(Test Bank) Wong's Nursing Care of Infants and Children

Hockenberry,Wilson, 11

Nursing

Test Bank

11th Edition

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Test Bank for Wong's Nursing Care of Infants and Children, The downloadable file consists of 948 pages, and the total size of the file is 3.25 MB. Purchase now only for highly discounted price.

Author(s): Hockenberry, Wilson

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Wong's Nursing Care of Infants and Children 11th Edition Hockenberry Test Bank Chapter 1.Perspectives of Pediatric Nursing MULTIPLE CHOICE 1.The clinic nurse is reviewing statistics on infant mortality for the United States versus other countries. Compared with other countries that have a population of at least 25 million, the nurse makes which determination? a.The United States is ranked last among 27 countries. b.The United States is ranked similar to 20 other developed countries. c.The United Stat es is ranked in the middle of 20 other developed countries. d.The United States is ranked highest among 27 other industrialized countries. ANS: A Although the death rate has decreased, the United States still ranks last in infant mortality among nations with a popul ation of at least 25 milli on. The United States has the highest infant death rate of developed nations. DIF: Cognitive Level: Remembering REF: MCS: 6 TOP: N ursing Process: Assessment MSC: Cl ient Needs: H ealth P romotion and Mai ntenance 2.W hich is the leading cause of death in infants younger than 1 year in the United States? a.Congenital anomalies b.Sudden infant death syndrome c.Disorders related to short gestation and low birth weight d.Maternal complications specific to the perinatal pe riod ANS: A Congenital anomalies account for 20.1% of deaths in infants younger than 1 year compared with sudden infant death syndrome, which accounts for 8.2% ; disorders related to short gestation and unspecifie d low birth weight, whic h account for 16.5% ; and maternal co mplications such as infections specific to the perinatal period, which account for 6.1% of deaths in infants younger than 1 year of age. DIF: Cognitive Level: Remembering REF: MCS: 7 TOP: Nursing Process: Planning MSC: C lient Needs: H ealth P romotion and Maintenance 3. What i s the major caus e of death f or children o lder t han 1 y ear in the United S tates? a.Heart disease b.Childhood cancer c.Unintentional injuries d.Congenital anomalies ANS: C Unintentional injuries (a ccidents) are the leadi ng cause of death after age 1 year through adolescence. The leading cause of death for those younge r than 1 year is congenital anomalies, and childhood canc ers and heart disease cause a significantly lower pe rcentage of deaths in children older than 1 y ear of age. DIF: Cognitive Level: Understanding REF: MCS: 7 TOP: Nursing Process: Planning MSC: C lient Needs: H ealth P romotion and Mai ntenance 4. In addition to injuries, what are the leading causes of death in adolescents ages 15 to 19 years? a.Suicide an d cancer b.Suicide and homicide c.Drowning and cancer d.Homicide and heart disease ANS: B Suicide and homicide ac count for 16.7% of deaths in this age group. Suicide and cancer account for 10.9% of deaths, heart disease and cancer account for approximately 5.5%, and homicide and heart disease account for 10.9% of the deaths in this age group. DIF: Cognitive Level: Remembering REF: MCS: 7 TOP: Nursing Process: Planning MSC: C lient Needs: H ealth P romotion and Mai ntenance 5. The nurse i s planning a teaching session t o adolescents about deat hs by un intentional injuries. Which should the nurse include in the session with regar d to deaths caused by injuries? a.More deaths occur in males. b.More deaths occur in females. c.The pattern of deaths does not va ry according to age and sex. d.The pattern of deaths does not vary widely among different ethnic groups. ANS: A The majority of deaths from unintentional injuries occur in males. The pattern of death does vary greatly among different ethnic groups, and the causes of unintentional deaths vary with age and gender. DIF: Cognitive Level: Applying REF: pp. 7-8 TOP: Integrated Process: Teaching/Learning MSC: Client Needs: Health Promotion and Maintenance 6.What do mortality statistics describe? a.Disease occ urring regularly within a geographic location b.The number of individuals who have died over a specific period c.The prevalence of specific illness in the population at a particular time d. Disease occurring in m ore than the number of expe ct ed c ases i n a community ANS: B Mortality statistics refer to the number of individuals who have died over a specific period. Morbidity statistics show the prevalence of specific illness in the popul ation at a particular time. Data regarding disease within a geographi c region, or in greater than expected numbers in a community, may be extrapolated from analyzing the morbidity statistics. DIF: Cognitive Level: Remembering REF: MCS: 3 TOP: Nursing Process: Planning MSC: C lient Needs: H ealth P romotion and Mai ntenance 7. The nurse should assess which age group for suicide ideation since suicide in which age group is the third l eading caus e of death? a.Preschoolers b.Young school age c.Middle school age d.Late school age and adolescents ANS: D Suicide is th e third leading cause of death in children ages 10 to 19 years; therefore , the age group should be late school age and adolescents . Suicide is not one of the leading causes of death for preschool and young or middle school-aged children. DIF: