TEST BANK for Principles of Pediatric Nursing: Caring for Children, 8th Edition by Cowen, Wisely, Da

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023

Principles of Pediatric Nursing, 8e (Ball et al.)

Chapter 1 Contemporary Child Health Nursing 1) Which nursing role is not directly involved when providing family-centered approach to the pediatric population?

1. Advocacy 2. Case management 3. Patient education 4. Researcher Answer: 4 Explanation: 1. A researcher is not involved in the family-centered approach to patient care of children and their families. Advocacy, case management, and patient education are all roles directly involved in the care of children and their families.

2. A researcher is not involved in the family-centered approach to patient care of children and their families. Advocacy, case management, and patient education are all roles directly involved in the care of children and their families.

3. A researcher is not involved in the family-centered approach to patient care of children and their families. Advocacy, case management, and patient education are all roles directly involved in the care of children and their families.

4. A researcher is not involved in the family-centered approach to patient care of children and their families. Advocacy, case management, and patient education are all roles directly involved in the care of children and their families.

Page Ref: 4 Cognitive Level: Analyzing Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential II: Basic organizational and systems leadership for quality care and patient safety. | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care Learning Outcome: 1.2 Identify the nursing roles available to pediatric nurses.

2) A nurse is working with pediatric clients in a research facility. The nurse recognizes that federal guidelines are in place that delineate which pediatrics clients must give assent for participation in research trials. Based upon the client's age, the nurse would seek assent from which children?

Select all that apply.

1. The precocious 4-year-old commencing as a cystic fibrosis research-study participant.

2. The 7-year-old leukemia client electing to receive a newly developed medication, now being researched.

3. The 10-year-old commencing in an investigative study for clients with precocious puberty.

4. The 13-year-old client commencing participation in a research program for Attention Deficit Hyperactivity Disorder (ADHD) treatments.

Answer: 2, 3, 4 Explanation: 1. Federal guidelines mandate that research participants 7 years old and older must receive developmentally appropriate information about healthcare procedures and treatments and 1 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 give assent.

2. Federal guidelines mandate that research participants 7 years old and older must receive developmentally appropriate information about healthcare procedures and treatments and give assent.

3. Federal guidelines mandate that research participants 7 years old and older must receive developmentally appropriate information about healthcare procedures and treatments and give assent.

4. Federal guidelines mandate that research participants 7 years old and older must receive developmentally appropriate information about healthcare procedures and treatments and give assent.

Page Ref: 11, 12 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential V: Healthcare policy, finance, and regulatory environments. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Planning/Coordination of care Learning Outcome: 1.8 Delineate significant legal and ethical issues that influence the practice of pediatric nursing.

3) The nurse in a pediatric acute care unit is assigned the following tasks. Which task is not appropriate for the nurse to complete?

1. Diagnose an 8-year-old with acute otitis media and prescribe an antibiotic.

2. Listen to the concerns of an adolescent about being out of school for a lengthy surgical recovery.

3. Provide information to a mother of a newly diagnosed 4-year-old diabetic about local supportgroup options.

4. Diagnose a 6-year-old with Diversional Activity Deficit related to placement in isolation.

Answer: 1 Explanation: 1. The role of the pediatric nurse includes providing nursing assessment, directing nursing care interventions, and educating client and family at developmentally appropriate levels; client advocacy, case management, minimization of distress, and enhancement of coping.

Advanced practice nurse practitioners perform assessment, diagnosis, and management of health conditions.

2. The role of the pediatric nurse includes providing nursing assessment, directing nursing care interventions, and educating client and family at developmentally appropriate levels; client advocacy, case management, minimization of distress, and enhancement of coping. Advanced practice nurse practitioners perform assessment, diagnosis, and management of health conditions.

3. The role of the pediatric nurse includes providing nursing assessment, directing nursing care interventions, and educating client and family at developmentally appropriate levels; client advocacy, case management, minimization of distress, and enhancement of coping. Advanced practice nurse practitioners perform assessment, diagnosis, and management of health conditions.

4. The role of the pediatric nurse includes providing nursing assessment, directing nursing care interventions, and educating client and family at developmentally appropriate levels; client advocacy, case management, minimization of distress, and enhancement of coping. Advanced 2 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 practice nurse practitioners perform assessment, diagnosis, and management of health conditions.

Page Ref: 2-4 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential II: Basic organizational and systems leadership for quality care and patient safety. | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Implementation/Coordination of care Learning Outcome: 1.2 Identify the nursing roles available to pediatric nurses.

4) A 7-year-old child is admitted for acute appendicitis. The parents are questioning the nurse about expectations during the child's recovery. Which information tool would be most useful in answering a parent's questions about the timing of key events?

1. Healthy People 2030 2. Clinical pathways 3. Child mortality statistics 4. National clinical practice guidelines Answer: 2 Explanation: 1. Clinical pathways are interdisciplinary documents provided by a hospital to suggest ideal sequencing and timing of events and interventions for specific diseases to improve efficiency of care and enhance recovery. This pathway serves as a model outlining the typical hospital stay for individuals with specified conditions. Healthy People 2030 contains objectives set by the U.S. government to improve the health and reduce the incidence of death in the twenty-first century.

Child mortality statistics can be compared with those from other decades for the evaluation of achievement toward health-care goals. National clinical practice guidelines promote uniformity in care for specific disease conditions by suggesting expected outcomes from specific interventions.

2. Clinical pathways are interdisciplinary documents provided by a hospital to suggest ideal sequencing and timing of events and interventions for specific diseases to improve efficiency of care and enhance recovery. This pathway serves as a model outlining the typical hospital stay for individuals with specified conditions. Healthy People 2030 contains objectives set by the U.S. government to improve the health and reduce the incidence of death in the twenty-first century.

Child mortality statistics can be compared with those from other decades for the evaluation of achievement toward health-care goals. National clinical practice guidelines promote uniformity in care for specific disease conditions by suggesting expected outcomes from specific interventions.

3. Clinical pathways are interdisciplinary documents provided by a hospital to suggest ideal sequencing and timing of events and interventions for specific diseases to improve efficiency of care and enhance recovery. This pathway serves as a model outlining the typical hospital stay for individuals with specified conditions. Healthy People 2030 contains objectives set by the U.S. government to improve the health and reduce the incidence of death in the twenty-first century.

Child mortality statistics can be compared with those from other decades for the evaluation of achievement toward health-care goals. National clinical practice guidelines promote uniformity in care for specific disease conditions by suggesting expected outcomes from specific interventions.

4. Clinical pathways are interdisciplinary documents provided by a hospital to suggest ideal sequencing and timing of events and interventions for specific diseases to improve efficiency of care and enhance recovery. This pathway serves as a model outlining the typical hospital stay for individuals with specified conditions. Healthy People 2030 contains objectives set by the U.S. 3 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 government to improve the health and reduce the incidence of death in the twenty-first century.

Child mortality statistics can be compared with those from other decades for the evaluation of achievement toward health-care goals. National clinical practice guidelines promote uniformity in care for specific disease conditions by suggesting expected outcomes from specific interventions.

Page Ref: 1, 2 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential II: Basic organizational and systems leadership for quality care and patient safety. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Planning/Health teaching and health promotion Learning Outcome: 1.1 Describe the continuum of pediatric healthcare.

5) The nurse recognizes that the pediatric client is from a cultural background different from that of the hospital staff. Which goal is most appropriate for this client when planning nursing care?

1. Overlook or minimize the differences that exist.

2. Facilitate the family's ability to comply with the care needed.

3. Avoid inadvertently offending the family by imposing the nurse's perspective.

4. Encourage complementary beneficial cultural practices as primary therapies.

Answer: 2 Explanation: 1. The incorporation of the family's cultural perspective into the care plan is most likely to result in the family's ability to accept medical care and comply with the regimen prescribed. Since culture develops from social learning, attempts to ignore or minimize cultural consideration will result in mistrust, suspicion, or offenses that can have negative effects upon the health of children by reducing the resources available to promote health and prevent illness.

Complementary therapy may be used later if other primary therapies prove to be ineffective.

2. The incorporation of the family's cultural perspective into the care plan is most likely to result in the family's ability to accept medical care and comply with the regimen prescribed. Since culture develops from social learning, attempts to ignore or minimize cultural consideration will result in mistrust, suspicion, or offenses that can have negative effects upon the health of children by reducing the resources available to promote health and prevent illness.

Complementary therapy may be used later if other primary therapies prove to be ineffective.

3. The incorporation of the family's cultural perspective into the care plan is most likely to result in the family's ability to accept medical care and comply with the regimen prescribed. Since culture develops from social learning, attempts to ignore or minimize cultural consideration will result in mistrust, suspicion, or offenses that can have negative effects upon the health of children by reducing the resources available to promote health and prevent illness.

Complementary therapy may be used later if other primary therapies prove to be ineffective.

4. The incorporation of the family's cultural perspective into the care plan is most likely to result in the family's ability to accept medical care and comply with the regimen prescribed. Since culture develops from social learning, attempts to ignore or minimize cultural consideration will result in mistrust, suspicion, or offenses that can have negative effects upon the health of children by reducing the resources available to promote health and prevent illness.

Complementary therapy may be used later if other primary therapies prove to be ineffective.

Page Ref: 3 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: 4 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 Essential II: Basic organizational and systems leadership for quality care and patient safety. | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Planning/Coordination of care Learning Outcome: 1.3 Summarize the current status of societal influences on pediatric health care and nursing practice.

6) The telephone triage nurse at a pediatric clinic knows each call is important. Which call would require attentiveness from the nurse because of an increased risk of mortality?

1. A 3-week-old infant born at 35 weeks' gestation with gastroenteritis 2. A term 2-week-old infant of American Indian descent with an upper respiratory infection 3. A postterm 4-week-old infant non-Hispanic black descent with moderate emesis after feeding 4. A 1-week-old infant born at 40 weeks' gestation with symptoms of colic Answer: 1 Explanation: 1. The leading causes of death in the neonatal period (birth to 28 days of age) are short gestation, low birth weight, and congenital malformations. The preterm infant experiencing gastroenteritis at 3 weeks of age is at the greatest risk for mortality; therefore, would require extra attentiveness from the registered nurse.

2. The leading causes of death in the neonatal period (birth to 28 days of age) are short gestation, low birth weight, and congenital malformations. The preterm infant experiencing gastroenteritis at 3 weeks of age is at the greatest risk for mortality; therefore, would require extra attentiveness from the registered nurse.

3. The leading causes of death in the neonatal period (birth to 28 days of age) are short gestation, low birth weight, and congenital malformations. The preterm infant experiencing gastroenteritis at 3 weeks of age is at the greatest risk for mortality; therefore, would require extra attentiveness from the registered nurse.

4. The leading causes of death in the neonatal period (birth to 28 days of age) are short gestation, low birth weight, and congenital malformations. The preterm infant experiencing gastroenteritis at 3 weeks of age is at the greatest risk for mortality; therefore, would require extra attentiveness from the registered nurse.

Page Ref: 6, 7 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Informatics/Patient-centered care | AACN Essential Competencies: Essential IV: Information management and application of patient care technology. | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Planning/Coordination of care Learning Outcome: 1.4 Report the most common public health data for causes of child morbidity and mortality.

7) Despite the availability of Children's Health Insurance Programs (CHIP), many eligible children are not enrolled. Which nursing intervention would be the most appropriate to help children become enrolled in CHIP? 1. Assess details of the family's income and expenditures 2. Case management to limit costly, unnecessary duplication of services 3. Advocate for the child by encouraging the family to investigate SCHIP eligibility 4. Educate the family about the need for keeping regular well-child-visit appointments Answer: 3 Explanation: 1. In the role of an advocate, a nurse will advance the interests of another; by 5 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 suggesting the family investigate its CHIP eligibility, the nurse is directing their action toward the child's best interest. Financial assessment is more commonly the function of a social worker.

The case-management activity mentioned will not provide a source of funding nor will the educational effort described.

2. In the role of an advocate, a nurse will advance the interests of another; by suggesting the family investigate its CHIP eligibility, the nurse is directing their action toward the child's best interest. Financial assessment is more commonly the function of a social worker. The casemanagement activity mentioned will not provide a source of funding nor will the educational effort described.

3. In the role of an advocate, a nurse will advance the interests of another; by suggesting the family investigate its CHIP eligibility, the nurse is directing their action toward the child's best interest. Financial assessment is more commonly the function of a social worker. The casemanagement activity mentioned will not provide a source of funding nor will the educational effort described.

4. In the role of an advocate, a nurse will advance the interests of another; by suggesting the family investigate its CHIP eligibility, the nurse is directing their action toward the child's best interest. Financial assessment is more commonly the function of a social worker. The casemanagement activity mentioned will not provide a source of funding nor will the educational effort described.

Page Ref: 2-4 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VI: Interprofessional communication and collaboration for improving patient health outcomes. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Planning/Coordination of care Learning Outcome: 1.2 Identify the nursing roles available to pediatric nurses.

8) A supervisor is reviewing documentation of the nurses in the unit. Which client documentation is the most accurate and contains all the required part for a narrative entry?

1. "2/2/05 1630 Catheterized using an 8 French catheter, 45 mL clear yellow urine obtained, specimen sent to lab, squirmed and cried softly during insertion of catheter. Quiet in mother's arms following catheter removal. M. May RN" 2. "1/9/05 2 pm nasogastric tube placement confirmed and irrigated with 30 ml sterile water.

Suction set at low, intermittent. Oxygen via nasal canal at 2 L/min. Nares patent, pink, and nonirritated. K. Earnst RN" 3. "4:00 tracheostomy dressing removed with dime-size stain of dry serous exudate. Site cleansed with normal saline. Dried with sterile gauze. New sterile tracheostomy sponge and trach ties applied. Respirations regular and even throughout the procedure. F. Luck RN" 4. "Feb. '05 Port-A-Cath assessed with Huber needle. Blood return present. Flushed with NaCl solution, IV gamma globulins hung and infusing at 30 cc/hr. Child smiling and playful throughout the procedure. P. Potter, RN" Answer: 1 Explanation: 1. The client record should include the date and time of entry, nursing care provided, assessments, an objective report of the client's physiologic response, exact quotes, and the nurse's signature and title.

2. The client record should include the date and time of entry, nursing care provided, 6 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 assessments, an objective report of the client's physiologic response, exact quotes, and the nurse's signature and title.

3. The client record should include the date and time of entry, nursing care provided, assessments, an objective report of the client's physiologic response, exact quotes, and the nurse's signature and title.

4. The client record should include the date and time of entry, nursing care provided, assessments, an objective report of the client's physiologic response, exact quotes, and the nurse's signature and title.

Page Ref: 2-4 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: Informatics | AACN Essential Competencies: Essential IV: Information management and application of patient care technology. | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care Learning Outcome: 1.2 Identify the nursing roles available to pediatric nurses.

9) A 12-year-old pediatric client is in need of surgery. Which member of the healthcare team is legally responsible for obtaining informed consent for an invasive procedure?

1. Nurse 2. Physician 3. Unit secretary 4. Social worker Answer: 2 Explanation: 1. Informed consent is legal preauthorization for an invasive procedure. It is the physician's legal responsibility to obtain this, because it consists of an explanation about the medical condition, a detailed description of treatment plans, the expected benefits and risks related to the proposed treatment plan, alternative treatment options, the client's questions, and the guardian's right to refuse treatment.

2. Informed consent is legal preauthorization for an invasive procedure. It is the physician's legal responsibility to obtain this, because it consists of an explanation about the medical condition, a detailed description of treatment plans, the expected benefits and risks related to the proposed treatment plan, alternative treatment options, the client's questions, and the guardian's right to refuse treatment.

3. Informed consent is legal preauthorization for an invasive procedure. It is the physician's legal responsibility to obtain this, because it consists of an explanation about the medical condition, a detailed description of treatment plans, the expected benefits and risks related to the proposed treatment plan, alternative treatment options, the client's questions, and the guardian's right to refuse treatment.

4. Informed consent is legal preauthorization for an invasive procedure. It is the physician's legal responsibility to obtain this, because it consists of an explanation about the medical condition, a detailed description of treatment plans, the expected benefits and risks related to the proposed treatment plan, alternative treatment options, the client's questions, and the guardian's right to refuse treatment.

Page Ref: 11, 12 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care 7 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 Standards: QSEN Competencies: Informatics | AACN Essential Competencies: Essential IV: Information management and application of patient care technology. | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Planning/Communication Learning Outcome: 1.7 Contrast the policies for obtaining informed consent of minors to policies for adults.

10) A child is being prepared for an invasive procedure. The mother of the child has legal custody but is not present. After details of the procedure are explained, who can provide legal consent on behalf of a minor child for treatment?

1. The divorced parent without custody 2. A cohabitating boyfriend of the child's mother 3. A grandparent who lives in the home with the child 4. A babysitter with written proxy Answer: 4 Explanation: 1. A parent may grant proxy consent in writing to another adult so that children are not denied necessary healthcare. In the case of divorced parents, the parent with custody may be the only parent allowed by some states to give informed consent. Residence in the same household with a child does not authorize an adult to sign consent for treatment.

2. A parent may grant proxy consent in writing to another adult so that children are not denied necessary healthcare. In the case of divorced parents, the parent with custody may be the only parent allowed by some states to give informed consent. Residence in the same household with a child does not authorize an adult to sign consent for treatment.

3. A parent may grant proxy consent in writing to another adult so that children are not denied necessary healthcare. In the case of divorced parents, the parent with custody may be the only parent allowed by some states to give informed consent. Residence in the same household with a child does not authorize an adult to sign consent for treatment.

4. A parent may grant proxy consent in writing to another adult so that children are not denied necessary healthcare. In the case of divorced parents, the parent with custody may be the only parent allowed by some states to give informed consent. Residence in the same household with a child does not authorize an adult to sign consent for treatment.

Page Ref: 11, 12 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: Informatics | AACN Essential Competencies: Essential IV: Information management and application of patient care technology. | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 1.7 Contrast the policies for obtaining informed consent of minors to policies for adults.

8 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 11) A 12-year-old child is admitted to the unit for a surgical procedure. The child is accompanied by two parents and a younger sibling. What is the level of involvement in treatment decision making for this child?

1. Emancipated minor 2. Mature minor 3. Assent 4. None Answer: 3 Explanation: 1. Assent requires the ability to generally understand what procedure and treatments are planned, to understand what participation is required, and to make a statement of agreement or disagreement with the plan. Usually, in Piaget's stage of formal operations, 11- to 13-year-olds should be able to problem solve using abstract concepts and are able to give valid assent when parents sign the informed consent. An emancipated minor is a self-supporting adolescent who is not subject to the control of a parent or guardian. A mature minor is a 14- or 15-year-old whom the state law designates as being able to understand medical risks and who is thus permitted to give informed consent for treatment.

2. Assent requires the ability to generally understand what procedure and treatments are planned, to understand what participation is required, and to make a statement of agreement or disagreement with the plan. Usually, in Piaget's stage of formal operations, 11- to 13-year-olds should be able to problem solve using abstract concepts and are able to give valid assent when parents sign the informed consent. An emancipated minor is a self-supporting adolescent who is not subject to the control of a parent or guardian. A mature minor is a 14- or 15-year-old whom the state law designates as being able to understand medical risks and who is thus permitted to give informed consent for treatment.

3. Assent requires the ability to generally understand what procedure and treatments are planned, to understand what participation is required, and to make a statement of agreement or disagreement with the plan. Usually, in Piaget's stage of formal operations, 11- to 13-year-olds should be able to problem solve using abstract concepts and are able to give valid assent when parents sign the informed consent. An emancipated minor is a self-supporting adolescent who is not subject to the control of a parent or guardian. A mature minor is a 14- or 15-year-old whom the state law designates as being able to understand medical risks and who is thus permitted to give informed consent for treatment.

4. Assent requires the ability to generally understand what procedure and treatments are planned, to understand what participation is required, and to make a statement of agreement or disagreement with the plan. Usually, in Piaget's stage of formal operations, 11- to 13-year-olds should be able to problem solve using abstract concepts and are able to give valid assent when parents sign the informed consent. An emancipated minor is a self-supporting adolescent who is not subject to the control of a parent or guardian. A mature minor is a 14- or 15-year-old whom the state law designates as being able to understand medical risks and who is thus permitted to give informed consent for treatment.

Page Ref: 11, 12 Cognitive Level: Analyzing Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential V: Healthcare policy, finance, and regulatory environments. | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Planning/Communication Learning Outcome: 1.7 Contrast the policies for obtaining informed consent of minors to 9 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 policies for adults.

12) Which nursing intervention is most appropriate when providing education to the pediatric client and family?

1. Giving primary care for high-risk children who are in hospital settings 2. Giving primary care for healthy children 3. Working toward the goal of informed choices with the family 4. Obtaining a physician consultation for any technical procedures at delivery Answer: 3 Explanation: 1. The educator works with the family toward the goal of making informed choices through education and explanation.

2. The educator works with the family toward the goal of making informed choices through education and explanation.

3. The educator works with the family toward the goal of making informed choices through education and explanation.

4. The educator works with the family toward the goal of making informed choices through education and explanation.

Page Ref: 3 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential II: Basic organizational and systems leadership for quality care and patient safety | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Planning/Health teaching and health promotion Learning Outcome: 1.2 Identify the nursing roles available to pediatric nurses.

13) What is the pediatric nurse's best defense against an accusation of malpractice or negligence?

1. Following the physician's written orders 2. Meeting the scope and standards of practice for pediatric nursing 3. Being a nurse practitioner or clinical nurse specialist 4. Acting on the advice of the nurse manager Answer: 2 Explanation: 1. Meeting the scope and standards of practice for pediatric nursing would cover the pediatric nurse against an accusation of malpractice or negligence because the standards are rigorous and cover all bases of excellent nursing practice. Following the physician's written orders or acting on the advice of the nurse manager are not enough to defend the nurse from accusations because the orders and/or advice may be wrong or unethical. Being a clinical nurse specialist or nurse practitioner does not defend the nurse against these accusations if he or she does not follow the Society of Pediatric Nurses standards of practice.

2. Meeting the scope and standards of practice for pediatric nursing would cover the pediatric nurse against an accusation of malpractice or negligence because the standards are rigorous and cover all bases of excellent nursing practice. Following the physician's written orders or acting on the advice of the nurse manager are not enough to defend the nurse from accusations because the orders and/or advice may be wrong or unethical. Being a clinical nurse specialist or nurse practitioner does not defend the nurse against these accusations if he or she does not follow the Society of Pediatric Nurses standards of practice.

3. Meeting the scope and standards of practice for pediatric nursing would cover the pediatric 10 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 nurse against an accusation of malpractice or negligence because the standards are rigorous and cover all bases of excellent nursing practice. Following the physician's written orders or acting on the advice of the nurse manager are not enough to defend the nurse from accusations because the orders and/or advice may be wrong or unethical. Being a clinical nurse specialist or nurse practitioner does not defend the nurse against these accusations if he or she does not follow the Society of Pediatric Nurses standards of practice.

4. Meeting the scope and standards of practice for pediatric nursing would cover the pediatric nurse against an accusation of malpractice or negligence because the standards are rigorous and cover all bases of excellent nursing practice. Following the physician's written orders or acting on the advice of the nurse manager are not enough to defend the nurse from accusations because the orders and/or advice may be wrong or unethical. Being a clinical nurse specialist or nurse practitioner does not defend the nurse against these accusations if he or she does not follow the Society of Pediatric Nurses standards of practice.

Page Ref: 9-11 Cognitive Level: Analyzing Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential V: Healthcare policy, finance, and regulatory environments. | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Planning/Ethics Learning Outcome: 1.8 Delineate significant legal and ethical issues that influence the practice of pediatric nursing.

11 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 14) Which legal or ethical offense would be committed if a nurse tells family members the condition of a newborn baby without first consulting the parents?

1. A breach of privacy 2. Negligence 3. Malpractice 4. A breach of ethics Answer: 1 Explanation: 1. A breach of privacy would have been committed in this situation, because it violates the right to privacy of this family. The right to privacy is the right of a person to keep his or her person and property free from public scrutiny, including other family members.

Negligence and malpractice are punishable legal offenses and are more serious. A breach of ethics would not apply to this situation.

2. A breach of privacy would have been committed in this situation, because it violates the right to privacy of this family. The right to privacy is the right of a person to keep his or her person and property free from public scrutiny, including other family members. Negligence and malpractice are punishable legal offenses and are more serious. A breach of ethics would not apply to this situation.

3. A breach of privacy would have been committed in this situation, because it violates the right to privacy of this family. The right to privacy is the right of a person to keep his or her person and property free from public scrutiny, including other family members. Negligence and malpractice are punishable legal offenses and are more serious. A breach of ethics would not apply to this situation.

4. A breach of privacy would have been committed in this situation, because it violates the right to privacy of this family. The right to privacy is the right of a person to keep his or her person and property free from public scrutiny, including other family members. Negligence and malpractice are punishable legal offenses and are more serious. A breach of ethics would not apply to this situation.

Page Ref: 9-11 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential V: Healthcare policy, finance, and regulatory environments. | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Implementation/Ethics Learning Outcome: 1.8 Delineate significant legal and ethical issues that influence the practice of pediatric nursing.

12 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 15) Pediatric nurses have foundational knowledge obtained in nursing school and add specific competencies related to the pediatric client. Which would be considered an additional specific expected competency of the pediatric nurse?

1. Physical assessment 2. Anatomical and developmental differences 3. Nursing process 4. Management of healthcare conditions Answer: 2 Explanation: 1. Assessing anatomical and developmental differences would be a specific expected competency for the pediatric nurse that would not be learned in nursing school.

Physical assessment, nursing process, and management of health conditions are all foundational knowledge learned in nursing school.

2. Assessing anatomical and developmental differences would be a specific expected competency for the pediatric nurse that would not be learned in nursing school. Physical assessment, nursing process, and management of health conditions are all foundational knowledge learned in nursing school.

3. Assessing anatomical and developmental differences would be a specific expected competency for the pediatric nurse that would not be learned in nursing school. Physical assessment, nursing process, and management of health conditions are all foundational knowledge learned in nursing school.

4. Assessing anatomical and developmental differences would be a specific expected competency for the pediatric nurse that would not be learned in nursing school. Physical assessment, nursing process, and management of health conditions are all foundational knowledge learned in nursing school.

Page Ref: 2-4 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential II: Basic organizational and systems leadership for quality care and patient safety. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Assessment/Education Learning Outcome: 1.2 Identify the nursing roles available to pediatric nurses.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 16) Which of the following are components of family-centered care? Select all that apply.

