Test 4 CH. 31 Flashcards
What was one of the major strides in pediatric care made by Dr. Abraham Jacobi?
a. Pediatric wards in hospitals
b. Free inoculations against smallpox
c. Milk stations in the city of New York
d. Serving nutritious foods in orphanages
ANS: C
Dr. Abraham Jacobi, referred to as the father of pediatrics, initiated the establishment of milk stations in New York demonstrating how to sanitize milk for children.
What was founded by Lillian Wald?
a. National Commission on Children
b. Henry Street Settlement
c. White House Conference
d. US Children’s Bureau
ANS: B
Lillian Wald, regarded as the founder of public health, founded Henry Street Settlement, which provided nursing services and social assistance.
When the pediatric nurse is attempting to establish a trusting relationship with a child, what is the most important and lasting thing to do?
a. Convey respect.
b. Talk with the child.
c. Be honest.
d. Talk with family.
ANS: C
To establish a trusting relationship, the most important thing is to behonest.
What is the special category that encompasses children who have congenital abnormalities, malignancies, gastrointestinal (GI) diseases, or central nervous system (CNS) anomalies?
a. Very dependent children
b. Children requiring special education
c. Children with special needs
d. Children requiring long-term care
ANS: C
The definition of children with special needs includes congenital abnormalities, malignancies, GI diseases, and CNS anomalies.
The mother of a child with diabetes asks the nurse in charge of the family-centered pediatric unit if she might see her child’s laboratory reports. What response by the nurse is the most appropriate?
a. “Although the actual reports are not shared, I can tell you the blood sugar is 200
mg.”
b. “I’ll write them down for you and bring them to your room.”
c. “Come to the conference room where we can have privacy while you look at them.”
d. “I’ll notify the health care provider that you wish to see the reports.”
ANS: C
With a family-centered care approach, hospitals welcome parents, and parents have access to information 24 hours a day.
What should be the focus of a practice where the pediatric nurse uses a developmental approach?
a. Stimulation of the child to reach expected norms
b. Age-centered care plans
c. Strengths and abilities of the child
d. Characteristics for the particular age
ANS: C
A developmental approach emphasizes the child’s strengths and abilities and considers individuality. It builds on what the child can do instead of focusing on what the child cannot do.
When using anticipatory guidance to prepare a 5-year-old for an IM injection, what statement by the nurse would be most appropriate?
a. “Ethan, I’m going to give you a shot.”
b. “Ethan, the health care provider wants you to have some medicine, and it will
hurt.”
c. “Ethan, some medicine can only be given with a needle.”
d. “Ethan, I am going to give you some medicine that will sting, but only for a little while.”
ANS: D
Anticipatory guidance is the psychological preparation of a patient for a stressful event by explaining what will happen and the probable outcome.
When measuring the head circumference of an infant, where should the nurse place the tape measure?
a. Across the eyebrows and around the occipital lobe
b. Over the zygomatic arches and around the parietal areas
c. Around forehead and around the crown of the head
d. Above the eyebrows and pinnas, and around the occipital lobe
ANS: D
Head circumference is measured in children up to 36 months above the eyebrows and pinnas, and around the occipital lobe.
What activity by an infant would cause a false elevation of the tympanic temperature?
a. Having a bowel movement
b. Crying vigorously
c. Having just eaten
d. Having been in a cold room
ANS: B
Crying increases the temperature; eating and bowel movements do not. A cold room would lower the temperature.
What is the correct order for assessing vital signs in an infant to ensure the accuracy of measurements?
a. Respiration, temperature, pulse
b. Pulse, respiration, temperature
c. Temperature, pulse, respiration
d. Respiration, pulse, temperature
ANS: D
The respiration is taken first on an infant before the child is disturbed, pulses are assessed next, and last the temperature is obtained.
Why does obtaining the respirations of an infant require a modified approach from that of an adult?
a. Infants breathe through their noses.
b. Infants have very rapid respirations.
c. Infants’ respirations are thoracic in nature.
d. Infants’ respiratory movements are abdominal.
ANS: D
In children under 6 or 7 years of age, respiratory movements are abdominal or diaphragmatic. Abdominal movements must be observed when counting respirations.
An 8-year-old child asks how a blood pressure is taken. What would be the most appropriate response?
a. “This small machine will measure your systolic and diastolic pressure.”
b. “The armband will hug your arm and tell me how well your blood is going through
your arm.”
c. “The armband will cut off your circulation for a while and then we can hear when
it comes back.”
d. “When you are ill we need to know if your blood is still moving in your body.”
