Chapter 32 End of Chapter Questions 1. A 5-year-old boy visits the pediatric office with an upper respiratory infection. Which approach would give the nurse the most information about the child’s developmental level? a. b. c. d. Playing a game with the child. Talking with the child about the teddy bear next to him. Using a screening tool during a follow-up office visit. Asking the 10-year-old sibling about the child. 2. Which statement indicates the best sequence for the nurse to conduct an assessment in a nonemergency situation? a. Introduce yourself, ask about any problems, take a history, and do the physical examination. b. Perform the physical examination and then ask the family if there are any problems in the child’s life. c. Do the physical examination while at the same time asking about the child’s previous illnesses; then talk about the family’s concerns. d. Get a complete history of the family’s health beliefs and practices, and then assess the child. 3. What approach by the nurse would most likely encourage a child to cooperate with an assessment of physical and developmental health? a. b. c. d. Explain to the child what’s going to happen when the child asks questions. Explain what is going to happen in words the child can understand. Force the child to cooperate by having a parent hold him or her down. Give the child a sticker before beginning the examination. 4. A sleeping 5-month-old girl is being held by the mother when the nurse comes in to do a physical examination. What assessment should be done initially? a. b. c. d. Listening to the bowel sounds Counting the heart rate Checking the temperature Looking in the ears 5. Which assessment finding is considered normal in children? a. b. c. d. Irregular respiratory rate and rhythm Split S2 and sinus arrhythmia Decreased heart rate with crying Genu varum past the age of 5 years Chapter 33 End of Chapter Questions 1. The nurse is preparing a 5-year-old boy for surgery on his lower leg. His mother is helping him into the hospital gown and the boy fights removal of his underwear. What is the most appropriate nursing action? a. b. c. d. Allow the mother to remove the underwear. Tell the boy he is acting childishly. Notify the OR that the underwear is on. Allow the boy to keep his underwear on. 2. A 6-month-old infant requires restraint to prevent removal of his nasogastric tube. What is the priority nursing intervention? a. b. c. d. Tie the restraint loosely to prevent skin breakdown. Leave the baby unrestrained when directly observed. Position the restrained infant prone to prevent aspiration. Place the infant in a room near the nurses’ station. 3. A 10-year-old child on a regular diet refuses to eat the food on her meal tray. She requests chicken nuggets, French fries, and ice cream. What is the best nursing action? a. b. c. d. Ask that the child’s desired foods be sent up from the kitchen. Negotiate with the child to eat at least part of the food on the tray. Remove a privilege. Offer the child cereal and milk from stock on the nursing unit. 4. The nurse providing home care to a 2-year-old listens to the child’s parents talk about how the child and family are adjusting to the child’s current illness. Which of the following roles is the nurse participating in? a. b. c. d. Case management Child and family advocacy Direct nursing care Child and family education 5. A child is to undergo a tympanostomy tube placement in a freestanding outpatient surgery center. What is the major disadvantage associated with this location? a. b. c. d. Increased risk for infection Increased health care costs Need to be transferred if overnight stay is required Increased disruption of family functioning Chapter 35 End of Chapter questions 1. A 3-year-old child is to receive a medication that is supplied as an enteric-coated tablet. What is the best nursing action? a. Crush the tablet and mix it with apple sauce. b. Dissolve the medication in the child’s milk. c. Place a pill in the posterior part of the pharynx and tell the child to swallow. d. Check with the prescriber to see if an alternative form can be used. 2. The nurse is caring for an infant who weighs 8.2 kg and is NPO and receiving IV fluid therapy. What rate does the nurse calculate as meeting the child’s daily fluid requirements? a. 82 mL per hour b. 41 mL per hour c. 34 mL per hour d. 22 mL per hour 100mlx8.2kg=820ml/24 hours in a day=34.2 3. When administering ear drops to a 2-year-old, which action would be most appropriate? a. b. c. d. 4. Tell the child that the drops are to treat his infection. Pull the pinna of the child’s ear down and back. Have the child turn his head to the opposite side after giving the drops. Massage the child’s forehead to facilitate absorption of the medication. An infant is to receive intermittent gavage feedings via a nasogastric tube every 6 hours. The feeding tube was inserted with a previous feeding and remains in place. The nurse is preparing to administer the next scheduled feeding. Place the events in the proper sequence. a. Check the placement of the feeding tube. b. c. d. e. f. Position the infant on his right side with the head of the bed slightly elevated. Allow the feeding