1. Recognizing and building on family strengths 2. Meeting the emotional, social, and developmental needs of the child and family 3. Respect all parenting practices 4. Support all cultural practices 5. Encourage parent-to-parent support Answer: 1, 2, 5 Explanation: 1. Recognizing and building on family strengths are one of the components of family-centered care.

2. Meeting the emotional, social, and developmental needs of the child and family are included in the components of family-centered care.

3. Respecting all parenting practices is not one of the components of family-centered care.

4. Supporting all cultural practices is not one of the components of family-centered care.

5. Encouraging parent-to-parent support is one of the components of family-centered care.

Page Ref: 6 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential II: Basic organizational and systems leadership for quality care and patient safety. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Intervention/Coordination of care Learning Outcome: 1.1 Describe the continuum of pediatric healthcare.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 17) A three-week-old infant is returned post-pyloromyotomy three hours ago. The father is refusing pain medication for the infant and states, "The baby is hungry. Can I give the baby a bottle?" How should the nurse best advocate for the infant? Select all that apply.

1. Call the physician to ask if the child can feed yet.

2. The FLACC scale rating is 8 out of 10; try swaddling and rocking the infant.

3. Ask the parent to obtain a FLACC scale rating and let the nurse know what rating they get.

4. Educate the parent about the surgery and why the infant should not have anything by mouth.

5. Inform the parent about the meaning of the pain scale and the need for pain medication.

Answer: 4, 5 Explanation: 1. Calling the physician to ask if the infant can feed yet is not the best way to advocate for the infant.

2. Swaddling and rocking the infant may calm the child but is not the best way to advocate for the infant.

3. Asking the parent to obtain a FLACC scale rating and let the nurse know what rating they get.

This is not the parents' duty. It is the nurse's responsibility to assess pain.

4. Educating the parent about the surgery and why the infant should not have anything by mouth is a good way to advocate for the infant.

5. Informing the parent about the meaning of the pain scale and the need for pain medication is a good way to advocate for the infant.

Page Ref: 3 Cognitive Level: Analyzing Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential II: Basic organizational and systems leadership for quality care and patient safety. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Assessment/Health teaching and health promotion Learning Outcome: 1.2 Identify the nursing roles available to pediatric nurses.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 18) A 6-year-old patient has just been diagnosed with a condition that will have a complex treatment plan. Which action(s) should the pediatric nurse take to facilitate understanding and acceptance? Select all that apply.

1. Schedule a family conference with the patient, family, and healthcare providers to discuss available treatment options.

2. Have the family choose a spokesperson for nurses to provide updates to decrease confusion and facilitate communication.

3. Provide the patient and family with a list of local peer support groups related to the diagnosis.

4. Discourage the family from bringing personal items for the patient while hospitalized to limit infection risks.

Answer: 1, 3 Explanation: 1. Scheduling a time for healthcare providers, family, and the patient to discuss options together supports open, unbiased communication and acknowledges each member is an important part of the team.

2. Although it might be easier to communicate with just one person, this may limit collaboration options, trust, and decision-making abilities of all involved.

3. Family members, as well as patients, can benefit from peer support from others in similar situations.

4. When possible, nurses should encourage inclusion of family traditions and customs to include the presence of meaningful items near the patient.

Page Ref: 6 Cognitive Level: Evaluating Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential II: Basic organizational and systems leadership for quality care and patient safety. | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Assessment/Health teaching and health promotion Learning Outcome: 1.3 Summarize the current status of societal influences on pediatric health care and nursing practice.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 19) During a routine well child check-up, the pediatric nurse discusses prevention and emergency preparedness with the parents of a 2-year-old. Which of the following would be the highest priority to address to keep the child safe?

1. Keeping firearms locked and secured 2. Implementing safety equipment for the family pool 3. Securing hazardous chemicals and medications 4. Promoting consistent seat belt use Answer: 2 Explanation: 1. Although an important topic to address, firearms are not the top safety hazard for this age group.

2. According to the National Center for Health Statistics (2021), drowning was the leading cause of death for children 1-4 years old, so pool safety would be a top priority.

3. Potential for poisoning is a known risk factor for a 2-year-old, but it is not the highest risk of mortality.

4. Motor vehicle accidents make up the 2nd largest cause of death for this age group, but for a 2year-old, depending on size, proper fitting car seats would be a priority over seat belt use.

Page Ref: 7 Cognitive Level: Analyzing Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential II: Basic organizational and systems leadership for quality care and patient safety. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 1.4 Report the most common public health data for causes of child morbidity and mortality.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 20) A pediatric nurse is reviewing a phenytoin order for an infant with a seizure disorder. Which of the following information is important for the nurse to know when administering medications to an infant? Select all that apply.

1. Correct patient identifiers, such as name and age 2. Patient's weight in kg 3. Patient's height in cm 4. Patient's body mass index (BMI) Answer: 1, 2 Explanation: 1. Properly identifying a patient is key to preventing medication errors, especially in an infant who cannot provide verbal verification.

2. Most pediatric medications are calculated by weight in kg or body surface area (BSA).

3. Although the patient's height would be important to determine the body surface area, by itself it is not a key piece of information.

4. BMI is used most frequently to determine appropriate weight whereas BSA is a specific calculation utilized in medication dosage calculations.

Page Ref: 8-9 Cognitive Level: Analyzing Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential II: Basic organizational and systems leadership for quality care and patient safety. | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 1.5 Explore the value of the QSEN project in promoting patient safety and high-quality care.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 21) A new nurse is utilizing the Quality and Safety Education for Nurses (QSEN) project competencies to identify safety risks in the pediatric department's practices. Which of the below practices would help prevent patients' injuries? Select all that apply.

1. Utilizing verbal medication orders so there is opportunity for clarification 2. Using abbreviations especially in dose and frequency orders for legibility 3. Verifying pediatric medication dose calculations with another nurse 4. Use of a credentialed translator for families with limited English proficiency Answer: 3, 4 Explanation: 1. Verbal orders have multiple opportunities for errors from misunderstanding what is said to transcribing the information incorrectly.

2. Abbreviations should be avoided because they can often be confusing. For example, µg is often misinterpreted as mg.

3. Pediatric medication doses can include complex complications. Verifying with another nurse would be a safe practice.

4. Risks of misunderstandings are greatly increased when there are language barriers. Using a credentialed translator can help ensure information is properly conveyed.

Page Ref: 8-9 Cognitive Level: Evaluating Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IV: Information management and application of patient care technology. | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Learning Outcome: 1.5 Explore the value of the QSEN project in promoting patient safety and high-quality care.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 22) The pediatric department director wants to improve engagement among nurses in the unit.

Which of the following projects utilize evidence-based practices to improve patient care? Select all that apply.

1. Starting a nursing journal club 2. Encouraging nurses to gain specialty certification 3. Using a set annual orientation plan 4. Encouraging front-line nurses participation in policy revisions Answer: 1, 2, 4 Explanation: 1. Staying up to date in safe patient care requires nurses to become "life-long learners." The use of journal clubs in units supports the need for current knowledge and performance improvement activities.

2. Achieving a specialty certification demonstrates the nurse's commitment to providing patients quality safe care by requiring recipients to stay up to date on current practice changes and innovations.

3. Although high-risk topics should be reviewed at least annually, orientation plans should shift with current evidence-based practices to ensure quality patient care.

4. Front-line nurses are the most aware of daily safety issues in the work environment. Their participation in committees and policy revisions utilize evidence-based practice to increase engagement and make quality improvement changes that will benefit patients.

Page Ref: 7-8 Cognitive Level: Analyzing Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: Evidence-based practice | AACN Essential Competencies: Essential IV: Information management and application of patient care technology. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Assessment/Health teaching and health promotion Learning Outcome: 1.6 Analyze the role of evidence-based practice in improving the quality of nursing care for childrearing families.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 23) A nurse caring for a 14-year-old who was newly diagnosed with diabetes would be utilizing evidence-based practice through which of the following nursing activities? Select all that apply.

1. Using a "teach-back" method to ensure the patient and family know how to program an insulin pump 2. Providing a robust packet of discharge information for the family to review and refer back to later 3. Ensuring that the documentation in the patient's health record is accurate and complete 4. Educating the patient and family the importance of accurate and consistent glucose monitoring Answer: 1, 4 Explanation: 1. One suggestion supported by evidence-based practice to lower risk in complex treatment, such as the use of insulin pumps, is to ensure the patient and family are competent in its use by demonstrating the process or providing "teach-back."

2. Evidence-based practice shows that overloading families with written materials does not facilitate understanding and may increase safety risks.

3. Proper documentation is an essential component in risk management but not necessarily a component in utilizing evidence-based practice.

4. Current research shows improper monitoring of conditions, such as diabetes, is a high-risk topic in pediatric care. Providing this education to patients and families can help mediate this risk.

Page Ref: 8-9 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Evidence-based practice | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Diagnosis/Education Learning Outcome: 1.6 Analyze the role of evidence-based practice in improving the quality of nursing care for childrearing families.

Principles of Pediatric Nursing, 8e (Ball et al.)

Chapter 2 Culture and the Family 1) The nurse is planning care for an adolescent client who will be hospitalized for several weeks following a traumatic brain injury. Which interventions will enhance family-centered care for this client and family? Select all that apply.

1. Making all ADL decisions for the adolescent and family 2. Asking the adolescent what foods to include during meal time 3. Allowing the family time to pray each day with the adolescent 4. Encouraging the adolescent's friends to visit during visiting hours 5. Leaving all questions for the healthcare provider Answer: 2, 3, 4 Explanation: 1. Interventions that will enhance family-centered care for this client and family include asking the adolescent to be an active member of care by making food choices, allowing the family to pray each day with the adolescent, and encouraging the adolescent's friends to visit during visiting hours. These interventions each promote the concepts of family-centered care.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 provider do not promote the concepts of family-centered care.

2. Interventions that will enhance family-centered care for this client and family include asking the adolescent to be an active member of care by making food choices, allowing the family to pray each day with the adolescent, and encouraging the adolescent's friends to visit during visiting hours. These interventions each promote the concepts of family-centered care. Making all decisions for the adolescent and family and leaving all questions for the healthcare provider do not promote the concepts of family-centered care.

3. Interventions that will enhance family-centered care for this client and family include asking the adolescent to be an active member of care by making food choices, allowing the family to pray each day with the adolescent, and encouraging the adolescent's friends to visit during visiting hours. These interventions each promote the concepts of family-centered care. Making all decisions for the adolescent and family and leaving all questions for the healthcare provider do not promote the concepts of family-centered care.

4. Interventions that will enhance family-centered care for this client and family include asking the adolescent to be an active member of care by making food choices, allowing the family to pray each day with the adolescent, and encouraging the adolescent's friends to visit during visiting hours. These interventions each promote the concepts of family-centered care. Making all decisions for the adolescent and family and leaving all questions for the healthcare provider do not promote the concepts of family-centered care.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 5. Interventions that will enhance family-centered care for this client and family include asking the adolescent to be an active member of care by making food choices, allowing the family to pray each day with the adolescent, and encouraging the adolescent's friends to visit during visiting hours. These interventions each promote the concepts of family-centered care. Making all decisions for the adolescent and family and leaving all questions for the healthcare provider do not promote the concepts of family-centered care.

Page Ref: 18, 19 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential II: Basic organizational and systems leadership for quality care and patient safety. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Coordination of care Learning Outcome: 2.5 Discuss the use of a cultural assessment tool as a means of providing culturally sensitive care.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 2) A school-age client tells you that "Grandpa, Mommy, Daddy, and my brother live at my house." Which type of family will the nurse identify in the medical record based on this description?

1. Binuclear family 2. Extended family 3. Gay or lesbian family 4. Traditional nuclear family Answer: 2 Explanation: 1. An extended family contains a parent or a couple who share the house with their children and another adult relative. A binuclear family includes the divorced parents who have joint custody of their biologic children, while the children alternate spending varying amounts of time in the home of each parent. A gay or lesbian family is comprised of two same-sex domestic partners; they may or may not have children. The traditional nuclear family consists of an employed provider parent, a homemaking parent, and the biologic children of this union.

2. An extended family contains a parent or a couple who share the house with their children and another adult relative. A binuclear family includes the divorced parents who have joint custody of their biologic children, while the children alternate spending varying amounts of time in the home of each parent. A gay or lesbian family is comprised of two same-sex domestic partners; they may or may not have children. The traditional nuclear family consists of an employed provider parent, a homemaking parent, and the biologic children of this union.

3. An extended family contains a parent or a couple who share the house with their children and another adult relative. A binuclear family includes the divorced parents who have joint custody of their biologic children, while the children alternate spending varying amounts of time in the home of each parent. A gay or lesbian family is comprised of two same-sex domestic partners; they may or may not have children. The traditional nuclear family consists of an employed provider parent, a homemaking parent, and the biologic children of this union.

4. An extended family contains a parent or a couple who share the house with their children and another adult relative. A binuclear family includes the divorced parents who have joint custody of their biologic children, while the children alternate spending varying amounts of time in the home of each parent. A gay or lesbian family is comprised of two same-sex domestic partners; they may or may not have children. The traditional nuclear family consists of an employed provider parent, a homemaking parent, and the biologic children of this union.

Page Ref: 19, 20 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care Learning Outcome: 2.1 Compare the characteristics of different types of families.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 3) The nurse is performing an assessment of a child's biologic family history. Which situation would necessitate the nurse's asking the mother for information should use the term "child's father" instead of "your husband"?

1. Traditional nuclear family 2. Traditional extended family 3. Two-income nuclear family 4. Cohabitating informal stepfamily Answer: 4 Explanation: 1. The mother from the cohabitating informal stepfamily does not have a husband; the nurse should be asking about the "child's father." In the traditional nuclear family, the traditional extended family, and the two-income nuclear family, the child's father is the same person as the mother's husband.

2. The mother from the cohabitating informal stepfamily does not have a husband; the nurse should be asking about the "child's father." In the traditional nuclear family, the traditional extended family, and the two-income nuclear family, the child's father is the same person as the mother's husband.

3. The mother from the cohabitating informal stepfamily does not have a husband; the nurse should be asking about the "child's father." In the traditional nuclear family, the traditional extended family, and the two-income nuclear family, the child's father is the same person as the mother's husband.

4. The mother from the cohabitating informal stepfamily does not have a husband; the nurse should be asking about the "child's father." In the traditional nuclear family, the traditional extended family, and the two-income nuclear family, the child's father is the same person as the mother's husband.

Page Ref: 19, 20 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care Learning Outcome: 2.1 Compare the characteristics of different types of families.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 4) Several children arrived at the emergency department accompanied by their fathers. Which father may legally sign emergency medical consent for treatment?

1. The divorced one from the binuclear family 2. The stepfather from the blended or reconstituted family 3. The divorced one when the single-parent mother has custody 4. The nonbiologic one from the heterosexual cohabitating family Answer: 1 Explanation: 1. The divorced father from the binuclear family may sign informed consent because he has equal legal rights with the mother under joint-custody arrangements. The nonbiologic stepfather from the blended or reconstituted family, the divorced biologic father when the single-parent mother has custody, and the nonbiologic father from the heterosexual cohabitating family are without legal authority to seek emergency medical care for the child.

2. The divorced father from the binuclear family may sign informed consent because he has equal legal rights with the mother under joint-custody arrangements. The nonbiologic stepfather from the blended or reconstituted family, the divorced biologic father when the single-parent mother has custody, and the nonbiologic father from the heterosexual cohabitating family are without legal authority to seek emergency medical care for the child.

3. The divorced father from the binuclear family may sign informed consent because he has equal legal rights with the mother under joint-custody arrangements. The nonbiologic stepfather from the blended or reconstituted family, the divorced biologic father when the single-parent mother has custody, and the nonbiologic father from the heterosexual cohabitating family are without legal authority to seek emergency medical care for the child.

4. The divorced father from the binuclear family may sign informed consent because he has equal legal rights with the mother under joint-custody arrangements. The nonbiologic stepfather from the blended or reconstituted family, the divorced biologic father when the single-parent mother has custody, and the nonbiologic father from the heterosexual cohabitating family are without legal authority to seek emergency medical care for the child.

Page Ref: 20 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential II: Basic organizational and systems leadership for quality care and patient safety. | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Planning/Coordination of care Learning Outcome: 2.1 Compare the characteristics of different types of families.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 5) The community health nurse is assessing several families for various strengths and needs in regard to after-school and backup childcare arrangements. Which family type will benefit the most from this assessment and subsequent interventions?

1. The binuclear family 2. The extended family 3. The single-parent family 4. The traditional nuclear family Answer: 3 Explanation: 1. The single-parent family most typically lacks social, emotional, and financial resources. Nursing considerations for such families should include referrals to options that will enable the parent to fulfill work commitments while providing the child with access to resources that can support the child's growth and development. The binuclear family, the extended family, and the traditional nuclear family generally have at least two adults who can share in the care and the nurturing of its children.

2. The single-parent family most typically lacks social, emotional, and financial resources.

Nursing considerations for such families should include referrals to options that will enable the parent to fulfill work commitments while providing the child with access to resources that can support the child's growth and development. The binuclear family, the extended family, and the traditional nuclear family generally have at least two adults who can share in the care and the nurturing of its children.

3. The single-parent family most typically lacks social, emotional, and financial resources.

Nursing considerations for such families should include referrals to options that will enable the parent to fulfill work commitments while providing the child with access to resources that can support the child's growth and development. The binuclear family, the extended family, and the traditional nuclear family generally have at least two adults who can share in the care and the nurturing of its children.

4. The single-parent family most typically lacks social, emotional, and financial resources.

Nursing considerations for such families should include referrals to options that will enable the parent to fulfill work commitments while providing the child with access to resources that can support the child's growth and development. The binuclear family, the extended family, and the traditional nuclear family generally have at least two adults who can share in the care and the nurturing of its children.

Page Ref: 19, 20 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Assessment/Health teaching and health promotion Learning Outcome: 2.1 Compare the characteristics of different types of families.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 6) A pediatric nurse is caring for a child whose family identifies as a culture the nurse is unfamiliar with. Despite the nurse's lack of knowledge, which of the following statements demonstrates understanding of the importance of culture? Select the best answer.

1. "In order to get better, your child must have the blood transfusion otherwise you are impeding care."

2. "Outside food from home cannot be brought in for the patient because the child's diet must be monitored and controlled."

3. "We will work with you so your child may wear a protective amulet or other item important to you."

4. "Only the parents can be involved in the treatment discussions. We cannot accommodate extended family members."

Answer: 3 Explanation: 1. Many cultures and religions do not support blood transfusions. The nurse should try to offer alternatives rather than blaming the parents for impeding care.

2. During special holy days, some cultures eat food prepared only by family members. It would be more helpful to work with the family to see if the child's diet can be changed or a compromise can be made to monitor nutrients but also allow the family to honor the practice.

3. Many cultures have special symbols or items that hold special meaning. Allowing those items to be with the patient when possible is very important to show cultural respect.

4. Some cultures may defer to a male family member only, like the father, while others request extending family to help make decisions. Efforts should be made to allow this when possible.

Page Ref: 19-20 Cognitive Level: Analyzing Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Implementation/Coordination of care Learning Outcome: 2.3 Identify prevalent cultural norms related to childrearing.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 7) The pediatric nurse hears an adolescent patient state he is ill because God is punishing him.

This view of health would be categorized as which of the three views of health by Andrews and Boyle?

1. Magico-religious 2. Biomedical 3. Holistic 4. Scientific Answer: 1 Explanation: 1. In the magico-religious view, health is controlled by supernatural events, such as magic, or God. 2. Both biomedical and scientific views support the thought that illness is caused by the physiological and is scientifically based. Many would describe this as the "Western Medicine" view.

3. Holistic views view the mind and body as one so balance must be maintained. This can occur through a variety of complementary therapies.

4. As stated prior, scientific view is the same as biomedical view.

Page Ref: 20-21 Cognitive Level: Analyzing Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care Learning Outcome: 2.3 Identify prevalent cultural norms related to childrearing.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 8) An employee overhears a pediatric nurse say how difficult it is to communicate with her patient's parents because they do not speak English and feels they should have to learn. This type of statement is an example of which of the following? Select all that apply.

1. Acculturation 2. Ethnocentrism 3. Assimilation 4. Stereotyping Answer: 2, 3 Explanation: 1. Acculturation refers to steps a person may take to fit in to a new culture, such as dressing differently but not necessarily changing to the cultural norms.

2. Ethnocentrism is the belief that one's own culture is the best and everyone should follow its practices.

3. Assimilation is similar to acculturation but goes further to actually adopt the cultural practice as their own.

4. Stereotyping could be an appropriate answer if the nurse assumed the parents didn't speak English due to their race but in this case it is actually a fact.

Page Ref: 22-23 Cognitive Level: Analyzing Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care Learning Outcome: 2.4 Summarize the importance of cultural competency in providing nursing care.

9) The pediatric nurse is assigned a child whose family is of Mexican descent. The parents refer to the nurse as a curandera. What does this term mean? Select the best answer.

1. Empathic person 2. Female healer 3. Male healer 4. Holy person Answer: 2 Explanation: 1. Although demonstrating empathy is important as a nurse, that is not the meaning of the term.

2. Curandera means female healer.

3. A male healer is called a curandero.

4. Some cultures may view healthcare providers or other folk healers as holy persons, but it is not the best answer in this scenario.

Page Ref: 21 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential II: Basic organizational and systems leadership for quality care and patient safety. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care Learning Outcome: 2.4 Summarize the importance of cultural competency in providing nursing care.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 10) The nurse makes the following statements. Which shows understanding of the differences between religion and spirituality? Select all that apply.

1. Praying to Allah is a religious practice for Islam, whereas shamanic meditation to ask for one's guide's assistance would be more spiritual.

2. Spirituality refers to one's relationship with a higher power, whereas religion focuses on worship of that power.

3. Both terms have the same meaning, but religion is specific to God and spirituality is more focused on nature.

4. It is possible to have anti-religious views, like atheism, but still have a spirituality belief.

Answer: 1, 2, 4 Explanation: 1. Prayer is a common ritual shared by many religions whereas shamanic practices are not tied to a specific deity, but a broader spiritual belief.

2. Spirituality's focus is more holistic and vast, whereas religion has set beliefs usually focusing on one God. 3. The terms are similar but they are not the same. Spirituality may include practices involving nature, but that is not the only belief.

4. Because spirituality does not focus on one set God, it is possible to not believe in a God but still have spiritual desires for connection with the universe.

Page Ref: 21-22 Cognitive Level: Analyzing Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Assessment/Health teaching and health promotion Learning Outcome: 2.6 Identify key considerations in providing spiritually sensitive care.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 11) At times, a family's religious views may disagree or even contradict those of the nurses caring for their child. Which statements related to medical and religious conflicts are correct?

Select all that apply.

1. Jehovah Witness families often will refuse all medical treatments.

2. Roman Catholics may refuse the use of contraception devices and medicines.

3. Buddhists may ask for a nurse that is the same gender as the patient.

4. Those who practice Judaism may demand an autopsy if a loved one dies.

Answer: 2, 3 Explanation: 1. Jehovah Witnesses do not tend to refuse all medical treatments but will often refuse those requiring transfusion of blood.

2. Many Roman Catholics hold beliefs against the use of contraception to prevent pregnancy.

3. Modesty is a strongly held belief in Buddhism, so a family may request a female nurse care for their female child, instead of a male.

4. This statement is completely untrue. In fact, most Jews will request a quick burial after death with no autopsy.

Page Ref: 21-22 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care Learning Outcome: 2.6 Identify key considerations in providing spiritually sensitive care.

12) When assessing a new patient, which question might be important for the pediatric nurse to ask in reference to the use complementary and alternative therapies? Select all that apply.

1. Does the child or anyone in the family take herbal supplements?

2. Does the child have any allergies to food or scents?

3. Is the child on any special diet not prescribed by a MD? 4. When was the last time the child had a physical?

Answer: 1, 2, 3 Explanation: 1. Many herbal medications can interfere or counteract prescription medications and treatments. This can result in life-threatening complications.

2. Allergies are always important to know. Allergies to foods and/or specific scents can be exacerbated with some homeopathic remedies and aromatherapies.

3. Children are at risk for nutritional deficiencies, and some alternative diets can cause physical damage to a growing body.

4. Although this is important information, it is not specific to CAM treatments.

Page Ref: 26 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Assessment/Health teaching and health promotion Learning Outcome: 2.8 Determine the benefits and risks of complementary and alternative therapies.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 13) Complementary therapies tend to be used in conjunction with Western Medicine whereas Alternative therapies are used instead of conventional medicine. Which example would be an example of an alternative therapy? Select the best answer.

1. Massage therapy for back pain while pregnant 2. Guided imagery for stress relief during labor 3. Aromatherapy to reduce symptoms of morning sickness 4. Drinking red raspberry leaf tea for leg cramps rather than checking calcium levels Answer: 1, 2, 3 Explanation: 1. Massage is a complementary therapy often used in conjunction with Western Medicine.

2. Guided imagery is a complementary therapy often used in conjunction with Western Medicine.

3. Aromatherapy is a complementary therapy often used in conjunction with Western Medicine.

4. Drinking tea instead of getting medical therapy is an alternative therapy.

Page Ref: 27 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: Informatics | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Implementation/Coordination of care Learning Outcome: 2.7 Differentiate between complementary and alternative therapies.

14) The pediatric nurse is explaining to a 5-year-old and parents why alternative therapies are generally not considered safe. Which comments from the parents show they understand this teaching? Select all that apply.

1. Alternative therapies are often not tested appropriately or FDA approved.

2. Alternative therapies are additional treatments I can use with my child's doctor.

3. Many herbs used in alternative therapy can interact with my child's prescribed medications.

4. Alternative therapies are widely available and cheaper than prescription medications.

Answer: 1, 3 Explanation: 1. Alternative therapies currently have no regulations, no robust testing, and no FDA approval. So, there is really no way to know what you are getting and whether it's safe.

2. Alternative therapies are used instead of conventional medicine, not in addition to.

3. Many herbal therapies can interact or counteract other medications causing dangerous side effects.

4. Since these therapies are not regulated, they are usually not available at most clinics or hospitals and insurance will not pay for them.

Page Ref: 26 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Assessment/Health teaching and health promotion Learning Outcome: 2.8 Determine the benefits and risks of complementary and alternative therapies.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 15) Complementary therapies can be very beneficial for preventative care and health maintenance of infants and children. Which therapies should the pediatric nurse caution families to seek out specially trained providers for children?

