Wong's Study Guide - Perspectives of Pediatric Nursing Ch. 1

1. Which of the following is the most common cause of death and disability to children aged 1 to 4 years in the United States?

a. Fires and burns

b. Firearms

c. Unintentional injuries

d. Falls

Unintentional injuries

2. Which of the following best defines the primary goal of Healthy People 2020?

a. Reduce substance and tobacco use through educative measures.

b. Increase quality and length of life, and eliminate health disparities.

c. Avoid injury and violence by adhering to preventive health outcomes.

d. Provide access to care and immunizations to avoid potential injuries and health disparities.

Increase quality and length of life, and eliminate health disparities.

3. The health status of children has improved in the past few years in a number of areas. Which best describes how the health status of children has improved? a. Average reading scores for fourth- through eighth-grade students have increased. b. The percentage of children living in poverty has decreased.

c. The percentage of children with at least one parent employed full time year-round has decreased.

d. The violent crime victimization rate among youth has decreased.

The violent crime victimization rate among youth has decreased.

4. What is considered to be the most dramatic time of physical, motor, cognitive, emotional, and social development?

a. Development that occurs during infancy

b. Development that occurs during gestation '

c. Development that occurs during preschool

d. Every stage of development in a child's life

Development that occurs during infancy

5. Which of the following is the single most common chronic disease of childhood?

a. Cancer

b. Obesity

c. Dental caries

d. Otitis media

Dental caries

6. Children who grow up with an inadequate intake of nutritional foods are at risk for certain negative outcomes. Which of the following is the most recognized negative outcome related to inadequate nutrition?

a. Infections and reading delays

b. Appropriate protein intake with a reduction in sugar and carbohydrate intake

c. Negative caloric intake with behavioral problems

d. Growth and developmental delays and depression

Growth and developmental delays and depression

7. Pediatric social illness is the new morbidity. Which statement best describes pediatric social illness?

a. The behavior, social, and educational problems that children face

b. The influence of culture and society in the health disparities of children

c. The national health trend toward identifying and eliminating mental health problems in children

d. Childhood illnesses that are a direct effect of the environment in which children live

The behavior, social, and educational problems that children face

8. You are observing a nurse who is caring for a 14-year-old boy in the pediatric clinic. Which of the following should you recognize to be the most common nutritional problem among American children?

a. The 14-year-old boy has multiple dental caries.

b. The 14-year-old boy's body mass index is at the 97th percentile for children of the same age.

c. The 14-year-old boy reports consuming large amounts of sugar at each meal.

d. The 14-year-old boy's height is in the 55th percentile for children of the same age.

The 14-year-old boy's body mass index is at the 97th percentile for children of the same age.

9. Which of the following has surpassed motor vehicle accidents as the leading cause of injury and mortality in children?

a. Drowning

b. Burns

c. Head injuries

d. Suicide

Suicide

10. Define infant mortality.

The number of deaths per 1000 live births during the first year of life

11. Which of the following increases the risk of childhood suicide by about fivefold and the risk of homicide by about threefold?

a. Exposure to violent video games

b. Presence of a gun in a household

c. Exposure to violence in the home d. Growing up in a disadvantaged neighborhood

Presence of a gun in a household

12. Which of the following best describes the major determinant of neonatal death in technologically developed countries?

a. Maternal education level

b. Birth weight

c. Amount of prenatal care

d. Health care services

Birth weight

13. Which of the following is true with regard to African-American infants in the United States?

a. They are at a lower risk of infant mortality compared with Caucasian infants.

b. They are at a lower risk of low birth weight compared with Caucasian infants.

c. Their infant mortality risk is two times higher than that of Caucasian infants.

d. Their infant mortality risk is three times higher than that of Caucasian infants

Their infant mortality risk is two times higher than that of Caucasian infants.