Cognitive Level: Understanding REF: MCS: 6 TOP: N ursing Pr ocess: Assessment MSC : C lient Needs: H ealth P romotion and Mai ntenance 8. Parents of a hospitalized toddler ask the nurse, What is meant by family- centered c are? T he nurse should respond with which statement? a. Family- centered ca re reduces the effect of cultural diversity on the family. b.Family -centered care encourages family dependence on the health care system. c.Family -centered care recognizes that the family is the constant in a childs life. d.Family -centered care avoids expecting families to be part of the decision -making process. ANS: C The three key components of family-centered care are respect, collaboration, and support. Family- centered ca re recogni zes the family as the constant in t he childs life. T he famil y should be enable d and empowered to wor k with the health care system and is expecte d to be part of the decision-making process. The nurse should also support the familys cultural diversit y, not reduce its effect. DIF: Cognitive Level: Applying REF: MCS: 8 TOP: Nursing Process : Implementation MSC: Client Needs : Health P romotion and Maintenance 9. The nurse is describing clinical reasoning t o a group of nursing students . Which is most descriptive of clinical reasoning? a.Purposeful and goal directed b.A sim ple developmental process c.Based on deliberate and irrational thought d.Assists individuals in guessing what is most appropriate ANS: A Clinical reasoning is a complex developmental process based on rational and deliberate thought. When thinking is clear, p recise, accu rate, r elevant, cons istent, and fair, a logical connection develops between the elements of thought and the problem at hand. DIF: Cognitive Level: Applying REF: MCS: 12 TOP: I ntegrated P rocess: T eaching/Learning MSC: Client Needs: Health P romotion and Maintenance 10. Evidence- based practice (EBP), a decision -making model, is best described as which? a.Using information in textbooks to guide care b.Combining knowledge with clinical experience and intuition c.Using a professional code of ethics as a means for decision making d.Gathering all evidence that applies to the childs health and family situation ANS: B EBP helps focus on measurable outcomes; the use of demonstrated, effective interventions; and questioni ng what is the best approach. EBP involves decision making based on data, not all evidence on a particular situation, and involve s the latest av ailable data. Nurses can use textbooks to determine areas of concern and potential involvement. DIF: Cognitive Level: Remembering REF: MCS: 11 TOP: Nursing Process: Planning MSC: C lient Needs: S afe and E ffective Care Environment 11. Which best describes signs and symptoms as part of a nursing diagnosis? a.Description of potential risk factors b.Identification of actual health problems c.Human response to state of illness or health d.Cues and clusters derived from patient assessment ANS: D Signs and symptoms are the cues and clusters of defining characteristics that are derived from a patient assessment and indicate actual health probl ems. The first part of the nursing diagnosis is the problem statement, also known as the human response to the state of illness or health. The identification of actual health problems may be part of the medical diagnosis. The nursing diagnosis is based on the human response to these problems. The human response is therefore a component of the nursing diagnostic statement. Potential ris k factors are used to identify nursing care needs to avoid the development of an actual health problem when a potential one exists. DIF: Cognitive Level: Understanding REF: MCS: 13 TOP: Integrated Process: Communication and Documentation MSC: C lient Needs: S afe and E ffective Care Environment 12. The nurse is talking to a group of parents of school- age children a t an a fter-school program about childhood health problems . Which statement should the nurse include in the teaching? a.Childhood obesity is the most common nutritional problem among children. b.Immunization rates are the same among children of different races and ethnici ty. c.Dental caries is not a problem commonly seen in children since the introduction of fluoridated water. d.Mental health problems are typically not seen in school -age children but may be diagnosed in adolescents. ANS: A When t eaching par ents of sch ool-age children about childhood health problems, the nurse should include information about childhood obesity because it is the most common problem among children and is associated with type 2 diabetes . Teaching parents about ways to prevent obesity is important to include . Immunizati on rates differ depending on the childs race and ethnicity; dental caries continues to be a common chronic dis ease in childhood; and mental he alth p roblems are seen in children as young as school age, not just in adolescents. DIF: Cognitive Level: Applying REF: MCS: 3 TOP: I ntegrated P rocess: T eaching/Learning MSC: C lient Needs: H ealth P romotion and Mai ntenance 13. The nurse is planning care for a hospitalized preschool-aged child. Which should the nurse plan to en sure atraumatic care? a. Limit explanation of procedures because the child is preschool aged. b. Ask that all family members leave the room when performing procedures. c. Allow the child to choose the type of juice to drink with the administration of oral medications. d. Explain that EMLA cream cannot be used for the morning lab draw because there is not time for it to be effective. ANS: C The overriding goal in providing atraumatic care is first, do no harm. Allowing the child a choice of juice to drink when taking oral medications provides the child with a sense of control. The preschool child should be prepared before procedures, so limiting explanations of procedures would increase anxiety. The family should be allowed to stay with the child during procedures, minimizing stress. Lidocaine/prilocaine (EMLA) cream is a topical local anesthetic. The nurse should plan to use the prescribed cream in time for morning laboratory draws to minimize pain. DIF: Cognitive Level: Applying REF: pp. 8-9 TOP: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance 14. Which situation denotes a nontherapeutic nursepatientfamily relationship? a. The nurse is planning to read a favorite fairy tale to a patient. b. During shift report, the nurse is criticizing par ents for not visiting their child. c. The nurse is discussing with a fellow nurse the emotional draw to a certain patient. d. The nurse is working with a family to find ways to decrease the familys dependence on health care providers. ANS: B Criticizing parents for not visiting in shift report is nontherapeutic and shows an underinvolvement with the parents. Reading a fairy tale is a therapeutic and age appropriate action. Discussing feelings of an emotional draw with a fellow nurse is therapeutic and shows a willingness to understand feelings . Working with parents t o decrease dependence on health care providers is therapeutic and helps to empower the family. DIF: Cognitive Level: Analyzing REF: MCS: 9 TOP: Integrated Process: Caring MSC: C lient Needs: P sychosocial Integrity 15. The nurse is aware that which age group is at risk for childhood injur y because of the cognitive characteristic of magical a nd egoc entric thinking? a.Preschool b.Young school age c.Middle school age d.Adolescent ANS: A Preschool children have the cognitive characteristic of magical and egocentric thinkin g, meaning they are unable to comprehend danger to self or others. Young and middle school-aged children have transitional cognitive processes, and they may attempt dangerous acts without detailed planning but recognize danger to themselves or others. Adolescents have formal operational cognitive processes and are preoccupied with abstract thinking. DIF: Cognitive Level: Understanding REF: MCS: 4 TOP: N ursing Process: Assessment MSC: C lient Needs: S afe and Effective Care Environment 16. The school nurse is assessing children for risk factors related t o childhood injuries . Which child has the most risk factors related to childhood injury? a.Female, multiple siblings, stable home li fe b.Male, high activity level, stressful home life c.Male, even tempered, history of previous injuries d. Female, reacts negatively to new situations, no serious previous injuries ANS: B Boys have a preponderance for injuries over girls because of a difference in behavioral characteristics, a high ac tivity t emperament is as sociated w ith risk-taking behaviors , and stress predisposes children t o increased risk taking and self-destructive behaviors. T herefore, a male child with a high activity level and living in a stressful environment has the highest number of risk f actors. A gi rl with s everal siblings and a stable h ome lif e is low risk. A boy with pr e vious injuries has two risk factors, but an even temper is not a risk factor for injuries. A girl who r eacts negatively to new situations but has no previous serious illnesses has only one risk factor. DIF: Cognitive Level: Analyzing REF: MCS: 4 TOP: N ursing Pr ocess: Assessment MSC: C lient Needs: S afe and E ffective Care Environment 17. The school nurse is eva l uating the number of school- age children cl assified as obese. T he nurse recognizes that the percentile of body mass index t hat classifies a child as obese is greater than which? a.50th percentile b.75th percentile c.80th percentile d.95th percenti le ANS: D Obesity i n children a nd adolescents is defined as a body mass index at or greater than the 95th percentile for youth of the same age and gender. DIF: Cognitive Level: Remembering REF: MCS: 3 TOP: Nursing Process: Evaluation MSC: C lient Needs: H ealth Promotion and Maintenance 18. The nurse is teaching parents about the types of behaviors children exhibit when living with chronic violence. Which statement made by the parents indicates further teaching is needed? a.We should watch for aggressive play . b.Our child may show lasting symptoms of stress. c.We know that our child will show caring behaviors. d.Our child may have difficulty concentrating in school. ANS: C The statement that the child will show caring behaviors needs further teaching. Children living with chronic violence may exhibit behaviors such as difficulty concentrating in school , memory impairment, aggressive play, uncaring behaviors, and lasting symptoms of stress. DIF: Cognitive Level: Applying REF: MCS: 6 TOP: I ntegrated P rocess: Teaching/Learning MSC: C lient Needs: H ealth P romotion and Mai ntenance 19. The nurse is evaluating research studi es according to the GRADE cr iteria and has determined the quality of evidence on the subject is moderate . Which type of evidence does this determination indi cate? a.Strong evidence from unbiased observational studies b.Evidence from randomized clinical trials showed inconsistent results c.Consistent evidence from well -performed randomized clinical trials d.Evidence for at least one critica l outcome from randomized clinical trials had