1. Therapeutic touch 2. Aromatherapy 3. Biofeedback 4. Infant massage Answer: 1 Explanation: 1. Therapeutic touch has special precautions for newborns and young children.

2. Aromatherapy specialties are often distinguished between human and animal, not as much by age.

3. Biofeedback is a common therapy now and almost considered conventional now.

4. Infant massage is developed for this age group but is something parents can learn and apply.

Page Ref: 28 Cognitive Level: Analyzing Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: Informatics | AACN Essential Competencies: Essential II: Basic organizational and systems leadership for quality care and patient safety. | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Implementation/Coordination of care Learning Outcome: 2.7 Differentiate between complementary and alternative therapies.

16) A pediatric nurse is an avid yoga practitioner and thinks the "mama yoga" class at the studio she attends would be beneficial for one of her patients. Before the nurse professionally recommends any therapy, what must be attained?

1. Insurance approval 2. Informed consent 3. Evidence-based studies showing clinical usefulness 4. Permission from the patient's primary physician Answer: 2 Explanation: 1. Although many complementary therapies are partially covered by insurance, that would not be a responsibility of prudent nursing care.

2. Before recommending any therapy, the nurse should provide all the necessary risks, benefits, and alternatives to the patient to ensure informed consent.

3. Researching evidence-based research can be helpful to educate patients about the benefits but isn't a necessity.

4. Professional courtesy might lead the nurse to inform the patient's PCP prior to recommending any therapy, but it is not mandatory to do so.

Page Ref: 29 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care Learning Outcome: 2.9 Summarize complementary therapies appropriate for the nurse to use with childrearing families.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 17) Nurses have a duty to be life-long learners and support evidence-based research. Which are important reasons for nurses to record their results with complementary therapies and their pediatric patients? Select all that apply.

1. To improve the use of complementary therapies that have had success with pediatric issues 2. To educate other professionals on which therapies are not safe or effective 3. To encourage wider acceptance of these therapies and their benefits to childrearing families 4. To publish research and attain grants Answer: 1, 2, 3 Explanation: 1. Acceptance of complementary therapy options are improving, but documenting a specific therapy and its effectiveness for a particular health problem can help more patients get access to that option that otherwise would not.

2. While promoting good therapies, research documentation can also expose dangerous ones.

3. Many families do not utilize therapies that could be of benefit because of lack of knowledge or public stigma. Documenting the results of research can help change that.

4. Although good research may improve publishing and grant opportunities, the main focus should be on improving the profession and patient's wellbeing.

Page Ref: 28 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Evidence-based practice | AACN Essential Competencies: Essential II: Basic organizational and systems leadership for quality care and patient safety. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Assessment/Health teaching and health promotion Learning Outcome: 2.9 Summarize complementary therapies appropriate for the nurse to use with childrearing families.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 18) A pediatric nurse has just taken a role assessing the children at a border detention camp.

Which is a cultural assessment tool that can help this nurse determine bias to improve interactions with migrant families?

1. Self-assessment tool 2. Communication climate assessment 3. Caring efficacy scale 4. Belief formation scale Answer: 1 Explanation: 1. Self-assessment is the most important for this nurse to determine personal values and biases that could affect patient care.

2. The communication climate assessment tool is a cultural tool but is focused on identifying communication problems.

3. The caring efficacy scale measures the nurses knowledge of caring behaviors, and although does have a self-assessment option it is not focused on cultural competency.

4. The belief formation scale measures bias but not associated to culture but rather critical thinking.

Page Ref: 26 Cognitive Level: Evaluating Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care Learning Outcome: 2.5 Discuss the use of a cultural assessment tool as a means of providing culturally sensitive care.

19) Reviewing the 8-stage family lifecycle framework can help the pediatric nurse determine expected milestones for the typical nuclear family. Which is a stage of this lifecycle? Select all that apply.

1. Stage II- Childbearing family 2. Stage VII- Family with teenagers 3. Stage VIII- Family in retirement 4. Stage I- Family with infant Answer: 1, 3 Explanation: 1. Stage II of this scale is describing a childbearing family where the oldest child is no older than 30 months.

2. Family with teenagers is Stage V. Stage VII is middle-aged parents.

3. Stage VIII is a family in retirement. This stage continues until the death of both spouses.

4. Finally, Stage I is the beginning family that is newly married with no children. Stage II is the stage described with an infant.

Page Ref: 19 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care Learning Outcome: 2.2 Identify the stages of a family lifecycle.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 20) The make-up of a traditional family has changed since the traditional nuclear family frameworks. Which are other family stages or lifecycles that the pediatric nurse should be aware of? Select all that apply.

1. Single parent families 2. Gay and/or lesbian families 3. Blended families after a remarriage 4. Married adults not planning for children Answer: 1, 2, 3 Explanation: 1. Many families are broken due to divorce or not being married. Single parents face many challenges that the pediatric nurse should be alert to.

2. Families that do not fit the traditional definition are becoming more common and may invoke bias in some nurses that should be acknowledged.

3. With the increase in divorce, there is also an increase in blended families when parents remarry. Step-parent/Step-children and differences in values can be challenging when working with a family.

4. Although there are many married/cohabiting couples choosing not to have children, they would not apply to this scenario.

Page Ref: 19 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care Learning Outcome: 2.2 Identify the stages of a family lifecycle.

Principles of Pediatric Nursing, 8e (Ball et al.)

Chapter 3 Genetic and Genomic Influences in Child Health 1) Personalized healthcare for health promotion and maintenance can be based on environmental factors and which other item?

1. The genes a person inherited 2. Common conditions with known treatment strategies 3. Teaching strategies 4. The health of the person Answer: 1 Explanation: 1. Personalized healthcare is based on environmental factors and the genes the person inherited. Common conditions and the current health of the person are not part of personalized healthcare. Teaching strategies are not part of personalized healthcare.

2. Personalized healthcare is based on environmental factors and the genes the person inherited.

Common conditions and the current health of the person are not part of personalized healthcare.

Teaching strategies are not part of personalized healthcare.

3. Personalized healthcare is based on environmental factors and the genes the person inherited.

Common conditions and the current health of the person are not part of personalized healthcare.

Teaching strategies are not part of personalized healthcare.

4. Personalized healthcare is based on environmental factors and the genes the person inherited.

Common conditions and the current health of the person are not part of personalized healthcare.

Teaching strategies are not part of personalized healthcare.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 Page Ref: 49, 50 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Assessment/Health teaching and health promotion Learning Outcome: 3.1 Understand foundational concepts of genetics and genomics, including how DNA influences health and illness.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 2) A three-generation pedigree is constructed around the designated "index" patient. Based on this knowledge, which explanation of the term proband is the most accurate?

1. The "index" patient has the disorder of interest.

2. One parent of the "index" patient has the disorder of interest.

3. The "index" patient does not have the disorder of interest.

4. Siblings of the "index" patient do not have the disorder of interest.

Answer: 1 Explanation: 1. The proband indicates that the "index" patient has the disorder of interest. A consultand is an "index" patient seeking genetic counseling for a disorder she is not affected by at present.

2. The proband indicates that the "index" patient has the disorder of interest. A consultand is an "index" patient seeking genetic counseling for a disorder she is not affected by at present.

3. The proband indicates that the "index" patient has the disorder of interest. A consultand is an "index" patient seeking genetic counseling for a disorder she is not affected by at present.

4. The proband indicates that the "index" patient has the disorder of interest. A consultand is an "index" patient seeking genetic counseling for a disorder she is not affected by at present.

Page Ref: 58 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Assessment/Health teaching and health promotion Learning Outcome: 3.6 Describe the role of the nurses in assessing and communicating genetic risk, including eliciting a family history, creating a genetic pedigree, and incorporating understanding of genetics into physical assessment.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 3) A father is a known carrier of an X-linked condition, and asks when he will know whether his newborn son has the condition he carries. Which response by the nurse is the most appropriate?

1. "Genetic studies have been ordered, and they will take about a week to determine the results."

2. "We plan to run additional tests this afternoon, and should have results by the end of the day."

3. "Your son cannot have the condition because the condition is X-linked and cannot be passed on to him."

4. "There is a 50 percent chance you passed it on, but further tests are not recommended until he is a month old."

Answer: 3 Explanation: 1. A male child does not inherit any X chromosome from the father; therefore, the male child will not have the condition.

2. A male child does not inherit any X chromosome from the father; therefore, the male child will not have the condition.

3. A male child does not inherit any X chromosome from the father; therefore, the male child will not have the condition.

4. A male child does not inherit any X chromosome from the father; therefore, the male child will not have the condition.

Page Ref: 53, 54 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 3.4 Identify characteristics of common inheritance patterns of single-gene (Mendelian) conditions.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 4) A student nurse asks, "What is carrier testing?" Which response by the nurse educator is most appropriate to answer the student nurse's question?

1. "Carrier testing involves testing an asymptomatic individual for carrier status for a genetic condition."

2. "Carrier testing is used to establish a diagnosis of a genetic disorder in an individual who is symptomatic or has had a positive screening test."

3. "Carrier testing is testing to identify a fetus with a genetic disease or condition. Some prenatal testing is offered routinely; other testing may be initiated due to family history or maternal factors."

4. "Carrier testing follows in vitro fertilization (IVF) testing to identify embryos with a particular genetic condition."

Answer: 1 Explanation: 1. Carrier testing involves testing an asymptomatic individual for carrier status for a genetic condition. Diagnostic testing is testing to identify a fetus with a genetic disease or condition. Some prenatal testing is offered routinely; other testing may be initiated due to family history or maternal factors. Prenatal testing is testing to identify a fetus with a genetic disease or condition. Some prenatal testing is offered routinely; other testing may be initiated due to family history or maternal factors. Pre-implantation testing follows in vitro fertilization (IVF) testing to identify embryos with a particular genetic condition.

2. Carrier testing involves testing an asymptomatic individual for carrier status for a genetic condition. Diagnostic testing is testing to identify a fetus with a genetic disease or condition.

Some prenatal testing is offered routinely; other testing may be initiated due to family history or maternal factors. Prenatal testing is testing to identify a fetus with a genetic disease or condition.

Some prenatal testing is offered routinely; other testing may be initiated due to family history or maternal factors. Pre-implantation testing follows in vitro fertilization (IVF) testing to identify embryos with a particular genetic condition.

3. Carrier testing involves testing an asymptomatic individual for carrier status for a genetic condition. Diagnostic testing is testing to identify a fetus with a genetic disease or condition.

Some prenatal testing is offered routinely; other testing may be initiated due to family history or maternal factors. Prenatal testing is testing to identify a fetus with a genetic disease or condition.

Some prenatal testing is offered routinely; other testing may be initiated due to family history or maternal factors. Pre-implantation testing follows in vitro fertilization (IVF) testing to identify embryos with a particular genetic condition.

4. Carrier testing involves testing an asymptomatic individual for carrier status for a genetic condition. Diagnostic testing is testing to identify a fetus with a genetic disease or condition.

Some prenatal testing is offered routinely; other testing may be initiated due to family history or maternal factors. Prenatal testing is testing to identify a fetus with a genetic disease or condition.

Some prenatal testing is offered routinely; other testing may be initiated due to family history or maternal factors. Pre-implantation testing follows in vitro fertilization (IVF) testing to identify embryos with a particular genetic condition.

Page Ref: 56 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 3.5 Explain ways that nurses can advocate for and support patients and families undergoing genetic testing.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 5) Which genetic test would be best for the prospective father who recently had a positive screen for a genetic condition?

1. Carrier testing 2. Predictive testing 3. Diagnostic testing 4. Prenatal testing Answer: 3 Explanation: 1. Diagnostic testing is best for an individual who has a positive screen for a genetic disorder. Prenatal testing would be done with a pregnancy. Carrier testing is done with an asymptomatic individual who wishes to know whether he or she is a carrier of a condition.

Predictive testing predicts the likelihood of a condition later in life.

2. Diagnostic testing is best for an individual who has a positive screen for a genetic disorder.

Prenatal testing would be done with a pregnancy. Carrier testing is done with an asymptomatic individual who wishes to know whether he or she is a carrier of a condition. Predictive testing predicts the likelihood of a condition later in life.

3. Diagnostic testing is best for an individual who has a positive screen for a genetic disorder.

Prenatal testing would be done with a pregnancy. Carrier testing is done with an asymptomatic individual who wishes to know whether he or she is a carrier of a condition. Predictive testing predicts the likelihood of a condition later in life.

4. Diagnostic testing is best for an individual who has a positive screen for a genetic disorder.

Prenatal testing would be done with a pregnancy. Carrier testing is done with an asymptomatic individual who wishes to know whether he or she is a carrier of a condition. Predictive testing predicts the likelihood of a condition later in life.

Page Ref: 55-57 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Assessment/Health teaching and health promotion Learning Outcome: 3.5 Explain ways that nurses can advocate for and support patients and families undergoing genetic testing.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 6) The nurse is preparing a three-generation family pedigree. A student asks the nurse the significance of the darkened circles. Which response by the nurse is the most appropriate?

1. "Males unaffected by the disease."

2. "Males affected by the disease."

3. "Females unaffected by the disease."

4. "Females affected by the disease."

Answer: 4 Explanation: 1. A circle is the standard symbol for a female, and darkening the circle represents a female affected by a disease. A male is represented by a square.

2. A circle is the standard symbol for a female, and darkening the circle represents a female affected by a disease. A male is represented by a square.

3. A circle is the standard symbol for a female, and darkening the circle represents a female affected by a disease. A male is represented by a square.

4. A circle is the standard symbol for a female, and darkening the circle represents a female affected by a disease. A male is represented by a square.

Page Ref: 57, 58 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Assessment/Health teaching and health promotion Learning Outcome: 3.6 Describe the role of the nurses in assessing and communicating genetic risk, including eliciting a family history, creating a genetic pedigree, and incorporating understanding of genetics into physical assessment.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 7) A family desires genetic testing for their adolescent. What response by the clinic nurse is appropriate?

1. "The child is a minor and cannot give consent."

2. "It is not advisable because insurance does not pay for this test."

3. "Let me discuss this with the adolescent and then we can discuss it more fully."

4. "There is a chance the adolescent might be discriminated against because of the test."

Answer: 3 Explanation: 1. The adolescent is old enough to understand the pros and cons of testing. It would be advisable to discuss the matter with the adolescent and then more fully with the parents. That the minor is not able to give consent is true, but this answer cuts off discussion and is not appropriate. Insurance and discrimination can play a role in the decision, but still are not the appropriate answers because they do not address the issue of the request for testing.

2. The adolescent is old enough to understand the pros and cons of testing. It would be advisable to discuss the matter with the adolescent and then more fully with the parents. That the minor is not able to give consent is true, but this answer cuts off discussion and is not appropriate.

Insurance and discrimination can play a role in the decision, but still are not the appropriate answers because they do not address the issue of the request for testing.

3. The adolescent is old enough to understand the pros and cons of testing. It would be advisable to discuss the matter with the adolescent and then more fully with the parents. That the minor is not able to give consent is true, but this answer cuts off discussion and is not appropriate.

Insurance and discrimination can play a role in the decision, but still are not the appropriate answers because they do not address the issue of the request for testing.

4. The adolescent is old enough to understand the pros and cons of testing. It would be advisable to discuss the matter with the adolescent and then more fully with the parents. That the minor is not able to give consent is true, but this answer cuts off discussion and is not appropriate.

Insurance and discrimination can play a role in the decision, but still are not the appropriate answers because they do not address the issue of the request for testing.

Page Ref: 59-61 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 3.7 Identify children or families who might benefit from genetic information and services or referral to a genetic professional, and explain the nurse's role in supporting the family undergoing genetic counseling.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 8) A nurse is planning an education session on genetic testing. What would not concern the nurse when planning the session?

1. Cultural beliefs 2. Religious beliefs 3. Family values 4. Insurance reimbursement Answer: 4 Explanation: 1. Cultural and religious beliefs and family values are all considerations when planning a teaching session on genetic testing. Insurance plays a factor in determining whether the test is done, but is not a consideration in the teaching session itself.

2. Cultural and religious beliefs and family values are all considerations when planning a teaching session on genetic testing. Insurance plays a factor in determining whether the test is done, but is not a consideration in the teaching session itself.

3. Cultural and religious beliefs and family values are all considerations when planning a teaching session on genetic testing. Insurance plays a factor in determining whether the test is done, but is not a consideration in the teaching session itself.

4. Cultural and religious beliefs and family values are all considerations when planning a teaching session on genetic testing. Insurance plays a factor in determining whether the test is done, but is not a consideration in the teaching session itself.

Page Ref: 62, 63 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Planning/Health teaching and health promotion Learning Outcome: 3.8 Discuss ethical, legal, and social implications of genomic healthcare.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 9) A nurse is planning care for a family who is undergoing genetic screening. Which expected outcome will the nurse include in the plan of care for this family?

1. Consult an attorney before making a decision.

2. Make a voluntary decision related to genetic health issues.

3. Not consider the influence of genetics on health promotion.

4. Look closely at the present before considering the future as it relates to genetic screening.

Answer: 2 Explanation: 1. The goal of nursing care is to allow informed, voluntary decisions when it comes to genetic screening.

2. The goal of nursing care is to allow informed, voluntary decisions when it comes to genetic screening.

3. The goal of nursing care is to allow informed, voluntary decisions when it comes to genetic screening.

4. The goal of nursing care is to allow informed, voluntary decisions when it comes to genetic screening.

Page Ref: 61 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Planning/Health teaching and health promotion Learning Outcome: 3.8 Discuss ethical, legal, and social implications of genomic healthcare.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 10) The nurse notes some dysmorphic facial features when examining a toddler in the well-child clinic. Which measurement taken by the nurse would not be considered when looking at dysmorphic facial features?

1. Interpupillary distance 2. Intercanthal distance 3. The distance from the outer canthus to the pinna 4. Outer cantus distance Answer: 3 Explanation: 1. The distance from the outer canthus to the pinna does not apply to the face. The other measurements would be necessary when evaluating facial dysmorphic features.

2. The distance from the outer canthus to the pinna does not apply to the face. The other measurements would be necessary when evaluating facial dysmorphic features.

3. The distance from the outer canthus to the pinna does not apply to the face. The other measurements would be necessary when evaluating facial dysmorphic features.

4. The distance from the outer canthus to the pinna does not apply to the face. The other measurements would be necessary when evaluating facial dysmorphic features.

Page Ref: 58-60 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Assessment/Quality of practice Learning Outcome: 3.6 Describe the role of the nurses in assessing and communicating genetic risk, including eliciting a family history, creating a genetic pedigree, and incorporating understanding of genetics into physical assessment.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 11) When conducting a health history on a late school-age client, what would the nurse document as a dysmorphic feature?

1. A repaired cleft palate 2. A 10 percent burn to the face 3. A severed finger 4. A flat anterior fontanel Answer: 1 Explanation: 1. A dysmorphic feature was present at birth. A cleft palate, even though repaired, would be included in a health history as a dysmorphic feature. The burns and a severed digit were not present at birth, and would not be considered dysmorphic. A soft fontanel would be considered normal.

2. A dysmorphic feature was present at birth. A cleft palate, even though repaired, would be included in a health history as a dysmorphic feature. The burns and a severed digit were not present at birth, and would not be considered dysmorphic. A soft fontanel would be considered normal.

3. A dysmorphic feature was present at birth. A cleft palate, even though repaired, would be included in a health history as a dysmorphic feature. The burns and a severed digit were not present at birth, and would not be considered dysmorphic. A soft fontanel would be considered normal.

4. A dysmorphic feature was present at birth. A cleft palate, even though repaired, would be included in a health history as a dysmorphic feature. The burns and a severed digit were not present at birth, and would not be considered dysmorphic. A soft fontanel would be considered normal.

Page Ref: 60 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Quality improvement | AACN Essential Competencies: Essential IV: Information management and application of patient care technology. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Implementation/Quality of practice Learning Outcome: 3.6 Describe the role of the nurses in assessing and communicating genetic risk, including eliciting a family history, creating a genetic pedigree, and incorporating understanding of genetics into physical assessment.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 12) When completing a pedigree, which factors should be included? Select all that apply.

1. Full siblings only 2. Begin with the proband 3. Mark each generation with a Roman numeral 4. Include at least three generations 5. Use only standard pedigree symbols Answer: 2, 3, 4, 5 Explanation: 1. It is important to include half-siblings in addition to full siblings, as half-siblings have half the genetic history that the full siblings do. The other answers are all important to include in a pedigree.

2. It is important to include half-siblings in addition to full siblings, as half-siblings have half the genetic history that the full siblings do. The other answers are all important to include in a pedigree.

3. It is important to include half-siblings in addition to full siblings, as half-siblings have half the genetic history that the full siblings do. The other answers are all important to include in a pedigree.

4. It is important to include half-siblings in addition to full siblings, as half-siblings have half the genetic history that the full siblings do. The other answers are all important to include in a pedigree.

5. It is important to include half-siblings in addition to full siblings, as half-siblings have half the genetic history that the full siblings do. The other answers are all important to include in a pedigree.

Page Ref: 57, 58 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Planning/Quality of practice Learning Outcome: 3.6 Describe the role of the nurses in assessing and communicating genetic risk, including eliciting a family history, creating a genetic pedigree, and incorporating understanding of genetics into physical assessment.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 13) The nurse is discussing genetic conditions with a family of a newborn. Which genetic conditions fall under the inheritance pattern of autosomal recessive conditions? Select all that apply.

1. Achondroplasia 2. Marfan syndrome 3. Hemophilia A 4. Cystic fibrosis 5. Sickle cell disease Answer: 4, 5 Explanation: 1. Achondroplasia is not an autosomal recessive condition. Beta-thalassemia, cystic fibrosis, Gaucher disease, phenylketonuria, sickle cell disease, and Tay-sachs disease all are autosomal recessive conditions.

2. Marfan syndrome is not an autosomal recessive condition. Beta-thalassemia, cystic fibrosis, Gaucher disease, phenylketonuria, sickle cell disease, and Tay-sachs disease all are autosomal recessive conditions.

3. Hemophilia A is not an autosomal recessive condition. Beta-thalassemia, cystic fibrosis, Gaucher disease, phenylketonuria, sickle cell disease, and Tay-sachs disease all are autosomal recessive conditions.

4. Cystic fibrosis is an autosomal recessive condition. Beta-thalassemia, cystic fibrosis, Gaucher disease, phenylketonuria, sickle cell disease, and Tay-sachs disease all are autosomal recessive conditions.

5. Sickle cell disease is an autosomal recessive condition. Beta-thalassemia, cystic fibrosis, Gaucher disease, phenylketonuria, sickle cell disease, and Tay-sachs disease all are autosomal recessive conditions.

Page Ref: 52 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Diagnosis/Education Learning Outcome: 3.4 Identify characteristics of common inheritance patterns of single-gene (Mendelian) conditions.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 14) The pediatric nurse is reviewing the electronic medical record (EMR) of the next patient and sees that the child has a chromosome alteration known as trisomy 21. The nurse can anticipate the child has which of the following conditions?

1. Turner syndrome 2. Down syndrome 3. Patau syndrome 4. Edwards syndrome Answer: 2 Explanation: 1. Turner syndrome is a monosomic condition, having only one X chromosome.

2. Down syndrome, also known as trisomy 21, is the most common extra chromosome alteration.

3. Although Patau syndrome is also a trisomy condition, it has 13 chromosomes not 21.

4. Edwards syndrome is also a trisomy condition but instead of 21 chromosomes, these persons have 18.

Page Ref: 33 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Assessment/Health teaching and health promotion Learning Outcome: 3.2 Explain mechanisms by which alterations in DNA cause disease.

15) During cell division, alterations can occur in the chromosomes affecting their number or structure. Which alterations is an abnormality in chromosome structure? Select all that apply.

1. Inversion 2. Mosaicism 3. Translocation 4. Monozygotic Answer: 1, 3 Explanation: 1. Inversion is a form of alteration in the chromosomal structure where the chromosome breaks in two and reattaches to itself at the opposite end.

2. Mosaicism is actually an alteration of chromosomal number not structure, resulting in separate but different lines of chromosomes.

3. Translocation is a form of structure alteration in which two chromosomes exchange pieces of DNA with one another.

4. Monozygotic is not an alteration in chromosome number or structure. It refers to two people who developed from the same ovum, also known as identical twins.

Page Ref: 32-33 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Assessment/Health teaching and health promotion Learning Outcome: 3.2 Explain mechanisms by which alterations in DNA cause disease.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 16) A single genetic variation, whether inherited or acquired, can increase or decrease a patient's risk of disease. Example(s) of a single-gene variant a pediatric nurse might encounter include(s) which disorders? Select all that apply.

1. Cystic fibrosis 2. Autism 3. Asthma 4. Huntington disease Answer: 1 Explanation: 1. Cystic fibrosis is a common hereditary single gene, also known as Mendelian, variant.

2. Autism is a multifactorial disorder, meaning it is the result of several altered genes influenced by the environment.

3. Like autism, asthma is also a multifactorial disorder.

4. Unlike the previous disorders, Huntington disease is a trinucleotide repeat disorder consisting of sets of triple variants instead of just one.

Page Ref: 35 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 3.3 Distinguish between single-gene (Mendelian) and multifactorial diseases and health conditions.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 17) Not all genetic mutations cause disease; some Mendelian variations can result in protective autosomal recessive disorders. While educating a family with recessive genes for sickle cell disease, the nurse informs them this alteration can lower the risk of developing which disease?

1. HIV 2. AIDS 3. Malaria 4. Heart disease Answer: 3 Explanation: 1. The alteration of the CCR5 gene, not sickle cell, can affect infection from the HIV virus.

2. If a person has that same alteration of the CCR5 gene, but it is copied, the HIV infected person will have a delayed progression to AIDS. 3. A single altered copy of the gene that causes sickle cell can result in decreased chance of malaria infection.

4. Heart disease is actually caused by multifactorial variants, not prevented.

Page Ref: 35 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 3.3 Distinguish between single-gene (Mendelian) and multifactorial diseases and health conditions.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 18) While caring for an unusually small 6-month-old girl, the pediatric nurse notes the diagnosis of failure to thrive and the child's parents are reluctant to seek genetic counseling to discover the cause. How might the nurse support the family during the genetic counseling process? Select all that apply.

1. Explain to the family what to expect during the counseling visits.

2. Provide support group information, if appropriate.

3. Provide direction to the family to proceed with testing.

4. Ensure the family that a definitive diagnosis should be provided quickly.

Answer: 1, 2 Explanation: 1. Explaining what the counseling visit will be like, such as how long it may take and what types of questions may be asked, can help the family prepare and be less stressed.