Identify the four most common causes of death during infancy.

a.

b.

c.

d.

a. Congenital anomalies

b. Disorders relating to short gestation and unspecified low birth weight

c. Sudden infant death syndrome

d. Newborn affected by maternal

complications of pregnancy

15. Which age group has the lowest rate of death?

a. Children aged 2 to 3 years

b. Children aged 15 to 17 years

c. Children aged 5 to 14 years

d. Children aged 2 to 4 years

Children aged 5 to 14 years

16. What is the chief illness of childhood?

a. Bacterial infections

b. Viral infections

c. Meningitis

d. Common cold

Common cold

7. Which of the following scenarios best describes how empowerment can be used to promote family-centered care?

a. Creating opportunities and means for all family members to display their current abilities

b. Providing the family with opportunities to acquire new abilities

c. Providing care that meets the immediate needs of the family

d. Providing an environment where the family has a sense of control over their lives by fostering their own strengths, abilities, and actions

Providing an environment where the family has a sense of control over their lives by fostering their own strengths, abilities, and actions

18. Atraumatic care is the provision of therapeutic care in settings, by personnel, and through the use of interventions that eliminate or minimize the ____________

children and their families in the health care system.

and ____________ distress experienced by

psychologic, physical

19. List the three principles that provide the framework for achieving the goal in providing atraumatic care.

a.

b.

c.

a. Prevent or minimize the child's

separation from the family

b. Promote a sense of control

c. Prevent or minimize bodily injury and pain

20. The establishment of a ____________ is the essential foundation for providing high-quality nursing care.

20. therapeutic relationship

21. Which of the following is a warning sign of a nontherapeutic relationship?

a. Staff members voicing concerns about their peer's actions with a family

b. Open communication between staff and family

c. Staff offering anticipatory guidance before procedures

d. Care provided to reduce or eliminate pain or discomfort

Staff members voicing concerns about their peer's actions with a family

22. In a therapeutic relationship, caring, well-defined ____________ separate the nurse from the child and family.

22. boundaries

23. As an advocate, the nurse assists children and their families in making informed choices and acting in the child's best interests. Please choose the best answer from the statements below. Advocacy involves ensuring that families are

a. aware of all available health services.

b. informed and involved in treatments and procedures.

c. encouraged to change or support existing health care practices.

d. all of the above.

23. d all of the above

24. One of the most important aspects of providing pediatric care is that the care's focus is often on ____________

a. secondary

b. preventative

c. treatment

d. remedy

.24. b preventative

25. Which of the following is often perceived by families as quality nursing care? a. Care focused on the technical needs of the child and family b. Care focused on the nontechnical needs of the child and family c. Care focused on the general needs of the child

d. Care focused on the nursing process

25. b

26. Which of the following is the best approach to disease prevention? a. Quick and adequate treatment b. Family-centered care c. Education and anticipatory guidance

d. Communication and building rapport

26. c

27. What is an indirect health-teaching strategy? a. Encouraging a parent to learn cardiopulmonary resuscitation b. Teaching a family how to bathe an infant c. Teaching a parent how to feed a newborn d. Encouraging parents to ask questions

27. d

28. When caring for a child, the nurse recognizes that the following intervention is the best way to facilitate nonverbal communication:

a. Touching and physical presence b. Verbal communication c. Anticipatory guidance d. Play

28. a

29. Which of the following moral values is recognized as the obligation to minimize or prevent harm? a. Justice

b. Nonmaleficence c. Beneficence d. Autonomy

29. b

30. The art of questioning why something is effective and whether a better approach exists is best described as a. intuition.

b. the nursing process. c. evidence-based practice. d. problem solving

30. c

31. Which of the following describes the GRADE criteria that indicate a high quality of evidence? a. Consistent evidence from well-performed randomized clinical trials (RCTs) or exceptionally strong evidence

from unbiased observational studies b. Evidence from RCTs with important limitations (inconsistent results, flaws in methodology, indirect evidence, or

imprecise results) or unusually strong evidence from unbiased observational studies c. Evidence for at least one critical outcome from observational studies, from RCTs with serious flaws, or from

indirect evidence d. Evidence for at least one of the critical outcomes from unsystematic clinical observations or very indirect evi-

dence

31. a

32. Describe clinical reasoning.

32. It is a cognitive process that uses

formal and informal thinking to gather and analyze patient data, evaluate the significance of the information, and consider alter- native actions.

33. Define the nursing process, and list its five steps.

a.

b.

c.

d.

e.

