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ch4 Flashcards

1
Q
  1. A nurse is planning a teaching session for parents of preschool children. Which state-ment explains why the nurse should include information about morbidity and mortality?
    a. Life span statistics are included in the data.
    b. It explains effectiveness of treatment.
    c. Cost-effective treatment is detailed for the general population.
    d. High-risk age groups for certain disorders or hazards are identified.
A

ANS: D
Analysis of morbidity and mortality data provides the parents with information about which groups of individuals are at risk for which health problems. Life span statistics is a part of the mortality data. Treatment modalities and cost are not included in morbidity and mortality data.

DIF: Cognitive Level: Apply REF: p. 11
TOP: Integrated Process: Nursing Process: Planning
MSC: Area of Client Needs: Health Promotion and Maintenance

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2
Q
  1. A clinic nurse is planning a teaching session about childhood obesity prevention for parents of school-age children. The nurse should include which associated risk of obesity in the teaching plan?
    a. Type I diabetes
    b. Respiratory disease
    c. Celiac disease
    d. Type II diabetes
A

ANS: D
Childhood obesity has been associated with the rise of type II diabetes in children. Type I dia-betes is not associated with obesity and has a genetic component. Respiratory disease is not as-sociated with obesity, and celiac disease is the inability to metabolize gluten in foods and is not associated with obesity.

DIF: Cognitive Level: Apply REF: p. 2
TOP: Integrated Process: Nursing Process: Planning
MSC: Area of Client Needs: Health Promotion and Maintenance

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3
Q
  1. Which is the leading cause of death in infants younger than 1 year?
    a. Congenital anomalies
    b. Sudden infant death syndrome
    c. Respiratory distress syndrome
    d. Bacterial sepsis of the newborn
A

ANS: A
Congenital anomalies account for 20.1% of deaths in infants younger than 1 year. Sudden infant death syndrome accounts for 8.2% of deaths in this age group. Respiratory distress syndrome accounts for 3.4% of deaths in this age group. Infections specific to the perinatal period account for 2.7% of deaths in this age group.

DIF: Cognitive Level: Remember REF: p. 6
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance

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4
Q

Which leading cause of death topic should the nurse emphasize to a group of African-American boys ranging in age from 15 to 19 years?

a. Suicide
b. Cancer
c. Firearm homicide
d. Occupational injuries

A

ANS: C
Firearm homicide is the second overall cause of death in this age group and the leading cause of death in African-American males. Suicide is the third-leading cause of death in this population. Cancer, although a major health problem, is the fourth-leading cause of death in this age group. Occupational injuries do not contribute to a significant death rate for this age group

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5
Q
  1. Which is the major cause of death for children older than 1 year?
    a. Cancer
    b. Heart disease
    c. Unintentional injuries
    d. Congenital anomalies
A 
ANS:	C
Unintentional injuries (accidents) are the leading cause of death after age 1 year through ado-lescence. Congenital anomalies are the leading cause of death in those younger than 1 year. Cancer ranks either second or fourth, depending on the age group, and heart disease ranks fifth in the majority of the age groups.

DIF: Cognitive Level: Remember REF: p. 7
TOP: Integrated Process: Nursing Process: Planning
MSC: Area of Client Needs: Health Promotion and Maintenance

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6
Q
  1. Which is the leading cause of death from unintentional injuries for females ranging in age from 1 to 14?
    a. Mechanical suffocation
    b. Drowning
    c. Motor vehicle–related fatalities
    d. Fire- and burn-related fatalities
A

ANS: C
Motor vehicle–related fatalities are the leading cause of death for females ranging in age from 1 to 14, either as passengers or as pedestrians. Mechanical suffocation is fourth or fifth, depending on the age. Drowning is the second- or third-leading cause of death, depending on the age. Fire- and burn-related fatalities are the second-leading cause of death.

DIF: Cognitive Level: Remember REF: p. 3
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance

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7
Q

Which factor most impacts the type of injury a child is susceptible to, according to the child’s age?

a. Physical health of the child
b. Developmental level of the child
c. Educational level of the child
d. Number of responsible adults in the home

A

ANS: B
The child’s developmental stage determines the type of injury that is likely to occur. The child’s physical health may facilitate the child’s recovery from an injury but does not impact the type of injury. Educational level is related to developmental level, but it is not as important as the child’s developmental level in determining the type of injury. The number of responsible adults in the home may affect the number of unintentional injuries, but the type of injury is re-lated to the child’s developmental stage.