2. The nurse should be a support to the family but also provide resources, such as support groups, which can also be of benefit.

3. The nurse should educate but encourage families to make their own decisions, not guide or sway them.

4. Families should be informed that some ideas may be presented at the initial counseling visit; a definitive diagnosis may take time.

Page Ref: 47-48 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Diagnosis/Education Learning Outcome: 3.5 Explain ways that nurses can advocate for and support patients and families undergoing genetic testing.

Principles of Pediatric Nursing, 8e (Ball et al.)

Chapter 4 Growth and Development 1) While being comforted in the emergency department, the 6-year-old male sibling of a pediatric trauma victim blurts out to the nurse, "It's all my fault! When we were fighting yesterday, I told him I wished he was dead!" Which response by the nurse is most therapeutic?

1. Asking the child if he would like to sit down and drink some water 2. Sitting the child down in an empty room with markers and paper so that he can draw a picture 3. Reassuring the child that it is normal to get angry and say things that we do not mean, but that we have no control over whether an accident happens 4. Discussing the catheters, tubes, and equipment that the sibling requires, and explaining why they are needed Answer: 3 Explanation: 1. Ignoring the child's outburst will not help the child understand it really was not his fault.

2. Asking the child to draw a picture might be appropriate later, but the nurse first needs to make sure the child knows the trauma did not occur because of anything he said.

3. Magical thinking is the belief that events occur because of one's thoughts or actions, and the most therapeutic way to respond to this is to correct any misconceptions that the child might have and reassure him that he is not to blame for any accident or illness.

4. Addressing the sibling's needs and equipment reinforces the child's magical thinking that the 54 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 trauma was his fault.

Page Ref: 59 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: III.C.1. Appreciate strengths and weaknesses of scientific bases for practice | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Knowledge and Science: Knowledge: Integration of knowledge from nursing and other disciplines | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 4.1 Describe the major theories of development as formulated by Freud, Erikson, Piaget, Kohlberg, social learning theorists, and behaviorists.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 2) The nurse is conducting a physical assessment for a pediatric client. Which part of Bronfenbrenner's ecologic theory of development is the nurse assessing when discussing the parents' work environment in relation to the client?

1. Chronosystem 2. Mesosystem 3. Macrosystem 4. Exosystem Answer: 4 Explanation: 1. The chronosystem involves the perspective of time in the child's life.

2. The relationships of one microsystem to another involve a child's mesosystem.

3. Political and cultural beliefs comprise a child's macrosystem.

4. A child's exosystem is composed of the settings that influence a child even though he or she is not in daily contact with that system.

Page Ref: 61 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: III.C.1. Appreciate strengths and weaknesses of scientific bases for practice | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Knowledge and Science: Knowledge: Integration of knowledge from nursing and other disciplines | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 4.4 Explain contemporary developmental approaches such as temperament theory, ecological theory, and the resilience framework.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 3) The parents of a toddler are concerned that their child seems different from their other child, stating, "He just doesn't seem to like new people and wants us with him in these situations."

Which response by the nurse is appropriate when using the temperament theory to respond to the toddler's parents?

1. "Your child seems to withdraw from new situations. This is typical with slow-to-warm-up children."

2. "Your child is having an intense reaction to the environment and new people, and we will need to investigate this more closely."

3. "Difficult children often display a negative mood. Does your child often throw temper tantrums?"

4. "Slow-to-warm-up children are often diagnosed with autism spectrum disorder."

Answer: 1 Explanation: 1. Slow-to-warm-up children adapt slowly to new situations and initially will withdraw.

2. Having intense reactions to the environment is a characteristic of "difficult" children. The child in this scenario is not displaying this temperament. This response is inaccurate and not appropriate.

3. Displaying a predominately negative mood to the environment is a characteristic of "difficult" children. The child in this scenario is not displaying this temperament. This response is inaccurate and not appropriate.

4. Slow-to-warm-up children are not often diagnosed with autism spectrum disorder. This statement is inaccurate and not appropriate.

Page Ref: 62 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: III.C.1. Appreciate strengths and weaknesses of scientific bases for practice | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Knowledge and Science: Knowledge: Integration of knowledge from nursing and other disciplines | Nursing/Integrated Concepts: Implementation/Communication and Documentation Learning Outcome: 4.4 Explain contemporary developmental approaches such as temperament theory, ecological theory, and the resilience framework.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 4) The parents of a 12-month-old client ask the nurse for suggestions regarding age-appropriate toys for their child. Which toys are appropriate for the nurse to recommend for this client? Select all that apply.

1. Soft toys that can be mouthed 2. Toys with black-and-white patterns 3. Toys that can pop apart and go back together 4. Jack-in-the-box toys 5. Push-and-pull toys Answer: 3, 4, 5 Explanation: 1. A 12-month-old client is more mobile and shows less interest in soft toys that can be placed in the mouth.

2. A 12-month-old client will tend to enjoy colorful toys, not toys with black-and-white patterns.

3. A 12-month-old client has gross and fine motor skills that are becoming more developed and enjoys toys that can help them refine these skills.

4. A 12-month-old client enjoys toys that can be manipulated and that grab his or her attention. A jack-in-the-box toy allows both.

5. A 12-month-old client is learning to walk and will enjoy toys that promote mobility.

Page Ref: 70 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Knowledge and Science: Knowledge: Integration of knowledge from nursing and other disciplines | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 4.5 Identify major developmental milestones for infants, toddlers, preschoolers, school-age children, and adolescents.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 5) While assessing the development of a 9-month-old client, the nurse asks the mother if the child actively looks for toys when they are placed out of sight. Which is the nurse assessing with this question to the parent?

1. Transductive reasoning 2. Conservation 3. Centration 4. Object permanence Answer: 4 Explanation: 1. Transductive reasoning is when a child connects two events in a cause—effect relationship because the events occurred at the same time.

2. Conservation is when a child knows that matter is not changed when its form is altered.

3. Centration is when a child focuses on only one particular aspect of a situation.

4. A child who has developed object permanence has the ability to understand that even though something is out of sight, it still exists.

Page Ref: 72 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Knowledge and Science: Knowledge: Integration of knowledge from nursing and other disciplines | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 4.5 Identify major developmental milestones for infants, toddlers, preschoolers, school-age children, and adolescents.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 6) The nurse is assessing language development in all the pediatric clients presenting at the healthcare provider's office for well-child visits. At which age would the nurse further assess language development if the client is unable to verbalize the words "dada" and "mama"?

1. 3 months 2. 6 months 3. 8 months 4. 12 months Answer: 4 Explanation: 1. By 3 months of age, infants vocalize during play and with familiar people. The infant may also begin to laugh. At this time, they do not use these as names for the parents.

2. By 6 months of age, infants will be making the sounds "mamamamam" and "dadadada" because they like to repeat sounds. At this time, they do not use these as names for the parents.

3. By 8 months of age, infants will be making the sounds "mamamamam" and "dadadada" because they like to repeat sounds. At this time, they do not use these as names for the parents.

4. By 12 months of age, children should be able to verbalize "mama" or "dada" to identify their mother or father. This client would require further assessment by the nurse.

Page Ref: 69 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Knowledge and Science: Knowledge: Integration of knowledge from nursing and other disciplines | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 4.6 Synthesize information from several theoretical approaches to plan assessments of the child's physical growth and developmental milestones.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 7) Two 3-year-old clients are playing together in a hospital playroom. One is working on a puzzle, while the other is stacking blocks. Which type of play are these children participating in based on this scenario?

1. Cooperative play 2. Solitary play 3. Parallel play 4. Associative play Answer: 3 Explanation: 1. Cooperative play is when children demonstrate the ability to cooperate with others and to play a part in order to contribute to a unified whole. The school-age child participates in cooperative play.

2. Solitary play is when a child plays alone. Infants' play style is described as solitary.

3. Parallel play is when two or more children play together, each engaging in his or her own activities.

4. Associative play is characterized by children interacting in groups and participating in similar activities. Preschoolers' play style is associative.

Page Ref: 72 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Knowledge and Science: Knowledge: Integration of knowledge from nursing and other disciplines | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 4.3 Plan nursing interventions for children that are appropriate for each child's developmental state based on theoretical frameworks.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 8) The nurse is teaching new parents how to communicate with their infant. Which response by the parents indicates accurate understanding of the information presented?

1. "I will prop the bottle while my baby is in the car seat so that I can cook dinner."

2. "I will use a low-pitched voice while talking to my baby as this is most appropriate."

3. "I will unwrap my baby when she is upset to allow interaction with the environment."

4. "I will talk and sing to my baby while I am providing daily care, including diaper changes."

Answer: 4 Explanation: 1. Parents should hold their babies during feedings as a method of communicating with their infants. This parental response indicates the need for further education.

2. Parents should use a high-pitched, not low-pitched, voice when talking with their infant children. This parental response indicates the need for further education.

3. Parents should swaddle and hold their infants when they are upset as a communication method. Unwrapping the baby when the baby is upset indicates the need for further education.

4. Parents should talk and sing to their infants while providing daily care, such as diaper changes.

This parental response indicates accurate understanding of the information presented.

Page Ref: 70 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Knowledge and Science: Knowledge: Integration of knowledge from nursing and other disciplines | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 4.3 Plan nursing interventions for children that are appropriate for each child's developmental state based on theoretical frameworks.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 9) While trying to inform a 5-year-old child about what will occur during an upcoming CT scan, the nurse notices that the child is engaged in a collective monologue, talking about a new puppy.

Which response by the nurse is age appropriate?

1. "You must be so excited to have a new puppy! They are so much fun. Now let me tell you again about going downstairs in a wheelchair to a special room."

2. Redirect the child by saying, "Please stop talking about your puppy. I need to tell you about your CT scan."

3. "I'll come back when you are ready to talk with me more about your CT scan."

4. Ignore the information regarding the puppy and state, "I need to teach you about going to the special room later today."

Answer: 1 Explanation: 1. When a child becomes engaged in a collective monologue, it is best to respond to the content of her conversation and then attempt to reinsert facts about the content that needs to be covered.

2. Asking the child to stop talking about her puppy and then abruptly talking about the CT scan will alienate the child and possibly make her shut down.

3. Coming back later is not usually an option, as radiologic exams are scheduled for a certain time. The nurse needs to address the inattention but should listen for a few moments before directing the client's attention.

4. Ignoring the child's obvious lack of attention will not help prepare her for the upcoming procedure.

Page Ref: 77 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Knowledge and Science: Knowledge: Integration of knowledge from nursing and other disciplines | Nursing/Integrated Concepts: Implementation/Communication and Documentation Learning Outcome: 4.3 Plan nursing interventions for children that are appropriate for each child's developmental state based on theoretical frameworks.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 10) The mother of a 6-year-old boy who has recently had surgery for the removal of his tonsils and adenoids complains that he has begun sucking his thumb again. Which defense mechanism will the nurse include when responding to the mother?

1. Repression 2. Rationalization 3. Fantasy 4. Regression Answer: 4 Explanation: 1. Repression is the involuntary forgetting of uncomfortable situations. The child is not exhibiting repression.

2. Rationalization is an attempt to make unacceptable feelings acceptable. The child is not exhibiting rationalization.

3. Fantasy is a creation of the mind to help deal with an unacceptable fear. The child is not exhibiting fantasy.

4. Regression is a return to an earlier behavior and can often occur during a hospital stay. The nurse will include regression in the response to the mother.

Page Ref: 55 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Knowledge and Science: Knowledge: Integration of knowledge from nursing and other disciplines | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 4.2 Recognize risks to developmental progression and factors that protect against those risks.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 11) The nurse is preparing to administer an intramuscular injection to a toddler-age client. Which is the most appropriate statement by the nurse prior to this procedure?

1. "It is all right to cry. After we are done, you can go to the box and pick out your favorite sticker."

2. "We will give you your shot when your mommy comes back."

3. "I will wipe your skin with a magic wipe and then hold the needle like this and say 'one, two, three, go' and give you your shot. Are you ready?"

4. "This is a magic sword that will give you your medicine and make you all better."

Answer: 1 Explanation: 1. The most appropriate response would be to acknowledge the child's feelings, and allow the child to pick out a sticker at the conclusion of the injection.

2. Waiting for the mother to come back would be inappropriate because toddlers do not have an understanding of time.

3. Giving elaborate descriptions and using colorful language are inappropriate because the instructions are unclear and lengthy.

4. The nurse should not make statements that are not true and might confuse the child.

Page Ref: 74 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Knowledge and Science: Knowledge: Integration of knowledge from nursing and other disciplines | Nursing/Integrated Concepts: Implementation/Communication and Documentation Learning Outcome: 4.8 Use data collected during developmental assessments to implement activities that promote development of children and adolescents.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 12) An adolescent client diagnosed with cystic fibrosis suddenly becomes noncompliant with the medication regimen. Which nursing intervention would most likely improve compliance?

1. Give the client a computer-animated game that presents information on the management of cystic fibrosis.

2. Set up a meeting with other adolescents with the cystic fibrosis who have been managing their disease effectively.

3. Arrange for the primary healthcare provider to sit down and talk to the client about the risks related to noncompliance with medications.

4. Discuss with the client's parents that privileges, such as a cell phone, can be taken away if compliance fails to improve.

Answer: 2 Explanation: 1. Interest in games might begin to wane during adolescence.

2. Providing adolescents with positive role models who are in their peer group is the intervention most likely to improve compliance.

3. Adult opinions, even from a primary healthcare provider, could be viewed negatively and challenged.

4. Threatening punishment could further incite rebellion.

Page Ref: 82 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Knowledge and Science: Knowledge: Integration of knowledge from nursing and other disciplines | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 4.8 Use data collected during developmental assessments to implement activities that promote development of children and adolescents.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 13) The home health nurse is conducting a home visit for a family. The toddler-age child, who is potty training, has an "accident." The mother becomes angry with the child and calls him a baby for messing himself. Which is the nurse concerned with regarding the toddler's development, based on the mother's reaction?

1. The child's cognitive development 2. The child's sense of independence 3. The child's conscience 4. The child's superego Answer: 2 Explanation: 1. Erikson's theory is related to psychosocial development. The mother's criticism will not affect the child's ability to think.

2. Erikson's toddler stage is autonomy (independence) versus shame and doubt. The mother's criticism may hinder the child's sense of independence.

3. Conscience is what controls our knowledge of right and wrong and is a component of Kohlberg's theory. The mother's criticism will not affect the child's conscience, according to Kohlberg.

4. In Freudian theory, the superego is the moral and ethical system of the personality. The mother's criticism will not affect the child's superego.

Page Ref: 56 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Knowledge and Science: Knowledge: Integration of knowledge from nursing and other disciplines | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 4.6 Synthesize information from several theoretical approaches to plan assessments of the child's physical growth and developmental milestones.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 14) The clinic administrator has suggested that the nurse teach all children newly diagnosed with diabetes in a single class to save nursing time. The children recently diagnosed range in age from 6 to 15. Which is the rationale for the nursing staff to continue with more than one group session?

1. Freud's theory of psychosexual development, which states that the 6-year-old child's sexual energy is at rest while the adolescent has developed mature sexuality.

2. Erikson's psychosocial theory, which discusses how children learn to relate to others.

3. Piaget's cognitive development theory, which says the 6-year-old child learns by concrete examples, while the 15-year-old adolescent can think abstractly.

4. Kohlberg's theory, which says the young children are conventional in their thinking and will want to learn to please others, while older children can internalize values and will learn for their own principles.

Answer: 3 Explanation: 1. This theory would not explain why it would be the best to separate the group by age.

2. Erikson's theory is about relationships, not learning ability.

3. The younger child will need to handle the equipment, and observe demonstrations, while the older child will require more discussion and less demonstration.

4. Kohlberg's theory may explain the reasons the child learns the material but does not discuss the learning style.

Page Ref: 58 Cognitive Level: Understanding Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Knowledge and Science: Knowledge: Integration of knowledge from nursing and other disciplines | Nursing/Integrated Concepts: Planning/Teaching and Learning Learning Outcome: 4.6 Synthesize information from several theoretical approaches to plan assessments of the child's physical growth and developmental milestones.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 15) As children grow and develop, their style of play changes. Place the descriptions of play styles in order from infancy to school age.

1. Plays beside but not with other children 2. Plays games with other children and is able to follow the rules of the game 3. Plays alone with play directed by others 4. Plays with others in loose groups Answer: 3, 1, 4, 2 Explanation: 1.

This describes parallel play, seen in toddlers.

2. This describes cooperative play, seen in the school-age child.

3. This describes infant-style play, called solitary play.

4. This describes associative play, which is seen in the preschooler.

Page Ref: 70, 73, 74, 77 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: I2.5 Develop a plan of care. | NLN Competencies: Knowledge and Science: Knowledge: Integration of knowledge from nursing and other disciplines | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 4.5 Identify major developmental milestones for infants, toddlers, preschoolers, school-age children, and adolescents.

16) A 10-year-old client has been struggling with his self-esteem. Which activity would best help this child have a positive resolution of Erikson's industry versus inferiority stage?

1. Playing sports with his older brother and the brother's friends 2. Having his mother compliment him when he completes his homework 3. Encouraging the child to participate in Boy Scouts and earn badges 4. Suggesting to the mother that she allow the child to babysit his younger siblings Answer: 3 Explanation: 1. This would not help the child develop a positive self-esteem because the older boys will be more skilled at the sport than this child.

2. Positive reinforcement is beneficial but does not support the development of industry.

3. The badges will be a visible documentation of his accomplishments.

4. The 10-year-old cannot safely babysit the younger children, and this is unrelated to Erikson's sense of industry.

Page Ref: 56 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Knowledge and Science: Knowledge: Integration of knowledge from nursing and other disciplines | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 4.3 Plan nursing interventions for children that are appropriate for each child's developmental state based on theoretical frameworks.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 17) Two hospitalized pediatric clients are working on a puzzle together in the hospital playroom.

Which type of play are the clients exhibiting?

1. Solitary play 2. Associative play 3. Parallel play 4. Cooperative play Answer: 4 Explanation: 1. Solitary play is when a child plays alone.

2. Associative play is characterized by children interacting in groups and participating in similar activities.

3. Parallel play is when two or more children play together, each engaging in his or her own activities.

4. Cooperative play is when children demonstrate the ability to cooperate with others and to play a part in order to contribute to a unified whole.

Page Ref: 78 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Knowledge and Science: Knowledge: Integration of knowledge from nursing and other disciplines | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 4.7 Describe the role of play in the growth and development of children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 18) Which nursing actions are developmentally appropriate when caring for a hospitalized school-age child? Select all that apply.

1. Knocking on the school-age child's hospital room door prior to entering 2. Giving clear instructions about details of treatment 3. Providing brochures regarding sexuality 4. Offering medical equipment to play with prior to a procedure 5. Using toys for distraction during a painful procedure Answer: 1, 2 Explanation: 1. It is developmentally appropriate for the nurse to knock on the school-age child's door prior to entering the hospital room to provide care.

2. It is developmentally appropriate for the nurse to give clear instructions to the school-age child regarding details of the treatment.

3. Information regarding sexuality is more appropriate for the adolescent versus the school-age child.

4. Offering medical equipment to play with prior to a procedure is more appropriate for the preschool, not the school-age, child.

5. Using toys for distraction during a painful procedure is more appropriate for the preschool, not the school-age, child.

Page Ref: 58 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Knowledge and Science: Knowledge: Integration of knowledge from nursing and other disciplines | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 4.3 Plan nursing interventions for children that are appropriate for each child's developmental state based on theoretical frameworks.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 19) Which nursing actions are developmentally appropriate when providing care to a hospitalized toddler-age child? Select all that apply.

1. Using a crib mobile for distraction during a procedure 2. Having a potty-chair available 3. Allowing self-feeding opportunities 4. Showing equipment that will be used during the scheduled surgery 5. Assessing drawings to determine concerns Answer: 2, 3 Explanation: 1. A crib mobile would be more developmentally appropriate for the infant, not the toddler-age, child.

2. Many toddlers are potty training; therefore, it is appropriate for the nurse to have a potty-chair available for the child.

3. It is appropriate for the nurse to allow for self-feeding opportunities as this is developmentally appropriate for a toddler-age child.

4. Showing equipment that will be used during a scheduled surgery is not a developmentally appropriate intervention for a toddler-age child. This is more appropriate for the preschool-age child.

5. Assessing drawing to determine concerns is developmentally appropriate for the preschool, not the toddler-age, child.

Page Ref: 57 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Knowledge and Science: Knowledge: Integration of knowledge from nursing and other disciplines | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 4.3 Plan nursing interventions for children that are appropriate for each child's developmental state based on theoretical frameworks.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 20) The nurse is assessing a 6-month-old infant during a scheduled well-baby checkup. Which are expected findings for this infant? Select all that apply.

1. No head lag when pulled for sitting 2. Ability to turn from back to abdomen 3. Manipulates objects.

4. Transfers objects from one hand to the other.

5. A pincer grasp is noted.

Answer: 1, 2, 3 Explanation: 1. A 6-month-old infant should not have head lag when pulled for sitting. This is an expected finding.

2. A 6-month-old infant should be able to turn from back to abdomen. This is an expected finding.

3. A 6-month-old infant is able to manipulate objects. This is an expected finding.

4. The nurse would not anticipate that the 6-month-old infant would be able to transfer objects from one hand to the other. This is an unexpected finding.

5. The nurse would not anticipate that the 6-month-old infant would use a pincer grasp. This is an unexpected finding.

Page Ref: 68 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Knowledge and Science: Knowledge: Integration of knowledge from nursing and other disciplines | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 4.5 Identify major developmental milestones for infants, toddlers, preschoolers, school-age children, and adolescents.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 21) The nurse provides education to the parents of a 7-month-old infant regarding play. Which parental responses indicate accurate understanding of the information presented? Select all that apply.

1. "I should offer my baby toys that are black and white."

2. "My baby will prefer stuffed animals during this stage of development."

3. "I should offer my baby a teething ring during this stage of development."

4. "My baby will want to interact with other people."

5. "I should offer my baby large blocks to stack while sitting on the floor."

Answer: 3, 4 Explanation: 1. Black and white toys are often preferred by infants from birth to 3 months, not at 7 months. The statement indicates the need for further education.

2. Stuffed animals are often enjoyed by infants between 3 months and 6 months, not at 7 months.

The statement indicates the need for further education.

3. Many babies are teething by 7 months of age; therefore, it is appropriate to offer the infant a teething ring. This statement indicates accurate understanding of the information presented.

4. By 6 to 9 months of age, the infant will enjoy interacting with other people. This statement indicates appropriate understanding of the information presented.

5. Stacking blocks is not a skill acquired until 9 to 12 months of age. This statement indicates the need for further education.

Page Ref: 70 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Knowledge and Science: Knowledge: Integration of knowledge from nursing and other disciplines | Nursing/Integrated Concepts: Nursing Process: Evaluation/Teaching and Learning Learning Outcome: 4.7 Describe the role of play in the growth and development of children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 22) Which activities will the nurse suggest to the parents of a preschool-age child to enhance fine motor skills? Select all that apply.

1. Using scissors 2. Playing with clay 3. Riding a bicycle 4. Throwing a ball 5. Tying shoe laces Answer: 1, 2, 5 Explanation: 1. Using scissors is an activity that will enhance fine motor skills during the preschool years.

2. Playing with clay is an activity that will enhance fine motor skills during the preschool years.

3. Riding a bicycle is an activity that will enhance gross, not fine, motor skills during the preschool years.

4. Throwing a ball is an activity that will enhance gross, not fine, motor skills during the preschool years.

5. Tying shoe laces is an activity that will enhance fine motor skills during the preschool years.

Page Ref: 74 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Knowledge and Science: Knowledge: Integration of knowledge from nursing and other disciplines | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 4.8 Use data collected during developmental assessments to implement activities that promote development of children and adolescents.

Principles of Pediatric Nursing, 8e (Ball et al.)

Chapter 5 Infant, Child, and Adolescent Nutrition 1) A school-age client, recently diagnosed with asthma, also has a peanut allergy. The nurse instructs the family to not only avoid peanuts but also to carefully check food label ingredients for peanut products and to make sure dishes and utensils are adequately washed prior to food preparation. The mother asks why this is specific for her child. Based on the client's history, the nurse knows that this client is at an increased risk for which complication?

1. Urticaria 2. Diarrhea 3. Anaphylaxis 4. Headache Answer: 3 Explanation: 1. Children with food allergies may experience all of the above reactions to a particular food, but the child who also has asthma is most at risk for death secondary to anaphylaxis caused by a food allergy.

2. Children with food allergies may experience all of the above reactions to a particular food, but the child who also has asthma is most at risk for death secondary to anaphylaxis caused by a food allergy.

3. Children with food allergies may experience all of the above reactions to a particular food, but 75 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 the child who also has asthma is most at risk for death secondary to anaphylaxis caused by a food allergy.

4. Children with food allergies may experience all of the above reactions to a particular food, but the child who also has asthma is most at risk for death secondary to anaphylaxis caused by a food allergy.

Page Ref: 305 Cognitive Level: Applying Client Need/Sub: Physiological Integrity Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 5.5 Develop nursing interventions for children with nutritional disorders.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 2) While teaching the parents of a newborn about infant care and feeding, which instruction by the nurse is the most appropriate?

1. Delay supplemental foods until the infant is 4 to 6 months old.

2. Delay supplemental foods until the infant reaches 15 pounds or greater.

3. Begin diluted fruit juice at 2 months of age, but wait 3 to 5 days before trying a new food.

4. Add rice cereal to the nighttime feeding if the infant is having difficulty sleeping after 2 months of age.

Answer: 1 Explanation: 1. Four to six months is the optimal age to begin supplemental feedings because earlier feeding of nonformula foods is not needed by the infant and does not promote sleep.

Earlier feeding of nonformula foods, regardless of the infant's weight, is more likely to cause the development of food allergies. Also, early feeding is not well tolerated by infants because the necessary tongue control is not well developed and they lack the digestive enzymes to take in and metabolize many food products.

2. Four to six months is the optimal age to begin supplemental feedings because earlier feeding of nonformula foods is not needed by the infant and does not promote sleep. Earlier feeding of nonformula foods, regardless of the infant's weight, is more likely to cause the development of food allergies. Also, early feeding is not well tolerated by infants because the necessary tongue control is not well developed and they lack the digestive enzymes to take in and metabolize many food products.