to come to room temperature. Flush the tube with water. Clamp the tube to prevent air from entering the stomach. Pour the solution into the barrel of the syringe. C, A, F, D, E, B Chapter 36 End of Chapter Questions 1. The nurse is preparing to assess the pain of a 3-year-old child who had surgery the day before. Which pain assessment method would be most appropriate for the nurse to use? a. b. c. d. FACES pain rating scale and poker chip tool FACES pain rating scale, observation of the child, and parent report Asking the parents to rate their child’s pain using the word-graphic rating scale Visual analog scale 2. When developing the plan of care for a child in pain, the nurse identifies appropriate strategies aimed at modifying which factors influencing pain? a. b. c. d. Gender Cognitive level Previous pain experiences Anticipatory anxiety 3. An adolescent who is a competitive swimmer comes to the emergency department complaining of localized aching pain in his shoulder. He states, “I’ve been practicing really hard and long to get myself ready for my meet this weekend.” The area is tender to the touch. The nurse determines that the adolescent is most likely experiencing which type of pain? a. b. c. d. 4. Cutaneous pain Deep somatic pain Visceral pain Neuropathic pain After teaching a child’s parents about the different methods of distraction that can be used for pain management, which statement by the parents indicates a need for additional teaching? a. b. c. d. “We’ll have her focus on her hand and count each finger slowly.” “We’ll read some of her favorite stories to her.” “We’ll have her imagine that she’s at the beach this summer.” “She likes to play video games, so we’ll bring in some from home.” 5. A child is scheduled for a bone marrow aspiration at 4 p.m. The nurse would plan to apply EMLA cream to the intended site at which time? a. b. c. d. 1:30 p.m. 3:00 p.m. 3:30 p.m. 4:00 p.m. Chapter 37 End of Chapter Questions 1. Compared with adults, why are infants and children at an increased risk for infection and communicable diseases? a. The infant has had limited exposure to disease and is losing the passive immunity acquired from maternal antibodies. b. The infant demonstrates an increased inflammatory response. c. Cellular immunity is not functional at birth. d. Infants have an increased risk for infection until they receive their first set of immunizations. 2. A mother calls the clinic because her 2-year-old daughter has a rectal temperature of 37.8°C (100°F). She wonders how high a fever should be before she should give medications to reduce it. What is the best response by the nurse? a. “All fevers should be treated to prevent seizures.” b. “Antipyretics should be used with any rise in temperature. They can help change the course of the infection.” c. “Give your child aspirin when her fever is above 38°C (100.4°F).” d. “In a normal healthy child, if your child is not uncomfortable, fevers less than 39°C (102.2°F) do not require medication.” 3. A neonate should be evaluated by a physician if which signs and symptoms are present? a. Acting fussier than normal b. Refusing the pacifier c. Rectal temperature above 38°C (100.4) d. Mottling that is present during bathing 4. The public health nurse has been asked to provide information to local child care centers on controlling the spread of infectious diseases. What is the best information the nurse can provide? a. The etiology of common infectious diseases b. Proper handwashing techniques c. The physiology of the immune system d. Why children are at a higher risk of infection than adults Chapter 38 1. When compared with adults, why are infants and children at an increased risk of head trauma? a. The head of the infant and young child is large in proportion to the body and the neck muscles are not well developed. b. The development of the nervous system is complete at birth but remains immature. c. The spine is very immobile in infants and young children. d. The skull is more flexible due to the presence of sutures and fontanels. 2. At a well-child visit, hydrocephalus may be suspected in an infant if upon assessment the nurse finds a. narrow sutures. b. sunken fontanels. c. a rapid increase in head circumference. d. increase in weight since last visit. 3. A 10-year-old child is admitted to the hospital due to history of seizure activity. As his nurse, you are called into the room by his mother, who states he is having a seizure. What would be the priority nursing intervention? a. Prevention of injury by removing the child from his bed b. Prevention of injury by placing a tongue blade in the child’s mouth c. Prevention of injury by restraining the child d. Prevention of injury by placing the child on his side and opening his airway 4. A 6-month-old infant is admitted to the hospital with suspected bacterial meningitis. She is crying, irritable, and lying in the opisthotonic position. The priority nursing intervention would be a. educate the family on ways to prevent bacterial meningitis. b. initiate appropriate isolation precautions and begin intravenous antibiotics. c. assess the infant’s fontanels. d. encourage the mother to hold the infant and feed her.
