduce anxiety and promotes a trusting relationship. Playtime allows a child to cope and fosters self -expression, which reduces stress. CLD provides a working relationship between the hospital and school for patients who are in the hospital long term. 8. A nurse is discussing pain management of a 3 year-old with the parents. An important factor the nurse should mention is: 1. A child is like a mini-adult, so they cope with pain the same way. 2. Effective pain management for a child may require pharmacological and non-pharmacological methods. 3. Children use the pain scale of 0-10. 4. Pain is subjective, and all children cry when they are in pain. ANS: 2 Feedback 1. Children have a unique response to pain. 2. Pharmacological methods may work for children, but using non - pharmacological methods, such as distraction, are also beneficial. 3. Common pain scales for children consist of the FLACC and NAP. 4. Pain is subjective, but not all children will cry. Some will be irritable or withdrawn. 9. A 6-year-old boy is to receive a dose of morphine to aid in pain management after an open appendectomy. The nurse knows the correct dose for the morphine is calculated based on: 1. Age. 2. Height. 3. Body weight. 4. All of the above. ANS: 3 Feedback 1. Age is not a factor in drug calculation. 2. Height is not a factor in drug calculation. 3. Body weight is used for drug calculation. 4. Age and height do not affect drug calculation. 10. A nurse at the clinic is teaching a new mother how to give Tylenol drops to her infant. The nurse knows that the mother has an understanding of medication administration when the mother states: 1. I will give the medication as prescribed and use a teaspoon to measure the correct amount. 2. I will use a syringe to measure the correct amount and place the syringe in the side of his cheek to take the medicine. 3. I will measure the medication in a cup and place it into the bottle. 4. I will make sure he only takes the medicine until he acts like he feels better. ANS: 2 Feedback 1. A teaspoon does not give an accurate measurement for childrens medication. 2. A syringe is the best option for medication administration. Placing it in the side of the cheek enables the infant to swallow without choking. 3. This method does not ensure that the child received all the medication, especially if the entire bottle is not consumed. 4. Medication should be taken for as long as the doctor has ordered. 11. The public health nurse is working on new printed material for the pediatric clinic. The public health nurse decides more education needs to be provided on nutritious snacks for children 5 to 10 years of age. In the design process of the pamphlets, it is important for the public health nurse to: 1. Provide information at an educational level no higher than 8th grade. 2. Provide information at an education level no higher than 12th grade. 3. Provide the material in an easy manner, using acronyms to keep the pamphlet small. 4. Provide information in small print and place the pamphlet in open areas for people to take freely. ANS: 1 Feedback 1. Information should be at the 8th grade level or lower. 2. Information should be at 8th grade level or lower. 3. Acronyms may give different ideas than what the material is stating. 4. Allowing for people to take freely is good, but small print can deter someone from reading the information. Bold and bright print is best. 12. A pediatric clinic nurses main responsibilities include: 1. Assessing parenting styles. 2. Assessing readiness to learn for the patient and family. 3. Documentation of family and parental responses to education. 4. Assessing the culture of the family. 5. All of the above. 6. None of the above. ANS: 5 Feedback 1. It is a responsibility along with others. 2. It is a responsibility along with others. 3. It is a responsibility along with others. 4. It is a responsibility along with others. 5. Correct because all are responsibilities of the nurse. 6. One answer is correct. 13. Grant, who is 16, is at the pediatric clinic for his yearly checkup. The nurse requests that his father step out of the patient room because: 1. Grants father is not providing information the nurse needs. 2. Grant appears apprehensive with his father in the room. 3. Grant has a right to confidentiality to discuss his use of alcohol. 4. Privacy is not appropriate for this age range, and the father should remain in the room.