Perspectives of Pediatric Nursing Test Answers

MULTIPLE CHOICE

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 States is ranked in the middle of 20 other developed countries.
d.	The United States is ranked highest among 27 other industrialized countries.

Although the death rate has decreased, the United States still ranks last in infant mortality among nations with a population of at least 25 million. The United States has the highest infant death rate of developed nations.

DIF: Cognitive Level: Remembering REF: p. 6

TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

Which 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 period

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 unspecified low birth weight, which account for 16.5%; and maternal complications 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: p. 7 TOP: Nursing Process: Planning

MSC: Client Needs: Health Promotion and Maintenance

What is the major cause of death for children older than 1 year in the United States?

a.	Heart disease
b.	Childhood cancer
c.	Unintentional injuries
d.	Congenital anomalies

Unintentional injuries (accidents) are the leading cause of death after age 1 year through adolescence. The leading cause of death for those younger than 1 year is congenital anomalies, and childhood cancers and heart disease cause a significantly lower percentage of deaths in children older than 1 year of age.

DIF: Cognitive Level: Understanding REF: p. 7 TOP: Nursing Process: Planning

MSC: Client Needs: Health Promotion and Maintenance

In addition to injuries, what are the leading causes of death in adolescents ages 15 to 19 years?

a.	Suicide and cancer
b.	Suicide and homicide
c.	Drowning and cancer
d.	Homicide and heart disease

Suicide and homicide account 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: p. 7 TOP: Nursing Process: Planning

MSC: Client Needs: Health Promotion and Maintenance

The nurse is planning a teaching session to adolescents about deaths by unintentional injuries. Which should the nurse include in the session with regard to deaths caused by injuries?

a.	More deaths occur in males.
b.	More deaths occur in females.
c.	The pattern of deaths does not vary according to age and sex.
d.	The pattern of deaths does not vary widely among different ethnic groups.

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

What do mortality statistics describe?

a.	Disease occurring 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 more than the number of expected cases in a community

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 population at a particular time. Data regarding disease within a geographic region, or in greater than expected numbers in a community, may be extrapolated from analyzing the morbidity statistics.

DIF: Cognitive Level: Remembering REF: p. 3 TOP: Nursing Process: Planning

MSC: Client Needs: Health Promotion and Maintenance

The nurse should assess which age group for suicide ideation since suicide in which age group is the third leading cause of death?

a.	Preschoolers
b.	Young school age
c.	Middle school age
d.	Late school age and adolescents

Parents of a hospitalized toddler ask the nurse, “What is meant by family-centered care?” The nurse should respond with which statement?

a.	Family-centered care 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 child’s life.
d.	Family-centered care avoids expecting families to be part of the decision-making process.

The nurse is describing clinical reasoning to a group of nursing students. Which is most descriptive of clinical reasoning?

a.	Purposeful and goal directed
b.	A simple developmental process
c.	Based on deliberate and irrational thought
d.	Assists individuals in guessing what is most appropriate

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 child’s health and family situation

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

The nurse is talking to a group of parents of school-age children at an after-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 ethnicity.
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.

The nurse is planning care for a hospitalized preschool-aged child. Which should the nurse plan to ensure 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.

Which situation denotes a nontherapeutic nurse–patient–family relationship?

a.	The nurse is planning to read a favorite fairy tale to a patient.
b.	During shift report, the nurse is criticizing parents 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 family’s dependence on health care providers.

The nurse is aware that which age group is at risk for childhood injury because of the cognitive characteristic of magical and egocentric thinking?

a.	Preschool
b.	Young school age
c.	Middle school age
d.	Adolescent

The school nurse is assessing children for risk factors related to childhood injuries. Which child has the most risk factors related to childhood injury?

a.	Female, multiple siblings, stable home life
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

The school nurse is evaluating the number of school-age children classified as obese. The nurse recognizes that the percentile of body mass index that classifies a child as obese is greater than which?

a.	50th percentile
b.	75th percentile
c.	80th percentile
d.	95th percentile

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.”

The nurse is evaluating research studies according to the GRADE criteria and has determined the quality of evidence on the subject is moderate. Which type of evidence does this determination indicate?

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 critical outcome from randomized clinical trials had serious flaws

An adolescent patient wants to make decisions about treatment options, along with his parents. Which moral value is the nurse displaying when supporting the adolescent to make decisions?

a.	Justice
b.	Autonomy
c.	Beneficence
d.	Nonmaleficence

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

MULTIPLE RESPONSE

Which responsibilities are included in the pediatric nurse’s 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 friendships
e.	Establishing a therapeutic relationship
f.	Participating in ethical decision making

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 adequate nutrition? (Select all that apply.)

a.	Homelessness
b.	Lower income
c.	Migrant status
d.	Working parents
e.	Single parent status

The nurse is preparing to complete documentation on a patient’s chart. Which should be included in documentation of nursing care? (Select all that apply.)

a.	Reassessments
b.	Incident reports
c.	Initial assessments
d.	Nursing care provided
e.	Patient’s response of care provided

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

Which are included in the evaluation step of the nursing process? (Select all that apply.)

a.	Determination if the outcome has been met
b.	Ascertaining if the plan requires modification
c.	Establish priorities and selecting expected patient goals
d.	Selecting alternative interventions if the outcome has not been met
e.	Determining if a risk or actual dysfunctional health problem exists

Which should the nurse teach to parents regarding oral health of children? (Select all that apply.)

a.	Fluoridated water should be used.
b.	Early childhood caries is a preventable disease.
c.	Dental caries is a rare chronic disease of childhood.
d.	Dental hygiene should begin with the first tooth eruption.
e.	Childhood caries does not happen until after 2 years of age.

The school nurse is explaining to older school children that obesity increases the risk for which disorders? (Select all that apply.)

a.	Asthma
b.	Hypertension
c.	Dyslipidemia
d.	Irritable bowel disease
e.	Altered glucose metabolism

The nurse is reviewing the Healthy People 2020leading health indicators for a child health promotion program. Which are included in the leading health indicators? (Select all that apply.)

a.	Decrease tobacco use.
b.	Improve immunization rates.
c.	Reduce incidences of cancer.
d.	Increase access to health care.
e.	Decrease the number of eating disorders.

Which actions by the nurse demonstrate clinical reasoning? (Select all that apply.)

a.	Basing decisions on intuition
b.	Considering alternative action
c.	Using formal and informal thinking to gather data
d.	Giving deliberate thought to a patient’s problem
e.	Developing an outcome focused on optimum patient care

COMPLETION

The nurse is determining if a newborn is classified in the low birth weight (LBW) category of less than 2500 g. The newborn’s weight is 5 lb, 4 oz. What is the newborn’s weight in grams? Record your answer in a whole number.

__________________

ANS:

2386

Convert the 4 oz to a decimal by dividing 4 by 16 = 0.25. Use 5.25 lb and divide by 2.2 to get 2.386 kg. Multiply by 1000 to convert to grams = 2386.

DIF: Cognitive Level: Applying REF: p. 3