3. Four to six months is the optimal age to begin supplemental feedings because earlier feeding of nonformula foods is not needed by the infant and does not promote sleep. Earlier feeding of nonformula foods, regardless of the infant's weight, is more likely to cause the development of food allergies. Also, early feeding is not well tolerated by infants because the necessary tongue control is not well developed and they lack the digestive enzymes to take in and metabolize many food products.

4. Four to six months is the optimal age to begin supplemental feedings because earlier feeding of nonformula foods is not needed by the infant and does not promote sleep. Earlier feeding of nonformula foods, regardless of the infant's weight, is more likely to cause the development of food allergies. Also, early feeding is not well tolerated by infants because the necessary tongue control is not well developed and they lack the digestive enzymes to take in and metabolize many food products.

Page Ref: 285-286 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Evidence-based practice | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 5.1 Discuss major nutritional concepts pertaining to the growth and development of children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 3) During a 4-month-old's well-child check, the nurse discusses introduction of solid foods into the infant's diet and concerns for foods commonly associated with food allergies. Due to allergies, which foods will the nurse instruct the parents to avoid until after 1 year of age?

1. Strawberries 2. Peas 3. Carrots 4. Squash Answer: 1 Explanation: 1. Strawberries, eggs, and wheat, along with corn, fish, and nut products, are all foods that have commonly been associated with food allergies.

2. Peas and tomatoes are acceptable to try after an infant is 4 to 6 months old but should be given one at a time and 3 to 5 days after starting a new food.

3. Carrots, beets, and spinach contain nitrates and should not be given before the age of 4 months.

4. Squash is acceptable to try after an infant is 4 to 6 months old but should be given one at a time and 3 to 5 days after starting a new food.

Page Ref: 89 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Evidence-based practice | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 5.1 Discuss major nutritional concepts pertaining to the growth and development of children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 4) The mother of a toddler is concerned because her child does not seem interested in eating. The child is drinking 5 to 6 cups of whole milk per day and one cup of fruit juice. When the weightto-height percentile is calculated, the child is in the 90th to 95th percentile. What is the best advice the nurse can provide to the mother?

1. Eliminate the fruit juice from the child's diet.

2. Offer healthy snacks, presented in a creative manner, and let the child choose what he wants to eat without pressure from the parents.

3. Change from whole milk to 2 percent milk, and decrease milk consumption to two to three cups per day and only at mealtimes and snacks.

4. Make sure that the child is getting adequate opportunities for exercise, as this will increase his appetite and help lower the child's weight-to-height percentile.

Answer: 3 Explanation: 1. Toddlers require a maximum of 16-24 oz (1/2 to 3/4 L) of milk daily. This toddler is consuming most of his or her calories from the milk and thus is not hungry. The high fat content of the milk is also contributing to the child's higher weight-to-height percentile.

Decreasing the amount and fat content of the milk will decrease calories and thus make the child hungry for other foods. The other advice is also appropriate but did not address the problem of excessive milk consumption.

2. It is not necessary to remove all juice from the diet, but to provide in moderation, no more than 4 oz (1/2 cup) daily.

3. This advice is appropriate but does not address the problem of excessive milk consumption.

4. This advice is also appropriate but still does not address the problem of excessive milk consumption.

Page Ref: 90 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 5.2 Describe and plan nursing interventions to meet nutritional needs for all age groups from infancy through adolescence.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 5) A nurse is talking to the mother of an exclusively breastfed African American 3-month-old infant who was born in late fall. Which supplement will the nurse recommend for this infant?

1. Iron 2. Vitamin D 3. Fluoride 4. Calcium Answer: 2 Explanation: 1. An infant's iron stores are usually adequate until about 4 to 6 months of age. The infant should be receiving sufficient amounts of calcium from breast milk, and fluoride supplementation, if needed, does not begin until the child is approximately 6 months old. This infant will have limited exposure to sunlight and thus vitamin D because of the infant's dark skin and decreased sun exposure in the fall and winter months.

2. An infant's iron stores are usually adequate until about 4 to 6 months of age. The infant should be receiving sufficient amounts of calcium from breast milk, and fluoride supplementation, if needed, does not begin until the child is approximately 6 months old. This infant will have limited exposure to sunlight and thus vitamin D because of the infant's dark skin and decreased sun exposure in the fall and winter months.

3. An infant's iron stores are usually adequate until about 4 to 6 months of age. The infant should be receiving sufficient amounts of calcium from breast milk, and fluoride supplementation, if needed, does not begin until the child is approximately 6 months old. This infant will have limited exposure to sunlight and thus vitamin D because of the infant's dark skin and decreased sun exposure in the fall and winter months.

4. An infant's iron stores are usually adequate until about 4 to 6 months of age. The infant should be receiving sufficient amounts of calcium from breast milk, and fluoride supplementation, if needed, does not begin until the child is approximately 6 months old. This infant will have limited exposure to sunlight and thus vitamin D because of the infant's dark skin and decreased sun exposure in the fall and winter months.

Page Ref: 284 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Planning/Health teaching and health promotion Learning Outcome: 5.2 Describe and plan nursing interventions to meet nutritional needs for all age groups from infancy through adolescence.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 6) The nurse is teaching the parents of a 4-month-old infant about good feeding habits. The nurse emphasizes the importance of holding the baby during feeding and not letting the infant go to sleep with the bottle. Which disorder is associated with propped feedings and going to sleep with the bottle?

1. Otitis media 2. Aspiration 3. Malocclusion problems 4. Sleeping disorders Answer: 1 Explanation: 1. It has been shown in numerous studies that allowing an infant to fall asleep with a bottle in his or her mouth causes pooling of the formula in the mouth, which increases the risk of both dental caries and otitis media. There has been limited data to date showing a positive correlation between bottle propping and increased risk of aspiration, malocclusions, and sleeping disorders.

2. It has been shown in numerous studies that allowing an infant to fall asleep with a bottle in his or her mouth causes pooling of the formula in the mouth, which increases the risk of both dental caries and otitis media. There has been limited data to date showing a positive correlation between bottle propping and increased risk of aspiration, malocclusions, and sleeping disorders.

3. It has been shown in numerous studies that allowing an infant to fall asleep with a bottle in his or her mouth causes pooling of the formula in the mouth, which increases the risk of both dental caries and otitis media. There has been limited data to date showing a positive correlation between bottle propping and increased risk of aspiration, malocclusions, and sleeping disorders.

4. It has been shown in numerous studies that allowing an infant to fall asleep with a bottle in his or her mouth causes pooling of the formula in the mouth, which increases the risk of both dental caries and otitis media. There has been limited data to date showing a positive correlation between bottle propping and increased risk of aspiration, malocclusions, and sleeping disorders.

Page Ref: 284 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 5.4 Identify and explain common nutritional problems of children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 7) The parents of a toddler are concerned about their child's finicky eating habits. While counseling the parents, which statements by the nurse are the most appropriate? Select all that apply.

1. "The child is still learning to use utensils, so small servings of finger foods may be helpful."

2. "A general guideline for food quantity at a meal is one-quarter cup of each food per year of age."

3. "Like many areas, toddlers may attempt to exhibit autonomy during mealtime and should be allowed to make some simple choices."

4. "The toddler should drink a maximum of 16 to 24 ounces of milk daily."

Answer: 1, 3, 4 Explanation: 1. Toddlers may find utensils difficult and frustrating to use. Providing finger foods can encourage eating.

2. The correct general guideline for food quantity is one tablespoon of each food per year of age.

3. Food should only be offered at meal and snack times, and children should sit at the table while eating to encourage their socialization skills but also their independence in making small choices.

4. Two to three cups of milk per day are sufficient for a toddler, and more than that can decrease the child's desire for other foods and lead to dietary deficiencies.

Page Ref: 90 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential II: Basic organizational and systems leadership for quality care and patient safety. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 5.2 Describe and plan nursing interventions to meet nutritional needs for all age groups from infancy through adolescence.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 8) The nurse is providing nutritional guidance to the parents of a toddler. Which comment by the parent would prompt the nurse to provide additional education?

1. "I should not give my child raw oysters."

2. "It is safe to leave my meat red in the center as long as there are no juices running."

3. "We always wash our hands well before any food preparation."

4. "We use separate utensils for preparing raw meat and preparing fruits, vegetables, and other foods."

Answer: 2 Explanation: 1. Meats should be cooked thoroughly before eating. Meat that is red in the center, with or without running juices, is insufficiently cooked and increases the risk of food-borne illness. Washing hands and using separate utensils help to prevent infection with food-borne pathogens. Raw oysters should be avoided.

2. Meats should be cooked thoroughly before eating. Meat that is red in the center, with or without running juices, is insufficiently cooked and increases the risk of food-borne illness.

Washing hands and using separate utensils help to prevent infection with food-borne pathogens.

Raw oysters should be avoided.

3. Meats should be cooked thoroughly before eating. Meat that is red in the center, with or without running juices, is insufficiently cooked and increases the risk of food-borne illness.

Washing hands and using separate utensils help to prevent infection with food-borne pathogens.

Raw oysters should be avoided.

4. Meats should be cooked thoroughly before eating. Meat that is red in the center, with or without running juices, is insufficiently cooked and increases the risk of food-borne illness.

Washing hands and using separate utensils help to prevent infection with food-borne pathogens.

Raw oysters should be avoided.

Page Ref: 296-297 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Evidence-based practice | AACN Essential Competencies: Essential II: Basic organizational and systems leadership for quality care and patient safety. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Evaluation/Health teaching and health promotion Learning Outcome: 5.2 Describe and plan nursing interventions to meet nutritional needs for all age groups from infancy through adolescence.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 9) During a well-child physical, an adolescent female has a normal history and physical except for an excessive amount of tooth enamel erosion, a greater-than-normal number of filled cavities, and calluses on the back of her hand. Her body mass index is in the 50th to 75th percentile for her age. Which disorder is the nurse concerned about based on the assessment findings?

1. Anorexia nervosa 2. Kwashiorkor 3. Bulimia nervosa 4. Marasmus Answer: 3 Explanation: 1. The erosion of tooth enamel, dental caries, and calluses on the back of her hand all most likely are due to frequent vomiting of gastric acids, which is common with bulimia nervosa as part of a binge-purge cycle. Anorexia nervosa is an eating disorder where adolescents literally starve themselves to prevent weight gain; they also exercise excessively and use laxatives and diuretics to lose weight. Anorexia usually manifests as extreme weight loss and an obsession with food. Kwashiorkor is a protein deficiency, usually from malnutrition, that manifests as generalized edema. Marasmus is a lack of energy-producing calories that can be seen in anorexia, and this causes emaciation, decreased energy levels, and retarded development.

2. The erosion of tooth enamel, dental caries, and calluses on the back of her hand all most likely are due to frequent vomiting of gastric acids, which is common with bulimia nervosa as part of a binge-purge cycle. Anorexia nervosa is an eating disorder where adolescents literally starve themselves to prevent weight gain; they also exercise excessively and use laxatives and diuretics to lose weight. Anorexia usually manifests as extreme weight loss and an obsession with food.

Kwashiorkor is a protein deficiency, usually from malnutrition, that manifests as generalized edema. Marasmus is a lack of energy-producing calories that can be seen in anorexia, and this causes emaciation, decreased energy levels, and retarded development.

3. The erosion of tooth enamel, dental caries, and calluses on the back of her hand all most likely are due to frequent vomiting of gastric acids, which is common with bulimia nervosa as part of a binge-purge cycle. Anorexia nervosa is an eating disorder where adolescents literally starve themselves to prevent weight gain; they also exercise excessively and use laxatives and diuretics to lose weight. Anorexia usually manifests as extreme weight loss and an obsession with food.

Kwashiorkor is a protein deficiency, usually from malnutrition, that manifests as generalized edema. Marasmus is a lack of energy-producing calories that can be seen in anorexia, and this causes emaciation, decreased energy levels, and retarded development.

4. The erosion of tooth enamel, dental caries, and calluses on the back of her hand all most likely are due to frequent vomiting of gastric acids, which is common with bulimia nervosa as part of a binge-purge cycle. Anorexia nervosa is an eating disorder where adolescents literally starve themselves to prevent weight gain; they also exercise excessively and use laxatives and diuretics to lose weight. Anorexia usually manifests as extreme weight loss and an obsession with food.

Kwashiorkor is a protein deficiency, usually from malnutrition, that manifests as generalized edema. Marasmus is a lack of energy-producing calories that can be seen in anorexia, and this causes emaciation, decreased energy levels, and retarded development.

Page Ref: 303-304 Cognitive Level: Applying Client Need/Sub: Physiological Integrity Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care 84 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 Learning Outcome: 5.4 Identify and explain common nutritional problems of children.

10) The nurse is instructing a parent of a newborn on the foods that are to be started based on age. The nurse instructs the parent that the first food given to a newborn is rice cereal. What statement by the parent suggests appropriate understanding of the next food that can be introduced?

1. "Chicken can be given next."

2. "Eggs can be given next."

3. "Fruits should be given next."

4. "Whole milk should be started."

Answer: 3 Explanation: 1. Chicken is not given until 8 to 10 months, eggs are not given until 12 months, whole milk is given at 12 months. Fruits are given after rice cereal.

2. Chicken is not given until 8 to 10 months, eggs are not given until 12 months, whole milk is given at 12 months. Fruits are given after rice cereal.

3. Chicken is not given until 8 to 10 months, eggs are not given until 12 months, whole milk is given at 12 months. Fruits are given after rice cereal.

4. Chicken is not given until 8 to 10 months, eggs are not given until 12 months, whole milk is given at 12 months. Fruits are given after rice cereal.

Page Ref: 286 Cognitive Level: Applying Client Need/Sub: Physiological Integrity Standards: QSEN Competencies: Evidence-based practice | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Evaluation/Health teaching and health promotion Learning Outcome: 5.2 Describe and plan nursing interventions to meet nutritional needs for all age groups from infancy through adolescence.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 11) The mother of an infant born prematurely at 32 weeks expresses the desire to breastfeed her child. The nurse correctly responds with which statement when the mother asks how long she should breastfeed her baby?

1. "Until the child begins solid foods."

2. "Many breastfeed for 2 years."

3. "It is recommended that mothers of preterm infants breastfeed at least a month."

4. "Breast milk should be the only food for the first 6 months."

Answer: 4 Explanation: 1. Breast milk should be the only food for the first 6 months, and should continue until 12 months even after solid foods are introduced.

2. Breast milk should be the only food for the first 6 months, and should continue until 12 months even after solid foods are introduced.

3. Breast milk should be the only food for the first 6 months, and should continue until 12 months even after solid foods are introduced.

4. Breast milk should be the only food for the first 6 months, and should continue until 12 months even after solid foods are introduced.

Page Ref: 283-284 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Evidence-based practice | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 5.2 Describe and plan nursing interventions to meet nutritional needs for all age groups from infancy through adolescence.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 12) Celiac disease presents many challenges for a family. What should the nurse emphasize when educating the parents of a newly diagnosed child?

1. Ice cream is a safe dessert on a gluten-free diet.

2. The child's weight and height should reach normal levels in about 1 year.

3. Processed foods are usually gluten-free.

4. Insurance pays only a small amount of the cost of celiac diets.

Answer: 2 Explanation: 1. Ice cream and many processed foods contain gluten. Payment by insurance is dependent on the plan the family has. Once on a gluten-free diet, the child's height and weight will reach normal range in about 1 year.

2. Ice cream and many processed foods contain gluten. Payment by insurance is dependent on the plan the family has. Once on a gluten-free diet, the child's height and weight will reach normal range in about 1 year.

3. Ice cream and many processed foods contain gluten. Payment by insurance is dependent on the plan the family has. Once on a gluten-free diet, the child's height and weight will reach normal range in about 1 year.

4. Ice cream and many processed foods contain gluten. Payment by insurance is dependent on the plan the family has. Once on a gluten-free diet, the child's height and weight will reach normal range in about 1 year.

Page Ref: 298-299 Cognitive Level: Applying Client Need/Sub: Physiological Integrity Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 5.5 Develop nursing interventions for children with nutritional disorders.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 13) Parents of a child who will begin enteral feedings ask the nurse what advantage this type of feeding has over other methods. Which responses by the nurse are the most appropriate?

Select all that apply.

1. "Enteral feeding is the closest to natural feeding methods."

2. "The child must be able to absorb nutrients."

3. "Enteral feeding is complex to administer."

4. "Enteral feeding requires a central venous catheter."

5. "Enteral feeding has a high success rate."

Answer: 1, 2, 5 Explanation: 1. Enteral feedings are the closest to natural feeding methods. The child must be able to absorb nutrients. Enteral feeding has a high success rate. It is not complex to administer, and does not require a central venous catheter.

2. Enteral feedings are the closest to natural feeding methods. The child must be able to absorb nutrients. Enteral feeding has a high success rate. It is not complex to administer, and does not require a central venous catheter.

3. Enteral feedings are the closest to natural feeding methods. The child must be able to absorb nutrients. Enteral feeding has a high success rate. It is not complex to administer, and does not require a central venous catheter.

4. Enteral feedings are the closest to natural feeding methods. The child must be able to absorb nutrients. Enteral feeding has a high success rate. It is not complex to administer, and does not require a central venous catheter.

5. Enteral feedings are the closest to natural feeding methods. The child must be able to absorb nutrients. Enteral feeding has a high success rate. It is not complex to administer, and does not require a central venous catheter.

Page Ref: 307-308 Cognitive Level: Applying Client Need/Sub: Physiological Integrity Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Planning/Health teaching and health promotion Learning Outcome: 5.5 Develop nursing interventions for children with nutritional disorders.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 14) The nurse is providing care to a pediatric client recently diagnosed with celiac disease.

Which food choice indicates appropriate understanding of the material presented?

1. Pizza with milk 2. Spaghetti and meat sauce with juice 3. Hot dog on a bun with a shake 4. Fruit plate with Gatorade Answer: 4 Explanation: 1. A child with celiac disease needs a gluten-free diet. Included on the list are fruits, meats, rice, and vegetables, including corn. Excluded are bread, cake, doughnuts, cookies, crackers, and many processed foods that may contain hidden gluten. Therefore, the child would be allowed to have the fruit plate with Gatorade.

2. A child with celiac disease needs a gluten-free diet. Included on the list are fruits, meats, rice, and vegetables, including corn. Excluded are bread, cake, doughnuts, cookies, crackers, and many processed foods that may contain hidden gluten. Therefore, the child would be allowed to have the fruit plate with Gatorade.

3. A child with celiac disease needs a gluten-free diet. Included on the list are fruits, meats, rice, and vegetables, including corn. Excluded are bread, cake, doughnuts, cookies, crackers, and many processed foods that may contain hidden gluten. Therefore, the child would be allowed to have the fruit plate with Gatorade.

4. A child with celiac disease needs a gluten-free diet. Included on the list are fruits, meats, rice, and vegetables, including corn. Excluded are bread, cake, doughnuts, cookies, crackers, and many processed foods that may contain hidden gluten. Therefore, the child would be allowed to have the fruit plate with Gatorade.

Page Ref: 299 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Evaluation/Coordination of care Learning Outcome: 5.5 Develop nursing interventions for children with nutritional disorders.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 15) The nurse is conducting a nutritional assessment for a toddler client who is diagnosed with failure to thrive (FTT). Which parameters will the nurse include in the assessment process for this toddler and family? Select all that apply.

1. Height 2. Weight 3. Hemoglobin and hematocrit 4. Twenty-four-hour food diary 5. Maternal dietary intake during pregnancy Answer: 1, 2, 3, 4 Explanation: 1. In order to adequately assess the toddler client's FTT, the nurse would plan to measure height and weight; obtain a hemoglobin and hematocrit; and ask the family for a 24hour food diary. Information regarding maternal dietary intake during pregnancy is not information that is necessary to assess for a toddler diagnosed with FTT. 2. In order to adequately assess the toddler client's FTT, the nurse would plan to measure height and weight; obtain a hemoglobin and hematocrit; and ask the family for a 24-hour food diary.

Information regarding maternal dietary intake during pregnancy is not information that is necessary to assess for a toddler diagnosed with FTT. 3. In order to adequately assess the toddler client's FTT, the nurse would plan to measure height and weight; obtain a hemoglobin and hematocrit; and ask the family for a 24-hour food diary.

Information regarding maternal dietary intake during pregnancy is not information that is necessary to assess for a toddler diagnosed with FTT. 4. In order to adequately assess the toddler client's FTT, the nurse would plan to measure height and weight; obtain a hemoglobin and hematocrit; and ask the family for a 24-hour food diary.

Information regarding maternal dietary intake during pregnancy is not information that is necessary to assess for a toddler diagnosed with FTT. 5. In order to adequately assess the toddler client's FTT, the nurse would plan to measure height and weight; obtain a hemoglobin and hematocrit; and ask the family for a 24-hour food diary.

Information regarding maternal dietary intake during pregnancy is not information that is necessary to assess for a toddler diagnosed with FTT. Page Ref: 300 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care Learning Outcome: 5.3 Integrate methods of nutritional assessment into nursing care of infants, children, and adolescents.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 16) The nurse is assessing a 14-year-old and notes signs and symptoms of bulimia nervosa.

Which assessments led the nurse to this conclusion? Select all that apply.

1. Pale skin 2. Dry, splitting hair 3. Erosion of tooth enamel 4. Calluses on back of hand 5. Gum recession Answer: 3, 4, 5 Explanation: 1. Pale skin is not a sign and symptom of bulimia nervosa.

2. Dry, splitting hair is not a sign and symptom of bulimia nervosa.

3. Erosion of tooth enamel is a sign and symptom of bulimia nervosa.

4. Calluses on back of hand is a sign and symptom of bulimia nervosa.

5. Gum recession is a sign and symptom of bulimia nervosa.

Page Ref: 303-304 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care Learning Outcome: 5.3 Integrate methods of nutritional assessment into nursing care of infants, children, and adolescents.

17) The nurse is assessing an adolescent and notes signs and symptoms of anorexia nervosa.

Which signs and symptoms led the nurse to believe the adolescent has this condition?

Select all that apply.

1. Extreme weight loss 2. Depression 3. Irregular menses 4. Sedentary lifestyle 5. Bradycardia Answer: 1, 2, 3, 5 Explanation: 1. Extreme weight loss is a sign and symptom of anorexia nervosa.

2. Depression is a sign and symptom of anorexia nervosa.

3. Irregular menses is a sign and symptom of anorexia nervosa.

4. Sedentary lifestyle is not a sign and symptom of anorexia nervosa.

5. Bradycardia is a sign and symptom of anorexia nervosa.

Page Ref: 301-303 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care Learning Outcome: 5.3 Integrate methods of nutritional assessment into nursing care of infants, children, and adolescents.

Principles of Pediatric Nursing, 8e (Ball et al.)

Chapter 6 Pediatric Assessment 91 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 1) During the newborn examination, the nurse assesses for signs of developmental dysplasia of the hip. Which finding would strongly suggest this disorder?

1. Asymmetric knee height 2. A positive Babinski reflex 3. A negative Moro reflex 4. Flat soles with prominent fat pads Answer: 1 Explanation: 1. To check knee height symmetry, flex the infant's hips and knees so the heels are as close to the buttocks as possible. Place the feet flat on the examining table. The knees are usually the same height. A difference in knee height is an indicator of hip dislocation.

2. A positive Babinski reflex is a normal neurologic response in children up to 2 years old.

3. The Moro reflex should be present in a newborn assessment; it will disappear as the newborn grows 4. This is a foot assessment and is not evaluating the development of dysplasia of the hip.

Page Ref: 149 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.A.5. Explain the role of evidence in determining best clinical practice | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Knowledge and Context and Environment: transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 6.1 Discuss the elements of a health history appropriate for infants and children of different ages.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 2) The nurse is taking a health history from the family of a 3-year-old child. Which statement or question by the nurse would be most likely to establish rapport, and elicit an accurate response from the family?

1. "Tell me about the concerns that brought you to the clinic today."

2. "Does any member of your family have a history of asthma, heart disease, or diabetes?"

3. "Hello, I would like to talk with you and get some information about you and your child."

4. "You will need to fill out these forms; make sure that the information is as complete as possible."

Answer: 1 Explanation: 1. Asking the parents to talk about their concerns is an open-ended question and one that is more likely to establish rapport and an understanding of the parents' perceptions.

2. This is a good historical question to ask after rapport is established.

3. It is important to validate why the child was brought into the clinic before you jump into the interview.

4. It is important to understand that all clients have different literacy levels, so we must allow for flexibility when it comes to the paperwork.

Page Ref: 114 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: III.A.5. Explain the role of evidence in determining best clinical practice | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Knowledge and Context and Environment: transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 6.1 Discuss the elements of a health history appropriate for infants and children of different ages.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 3) A newborn has a respiratory rate of 50 breaths per minute. Which action should the nurse take?

1. Continue to observe.

2. Suction the mouth and nares.

3. Prepare for intubation.

4. Turn the newborn to the right side.

Answer: 1 Explanation: 1. A respiratory rate of 50 breaths per minute in a newborn is within normal limits.

The child does not need suctioned, intubation, or turned onto the right side.

2. The respiratory rate is normal and does not require suctioning of the infant.

3. The respiratory rate is normal and does not require the infant to be intubated.

4. The respiratory rate is normal and the infant does not need to be placed on the right side at this time.

Page Ref: 137 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Knowledge and Context and Environment: transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 6.6 List five normal variations in pediatric physical findings (such as breast budding in a girl) found during a physical assessment.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 4) The nurse is completing a physical examination of a 4-year-old girl. Which is the best position to place the child in to assess the genitalia?

1. Supine, with legs at a 50-degree angle 2. Right side-lying 3. In prone position, with knees drawn up under the body 4. Frog-legged position Answer: 4 Explanation: 1. This is not the best position to allow for a genitalia examination and will be hard for the patient to maintain.

2. This will not allow for visualization of the genitalia.

3. This is not a position that will be comfortable for the client or allow for a good visual of the genitalia.

4. Having the child lie supine, flexing her knees and pulling them up to a frog-legged position, allows for accurate assessment of the genitalia and is well tolerated by the majority of children.

Page Ref: 144 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: III.A.5. Explain the role of evidence in determining best clinical practice | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Knowledge and Context and Environment: transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 6.5 Modify physical assessment techniques for the age and developmental stage of the child.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 5) Which is the correct order for the nurse to conduct a physical assessment for a toddler-age client? Place in order from first assessment to last assessment.