DIF: Cognitive Level: Understand REF: p. 3
TOP: Integrated Process: Nursing Process: Planning
MSC: Area of Client Needs: Health Promotion and Maintenance

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8
Q
  1. Which is now referred to as the “new morbidity”?
    a. Limitations in the major activities of daily living
    b. Unintentional injuries that cause chronic health problems
    c. Discoveries of new therapies to treat health problems
    d. Behavioral, social, and educational problems that alter health
A

ANS: D
The new morbidity reflects the behavioral, social, and educational problems that interfere with the child’s social and academic development. It is currently estimated that the incidence of these issues is from 5% to 30%. Limitations in major activities of daily living and unintentional injuries that result in chronic health problems are included in morbidity data. Discovery of new therapies would be reflected in changes in morbidity data over time

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9
Q

A nurse on a pediatric unit is practicing family-centered care. Which is most descriptive of the care the nurse is delivering?

a. Taking over total care of the child to reduce stress on the family
b. Encouraging family dependence on health care systems
c. Recognizing that the family is the constant in a child’s life
d. Excluding families from the decision-making process

A

ANS: C
The three key components of family-centered care are respect, collaboration, and support. Fam-ily-centered care recognizes the family as the constant in the child’s life. Taking over total care does not include the family in the process and may increase stress instead of reducing stress. The family should be enabled and empowered to work with the health care system. The family is expected to be part of the decision-making process.

DIF: Cognitive Level: Remember REF: p. 7
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Health Promotion and Maintenance

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10
Q
  1. The nurse is preparing an in-service education to staff about atraumatic care for pediat-ric patients. Which intervention should the nurse include?
    a. Prepare the child for separation from parents during hospitalization by reviewing a video.
    b. Prepare the child before any unfamiliar treatment or procedure by demonstrating on a stuffed animal.
    c. Help the child accept the loss of control as-sociated with hospitalization.
    d. Help the child accept pain that is connected with a treatment or procedure.
A

ANS: B
Preparing the child for any unfamiliar treatments, controlling pain, allowing privacy, providing play activities for expression of fear and aggression, providing choices, and respecting cultural differences are components of atraumatic care. In the provision of atraumatic care, the separa-tion of child from parents during hospitalization is minimized. The nurse should promote a sense of control for the child. Preventing and minimizing bodily injury and pain are major components of atraumatic care.

DIF: Cognitive Level: Understand REF: p. 8
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Psychosocial Integrity

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11
Q

Which is most suggestive that a nurse has a nontherapeutic relationship with a patient and fam-ily?

a. Staff is concerned about the nurse’s actions with the patient and family.
b. Staff assignments allow the nurse to care for same patient and family over an extended time.
c. Nurse is able to withdraw emotionally when emotional overload occurs but still remains committed.
d. Nurse uses teaching skills to instruct patient and family rather than doing everything for them.

A

ANS: A
An clue to a nontherapeutic staff-patient relationship is concern of other staff members. Allow-ing the nurse to care for the same patient over time would be therapeutic for the patient and family. Nurses who are able to somewhat withdraw emotionally can protect themselves while providing therapeutic care. Nurses using teaching skills to instruct patient and family will assist in transitioning the child and family to self-care.

DIF: Cognitive Level: Analyze REF: p. 8
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Psychosocial Integrity

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12
Q
  1. Which is most descriptive of clinical reasoning?
    a. A simple developmental process
    b. Purposeful and goal-directed
    c. Based on deliberate and irrational thought
    d. Assists individuals in guessing what is most appropriate
A

ANS: B
Clinical reasoning is a complex, developmental process based on rational and deliberate thought. Clinical reasoning is not a developmental process. Clinical reasoning is based on ra-tional and deliberate thought. Clinical reasoning is not a guessing process.

DIF: Cognitive Level: Understand REF: p. 10
TOP: Integrated Process: Nursing Process: Planning
MSC: Area of Client Needs: Safe and Effective Care Environment: Management of Care

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13
Q

A nurse makes the decision to apply a topical anesthetic to a child’s skin before drawing blood. Which ethical principle is the nurse demonstrating?

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

A

ANS: B
Beneficence is the obligation to promote the patient’s well-being. Applying a topical anesthetic before drawing blood promotes reducing the discomfort of the venipuncture. Autonomy is the patient’s right to be self-governing. Justice is the concept of fairness. Truthfulness is the con-cept of honesty.

DIF: Cognitive Level: Understand REF: p. 10
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Physiological Integrity

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14
Q
  1. Which action by the nurse demonstrates use of evidence-based practice (EBP)?
    a. Gathering equipment for a procedure
    b. Documenting changes in a patient’s status
    c. Questioning the use of daily central line dressing changes
    d. Clarifying a physician’s prescription for morphine
A

ANS: C
The nurse who questions the daily central line dressing change is ascertaining whether clinical interventions result in positive outcomes for patients. This demonstrates EBP, which implies questioning why something is effective and whether a better approach exists. Gathering equip-ment for a procedure and documenting changes in a patient’s status are practices that follow established guidelines. Clarifying a physician’s prescription for morphine constitutes safe nurs-ing care.