serious flaws ANS: B Evidence from randomized clinical trials with important limitations indicates that the evidence is of moderate quality. Strong evidence from unbiased observational studies and consistent evidence from well -performed randomized clinical trials indicates high quality. Evidence for at least one cr itical outcome f rom ra ndomized c lin ical trials th at has s erious fla ws indi cates low quality. DIF: Cognitive Level: Remembering REF: MCS: 12 TOP: Nursing Process: Evaluation MSC: Client Needs: S afe and E ffective Care Environment 20. An adolescent patient wants to make decisions about treatment options, along with his parents. Which moral value is the nurse displaying when supporti ng the adolescent to make decisions? a.Justice b.Autonomy c.Beneficence d.Nonmaleficence ANS: B Autonomy is the patients right to be self-governing. The adolescent is trying to be autonomous, so the nurse is supporting this value. Justice is the concept of fairness. Benefi cence is the obligation to prom ote the pa tients w ell-being. Nonmaleficence is the obligation to minimize or prevent harm. DIF: Cognitive Level: Analyzing REF: MCS: 11 TOP: Nursing Process: Evaluation MSC: C lient Needs: H ealth P romotion and Mai ntenance 21. The nurse manager is compiling a report for a hospital committee on the quality of nursing- sensitive indicators for a nursing unit. Which does the nurse manager include in the report? a.The average age of the nurses on the unit b.The salary ranges for the nurses on the unit c.The education and certification of the nurses on the unit d.The number of nurses who have applied but were not hired for the unit ANS: C Nursing- sensitive indicators reflect the structure, pr ocess, an d outcomes of nursing care. F or example, the number of nursing staff, the skill level of the nursing staff, and the education and certificati on of nursing staff indicate the structure of nursing care. The average age of the nurses, salar y range, and number of nurses who have applied but were not hired for the unit are not nursing-s ensitive indicators. DIF: Cognitive Level: Applying REF: MCS: 15 TOP: Integrated Process: Communication and Documentation MSC: C lient Needs: S afe and E ffective Care Environment MULTIPLE RESPONSE 1. Which responsibilities are included in the pediatric nurses promotion of the health and well- being of children? (Select all that apply.) a.Promoting disease prevention b.Providing financial assistance c.Providing support and counseling d.Establishing lifelong f riendships e.Establishing a therapeutic relationship f.Participating in ethical decision making ANS: A, C, E, F The pediatric nurses role includes promoting disease prevention, providing support and counseling, establishing a therapeutic relationship, and participating in ethical decision making; a pediatric nurse does not need to establish lifelong friendships or provide financial assistance to children and their families. Boundaries should be set and clear. DIF: Cognitive Level: Applying REF: pp. 9-11 TOP: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance 2. The nurse is conducting a teaching session for parents on nutrition. Which characteristics of families should the nurse consider that can cause families to struggle in providing adequatenutrition? (Select all that apply.) a.Homelessness b.Lower income c.Migrant status d.Working parents e.Single parent status ANS: A, B, C Famili es that st ruggle with l ower incomes, ho melessness, and migrant st atus generally lack the resources to provide their children with adequate food intake , nutritious foods such as fresh fruits and vegetables, and appropriate protein intake. Working parents and single parent status do not mean the families will struggle to provide adequate nut rition. DIF: Cognitive Level: Applying REF: MCS: 2 TOP: I ntegrated P rocess: T eaching/Learning MSC: C lient Needs: H ealth P romotion and Mai ntenance 3. The nurse is preparing to complete documentation on a patients chart. Which should be included in documentat ion of nursing care? (Select all that apply.) a.Reassessments b.Incident reports c.Initial assessments d.Nursing care provided e.Patients response of care provided ANS: A, C, D, E The patients medical r ecord shoul d inc lude: initial asse ssments, r eassessments, nur si ng care provided, and the patients response of care provided. Incident reports are not documented in the patients chart. DIF: Cognitive Level: Applying REF: MCS: 14 TOP: Integrated Process: Communication and Documentation MSC: C lient Needs: S afe and E ffective Care Environment 4. Which actions by the nurse demonstrate overinvolvement with patients and their families? (Select all that apply.) a.Buying clothes for the patients b.Showing favoritism toward a patient c.Focusing on technical aspects of care d.Spending off -duty time with patients and families e.Asking questions if families are not participating in care ANS: A, B, D Actions that show overinvolvement include buying clothes for patients, showing favoritism toward a patient, a nd spending off -duty time with patients and families. Focusing on technical aspects of care is an action that indicates underinvolvement, and asking questions if families are not participating in care indicates a positive action. DIF: Cognitive Level: Analyzing REF: pp. 9- 10 TOP: Integrated Process: Caring MSC: Client Needs: Health Promotion and Maintenance 5. Which are included in the evaluation step of the nursing process? (Select all that apply.) a.Determination if the outcome has been met