1. Auscultation of chest 2. Examination of eyes, ears, and throat 3. Palpation of abdomen 4. General appearance Answer: 4, 1, 3, 2 Explanation: 1. Auscultation usually is less threatening to the toddler than is palpation, especially if the nurse first demonstrates using the stethoscope on a parent or a toy.

2. The most uncomfortable, most invasive examination for the toddler is most likely to be the examination of the eyes, ears, and throat; therefore, this assessment should be performed last.

3. Palpation can be more threatening than is observing or listening, so it should be completed after both.

4. The nurse will begin the assessment by looking at the child. This can be done while the mother is holding the child, and the nurse is talking to the mother. This environment will be neutral for the child and will not cause anxiety.

Page Ref: 120, 128 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: III.A.5. Explain the role of evidence in determining best clinical practice | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Knowledge and Context and Environment: transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 6.5 Modify physical assessment techniques for the age and developmental stage of the child.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 6) The nurse prepares to conduct a quick evaluation of a 1-month-old infant's hearing. Which action will provide the best information?

1. Examining the child's ear canal with an otoscope 2. Using a vibrating tuning fork placed against the child's skull 3. Using tympanometry to assess the child's hearing 4. Using a noisemaker to evaluate the child's response Answer: 4 Explanation: 1. The otoscope will allow for the visualization of the ear canal but will not allow for the evaluation of the patient's hearing.

2. A tuning fork is not suggested for this age group; its use is for school aged and up.

3. Tympanometry assess the pressure in the middle ear and tympanic membrane movement.

4. This is a quick, simple evaluation of the child's ability to hear sounds. The child's response can be a stopping of activity, widening of the eyes, or turning toward the sound.

Page Ref: 128 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: III.A.5. Explain the role of evidence in determining best clinical practice | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Knowledge and Context and Environment: transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 6.5 Modify physical assessment techniques for the age and developmental stage of the child.

7) Which action by the nurse is appropriate when assessing blood pressure (BP) on a child?

1. Give an opportunity to play with the equipment.

2. Ask the child to sit quietly for 3 to 5 minutes.

3. Encourage the child to sit on the parent's lap.

4. Ask the parent to leave the examination room.

Answer: 2 Explanation: 1. The child does not need to play with the equipment prior to having blood pressure measured.

2. The child should be seated and quiet for 3 to 5 minutes.

3. The child does not need to sit on the parent's lap.

4. The parent does not need to leave the examination room.

Page Ref: 142 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: III.A.5. Explain the role of evidence in determining best clinical practice | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Knowledge and Context and Environment: transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 6.5 Modify physical assessment techniques for the age and developmental stage of the child.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 8) While assessing a school-age child, the nurse notices a regular—irregular heartbeat. The nurse listens carefully and notes that the heart rate increases on inspiration and decreases on expiration.

Which nursing action is appropriate based on these data?

1. Record the finding as normal.

2. Notify the healthcare provider.

3. Schedule an electrocardiogram (ECG) immediately.

4. Ask the mother if a murmur has been detected before.

Answer: 1 Explanation: 1. This is sinus arrhythmia and is a normal finding in children but not in adults.

2. This is a normal finding so no need to notify the healthcare provider.

3. This is a normal finding and an ECG is not needed.

4. There is no murmur so no need to ask the mother if one has been identified previously.

Page Ref: 140 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Knowledge and Context and Environment: transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 6.6 List five normal variations in pediatric physical findings (such as breast budding in a girl) found during a physical assessment.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 9) While assessing the blood pressure of a school-age child, the nurse notes the blood pressure in the leg is higher than those of the arms. Which action should the nurse take?

1. Document the findings.

2. Notify the healthcare provider.

3. Elevate the child's legs.

4. Elevate the head of the bed.

Answer: 1 Explanation: 1. The blood pressure being higher up to 20 mmHg is expected so Documentation of the finding is appropriate 2. The blood pressure in the leg should be the same or up to 20 mmHg higher than the arm reading. The finding should be documented. There is no need to notify the healthcare provider, elevate the legs, or elevate the head of the bed.

3. There is no indication to elevate the child's legs 4. There is no indication to elevate the head of the bed.

Page Ref: 142 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: III.A.5. Explain the role of evidence in determining best clinical practice | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Knowledge and Context and Environment: transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment/Communication and Documentation Learning Outcome: 6.5 Modify physical assessment techniques for the age and developmental stage of the child.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 10) Which would the nurse consider as normal during a newborn assessment? Select all that apply.

1. Swelling over the occiput that crosses suture lines 2. Tiny white papules located primarily on the nose and chin.

3. Tiny red macules and pustules that come and go, primarily on the trunk and extremities.

4. When the Moro reflex is elicited, the right arm extends and returns to the body. The left arm remains resting against the chest.

5. Greenish discoloration of skin over the entire body that is not removed by the initial bath Answer: 1, 2, 3 Explanation: 1. By crossing suture lines, this finding indicates it is caput succedaneum, a normal finding after vaginal delivery. No further evaluation or treatment is needed.

2. This is a description of milia, a normal finding. No further care is required.

3. This is a description of erythema toxicum, a normal newborn finding that requires no further treatment.

4. The Moro reflex should be equal on each side of the infant.

5. A whole body Greenish discoloration is not a normal assessment finding, so it is important to look into further.

Page Ref: 114 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Knowledge and Context and Environment: transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 6.6 List five normal variations in pediatric physical findings (such as breast budding in a girl) found during a physical assessment.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 11) The nurse is conducting an admission assessment for a newborn client. Which physical finding should the nurse expect? Select all that apply.

1. Respiratory rate 20 per minute 2. Heart rate 80 per minute 3. Flaccid extremities 4. Anterior fontanelle palpable 5. Diaphragmatic breathing Answer: 4, 5 Explanation: 1. The respiratory rate is slow and should be reported to the healthcare provider.

2. The heart rate is slow and should be reported to the healthcare provider.

3. The extremities should not be flaccid and should be reported to the healthcare provider.

4. The anterior fontanelle should be palpable.

5. Diaphragmatic breathing should occur.

Page Ref: 114 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Knowledge and Context and Environment: transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 6.4 Describe the differences in sequence of the physical assessment for infants, children, and adolescents.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 12) The nurse is conducting a health history for the family of a 3-year-old child. Which statements or questions by the nurse would establish rapport, and elicit an accurate response from the family? Select all that apply.

1. "Hello, I would like to talk with you and get some information on you and your child."

2. "Does any member of your family have a history of asthma, heart disease, or diabetes?"

3. "Tell me about the concerns that brought you to the clinic today."

4. "You will need to fill out these forms; make sure that the information is as complete as possible."

5. Asking the child, "What is your doll's name?"

Answer: 3, 5 Explanation: 1. This is not an open-ended question and does not elicit information from the parents or establish rapport.

2. This is a good historical question to ask after rapport is established.

3. Asking the parents to talk about their concerns is an open-ended question, and one that will establish rapport, and give the nurse an understanding of the parents' perceptions.

4. It is important to understand that all clients have different literacy levels, so we must allow for flexibility when it comes to the paperwork.

5. Including the child in the health history process by asking the name of the doll is a question from the nurse that establishes rapport.

Page Ref: 114 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Knowledge and Context and Environment: transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 6.2 Apply communication strategies to improve the quality of historical data collected.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 13) Which question from the nurse during a health history and physical assessment for the school-age child would best determine cognitive development?

1. "What grade are you in?"

2. "What is your least favorite class?"

3. "What books have you read lately?"

4. "What classes are you taking, and what are your grades in them?"

Answer: 4 Explanation: 1. Grade level may not always match cognitive development in a child.

2. This is a good question to find out what the child is interested in but will not indicate cognitive development.

3. The level of books the child is reading will assist in the cognitive assessment but is not the best answer.

4. Asking about what kind of classes the child is taking and the grades that the child is receiving in those classes would give the nurse an indication of how the child is developing cognitively.

Page Ref: 118 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Knowledge and Context and Environment: transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 6.3 Demonstrate strategies to gain cooperation of a young child for assessment.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 14) While assessing a 10-month-old infant, the nurse notices that the sclerae have a yellowish tint. Which organ system would require more in-depth assessment based on this finding?

1. Hepatic 2. Cardiac 3. Genitourinary 4. Respiratory Answer: 1 Explanation: 1. This infant's sclerae are showing signs of jaundice, which most likely is secondary to a failure or malfunction of the liver or hepatic system.

2. Cardiac conditions do not usually affect the sclerae.

3. Genitourinary conditions do not usually affect the sclerae.

4. Respiratory conditions do not usually affect the sclerae.

Page Ref: 125 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Knowledge and Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 6.8 Distinguish between expected and unexpected physical signs to identify at least five signs that require urgent nursing intervention.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 15) During a routine physical assessment for a 9-month-old client, the nurse notes swelling in the ankles. The nurse presses against the ankle bone for 5 seconds; then, releases the pressure, noticing a markedly slow disappearance of the indentation. Which system requires a more indepth assessment based on these data?

1. Cardiovascular system 2. Musculoskeletal system 3. Respiratory system 4. Integumentary system Answer: 1 Explanation: 1. Dependent, pitting edema, especially in the lower extremities, can be a symptom of a cardiovascular disorder. The cardiovascular system would be suspected before the respiratory, musculoskeletal, or integumentary system.

2. Musculoskeltal system issues do not usually cause pitting edema in an infant.

3. Respiratory system issues that are associated with pitting edema are usually based in the cardiac system.

4. Integumentary system issues do not usually cause pitting edema in an infant.

Page Ref: 118 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Knowledge and Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 6.8 Distinguish between expected and unexpected physical signs to identify at least five signs that require urgent nursing intervention.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 16) Which questions will the nurse include in the health history for an infant when assessing the birth history? Select all that apply.

1. "When did you first receive prenatal care when you learned you were pregnant?"

2. "Where was your baby born?"

3. "Was your baby born vaginally or by cesarean birth?"

4. "Is your baby experiencing vomiting after bottle feedings?"

5. "Does your baby take any medications on a regular basis?"

Answer: 1, 2, 3 Explanation: 1. The nurse asks questions related to prenatal care when assessing the infant's birth history during the health history interview.

2. The nurse asks questions to determine a description of the birth when assessing the infant's birth history during the health history interview.

3. The nurse asks questions about the type of birth when assessing the infant's birth history during the health history interview.

4. This piece of information is not related to the birth history.

5. This piece of information is not related to the birth history.

Page Ref: 116 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: III.A.5. Explain the role of evidence in determining best clinical practice | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Knowledge and Context and Environment: transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 6.1 Discuss the elements of a health history appropriate for infants and children of different ages.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 17) Which actions by the nurse are appropriate to enhance cooperation when assessing a 10month-old infant? Select all that apply.

1. Placing the infant on the examination table 2. Using toys to distract the infant 3. Touching the infant's feet before moving on to the trunk 4. Keeping the infant's clothing on during the process 5. Observing the infant's interaction with the mother while she is holding the baby Answer: 2, 3, 5 Explanation: 1. Keeping the infant in the mother's lap as to not separate them is best to enhance cooperation for the assessment.

2. It is appropriate for the nurse to use toys to enhance cooperation during the infant assessment.

3. The nurse should first touch the infant's feet before moving onto the trunk to enhance cooperation during the assessment process.

4. The infant should be fine with clothes removal as long as the room is warm and they are not removed from their parent.

5. It is appropriate for the nurse to observe the interaction between infant and mother while the mother holds the infant during the assessment process.

Page Ref: 119 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Knowledge and Context and Environment: transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 6.3 Demonstrate strategies to gain cooperation of a young child for assessment.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 18) Which statements are true in regard to the physical assessment the nurse conducts for an infant and a toddler? Select all that apply.

1. An infant client will have all clothing removed during the weight assessment.

2. A toddler client's assessment will include a length assessment instead of a height assessment.

3. An infant client will have a blood pressure assessment at each visit.

4. It is inappropriate to ask the toddler-age client if he or she can perform certain tasks.

5. It is appropriate to allow the toddler-age client to play with equipment prior to use.

Answer: 1, 4 Explanation: 1. An infant client will have all clothing removed during the weight assessment.

2. The toddler will have a height assessment not a length assessment.

3. It is not necessary for an infant to have a blood pressure check at every appointment.

4. The nurse would not ask the toddler-age client if they can perform certain tasks, as the answer will typically be "no."

5. This is not a safe way to allow for a physical assessment, all equipment should be used last in the assessment.

Page Ref: 119, 120 Cognitive Level: Understanding Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Knowledge and Context and Environment: transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 6.4 Describe the differences in sequence of the physical assessment for infants, children, and adolescents.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 19) Which techniques would the nurse use when assessing a preschool-age child? Select all that apply.

1. Asking the child to sit on the examination table 2. Having the child undress for the examination leaving on the undergarments 3. Asking the child when he or she would like to have head, eyes, and ears assessed 4. Asking direct questions to the child 5. Having the parent of the child leave the room for the duration of the exam Answer: 1, 2, 3, 4 Explanation: 1. It is appropriate for the nurse to assess the preschool-age child on the examination table.

2. It is appropriate for the nurse to ask the preschool-age child to remove all clothing except for the undergarments.

3. It is appropriate to give the preschool-age child a choice regarding when the nurse will assess a certain system.

4. It is appropriate to ask the preschool-age child questions directly.

5. This is not suggested for the preschool child's exam. They prefer to stay with parents during the exam.

Page Ref: 120 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: III.A.5. Explain the role of evidence in determining best clinical practice | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Knowledge and Context and Environment: transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 6.5 Modify physical assessment techniques for the age and developmental stage of the child.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 20) The nurse is assessing a preschool-age child. Which finding indicates a change in the child's eyes? Select all that apply.

1. Blue eye color 2. Red conjunctiva 3. Pupils react to light 4. Left eyelid swelling 5. Squints when reading Answer: 2, 4, 5 Explanation: 1. Eye color is determined by genetics.

2. Red conjunctiva could indicate an infection or an allergic response.

3. Pupils reactive to light would be an expected finding.

4. Eyelid swelling could indicate a change in the client's vision.

5. Squinting when reading could indicate a change in the client's vision.

Page Ref: 118 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: III.A.5. Explain the role of evidence in determining best clinical practice | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Knowledge and Context and Environment: transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 6.7 Evaluate the growth pattern of an infant or child.

21) The nurse is completing an assessment of a school-age child. Which action should the nurse take when assessing the client's abdomen?

1. Use light palpation to locate the spleen.

2. Use percussion to locate the kidney border.

3. Use deep palpation to assess for an umbilical hernia.

4. Use auscultation for 10 to 30 seconds over all quadrants.

Answer: 4 Explanation: 1. Deep palpation is used to locate the spleen.

2. Deep palpation is used to locate the kidney border.

3. Light palpation is used to assess for an umbilical hernia.

4. Auscultation should occur for 10 to 30 seconds to listen for bowel sounds.

Page Ref: 142, 143 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: III.A.5. Explain the role of evidence in determining best clinical practice | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Knowledge and Context and Environment: transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 6.7 Evaluate the growth pattern of an infant or child.

Principles of Pediatric Nursing, 8e (Ball et al.)

Chapter 7 Introduction to Health Promotion and Maintenance 1) A nurse is helping the parents of 2-year-old twins cope with the daily demands of life in an active household. Which strategy is most appropriate for the nurse to use?

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 1. Health maintenance 2. Health promotion 3. Health protection 4. Health supervision Answer: 2 Explanation: 1. In health promotion, nurses partner with families to promote family strategies in the areas of lifestyle and coping. The definition of health maintenance and health supervision makes the other answers incorrect. Health protection is another term for health maintenance.

2. In health promotion, nurses partner with families to promote family strategies in the areas of lifestyle and coping. The definition of health maintenance and health supervision makes the other answers incorrect. Health protection is another term for health maintenance.

3. In health promotion, nurses partner with families to promote family strategies in the areas of lifestyle and coping. The definition of health maintenance and health supervision makes the other answers incorrect. Health protection is another term for health maintenance.

4. In health promotion, nurses partner with families to promote family strategies in the areas of lifestyle and coping. The definition of health maintenance and health supervision makes the other answers incorrect. Health protection is another term for health maintenance.

Page Ref: 146 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Collaboration Learning Outcome: 7.1 Define health promotion and health maintenance.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 2) A nurse in the outpatient pediatric clinic is reviewing the records of a preschool-age child and notes that because the parents often miss routine healthcare visits the child has not received the second measles, mumps, and rubella (MMR) vaccine. Which action by the nurse is most appropriate in this situation?

1. Speak firmly with the parents about the importance of being compliant.

2. Notify the physician that the child's immunizations are no longer up to date.

3. Call the parents and encourage them to bring the child for recommended care.

4. Plan to discuss the principles of health supervision at the next scheduled visit.

Answer: 3 Explanation: 1. The nurse in the pediatric healthcare setting is responsible for reviewing the health supervision of the child. Partnering with the parents and encouraging the parents to follow health-supervision guidelines are the best strategies to use. Speaking firmly with the parents about compliance will alienate the parents at this time. A discussion of the principles of health supervision without an intervention at this visit would mean a delay in needed healthcare for the child in this example. Discussing with the physician that the immunizations are not up to date is not necessary in an outpatient clinic. Immunizations are given per schedule.

2. The nurse in the pediatric healthcare setting is responsible for reviewing the health supervision of the child. Partnering with the parents and encouraging the parents to follow health-supervision guidelines are the best strategies to use. Speaking firmly with the parents about compliance will alienate the parents at this time. A discussion of the principles of health supervision without an intervention at this visit would mean a delay in needed healthcare for the child in this example.

Discussing with the physician that the immunizations are not up to date is not necessary in an outpatient clinic. Immunizations are given per schedule.

3. The nurse in the pediatric healthcare setting is responsible for reviewing the health supervision of the child. Partnering with the parents and encouraging the parents to follow health-supervision guidelines are the best strategies to use. Speaking firmly with the parents about compliance will alienate the parents at this time. A discussion of the principles of health supervision without an intervention at this visit would mean a delay in needed healthcare for the child in this example.

Discussing with the physician that the immunizations are not up to date is not necessary in an outpatient clinic. Immunizations are given per schedule.

4. The nurse in the pediatric healthcare setting is responsible for reviewing the health supervision of the child. Partnering with the parents and encouraging the parents to follow health-supervision guidelines are the best strategies to use. Speaking firmly with the parents about compliance will alienate the parents at this time. A discussion of the principles of health supervision without an intervention at this visit would mean a delay in needed healthcare for the child in this example.

Discussing with the physician that the immunizations are not up to date is not necessary in an outpatient clinic. Immunizations are given per schedule.

Page Ref: 147 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential II: Basic organizational and systems leadership for quality care and patient safety. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Implementation/Communication Learning Outcome: 7.5 Analyze the nurse's role in providing health promotion and health maintenance for children and families.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 3) A mother brings a child to the pediatric office for a sick visit. Which action by the nurse is the most appropriate?

1. Focus exclusively on the reported illness.

2. Review health-promotion and health-maintenance activities.

3. Ask the mother to leave the room after obtaining the history.

4. Obtain a comprehensive history, including sociodemographic data.

Answer: 2 Explanation: 1. A nurse should use every opportunity during an office visit to review healthpromotion and health-maintenance activities. Focusing exclusively on the reported illnesses ignores the opportunity to use health-promotion strategies. There is not enough data in this scenario to determine whether the mother should be asked to leave the room. There is not enough information to indicate that a comprehensive history should be taken at this visit.

2. A nurse should use every opportunity during an office visit to review health-promotion and health-maintenance activities. Focusing exclusively on the reported illnesses ignores the opportunity to use health-promotion strategies. There is not enough data in this scenario to determine whether the mother should be asked to leave the room. There is not enough information to indicate that a comprehensive history should be taken at this visit.

3. A nurse should use every opportunity during an office visit to review health-promotion and health-maintenance activities. Focusing exclusively on the reported illnesses ignores the opportunity to use health-promotion strategies. There is not enough data in this scenario to determine whether the mother should be asked to leave the room. There is not enough information to indicate that a comprehensive history should be taken at this visit.

4. A nurse should use every opportunity during an office visit to review health-promotion and health-maintenance activities. Focusing exclusively on the reported illnesses ignores the opportunity to use health-promotion strategies. There is not enough data in this scenario to determine whether the mother should be asked to leave the room. There is not enough information to indicate that a comprehensive history should be taken at this visit.

Page Ref: 148 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 7.5 Analyze the nurse's role in providing health promotion and health maintenance for children and families.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 4) Which of these strategies would be most effective for a teachable moment during a routine office visit for the parents of a 6-year-old child?

1. Select one topic and present a brief amount of information on the topic.

2. Review all 6-year-old anticipatory guidelines with the parents.

3. Review 7-year-old anticipatory guidelines with the parents.

4. Discuss signs of malnutrition with the parents.

Answer: 1 Explanation: 1. Children and families often learn best when presented with small bits of information. Do not give too much information to the parents at one time; therefore, selecting one topic and presenting information is appropriate. It is not appropriate to discuss malnutrition with these parents, since nothing in the stem of the question indicates that the child has a problem with nutrition.

2. Children and families often learn best when presented with small bits of information. Do not give too much information to the parents at one time; therefore, selecting one topic and presenting information is appropriate. It is not appropriate to discuss malnutrition with these parents, since nothing in the stem of the question indicates that the child has a problem with nutrition.

3. Children and families often learn best when presented with small bits of information. Do not give too much information to the parents at one time; therefore, selecting one topic and presenting information is appropriate. It is not appropriate to discuss malnutrition with these parents, since nothing in the stem of the question indicates that the child has a problem with nutrition.

4. Children and families often learn best when presented with small bits of information. Do not give too much information to the parents at one time; therefore, selecting one topic and presenting information is appropriate. It is not appropriate to discuss malnutrition with these parents, since nothing in the stem of the question indicates that the child has a problem with nutrition.

Page Ref: 148 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential I: Liberal education for Baccalaureate generalist nursing practice. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Evaluation/Health teaching and health promotion Learning Outcome: 7.3 Describe the components of a health supervision visit.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 5) The clinic administrator has asked each nurse to classify the nursing activities as a beginning step of clinic reorganization. Which of these strategies can be identified as health promotion and health maintenance? Select all that apply.

1. Administration of the flu vaccine for infants from 6 months to 23 months old 2. Daily feeding schedules for infants 3. Instruction to adolescents on how to use dental floss 4. Treatment for a child with a diagnosis of acute otitis media Answer: 1, 2, 3 Explanation: 1. Administering flu vaccines, discussion of feeding schedules, and instructions to adolescents are all health-promotion and health-maintenance topics. Treatment of an acute ear infection (otitis media) would not be a topic for health promotion and health maintenance since it is an acute illness.

2. Administering flu vaccines, discussion of feeding schedules, and instructions to adolescents are all health-promotion and health-maintenance topics. Treatment of an acute ear infection (otitis media) would not be a topic for health promotion and health maintenance since it is an acute illness.

3. Administering flu vaccines, discussion of feeding schedules, and instructions to adolescents are all health-promotion and health-maintenance topics. Treatment of an acute ear infection (otitis media) would not be a topic for health promotion and health maintenance since it is an acute illness.

4. Administering flu vaccines, discussion of feeding schedules, and instructions to adolescents are all health-promotion and health-maintenance topics. Treatment of an acute ear infection (otitis media) would not be a topic for health promotion and health maintenance since it is an acute illness.

Page Ref: 148 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Teamwork and collaboration | AACN Essential Competencies: Essential V: Healthcare policy, finance, and regulatory environments. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 7.1 Define health promotion and health maintenance.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 6) A mother of a 2-year-old child becomes very anxious when the child has a temper tantrum in the medical office. Which response by the nurse is the most appropriate?

1. "What do you usually do or say during a temper tantrum?"

2. "Let's ignore this behavior; it will stop sooner or later."

3. "Pick up and cuddle your child now, please."

4. "This is definitely a temper tantrum; I know exactly what you are feeling right now."

Answer: 1 Explanation: 1. Asking the mother to describe her usual behavior via an open-ended question will encourage the mother to talk about home management and will lead the nurse to assist the mother in making a plan of care for temper tantrums. Ignoring the behavior, instructing the mother to cuddle the child, or sympathizing with the mother ("I know exactly what you are feeling") are not effective ways to problem solve for temper tantrums.

2. Asking the mother to describe her usual behavior via an open-ended question will encourage the mother to talk about home management and will lead the nurse to assist the mother in making a plan of care for temper tantrums. Ignoring the behavior, instructing the mother to cuddle the child, or sympathizing with the mother ("I know exactly what you are feeling") are not effective ways to problem solve for temper tantrums.

3. Asking the mother to describe her usual behavior via an open-ended question will encourage the mother to talk about home management and will lead the nurse to assist the mother in making a plan of care for temper tantrums. Ignoring the behavior, instructing the mother to cuddle the child, or sympathizing with the mother ("I know exactly what you are feeling") are not effective ways to problem solve for temper tantrums.

4. Asking the mother to describe her usual behavior via an open-ended question will encourage the mother to talk about home management and will lead the nurse to assist the mother in making a plan of care for temper tantrums. Ignoring the behavior, instructing the mother to cuddle the child, or sympathizing with the mother ("I know exactly what you are feeling") are not effective ways to problem solve for temper tantrums.

Page Ref: 149 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VI: Interprofessional communication and collaboration for improving patient health outcomes. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 7.9 Apply the nursing process in assessment, diagnosis, goal setting, intervention, and evaluation of health promotion and health maintenance activities for children and families.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 7) A nurse says to the mother of a 6-month-old infant, "Does the baby sit without assistance, and is the baby crawling?" Which process is the nurse using in this interaction?

1. Health promotion 2. Health maintenance 3. Disease surveillance 4. Developmental surveillance Answer: 4 Explanation: 1. The question asked by the nurse is seeking information about developmental milestones; therefore, the nurse is involved in developmental surveillance. While healthpromotion and health-maintenance activities are related to developmental surveillance, this question is looking specifically at the milestones; therefore, the answers "health promotion" and "health maintenance" are incorrect. The questions asked in the stem are not classified as diseasesurveillance questions.

2. The question asked by the nurse is seeking information about developmental milestones; therefore, the nurse is involved in developmental surveillance. While health-promotion and health-maintenance activities are related to developmental surveillance, this question is looking specifically at the milestones; therefore, the answers "health promotion" and "health maintenance" are incorrect. The questions asked in the stem are not classified as diseasesurveillance questions.