ANS: B
Because children are upset by unfamiliar procedures, it is best to explain each step in simple terms. It is best not to mention anything that may increase anxiety.
What is the correct way to assess for the presence of jaundice in an African-American child?
a. Examine the sclera.
b. Press the edge of the pinna.
c. Apply pressure to the gum.
d. Compare the color on the soles of the feet.
ANS: C
The gums in individuals with dark complexions can be used to assess jaundice by pressing the gums about the teeth.
When discussing growth and development with the parents of a child, the nurse explains that nutrition is the single most important influence on:
a. cognitive development.
b. secondary sexual characteristics.
c. the production of blood cells.
d. the growth of bones and muscle.
ANS: D
Nutrition is probably the single most important influence on growth.
The mother of a 3-year-old expresses concern about her daughter’s slowed growth rate. What would be the most informative response by the nurse?
a. “Three-year-olds have typically finished a growth spurt, and you may notice a
decreased rate in your daughter’s growth.”
b. “Children’s growth is hereditary. She may be of small stature like you.”
c. “The growth of a 3-year-old is associated with their nutrition. How is she eating?”
d. “Your daughter is healthy and happy. Don’t worry about her growth right now.”
ANS: A
Three-year-olds slow down in their growth in a natural cycle.
What should be included in the teaching plan for the parents of a 3-year-old child who has been prescribed an opioid analgesic?
a. The opioid is likely to cause significant respiratory depression.
b. The medicine is prescribed with the knowledge that addiction may occur.
c. The opioid is very effective as a pain control method.
d. The opioid is only to be given in cases of severe pain.
ANS: C
It is an effective type of analgesia. When administered to children, opioid analgesics do not have any greater respiratory depression than when given to an adult, and the risk of addiction is virtually nonexistent in children.
The parents ask about preparation of their toddler for hospital admission. When does the nurse suggest that the parents tell their toddler of the admission?
a. A week prior
b. 2 weeks prior
c. The day of admission
d. Only 2 or 3 days before
D
The nurse should suggest the toddler be told only days before. School-age children can be given more time to prepare. Adolescents should be told as far in advance as possible.
When the newly admitted 2-year-old who was potty-trained before admission begins to wet the bed, the mother is frightened. What statement by the nurse will be most helpful to the mother?
a. “Don’t be concerned. Accidents happen.”
b. “Let’s put a diaper on your child until this gets better.”
c. “The stress of hospitalization makes children regress a little.”
d. “Your child will relearn ‘potty-training’ if you are patient.”
ANS: C
It is not unusual for children to regress when hospitalized. Explaining that regression is normal during hospitalization will help allay the mother’s anxiety.
When attempting to provide information to the parents of a child undergoing surgery, the nurse notes that the parents appear confused and do not seem to remember what they are being told. What is the most probable cause of the parents’ forgetfulness?
a. Noisy environment
b. Serious nature of surgery
c. Increased level of parents’ anxiety
d. Developmental age of the child
ANS: C
Anxiety of the parents may result in confusion and forgetfulness. It is not known if the environment is noisy, if the surgery is serious in nature, or what is the developmental age of the child.
What is the best time to bathe an infant?
a. At bedtime
b. Early in the morning
c. After a feeding
d. Before a feeding
ANS: D
Bathing is usually done before a feeding to reduce the possibility of vomiting, regurgitation, or stimulation.
How should an infant be positioned after a feeding?
a. On the stomach
b. On the right side
c. On the left side
d. On the back
ANS: B
After feeding, the infant is positioned on the right side to direct the food into the stomach.
When a safety reminder device (SRD) is used to protect a child, what is a responsibility of the nurse?
a. Apply it loosely.
b. Remove it every 2 hours.
c. Place it over clothing.
d. Apply only one type.
ANS: B
Any SRD should be removed every 2 hours.
What should be done before initiating a gavage feeding?
a. Hold the feeding tube under water to check for bubbling.
b. Check for gastric distention.
c. Aspirate stomach contents.
d. Ensure the sterility of feeding equipment.
ANS: C
Aspirating stomach contents and aspirating a small amount of air while listening for stomach gurgling are the best ways to ensure correct tube placement. Holding the feeding tube under water to check for bubbling is not an effective method to check tube placement. Gastric distention would be important following the feeding. A gavage feeding is not a sterile procedure.
What is the purpose of a mist tent?
a. To provide a constant oxygen supply
b. To liquefy respiratory secretions
c. To aid in lowering temperature
d. To improve the infant’s hydration
ANS: B
The purpose of the mist tent is to liquefy respiratory secretions. A constant oxygen supply can be given by methods other than a mist tent. A mist tent does not lower temperature or improve hydration.