The nursing process is a method of problem identification and problem solving that describes what the nurse actually does.

a. Assessment b. Diagnosis c. Planning d. Implementation e. Evaluation

34. Match each of the following definitions with the appropriate term.

a. ____________ b. ____________ c. ____________ d. ____________ e. ____________

Assessment Diagnosis Planning Implementation Evaluation

1. Once the nursing diagnoses have been identified, the nurse engages in this to establish outcomes or goals.

2. This is a continuous process that operates at all phases of problem solving and is the foundation for decision making.

3. This phase begins when the nurse puts the selected intervention into action and accumulates feedback data regarding its effects.

4. This phase begins when the nurse must interpret and make decisions about the data gathered.

5. In this phase the nurse gathers, sorts, and analyzes data to determine whether (1) the established outcome has been met, (2) the nursing inter- ventions were appropriate, (3) the plan requires modification, or (4) other alternatives should be considered.

a.2 b.4 c.1 d.3 e.5

35. The three components of nursing diagnosis are ____________ , ____________ , and ____________ .

problem statement, etiology, signs and symptoms

36. Match each of the following definitions with the appropriate term.

a. ____________ b. ____________ c. ____________

Problem statement Etiology Signs and symptoms

1. Describes the child's response to health pattern deficits in the child, family, or community

2. The cluster of cues and/or defining characteristics derived from the patient assessment

3. The physiologic, situational, and maturational factors that cause the problem or influence its development

36. a.1 b.3 c.2

37. Define quality of care.

37. The degree to which health ser- vices for individuals and popula- tions increase the likelihood of desired health outcomes and are consistent with current profes- sional knowledge

A. Spend a day following a nurse in a pediatric unit of an acute care facility. Briefly describe and give examples of the roles of the pediatric nurse in a pediatric unit.

1. Family advocacy

2. Disease prevention and health promotion

3. Restorative role

4. Coordination and collaboration

5. Ethical decision making

6. Research

7. Family-centered care

1. Ensure families' awareness of various health services; inform families of treatments and proce- dures; involve families in child's care; change or support existing health care practices.

2. Practice within the over- all framework for preventive health; employ an approach of education and anticipatory guidance.

3. Provide continual assessment and evaluation of the child's physical, emotional, and devel- opmental status.

4. Work with professionals in other disciplines to formulate and implement a care plan that meets the child's needs.

5. Determine the least harmful action within the framework of societal mores, professional practice standards, the law, institutional rules, religious traditions, the family's value system, and the nurse's personal values.

6. Conduct research to provide theoretical foundations for the nursing practice and to evaluate the nursing process.

7. Involve the family in all steps of the nursing process.

.You observe the care of a group of five children in an acute care unit of a children's hospital for one shift. Identify whether the principle of family-centered care is being applied or violated in the following examples. What steps could be taken to make these situations more family centered?

1. A child's father is allowed to visit for 3 hours a day. During his visitation time, the nurse decides to give the child a bath and asks the father to wait outside in the waiting room

2 The posted visiting hours are noon to 8 pm for families, and no children under 14 years of age are allowed.

3. A mother changes the dressing on her child's leg. The nurse observes and assists as necessary.

4. The nurse would like to perform the morning bath on a child, but the nurse notes the child's mother is just awaken- ing. The nurse asks the mother whether she would prefer the bath to occur now or at a time more convenient for her and the child.

1. Violated: Recognize that the family is the constant in a child's life. Consider the needs of the family members—not just the child. Work to extend family visitation hours. Cluster care in units that still have times when the unit is closed to visitors to provide the family with more meaningful interaction times with their child.

2. Violated: Family members, espe- cially siblings, should have free access to their family member. Work to extend visitation hours and to allow siblings of any age to visit. If this is not possible, strive to have a viewing room so siblings can see their brother or sister.

3. Applied: Enabling family mem- bers to display their ability and competence fosters a parent- professional partnership. This could be enhanced by including the family members in sched- uling activities of daily living throughout the day.

4. Applied: This empowers the family member to maintain a sense of control over daily activi- ties. This intervention could be further enhanced by asking the mother what activities of daily living she would like to assist with or perform throughout the day during the initial morning assessment.