3. The question asked by the nurse is seeking information about developmental milestones; therefore, the nurse is involved in developmental surveillance. While health-promotion and health-maintenance activities are related to developmental surveillance, this question is looking specifically at the milestones; therefore, the answers "health promotion" and "health maintenance" are incorrect. The questions asked in the stem are not classified as diseasesurveillance questions.

4. The question asked by the nurse is seeking information about developmental milestones; therefore, the nurse is involved in developmental surveillance. While health-promotion and health-maintenance activities are related to developmental surveillance, this question is looking specifically at the milestones; therefore, the answers "health promotion" and "health maintenance" are incorrect. The questions asked in the stem are not classified as diseasesurveillance questions.

Page Ref: 149 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Assessment/Health teaching and health promotion Learning Outcome: 7.7 Synthesize the areas of assessment and intervention for health supervision visits of newborns and infants: growth and developmental surveillance, nutrition, physical activity, oral health, mental and spiritual health, family and social relations, disease prevention strategies, and injury prevention strategies.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 8) A parent says to a nurse, "How do you know when my child needs these screening tests the doctor just mentioned?" Which response by the nurse is the most appropriate?

1. "Screening tests are administered at the ages when a child is most likely to develop a condition."

2. "Screening tests are done in the newborn nursery and from these results, additional screening tests are ordered throughout the first two years of life."

3. "Screening tests are most often done when the doctor suspects something is wrong with the child."

4. "Screening tests are done at each office visit."

Answer: 1 Explanation: 1. Screening tests administered at ages when a child is most likely to develop a condition provide a good basis for health promotion. The remaining answers all provide incorrect information to the parent. Abnormal newborn screening tests require immediate follow-up.

Screening tests are done to detect the possibility of problems, not when a problem is suspected; at that point, a child needs diagnostic testing. Screening tests are not done at each office visit.

2. Screening tests administered at ages when a child is most likely to develop a condition provide a good basis for health promotion. The remaining answers all provide incorrect information to the parent. Abnormal newborn screening tests require immediate follow-up. Screening tests are done to detect the possibility of problems, not when a problem is suspected; at that point, a child needs diagnostic testing. Screening tests are not done at each office visit.

3. Screening tests administered at ages when a child is most likely to develop a condition provide a good basis for health promotion. The remaining answers all provide incorrect information to the parent. Abnormal newborn screening tests require immediate follow-up. Screening tests are done to detect the possibility of problems, not when a problem is suspected; at that point, a child needs diagnostic testing. Screening tests are not done at each office visit.

4. Screening tests administered at ages when a child is most likely to develop a condition provide a good basis for health promotion. The remaining answers all provide incorrect information to the parent. Abnormal newborn screening tests require immediate follow-up. Screening tests are done to detect the possibility of problems, not when a problem is suspected; at that point, a child needs diagnostic testing. Screening tests are not done at each office visit.

Page Ref: 151 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential III: Scholarship for evidence-based practice. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 7.8 Plan health promotion and health maintenance strategies employed during health supervision visits of newborns and infants.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 9) Which nursing assessment activities should be included for the child and family at each health-supervision visit? Select all that apply.

1. Interview to obtain an updated health history 2. Performing an age-appropriate development assessment 3. Monitoring parents' ability to pay for services 4. Performing age-appropriate screening examinations 5. Physical assessment for genetic abnormalities Answer: 1, 2, 4 Explanation: 1. The interview, the developmental assessment, and age-appropriate screenings are all included in the nursing assessment of a child and family during each health-supervision visit. A nurse would not assess the parents' financial status at each health-supervision visit.

Physical assessments for genetic abnormalities would be done based on history and physical findings, not at each routine visit.

2. The interview, the developmental assessment, and age-appropriate screenings are all included in the nursing assessment of a child and family during each health-supervision visit. A nurse would not assess the parents' financial status at each health-supervision visit. Physical assessments for genetic abnormalities would be done based on history and physical findings, not at each routine visit.

3. The interview, the developmental assessment, and age-appropriate screenings are all included in the nursing assessment of a child and family during each health-supervision visit. A nurse would not assess the parents' financial status at each health-supervision visit. Physical assessments for genetic abnormalities would be done based on history and physical findings, not at each routine visit.

4. The interview, the developmental assessment, and age-appropriate screenings are all included in the nursing assessment of a child and family during each health-supervision visit. A nurse would not assess the parents' financial status at each health-supervision visit. Physical assessments for genetic abnormalities would be done based on history and physical findings, not at each routine visit.

5. The interview, the developmental assessment, and age-appropriate screenings are all included in the nursing assessment of a child and family during each health-supervision visit. A nurse would not assess the parents' financial status at each health-supervision visit. Physical assessments for genetic abnormalities would be done based on history and physical findings, not at each routine visit.

Page Ref: 150-151 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Implementation/Coordination of care Learning Outcome: 7.3 Describe the components of a health supervision visit.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 10) The nurse of an outpatient clinic is sitting with the parents while their adolescent goes for a test. The parents are complaining about their child's behavior. Which statement by the nurse fosters family-centered communication?

1. "I agree with you; discipline is an important part of parenting."

2. "I know just how you feel. I had the same experience with my children."

3. "You are so right. Adolescents function in the "me-first" mode all the time."

4. "Tell me what concerns you about your child's behavior."

Answer: 4 Explanation: 1. Using an open-ended question allows the parents to discuss a family concern.

All the other questions or statements are blocking statements and would not foster familycentered communication.

2. Using an open-ended question allows the parents to discuss a family concern. All the other questions or statements are blocking statements and would not foster family-centered communication.

3. Using an open-ended question allows the parents to discuss a family concern. All the other questions or statements are blocking statements and would not foster family-centered communication.

4. Using an open-ended question allows the parents to discuss a family concern. All the other questions or statements are blocking statements and would not foster family-centered communication.

Page Ref: 151 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VI: Interprofessional communication and collaboration for improving patient health outcomes. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Communication Learning Outcome: 7.2 Describe how health promotion and health maintenance are addressed by partnering with families during health supervision visits.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 11) The nurse is assessing an adolescent client whose weight is in the 5th percentile. Based on this information, which question is most appropriate for the nurse to ask the adolescent client?

1. "Do you eat the school lunches?"

2. "Do you have any concerns about your weight?"

3. "Do you eat fruits, vegetables, and drink milk?"

4. "How many meals do you eat each day?"

Answer: 2 Explanation: 1. The only question that addresses the adolescent's weight, which is below the expected norm, is "Do you have any concerns about your weight?" Asking about school lunches, eating fruits and vegetables, and how many meals eaten each day should be used to obtain a nutritional history; however, those questions do not address the underweight status of the adolescent.

2. The only question that addresses the adolescent's weight, which is below the expected norm, is "Do you have any concerns about your weight?" Asking about school lunches, eating fruits and vegetables, and how many meals eaten each day should be used to obtain a nutritional history; however, those questions do not address the underweight status of the adolescent.

3. The only question that addresses the adolescent's weight, which is below the expected norm, is "Do you have any concerns about your weight?" Asking about school lunches, eating fruits and vegetables, and how many meals eaten each day should be used to obtain a nutritional history; however, those questions do not address the underweight status of the adolescent.

4. The only question that addresses the adolescent's weight, which is below the expected norm, is "Do you have any concerns about your weight?" Asking about school lunches, eating fruits and vegetables, and how many meals eaten each day should be used to obtain a nutritional history; however, those questions do not address the underweight status of the adolescent.

Page Ref: 151 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VI: Interprofessional communication and collaboration for improving patient health outcomes. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care Learning Outcome: 7.9 Apply the nursing process in assessment, diagnosis, goal setting, intervention, and evaluation of health promotion and health maintenance activities for children and families.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 12) In the pediatric well-child clinic, the nurse explains the reason for an immunization series to the child's mother. This action represents which item?

1. Health assessment 2. Health promotion 3. Health maintenance 4. Health screening Answer: 2 Explanation: 1. The explanation to the mother by the nurse provides an understanding of the immunization series to the mother and enables the mother to make an intelligent choice. While administering immunizations is considered health maintenance, the activity described in the question is clearly health promotion. A health assessment would be completed to determine what immunizations are needed. Health maintenance is the actual administration of the immunization and health screening involves looking at the immunization record to determine which immunizations are needed.

2. The explanation to the mother by the nurse provides an understanding of the immunization series to the mother and enables the mother to make an intelligent choice. While administering immunizations is considered health maintenance, the activity described in the question is clearly health promotion. A health assessment would be completed to determine what immunizations are needed. Health maintenance is the actual administration of the immunization and health screening involves looking at the immunization record to determine which immunizations are needed.

3. The explanation to the mother by the nurse provides an understanding of the immunization series to the mother and enables the mother to make an intelligent choice. While administering immunizations is considered health maintenance, the activity described in the question is clearly health promotion. A health assessment would be completed to determine what immunizations are needed. Health maintenance is the actual administration of the immunization and health screening involves looking at the immunization record to determine which immunizations are needed.

4. The explanation to the mother by the nurse provides an understanding of the immunization series to the mother and enables the mother to make an intelligent choice. While administering immunizations is considered health maintenance, the activity described in the question is clearly health promotion. A health assessment would be completed to determine what immunizations are needed. Health maintenance is the actual administration of the immunization and health screening involves looking at the immunization record to determine which immunizations are needed.

Page Ref: 146 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 7.2 Describe how health promotion and health maintenance are addressed by partnering with families during health supervision visits.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 13) A pediatric nurse who is employed in a busy ambulatory clinic setting is informed by the nurse manager that average nursing time allocated for each child and family is being reduced to 10 minutes to more efficiently manage the clinic. The nursing activities must include a nursing assessment and discussion on anticipatory guidance. Which of these strategies should the nurse utilize in the plan of care delivery?

1. Attempt to complete the assessment and education in 10 minutes, but extend the time whenever the nurse deems necessary.

2. Plan to do the anticipatory guidance first since either the nurse practitioner or the physician can perform the assessment of the child.

3. Encourage the parent to ask for specific time to talk with the nurse privately at each office visit.

4. Focus anticipatory guidance strategies on topics that the parent or child have expressed as an area of interest.

Answer: 4 Explanation: 1. With limited time for each visit, the nurse should focus on anticipatory guidance strategies that will most benefit the parent and child during that office visit.

2. With limited time for each visit, the nurse should focus on anticipatory guidance strategies that will most benefit the parent and child during that office visit.

3. With limited time for each visit, the nurse should focus on anticipatory guidance strategies that will most benefit the parent and child during that office visit.

4. With limited time for each visit, the nurse should focus on anticipatory guidance strategies that will most benefit the parent and child during that office visit.

Page Ref: 148 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 7.5 Analyze the nurse's role in providing health promotion and health maintenance for children and families.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 14) Which assessment would not be included with a 17-year-old's screening during a routine health supervision visit?

1. STI evaluation 2. Autism screening 3. Hemoglobin test 4. Vision screening Answer: 2 Explanation: 1. Autism screening would not be appropriate at this age. If autism were present, it would have presented before this age. STI evaluation, hemoglobin test, and vision screening are all appropriate for a 17-year-old.

2. Autism screening would not be appropriate at this age. If autism were present, it would have presented before this age. STI evaluation, hemoglobin test, and vision screening are all appropriate for a 17-year-old.

3. Autism screening would not be appropriate at this age. If autism were present, it would have presented before this age. STI evaluation, hemoglobin test, and vision screening are all appropriate for a 17-year-old.

4. Autism screening would not be appropriate at this age. If autism were present, it would have presented before this age. STI evaluation, hemoglobin test, and vision screening are all appropriate for a 17-year-old.

Page Ref: 151 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Implementation/Coordination of care Learning Outcome: 7.3 Describe the components of a health supervision visit.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 15) A nurse is discussing health promotion activities with parents of a 4-year-old client. What health-promotion activity is most appropriate for this family?

1. Make arrangements to tour the kindergarten in which the child will enroll next year.

2. Plan a "movie afternoon" with the child's big brother.

3. Maintain appropriate immunizations.

4. Teach the child the proper method for brushing the teeth.

Answer: 4 Explanation: 1. Teaching proper oral hygiene through proper teeth brushing is a healthpromotion activity. Touring the kindergarten might alleviate anxiety, but is not health promotion.

A movie afternoon with the big brother is sedentary, and also not a health-promotion activity.

Maintaining immunizations is a health-maintenance, not health-promotion, activity.

2. Teaching proper oral hygiene through proper teeth brushing is a health-promotion activity.

Touring the kindergarten might alleviate anxiety, but is not health promotion. A movie afternoon with the big brother is sedentary, and also not a health-promotion activity. Maintaining immunizations is a health-maintenance, not health-promotion, activity.

3. Teaching proper oral hygiene through proper teeth brushing is a health-promotion activity.

Touring the kindergarten might alleviate anxiety, but is not health promotion. A movie afternoon with the big brother is sedentary, and also not a health-promotion activity. Maintaining immunizations is a health-maintenance, not health-promotion, activity.

4. Teaching proper oral hygiene through proper teeth brushing is a health-promotion activity.

Touring the kindergarten might alleviate anxiety, but is not health promotion. A movie afternoon with the big brother is sedentary, and also not a health-promotion activity. Maintaining immunizations is a health-maintenance, not health-promotion, activity.

Page Ref: 149 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 7.7 Synthesize the areas of assessment and intervention for health supervision visits of newborns and infants: growth and developmental surveillance, nutrition, physical activity, oral health, mental and spiritual health, family and social relations, disease prevention strategies, and injury prevention strategies.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 16) The nurse educator is teaching a group of students about the key concepts of a medical home during the developmental years of the pediatric client. Which items should the educator include in the teaching session? Select all that apply.

1. Financial accessibility 2. Consistent, ongoing care 3. Coordination of care 4. No individualization of care 5. A paternalistic view of care Answer: 1, 2, 3 Explanation: 1. All children need a medical home, where accessible, continuous, and coordinated health supervision is provided during the developmental years. Accessibility refers to both financial and geographic access; continuous indicates that the care is ongoing with consistent care providers; coordination refers to the need for communication among health professionals to provide for the needs of the child. Care is individualized and is not paternalistic.

2. All children need a medical home, where accessible, continuous, and coordinated health supervision is provided during the developmental years. Accessibility refers to both financial and geographic access; continuous indicates that the care is ongoing with consistent care providers; coordination refers to the need for communication among health professionals to provide for the needs of the child. Care is individualized and is not paternalistic.

3. All children need a medical home, where accessible, continuous, and coordinated health supervision is provided during the developmental years. Accessibility refers to both financial and geographic access; continuous indicates that the care is ongoing with consistent care providers; coordination refers to the need for communication among health professionals to provide for the needs of the child. Care is individualized and is not paternalistic.

4. All children need a medical home, where accessible, continuous, and coordinated health supervision is provided during the developmental years. Accessibility refers to both financial and geographic access; continuous indicates that the care is ongoing with consistent care providers; coordination refers to the need for communication among health professionals to provide for the needs of the child. Care is individualized and is not paternalistic.

5. All children need a medical home, where accessible, continuous, and coordinated health supervision is provided during the developmental years. Accessibility refers to both financial and geographic access; continuous indicates that the care is ongoing with consistent care providers; coordination refers to the need for communication among health professionals to provide for the needs of the child. Care is individualized and is not paternalistic.

Page Ref: 147 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Planning/Health teaching and health promotion Learning Outcome: 7.6 Perform the general observations made of infants and their families as they come to the pediatric healthcare home for health supervision visits.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 17) The nurse is preparing to perform a hearing screening on a 6-year-old child. The nurse knows this screening is what level of prevention?

1. Primary prevention 2. Secondary prevention 3. Tertiary prevention 4. Quaternary prevention Answer: 2 Explanation: 1. Primary prevention includes immunizations, teaching regarding seatbelts, helmets, and so on.

2. Secondary prevention includes developmental, hearing, and vision screenings.

3. Tertiary prevention includes rehab, PT, OT, and so on.

4. Quaternary prevention includes advanced levels of medicine and extensive tests.

Page Ref: 146 Cognitive Level: Analyzing Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Planning/Coordination of care Learning Outcome: 7.1 Define health promotion and health maintenance.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 18) The pediatric nurse is discussing the importance of regular preventative screenings with a new mother. Which statements by the nurse would be most helpful in explaining the importance of these screenings? Select all that apply.

1. "We will check your baby's labs to determine if blood levels are normal and if there is lead exposure."

2. "We will measure your baby's height and weight to be sure he is growing as he should."

3. "Developmental screenings are performed when the child is 3-4 years old to decide if preschool is needed."

4. "When immunizations are needed to prevent disease, you can be present to comfort your child."

Answer: 1, 2, 4 Explanation: 1. Checking blood levels, such as serum iron and or lead, are important parts of preventative screenings for early identification of health issues.

2. Monitoring the child's growth via height and weight measurements help determine the child is developing properly or identify health issues such as failure to thrive.

3. Developmental screenings are given at 9, 18, 24, and 30 months and can identify neurological issues not if a child should attend preschool.

4. Preventive vaccinations are an important part of a child's health screenings. Just as important is the comfort for both child and parent being allowed to stay together during these immunizations.

Page Ref: 163 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Communication Learning Outcome: 7.4 Apply the preventive care schedule for screenings and health assessment.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 19) A pediatric nurse notices that a single mother has had several cancellations of preventive screening appointments. What resource could the nurse suggest that could be helpful for this family if finances are limiting the ability to get services? Select the best answer.

1. The Patient Protection and Affordable Care Act 2. American Academy of Pediatrics committee 3. Bright futures 4. DHHS Office of Minority Health Answer: 1 Explanation: 1. This act requires insurance plans to pay for needed preventative screenings for children.

2. This committee helped develop the schedule recommendations for preventative pediatric screenings.

3. Bright Futures is a health promotion program through the American Association of Pediatrics.

4. This governmental office can help provide culturally appropriate services such as professional interpreters.

Page Ref: 163 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Coordination of care Learning Outcome: 7.4 Apply the preventive care schedule for screenings and health assessment.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 20) To identify issues and provide needed care, the pediatric nurse starts assessing the child and family through observations. When would be the most helpful time(s) for the nurse to utilize this technique? Select all that apply.

1. Reactions to physical contact between parent and child during a procedure 2. Manual dexterity of child while coloring 3. Behavior of a parent who has had to wait for 1 hour 4. The child's energy level during the screening Answer: 1, 2, 4 Explanation: 1. Observing how the parent and child react to physical contact with one another can be very important, especially to alert the nurse to signs of abuse.

2. A child who should have the developmental skills to hold a crayon but cannot or shows difficulty might alert the nurse to a developmental delay or neurological disorder.

3. Although the parent's reaction to stress can be a tip off to their relationship with the child, in this scenario it would not be as helpful.

4. A child that is excessively hyper or listless can alert to many issues physically and emotionally.

Page Ref: 163 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Planning/Health teaching and health promotion Learning Outcome: 7.6 Perform the general observations made of infants and their families as they come to the pediatric healthcare home for health supervision visits.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 21) During a wellness screening, the child's parents tell the nurse that the child drinks several sugary drinks a day. In addition to the lack of nutritional value, the pediatric nurse stresses the need for the child to receive regular dental check-ups. Why would this be suggested? Select all that apply.

1. Excessive sugar can damage teeth resulting in poor self-esteem.

2. Poor oral health can cause pain and infections, resulting in lack of sleep and missed school.

3. Dental caries become a common problem when children reach their teens, so it's important to build good habits now.

4. Poor oral health can affect speech and proper language development.

Answer: 1, 2, 4 Explanation: 1. Risk of dental caries, or cavities, is increased in a high sugar diet. This can result in damaged and/or missing teeth affecting a child's overall self-esteem and confidence.

2. Excessive dental caries puts the child at risk for systemic infections and may cause pain that keeps the child up at night. This can result in poor performance in school due to sleepiness or even missed days.

3. Dental caries do not only affect teens. They are actually the most common chronic health problem in children under 5 years old.

4. Missing teeth, damaged or painful teeth, can all affect the way the child is able to speak properly. This can hinder language development and social skills.

Page Ref: 164 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 7.8 Plan health promotion and health maintenance strategies employed during health supervision visits of newborns and infants.

Principles of Pediatric Nursing, 8e (Ball et al.)

Chapter 8 Health Promotion and Maintenance: The Newborn and the Infant 1) A nursery nurse is planning care for the newborns currently in the newborn nursery. Which activities does the nurse plan for the first 48 hours of life? Select all that apply.

1. Monitor feeding behaviors 2. Perform a hearing screening 3. Perform a heel stick to obtain blood for the newborn screen 4. Monitor the mother as she performs the first newborn bath to remove blood and amniotic fluids 5. Administer folic-acid injection to the infant to prevent bleeding Answer: 1, 2, 3 Explanation: 1. The nurse should assess feeding behaviors of the infant whether the infant is breastfed or bottle-fed. A hearing screening is performed on all newborn infants prior to discharge. The newborn screen is performed prior to infant discharge from the newborn unit. The nurse, not the mother, performs the first bath to remove blood and amniotic fluids. Vitamin K is administered, not folic acid.

2. The nurse should assess feeding behaviors of the infant whether the infant is breastfed or 131 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 bottle-fed. A hearing screening is performed on all newborn infants prior to discharge. The newborn screen is performed prior to infant discharge from the newborn unit. The nurse, not the mother, performs the first bath to remove blood and amniotic fluids. Vitamin K is administered, not folic acid.

3. The nurse should assess feeding behaviors of the infant whether the infant is breastfed or bottle-fed. A hearing screening is performed on all newborn infants prior to discharge. The newborn screen is performed prior to infant discharge from the newborn unit. The nurse, not the mother, performs the first bath to remove blood and amniotic fluids. Vitamin K is administered, not folic acid.

4. The nurse should assess feeding behaviors of the infant whether the infant is breastfed or bottle-fed. A hearing screening is performed on all newborn infants prior to discharge. The newborn screen is performed prior to infant discharge from the newborn unit. The nurse, not the mother, performs the first bath to remove blood and amniotic fluids. Vitamin K is administered, not folic acid.

5. The nurse should assess feeding behaviors of the infant whether the infant is breastfed or bottle-fed. A hearing screening is performed on all newborn infants prior to discharge. The newborn screen is performed prior to infant discharge from the newborn unit. The nurse, not the mother, performs the first bath to remove blood and amniotic fluids. Vitamin K is administered, not folic acid.

Page Ref: 156 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Evidence-based practice | AACN Essential Competencies: Essential III: Scholarship for evidence-based practice. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Coordination of care Learning Outcome: 8.1 Synthesize the areas of assessment and intervention for health supervision visits of newborns and infants: growth and developmental surveillance, nutrition, physical activity, oral health, mental and spiritual health, family and social relations, disease prevention strategies, and injury prevention strategies.

2) The nurse is planning care for clients seen in a newborn clinic. Which is the priority for a newborn client during the first clinic visit?

1. Providing pamphlets to reinforce information provided at the visit 2. Assessing the newborn-family interactions 3. Modeling infant-nurturing behaviors 4. Informing the parents of the infant's gains in height and weight Answer: 2 Explanation: 1. The first step in the nursing process is assessment; therefore, the nurse should assess the interactions of the parents with the newborn. Providing pamphlets to help educate the parents should be done at each appropriate office visit; however, the pamphlets would be distributed after assessment of parent needs. While the nurse should be a role model for nurturing behaviors during the office visit, this would not be the first thing the nurse performs at the office visit. While parents are informed of the infant's gains in height and weight, this activity does not take priority.

2. The first step in the nursing process is assessment; therefore, the nurse should assess the interactions of the parents with the newborn. Providing pamphlets to help educate the parents should be done at each appropriate office visit; however, the pamphlets would be distributed after assessment of parent needs. While the nurse should be a role model for nurturing behaviors 132 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 during the office visit, this would not be the first thing the nurse performs at the office visit.

While parents are informed of the infant's gains in height and weight, this activity does not take priority.

3. The first step in the nursing process is assessment; therefore, the nurse should assess the interactions of the parents with the newborn. Providing pamphlets to help educate the parents should be done at each appropriate office visit; however, the pamphlets would be distributed after assessment of parent needs. While the nurse should be a role model for nurturing behaviors during the office visit, this would not be the first thing the nurse performs at the office visit.

While parents are informed of the infant's gains in height and weight, this activity does not take priority.

4. The first step in the nursing process is assessment; therefore, the nurse should assess the interactions of the parents with the newborn. Providing pamphlets to help educate the parents should be done at each appropriate office visit; however, the pamphlets would be distributed after assessment of parent needs. While the nurse should be a role model for nurturing behaviors during the office visit, this would not be the first thing the nurse performs at the office visit.

While parents are informed of the infant's gains in height and weight, this activity does not take priority.

Page Ref: 156 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential III: Scholarship for evidence-based practice. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Implementation/Coordination of care Learning Outcome: 8.2 Plan health promotion and health maintenance strategies employed during health supervision visits of newborns and infants.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 3) The nurse in the newborn nursery is admitting a neonate. To determine the health and development of the newborn, what will the nurse include in the assessment? Select all that apply.

1. Head circumference 2. Body length 3. Weight 4. Length of pregnancy 5. Hearing screens Answer: 1, 2, 3, 4 Explanation: 1. The nurse should assess almost all of these parameters to determine the health of the newborn. However, hearing screens are typically done after the first 12 hours after birth and are not part of newborn assessment.

2. The nurse should assess almost all of these parameters to determine the health of the newborn.

However, hearing screens are typically done after the first 12 hours after birth and are not part of newborn assessment.

3. The nurse should assess almost all of these parameters to determine the health of the newborn.

However, hearing screens are typically done after the first 12 hours after birth and are not part of newborn assessment.

4. The nurse should assess almost all of these parameters to determine the health of the newborn.

However, hearing screens are typically done after the first 12 hours after birth and are not part of newborn assessment.

5. The nurse should assess almost all of these parameters to determine the health of the newborn.

However, hearing screens are typically done after the first 12 hours after birth and are not part of newborn assessment.

Page Ref: 156-157 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care Learning Outcome: 8.1 Synthesize the areas of assessment and intervention for health supervision visits of newborns and infants: growth and developmental surveillance, nutrition, physical activity, oral health, mental and spiritual health, family and social relations, disease prevention strategies, and injury prevention strategies.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 4) An infant weighs 9 pounds 3 ounces at birth. The nurse plans to make a home visit to the mother and infant when the infant is 7 days old. What is the lowest acceptable weight the infant should be at this age?

