Chapter 39

Question 1

The nurse is providing care to a pediatric client who is experiencing separation anxiety. Which data would support the documentation of the “despair” phase?

1. Lies quietly in bed.
2. Does not cry if his parents return and leave again.
3. Appears to be happy and content with staff.
4. Screams and cries when his parents leave.

Answer 1

1

Question 2

Which is a common fear, in addition to separation anxiety, for the hospitalized pediatric client between the ages of 6 and 18 months?

1. Disfigurement
2. Death
3. Stranger anxiety
4. Bodily injury

Answer 2

3

Question 3

The parents of a child who is critically injured wish to stay in the room while the child is receiving emergency care. Which nursing action is most appropriate in this situation?

1. Asking the healthcare provider if the parents can stay with the child
2. Allowing the parents to stay with the child
3. Escorting the parents to the waiting room and assuring them that they can see their child soon
4. Telling the parents that they do not need to stay with the child

Answer 3

2

Question 4

The pediatric group is providing care to a group of hospitalized clients. Which client is at the greatest risk for developing separation anxiety if the parents are unable to stay with the child at all times?

1. 6 month old
2. 18 month old
3. 4 year old
4. 6 year old

Answer 4

2

Question 5

A preschool-age boy presents to the outpatient clinic for a sore throat. In the child’s mind, which is the most likely causative agent of the sore throat?

1. Being exposed to a classmate with strep throat
2. Yelling at sibling for being annoying
3. Not eating the right foods
4. Not taking daily vitamins

Answer 5

2

Question 6

A school-age client is in the playroom when the respiratory therapist arrives to give a scheduled breathing treatment. Which is the most appropriate nursing action?

1. Escorting the child to his room and asking the child-life specialist to bring toys to the bedside
2. Rescheduling the treatment for a later time
3. Assisting the child back to his room for the treatment but reassuring him that he may return when the procedure is completed
4. Showing the respiratory therapist to the playroom so the treatment can be performed

Answer 6

3

Question 7

A preschool-age child is admitted to the pediatric unit for surgery. The parents request to stay with their child. Which is the best response by the nurse?

1. Tell the parents they can stay in the hospital but not on the unit.
2. Read the rules and regulations of rooming in with the child.
3. Let the parents know they are allowed to stay with the child.
4. Explain to the parents why they cannot stay with the child.

Answer 7

3

Question 8

A child is being prepared for surgery. The parents request to be present during anesthesia induction. Which response by the nurse is most appropriate?

1. Telling the parents the names of all the medications that will be administered
2. Explaining what the parents will see and hear during induction
3. Telling the parents they will be upset to see the child under anesthesia
4. Ignoring the request and focusing on the child

Answer 8

2

Question 9

The mother of a child admitted to the intensive care unit (ICU) appears very angry and tells the nurse no one is providing information about the child. Which response by the nurse is most appropriate?

1. Asking the mother to leave if the behavior continues
2. Apologizing for the mother’s perception and assure the mother that the staff will keep her informed.
3. Offering to ask the healthcare provider to come and talk with her
4. Telling the mother her behavior will upset the child

Answer 9

2

Question 10

The nurse is caring for a child in the pediatric intensive care unit (PICU). The parents have expressed anger over the nursing care their child is receiving. Which nursing action is most appropriate?

1. Explaining to the parents that their anger is affecting their child, and they will not be allowed to visit the child until they calm down
2. Asking the healthcare provider to talk with the family
3. Acknowledging the parents’ concerns and collaborating with them regarding the care of their child
4. Calling the hospital chaplain to sit with the family

Answer 10

3

Question 11

The nursing action is most appropriate when performing a procedure on a toddler-age child?

1. Allowing the child to cry or scream
2. Performing the procedure in the child’s hospital bed
3. Asking the child if it is okay to start the procedure
4. Asking the mother to restrain the child during the procedure

Answer 11

1

Question 12

A child has a planned hospitalization in a few weeks, and the client and family appear very stressed. Which nursing action will minimize the stress for the client and family?

1. Telling the client and family that everything will be fine
2. Explaining to the client and family how the child will benefit from the surgery
3. Telling the client and family that the surgeon is very good
4. Giving a tour of the hospital unit or surgical area to the client and family

Answer 12

4

Question 13

Which is the rationale for why parents should be allowed to be present with their children during a medical procedure?

1. Parents want to support their child before, during, and immediately after the procedure.
2. Parents want to ensure that nothing goes wrong with the child.
3. Parents are interested because they are also in the medical field.
4. Parents want to ensure that the correct medication is being used.

Answer 13

1

Question 14

The parents have requested to be present during their child’s procedure. How should the nurse plan for this request?

1. Explain in detail, using medical terms, what will occur.
2. Explain to the family that it is not permitted for family members to be present.
3. Prepare family members for what they should anticipate and what is expected of them.
4. Prepare the family to speak with the healthcare provider.

Answer 14

3

Question 15

The mother of a child admitted after a motor vehicle accident expresses concern about caring for the child’s wounds at home. The mother has demonstrated appropriate technique with medication administration and wound care. Which is the priority nursing diagnosis?

1. Parental Anxiety related to care of the child at home
2. Altered Family Processes related to hospitalization
3. Risk for Infection for related to presence of healing wounds
4. Knowledge Deficit related to home care

Answer 15

1

Question 16

A child is being discharged from the hospital requiring complex, long-term care with medication administration through a central line and maintenance of oxygen administration by nasal cannula. A home health nurse will be visiting each day. What should the nurse teach the family members prior to hospital discharge?