DIF: Cognitive Level: Apply REF: p. 10
TOP: Integrated Process: Nursing Process: Evaluation
MSC: Area of Client Needs: Safe and Effective Care Environment: Management of Care

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15
Q
  1. A nurse is admitting a toddler to the hospital. The toddler is with both parents and is currently sitting comfortably on a parent’s lap. The parents state they will need to leave for a brief period. Which type of nursing diagnosis should the nurse formulate for this child?
    a. Risk for anxiety
    b. Anxiety
    c. Readiness for enhanced coping
    d. Ineffective coping
A

ANS: A
A potential problem is categorized as a risk. The toddler has a risk to become anxious when the parents leave. Nursing interventions will be geared toward reducing the risk. The child is not showing current anxiety or ineffective coping. The child is not at a point for readiness for en-hanced coping, especially because the parents will be leaving.

DIF: Cognitive Level: Remember REF: p. 11
TOP: Integrated Process: Nursing Process: Diagnosis
MSC: Area of Client Needs: Health Promotion and Maintenance

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16
Q

A child has a postoperative appendectomy incision covered by a dressing. The nurse has just completed a prescribed dressing change for this child. Which description is an accurate documentation of this procedure?

a. Dressing change to appendectomy incision completed, child tolerated procedure well, parent present
b. No complications noted during dressing change to appendectomy incision
c. Appendectomy incision non-reddened, su-tures intact, no drainage noted on old dress-ing, new dressing applied, procedure tolerat-ed well by child
d. No changes to appendectomy incisional area, dressing changed, child complained of pain during procedure, new dressing clean, dry and intact

A

ANS: C
The nurse should document assessments and reassessments. Appearance of the incision de-scribed in objective terms should be included during a dressing change. The nurse should doc-ument patient’s response and the outcomes of the care provided. In this example, these include drainage on the old dressing, the application of the new dressing, and the child’s response. The other statements partially fulfill the requirements of documenting assessments and reassess-ments, patient’s response, and outcome, but do not include all three.

DIF: Cognitive Level: Analyze REF: p. 12
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Safe and Effective Care Environment: Management of Care

17
Q

A nurse is planning a class on accident prevention for parents of toddlers. Which safety topic is the priority for this class?

a. Appropriate use of car seat restraints
b. Safety crossing the street
c. Helmet use when riding a bicycle
d. Poison control numbers

A

A nurse is planning a class on accident prevention for parents of toddlers. Which safety topic is the priority for this class?

a. Appropriate use of car seat restraints
b. Safety crossing the street
c. Helmet use when riding a bicycle
d. Poison control numbers

18
Q
  1. A nurse is collecting subjective and objective information about target populations to diagnose problems based on community needs. This describes which step in the community nursing process?
    a. Planning
    b. Diagnosis
    c. Assessment
    d. Establishing objectives
A

ANS: C
The nursing process stages are similar, whether the client is one child or a population of chil-dren. The assessment phase of the nursing process focuses on collecting subjective and objec-tive data. Planning is the development of community-centered goals and objectives. Diagnosis is the identification of problems specific to the community.

DIF: Cognitive Level: Understand REF: p. 11
TOP: Integrated Process: Communication and Documentation
MSC: Area of Client Needs: Safe and Effective Care Environment: Management of Care

19
Q
  1. A nurse is establishing several health programs, such as bicycle safety, to improve the health status of a target population. This describes which step in the community nursing pro-cess?
    a. Planning
    b. Evaluation
    c. Assessment
    d. Implementation
A

ANS: D
The nurse working with the community to put into practice a program to reach community goals is the implementation phase of the community nursing process. Planning involves design-ing the program to meet community-centered goals. The evaluation stage would determine the effectiveness of the program. During the assessment phase, the nurse would identify the re-sources necessary and the barriers that would interfere with implementation.

DIF: Cognitive Level: Understand REF: p. 11
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Safe and Effective Care Environment: Management of Care

20
Q

A school nurse is conducting vision and hearing testing on fifth-grade children. Which level of prevention is the nurse demonstrating?

a. Primary
b. Secondary
c. Tertiary
d. Health promotion

A

ANS: B
Secondary prevention focuses on screening and early diagnosis of disease. Vision and hearing testing are screening tests to detect problems. Primary prevention focuses on health promotion and prevention of disease or injury. Tertiary prevention focuses on optimizing function for chil-dren with a disability or chronic disease. Health promotion is focused on preventing disease or illness.

DIF: Cognitive Level: Understand REF: p. 2
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Health Promotion and Maintenance

peds (13 decks)

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