1. How to insert an IV line
2. Nothing, the family is familiar with the care
3. Instruction on oxygen administration
4. How to remove a central line

Answer 16

3

Question 17

Prior to discharging the child from the hospital, what routine discharge instructions should the nurse discuss with the family?

1. Monitoring signs and symptoms specific to condition
2. Instruction on performing a medical examination on the child
3. No instructions are needed; the family is familiar with the child.
4. A list of all diagnostic tests obtained during the hospitalization and their results

Answer 17

1

Question 18

Which age groups can best tolerate separation from parents during hospitalization? Select all that apply.

1. Infants birth to 5 months
2. Infants 5 months to 1 year
3. Toddlers and preschoolers
4. School-age children
5. Adolescents

Answer 18

1,4,5

Question 19

A hospitalized preschool-age child will be left alone for short periods of time for the mother to return home to care for the child’s siblings. The mother asks the nurse what is the best way to leave. Which response by the nurse is appropriate? Select all that apply.

1. “Leave after your child falls asleep so he won’t know you are going.”
2. “Tell your child you are leaving and identify when you will return after dinner.”
3. “Leave an article of clothing behind to comfort your child.”
4. “Tell the nurse on duty when you are leaving so that the nurse can stay with your child while you are gone.”
5. “Plan to leave when your child is having procedures performed as the child will be busy and less aware of the parents’ absence.”

Answer 19

2,3

Question 20

A 6-year-old child is hospitalized for a surgical procedure. The parents ask if the child’s four siblings can visit. Which response by the nurse is the most appropriate?

1. “Let’s plan their visit for a time when the child has received pain medication.”
2. “Only those siblings over 16 will be allowed to visit.”
3. “I don’t think the other children should visit because it might scare them to see their sibling so sick.”
4. “Very young children shouldn’t visit as they may carry germs.”

Answer 20

1

Question 21

The 4-year-old child is undergoing cardiac surgery. Which nursing action will reduce the child’s stress in the preoperative period? Select all that apply.

1. Explain the procedure to the child in simple terms of what the child will see, hear, and feel while awake.
2. Explain to the child that the surgery will fix her “broken” heart.
3. Allow the parents to accompany the child to the surgical holding room and wait with the child.
4. Allow the child to hold onto their special “teddy bear” while awake.
5. Wait until the child is in the holding room to insert the Foley catheter.

Answer 21

1,3,4

Question 22

An adolescent tells the nurse that the new diagnosis of diabetes has him “stressed out.” Which stress-reduction activities will the nurse recommend to this adolescent? Select all that apply.

1. Daily exercise, such as walking
2. Learning more about his illness
3. Practicing deep breathing and other relaxation techniques
4. Not thinking about his diagnosis
5. Allowing the parents control of his disease

Answer 22

1,2,3

Question 23

The healthcare provider has prescribed the toddler an oral medication. The toddler has fought medication administration in the past. Which strategies may be helpful when administering the medication to this toddler? Select all that apply.

1. Request the medication in liquid form and draw the medication in an oral syringe.
2. Put the medication in a favorite drink in the child’s sippy cup.
3. Allow the mother to administer the medication to the child.
4. Notify the healthcare provider to change the route to intravenous.
5. Hold the child down and squirt the medication in the corner of his mouth.

Answer 23

1,3

Question 24

Which changes can a nurse manager implement to reduce the stress experienced by hospitalized pediatric clients?

1. Having only female nurses on the unit
2. Assigning nurses one-on-one with clients
3. Allowing the nurses to wear colored scrubs in place of white uniforms
4. Having the nurses avoid entering the client’s room unless a procedure is to be performed

Answer 24

3

Question 25

Which nursing actions are important when providing care to a pediatric client who is on contact precautions due to a communicable disease? Select all that apply.

1. Encouraging frequent family visits
2. Scheduling physical therapy (PT) for the child
3. Providing age-appropriate stimulation and activities
4. Allowing the parents to have physical contact with the child
5. Educating the family about personal protective equipment (PPE)

Answer 25

1,3,4,5

Question 26

The nurse is providing care to an infant who is hospitalized for bronchiolitis. Which infant stressors should the nurse plan for when providing care for this infant? Select all that apply.

1. Separation anxiety
2. Stanger anxiety
3. Disrupted sleep–wake cycle
4. Loss of self-control
5. Fear of the dark

Answer 26

1,2,3

Question 27

The nurse is providing care to a hospitalized adolescent client. Which should the nurse include in the adolescent’s plan of care related to stressors? Select all that apply.

1. Loss of privacy
2. Fear of the dark
3. Loss of identity
4. Fear of altered body image
5. Separation anxiety

Answer 27

1,3,4

Question 28

Which are barriers to successful discharge planning that the nurse may need to plan for when providing care to a pediatric client who is approaching discharge? Select all that apply.

1. Financial concerns
2. Parental unavailability for teaching
3. Lack of equipment
4. Poor teamwork
5. Insurance payment for services

Answer 28

1,2,3,4

Question 29

Which nursing actions are appropriate for teaching the family of a pediatric client requiring skilled care prior to discharge?

1. Teaching how to use home equipment
2. Educating on symptoms that indicate distress
3. Encouraging participation in a cardiopulmonary resuscitation course
4. Recommending that one parent take a leave of absence from work
5. Discouraging participation in case coordination activities

Answer 29

1,2,3