1. 7 pounds 12 ounces 2. 8 pounds 2 ounces 3. 8 pounds 12 ounces 4. 9 pounds Answer: 2 Explanation: 1. In the first week of life, most infants lose about one-tenth of their birth weight; therefore, this infant's weight should be 8 pounds 2 ounces at 7 days of age. A weight loss to 7 pounds 12 ounces would be too much for this infant. A decline to 8 pounds 12 ounces is less than the expected one-tenth weight loss after birth, and an infant would not be expected to lose only 3 ounces during the first week of life.

2. In the first week of life, most infants lose about one-tenth of their birth weight; therefore, this infant's weight should be 8 pounds 2 ounces at 7 days of age. A weight loss to 7 pounds 12 ounces would be too much for this infant. A decline to 8 pounds 12 ounces is less than the expected one-tenth weight loss after birth, and an infant would not be expected to lose only 3 ounces during the first week of life.

3. In the first week of life, most infants lose about one-tenth of their birth weight; therefore, this infant's weight should be 8 pounds 2 ounces at 7 days of age. A weight loss to 7 pounds 12 ounces would be too much for this infant. A decline to 8 pounds 12 ounces is less than the expected one-tenth weight loss after birth, and an infant would not be expected to lose only 3 ounces during the first week of life.

4. In the first week of life, most infants lose about one-tenth of their birth weight; therefore, this infant's weight should be 8 pounds 2 ounces at 7 days of age. A weight loss to 7 pounds 12 ounces would be too much for this infant. A decline to 8 pounds 12 ounces is less than the expected one-tenth weight loss after birth, and an infant would not be expected to lose only 3 ounces during the first week of life.

Page Ref: 157 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential III: Scholarship for evidence-based practice. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care Learning Outcome: 8.1 Synthesize the areas of assessment and intervention for health supervision visits of newborns and infants: growth and developmental surveillance, nutrition, physical activity, oral health, mental and spiritual health, family and social relations, disease prevention strategies, and injury prevention strategies.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 5) The nurse is teaching a new mother developmental expectations. Which activity should the nurse expect a newborn to do within the first month of life?

1. Bring hands to eyes and mouth 2. Push up with hands, moving chest up 3. Keep hands in a relaxed position 4. Roll over from back to abdomen Answer: 1 Explanation: 1. Newborns at one month of age can bring hands to their eyes and mouths, move their heads from side to side when lying on their abdomens, and attempt to lift their heads only when prone. Newborn hands are kept in tight fist position, and the newborn cannot roll over until 4 months of age.

2. Newborns at one month of age can bring hands to their eyes and mouths, move their heads from side to side when lying on their abdomens, and attempt to lift their heads only when prone.

Newborn hands are kept in tight fist position, and the newborn cannot roll over until 4 months of age.

3. Newborns at one month of age can bring hands to their eyes and mouths, move their heads from side to side when lying on their abdomens, and attempt to lift their heads only when prone.

Newborn hands are kept in tight fist position, and the newborn cannot roll over until 4 months of age.

4. Newborns at one month of age can bring hands to their eyes and mouths, move their heads from side to side when lying on their abdomens, and attempt to lift their heads only when prone.

Newborn hands are kept in tight fist position, and the newborn cannot roll over until 4 months of age.

Page Ref: 157 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential I: Liberal education for Baccalaureate generalist nursing practice. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Assessment/Health teaching and health promotion Learning Outcome: 8.1 Synthesize the areas of assessment and intervention for health supervision visits of newborns and infants: growth and developmental surveillance, nutrition, physical activity, oral health, mental and spiritual health, family and social relations, disease prevention strategies, and injury prevention strategies.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 6) The nurse is providing anticipatory guidance instructions to the parents of a newborn. Which instruction should the nurse give as a strategy for illness/disease prevention?

1. Don't allow visitors for the first month 2. Smoke outside only 3. Take the newborn to weekly child-stimulation classes 4. SIDS risk-reduction measures Answer: 4 Explanation: 1. Several disease-prevention strategies are used during anticipatory guidance for the parents of newborns. Not allowing visitors is unreasonable but screening for illness is appropriate. Smoking outside will not prevent disease. Attending weekly stimulation classes is not a disease prevention strategy. SIDS risk-reduction measures can reduce the risk of sudden infant death syndrome.

2. Several disease-prevention strategies are used during anticipatory guidance for the parents of newborns. Not allowing visitors is unreasonable but screening for illness is appropriate. Smoking outside will not prevent disease. Attending weekly stimulation classes is not a disease prevention strategy. SIDS risk-reduction measures can reduce the risk of sudden infant death syndrome.

3. Several disease-prevention strategies are used during anticipatory guidance for the parents of newborns. Not allowing visitors is unreasonable but screening for illness is appropriate. Smoking outside will not prevent disease. Attending weekly stimulation classes is not a disease prevention strategy. SIDS risk-reduction measures can reduce the risk of sudden infant death syndrome.

4. Several disease-prevention strategies are used during anticipatory guidance for the parents of newborns. Not allowing visitors is unreasonable but screening for illness is appropriate. Smoking outside will not prevent disease. Attending weekly stimulation classes is not a disease prevention strategy. SIDS risk-reduction measures can reduce the risk of sudden infant death syndrome.

Page Ref: 157 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Nursing judgment | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 8.3 Recognize the importance of family in newborn and infant healthcare and include family assessment and collaboration in each health supervision visit.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 7) A nurse assesses the height and weight measurements on an infant and documents these measurements at the 75th percentile. The nurse notes that the previous measurements two months ago were at the 25th percentile. Which interpretation by the nurse is the most accurate?

1. The infant is not gaining enough weight.

2. The infant has gained a significant amount of weight.

3. The previous measurements were most likely inaccurate.

4. These measurements are most likely inaccurate.

Answer: 2 Explanation: 1. A comparison of these two sets of measurements shows that the infant has crossed two percentiles going from the 25th to the 75th percentile and therefore has gained a significant amount of weight. There is neither indication that the previous measurements are inaccurate nor that the current measurement is inaccurate.

2. A comparison of these two sets of measurements shows that the infant has crossed two percentiles going from the 25th to the 75th percentile and therefore has gained a significant amount of weight. There is neither indication that the previous measurements are inaccurate nor that the current measurement is inaccurate.

3. A comparison of these two sets of measurements shows that the infant has crossed two percentiles going from the 25th to the 75th percentile and therefore has gained a significant amount of weight. There is neither indication that the previous measurements are inaccurate nor that the current measurement is inaccurate.

4. A comparison of these two sets of measurements shows that the infant has crossed two percentiles going from the 25th to the 75th percentile and therefore has gained a significant amount of weight. There is neither indication that the previous measurements are inaccurate nor that the current measurement is inaccurate.

Page Ref: 157 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential I: Liberal education for Baccalaureate generalist nursing practice. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Evaluation/Coordination of care Learning Outcome: 8.1 Synthesize the areas of assessment and intervention for health supervision visits of newborns and infants: growth and developmental surveillance, nutrition, physical activity, oral health, mental and spiritual health, family and social relations, disease prevention strategies, and injury prevention strategies.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 8) A nurse asks the mother of a 4-month-old infant to undress the infant. The nurse observes the mother taking off several layers of clothing and knows that the outdoor temperature is 70 degrees Fahrenheit. Which statement by the nurse is most appropriate in this situation?

1. "My, you are dressing your infant warmly today."

2. "Did you think it was cold when you left your home this morning?"

3. "I see that you have many layers of clothing on your baby. This may cause your baby's temperature to rise."

4. "When you leave the office, only put one layer of clothing on your baby."

Answer: 3 Explanation: 1. In this scenario, the mother has overdressed the infant. The nurse needs to gently inform the mother of this problem and to provide information to the mother on why it is a problem. Just making a statement on how warmly the child is dressed will not accomplish this goal or just telling the mother to only put one layer of clothing on the child does not provide a rationale for the mother to make a better decision the next time, so this statement also is not helpful to the mother.

2. In this scenario, the mother has overdressed the infant. The nurse needs to gently inform the mother of this problem and to provide information to the mother on why it is a problem. Just making a statement on how warmly the child is dressed will not accomplish this goal or just telling the mother to only put one layer of clothing on the child does not provide a rationale for the mother to make a better decision the next time, so this statement also is not helpful to the mother.

3. In this scenario, the mother has overdressed the infant. The nurse needs to gently inform the mother of this problem and to provide information to the mother on why it is a problem. Just making a statement on how warmly the child is dressed will not accomplish this goal or just telling the mother to only put one layer of clothing on the child does not provide a rationale for the mother to make a better decision the next time, so this statement also is not helpful to the mother.

4. In this scenario, the mother has overdressed the infant. The nurse needs to gently inform the mother of this problem and to provide information to the mother on why it is a problem. Just making a statement on how warmly the child is dressed will not accomplish this goal or just telling the mother to only put one layer of clothing on the child does not provide a rationale for the mother to make a better decision the next time, so this statement also is not helpful to the mother.

Page Ref: 157 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 8.1 Synthesize the areas of assessment and intervention for health supervision visits of newborns and infants: growth and developmental surveillance, nutrition, physical activity, oral health, mental and spiritual health, family and social relations, disease prevention strategies, and injury prevention strategies.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 9) The nurse working with a family has observed that the older children have a large number of dental caries and plans to provide the mother with information to prevent the development of dental caries in her new infant. Which interventions will prevent the development of dental caries in the infant?

Select all that apply.

1. Avoiding nursing or giving the infant a bottle at bedtime 2. Giving foods high in sugar only at breakfast time 3. Using a soft moist gauze for cleaning 4. Using a topical anesthetic daily beginning as soon as the first tooth begins to erupt Answer: 1, 3 Explanation: 1. The only interventions that will assist in the prevention of dental caries listed in this question are wiping the gums with a soft, moist gauze and avoiding putting the infant to bed with a bottle. Foods high in sugar should be avoided in the infant period. Topical anesthetic should not be applied daily.

2. The only interventions that will assist in the prevention of dental caries listed in this question are wiping the gums with a soft, moist gauze and avoiding putting the infant to bed with a bottle.

Foods high in sugar should be avoided in the infant period. Topical anesthetic should not be applied daily.

3. The only interventions that will assist in the prevention of dental caries listed in this question are wiping the gums with a soft, moist gauze and avoiding putting the infant to bed with a bottle.

Foods high in sugar should be avoided in the infant period. Topical anesthetic should not be applied daily.

4. The only interventions that will assist in the prevention of dental caries listed in this question are wiping the gums with a soft, moist gauze and avoiding putting the infant to bed with a bottle.

Foods high in sugar should be avoided in the infant period. Topical anesthetic should not be applied daily.

Page Ref: 159 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 8.1 Synthesize the areas of assessment and intervention for health supervision visits of newborns and infants: growth and developmental surveillance, nutrition, physical activity, oral health, mental and spiritual health, family and social relations, disease prevention strategies, and injury prevention strategies.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 10) A nurse is assessing an 11-month-old infant and notes that the infant's height and weight are at the 5th percentile on the growth chart. Family history reveals that the infant's two siblings are at the 50th percentile for height and at the 75th percentile for weight. Psychosocial history reveals that the parents are separated and are planning to divorce. Which of these nursing diagnoses takes priority?

1. Alteration in Growth Pattern Related to Parental Anxiety 2. Alteration in Growth Pattern Secondary to Familial Short Stature 3. Nutritional Intake: Excessive Secondary to Maternal Feeding Patterns 4. At Risk for Constitutional Growth Delay Related to Decreased Appetite Answer: 1 Explanation: 1. The scenario reveals parental anxiety due to marital problems. The most appropriate nursing diagnosis is alteration in growth patterns related to parental anxiety. There is no data that indicates familial short stature. Since height and weight are at the 5th percentile, there is no indication of increased nutritional intake. This infant is not at risk for constitutional growth delay.

2. The scenario reveals parental anxiety due to marital problems. The most appropriate nursing diagnosis is alteration in growth patterns related to parental anxiety. There is no data that indicates familial short stature. Since height and weight are at the 5th percentile, there is no indication of increased nutritional intake. This infant is not at risk for constitutional growth delay.

3. The scenario reveals parental anxiety due to marital problems. The most appropriate nursing diagnosis is alteration in growth patterns related to parental anxiety. There is no data that indicates familial short stature. Since height and weight are at the 5th percentile, there is no indication of increased nutritional intake. This infant is not at risk for constitutional growth delay.

4. The scenario reveals parental anxiety due to marital problems. The most appropriate nursing diagnosis is alteration in growth patterns related to parental anxiety. There is no data that indicates familial short stature. Since height and weight are at the 5th percentile, there is no indication of increased nutritional intake. This infant is not at risk for constitutional growth delay.

Page Ref: 162-163 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Diagnosis/Coordination of care Learning Outcome: 8.5 Evaluate data about the family and other social relationships to promote and maintain health of newborns and infants.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 11) While teaching parents of a newborn about normal growth and development, which statement is most appropriate for the nurse to include in the session?

1. Weight should triple by 6 months of age.

2. Weight should double by 1 year of age.

3. Weight should double by 4 months of age.

4. Weight should triple by 1 year of age.

Answer: 4 Explanation: 1. An infant should triple its birth weight by 1 year of age. The other answers are not appropriate weight gains.

2. An infant should triple its birth weight by 1 year of age. The other answers are not appropriate weight gains.

3. An infant should triple its birth weight by 1 year of age. The other answers are not appropriate weight gains.

4. An infant should triple its birth weight by 1 year of age. The other answers are not appropriate weight gains.

Page Ref: 158 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 8.1 Synthesize the areas of assessment and intervention for health supervision visits of newborns and infants: growth and developmental surveillance, nutrition, physical activity, oral health, mental and spiritual health, family and social relations, disease prevention strategies, and injury prevention strategies.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 12) A follow-up visit for a newborn client is scheduled with the pediatric nurse practitioner 3 days after discharge. What will the nurse include in the assessment during the scheduled visit for this newborn? Select all that apply.

1. Feeding pattern 2. Jaundice 3. Length 4. Vision screen 5. Sleep pattern Answer: 1, 2, 5 Explanation: 1. Feeding pattern, sleep pattern, and jaundice assessment would be appropriate 3 days after discharge. It would not be necessary to do a length or vision screen at this age.

2. Feeding pattern, sleep pattern, and jaundice assessment would be appropriate 3 days after discharge. It would not be necessary to do a length or vision screen at this age.

3. Feeding pattern, sleep pattern, and jaundice assessment would be appropriate 3 days after discharge. It would not be necessary to do a length or vision screen at this age.

4. Feeding pattern, sleep pattern, and jaundice assessment would be appropriate 3 days after discharge. It would not be necessary to do a length or vision screen at this age.

5. Feeding pattern, sleep pattern, and jaundice assessment would be appropriate 3 days after discharge. It would not be necessary to do a length or vision screen at this age.

Page Ref: 156 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Planning/Coordination of care Learning Outcome: 8.1 Synthesize the areas of assessment and intervention for health supervision visits of newborns and infants: growth and developmental surveillance, nutrition, physical activity, oral health, mental and spiritual health, family and social relations, disease prevention strategies, and injury prevention strategies.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 13) A mother asks which developmental milestones she can expect when her baby is 6 months old. Which response by the nurse is the most appropriate?

1. Lifts head momentarily when prone 2. Has well-developed pincer grasp 3. Transfers objects from one hand to the other 4. Rolls from front to back Answer: 3 Explanation: 1. Lifting head when prone is a milestone at 1 month. A well-developed pincer grasp is a milestone at 12 months. Transferring objects from one hand to the other is a milestone at 6 months. Rolling from front to back is a milestone at 4 months.

2. Lifting head when prone is a milestone at 1 month. A well-developed pincer grasp is a milestone at 12 months. Transferring objects from one hand to the other is a milestone at 6 months. Rolling from front to back is a milestone at 4 months.

3. Lifting head when prone is a milestone at 1 month. A well-developed pincer grasp is a milestone at 12 months. Transferring objects from one hand to the other is a milestone at 6 months. Rolling from front to back is a milestone at 4 months.

4. Lifting head when prone is a milestone at 1 month. A well-developed pincer grasp is a milestone at 12 months. Transferring objects from one hand to the other is a milestone at 6 months. Rolling from front to back is a milestone at 4 months.

Page Ref: 157-158 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential I: Liberal education for Baccalaureate generalist nursing practice. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 8.1 Synthesize the areas of assessment and intervention for health supervision visits of newborns and infants: growth and developmental surveillance, nutrition, physical activity, oral health, mental and spiritual health, family and social relations, disease prevention strategies, and injury prevention strategies.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 14) Injury prevention is an important aspect of parent teaching. Which injury prevention strategy would reduce the risk of suffocation?

1. Measure crib slat spacing at 2-3/8 inches or less.

2. Never leave an infant alone in a bath.

3. Position the infant on her back to sleep.

4. Use only approved restraint systems.

Answer: 3 Explanation: 1. Measuring crib slats will reduce strangulation. Not leaving an infant alone in a bath will reduce drowning. Positioning an infant on her back will reduce suffocation. Using approved restraint systems will reduce motor vehicle injury.

2. Measuring crib slats will reduce strangulation. Not leaving an infant alone in a bath will reduce drowning. Positioning an infant on her back will reduce suffocation. Using approved restraint systems will reduce motor vehicle injury.

3. Measuring crib slats will reduce strangulation. Not leaving an infant alone in a bath will reduce drowning. Positioning an infant on her back will reduce suffocation. Using approved restraint systems will reduce motor vehicle injury.

4. Measuring crib slats will reduce strangulation. Not leaving an infant alone in a bath will reduce drowning. Positioning an infant on her back will reduce suffocation. Using approved restraint systems will reduce motor vehicle injury.

Page Ref: 162 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential II: Basic organizational and systems leadership for quality care and patient safety. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 8.1 Synthesize the areas of assessment and intervention for health supervision visits of newborns and infants: growth and developmental surveillance, nutrition, physical activity, oral health, mental and spiritual health, family and social relations, disease prevention strategies, and injury prevention strategies.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 15) The nurse is assessing an infant client and parents during a routine health supervision visit at 2 months of age. Which items will the nurse assess to determine if the infant's mental health needs are being addressed? Select all that apply.

1. Immunization record 2. Newborn screen results 3. Temperament during the visit 4. Feeding schedule 5. Sleep-wake patterns Answer: 3, 4, 5 Explanation: 1. When addressing mental health issues, the nurse would assess the infant's temperament during the visit, feeding schedule, and sleep-wake patterns. The infant's mental health is related to early experiences, inborn characteristics such as temperament and resilience, and relationships with caregivers. The first year of life provides many opportunities for the infant to develop positive mental health; interventions during this important period can enhance the child's future mental status. The immunization record and the newborn screen results will not provide the needed information for the nurse in terms of whether the infant's mental health needs are being addressed.

2. When addressing mental health issues, the nurse would assess the infant's temperament during the visit, feeding schedule, and sleep-wake patterns. The infant's mental health is related to early experiences, inborn characteristics such as temperament and resilience, and relationships with caregivers. The first year of life provides many opportunities for the infant to develop positive mental health; interventions during this important period can enhance the child's future mental status. The immunization record and the newborn screen results will not provide the needed information for the nurse in terms of whether the infant's mental health needs are being addressed.

3. When addressing mental health issues, the nurse would assess the infant's temperament during the visit, feeding schedule, and sleep-wake patterns. The infant's mental health is related to early experiences, inborn characteristics such as temperament and resilience, and relationships with caregivers. The first year of life provides many opportunities for the infant to develop positive mental health; interventions during this important period can enhance the child's future mental status. The immunization record and the newborn screen results will not provide the needed information for the nurse in terms of whether the infant's mental health needs are being addressed.

4. When addressing mental health issues, the nurse would assess the infant's temperament during the visit, feeding schedule, and sleep-wake patterns. The infant's mental health is related to early experiences, inborn characteristics such as temperament and resilience, and relationships with caregivers. The first year of life provides many opportunities for the infant to develop positive mental health; interventions during this important period can enhance the child's future mental status. The immunization record and the newborn screen results will not provide the needed information for the nurse in terms of whether the infant's mental health needs are being addressed.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 5. When addressing mental health issues, the nurse would assess the infant's temperament during the visit, feeding schedule, and sleep-wake patterns. The infant's mental health is related to early experiences, inborn characteristics such as temperament and resilience, and relationships with caregivers. The first year of life provides many opportunities for the infant to develop positive mental health; interventions during this important period can enhance the child's future mental status. The immunization record and the newborn screen results will not provide the needed information for the nurse in terms of whether the infant's mental health needs are being addressed.

Page Ref: 159-160 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care Learning Outcome: 8.4 Integrate pertinent mental health care into health supervision visits for newborns and infants.

16) The nurse is teaching a mother of a 2-month-old that she will begin to introduce certain foods to the diet between 4 and 6 months. The nurse should recommend what foods? Select all that apply.

1. Vegetables 2. Pasta 3. Cereal 4. Fruits 5. Soups Answer: 1, 3, 5 Explanation: 1. Reinforce proper introduction of new foods, to include cereal, vegetables, and fruits. Discuss any unusual food reactions observed. Pasta and soups are not advised at this time.

2. Reinforce proper introduction of new foods, to include cereal, vegetables, and fruits. Discuss any unusual food reactions observed. Pasta and soups are not advised at this time.

3. Reinforce proper introduction of new foods, to include cereal, vegetables, and fruits. Discuss any unusual food reactions observed. Pasta and soups are not advised at this time.

4. Reinforce proper introduction of new foods, to include cereal, vegetables, and fruits. Discuss any unusual food reactions observed. Pasta and soups are not advised at this time.

5. Reinforce proper introduction of new foods, to include cereal, vegetables, and fruits. Discuss any unusual food reactions observed. Pasta and soups are not advised at this time.

Page Ref: 158 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Basic Care and Comfort Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Planning/Health teaching and health promotion Learning Outcome: 8.1 Synthesize the areas of assessment and intervention for health supervision visits of newborns and infants: growth and developmental surveillance, nutrition, physical activity, oral health, mental and spiritual health, family and social relations, disease prevention strategies, and injury prevention strategies.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 17) The nurse is teaching the mothers of three-month-olds about oral health. Which of the following should the nurse include? Select all that apply.

1. Include iron vitamins once a day.

2. Avoid breastfeeding or drinking from a bottle when sleeping.

3. Allow to drink from a bottle at will during the day.

4. Cleanse gums 1 to 2 times a day.

5. Put baby to bed with a bottle of 2 percent milk only.

Answer: 2, 4 Explanation: 1. The parents should wipe the infant's gums with soft moist gauze once or twice daily. Families are also cautioned to avoid having the infant breastfeed when sleeping, to avoid use of bottles in bed, and not to allow the infant to drink at will from a bottle during the day.

These practices are linked to early childhood caries and can lead to tooth decay.

2. The parents should wipe the infant's gums with soft moist gauze once or twice daily. Families are also cautioned to avoid having the infant breastfeed when sleeping, to avoid use of bottles in bed, and not to allow the infant to drink at will from a bottle during the day. These practices are linked to early childhood caries and can lead to tooth decay.

3. The parents should wipe the infant's gums with soft moist gauze once or twice daily. Families are also cautioned to avoid having the infant breastfeed when sleeping, to avoid use of bottles in bed, and not to allow the infant to drink at will from a bottle during the day. These practices are linked to early childhood caries and can lead to tooth decay.

4. The parents should wipe the infant's gums with soft moist gauze once or twice daily. Families are also cautioned to avoid having the infant breastfeed when sleeping, to avoid use of bottles in bed, and not to allow the infant to drink at will from a bottle during the day. These practices are linked to early childhood caries and can lead to tooth decay.

5. The parents should wipe the infant's gums with soft moist gauze once or twice daily. Families are also cautioned to avoid having the infant breastfeed when sleeping, to avoid use of bottles in bed, and not to allow the infant to drink at will from a bottle during the day. These practices are linked to early childhood caries and can lead to tooth decay.

Page Ref: 159 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Basic Care and Comfort Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Planning/Health teaching and health promotion Learning Outcome: 8.1 Synthesize the areas of assessment and intervention for health supervision visits of newborns and infants: growth and developmental surveillance, nutrition, physical activity, oral health, mental and spiritual health, family and social relations, disease prevention strategies, and injury prevention strategies.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 18) Infants should have a series of health maintenance visits through the first year of life. The pediatric nurse may assess the child and family for what information? Select all that apply.

1. Availability of a support system 2. Knowledge of the child's needs at the current age 3. Overall health of family members; recent illnesses 4. Type of child care used.

Answer: 1, 2, 3 Explanation: 1. Ensuring the family has a good support system of family and friends is vital, especially for new parents.

2. Nurses should identify knowledge deficits and educate, as appropriate, regarding needs and risks that are common for the child at the current age.

3. The nurse should also inquire about the overall health of family members and if the child or others have had any recent illnesses. This information can provide clues to possible future health risks.

4. Although information about child care can be important to determine who the child is exposed to, it is not a common question the nurse should focus on during health maintenance visits.

Page Ref: 170 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 8.2 Plan health promotion and health maintenance strategies employed during health supervision visits of newborns and infants.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 19) The pediatric nurse is aware of the vital role of family in a child's development. Which nurse's suggestions increase family engagement and promote positive development for the child?

Select all that apply.

1. Encourage the parents to play with the child to help with motor skill development 2. Inquire about cultural differences that may exist if the child has difficulties with a particular task or skill 3. Suggest the family take naps together to limit the child's physical activity in the first few months of life to prevent injury 4. Encourage families to make mealtimes interactive with the child to enhance social development Answer: 1, 2, 4 Explanation: 1. Parents should be encouraged to play with the child often and observe the developing skills during these sessions.

2. Some childhood games the nurse might suggest to evaluate skills might be unfamiliar to the child and family due to cultural differences. Evaluate alternatives before labeling the child as delayed.

3. Physical activity is extremely important for infants to develop gross and fine motor skills.

Naps have value but limiting activity is not encouraged.

4. Meals are another opportunity to allow the child to develop motor skills as well as socialization.

Page Ref: 173 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 8.3 Recognize the importance of family in newborn and infant healthcare and include family assessment and collaboration in each health supervision visit.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 20) Observations of an infant's behavior during visits can also provide information about developmental progress. Which observations would suggest to the nurse that a positive attachment exists between parents and child. Select the best answer.

1. The infant is unbothered when a stranger holds him/her.

2. There is little touching or eye contact between the parents and child.

3. When held, both the infant and parent appear comfortable and calm.

4. The infant is unable to self-soothe without the parent.

Answer: 3 Explanation: 1. It is normal for a positively attached infant to protest when picked up by a stranger.

2. Lack of physical touch and eye contact may be cultural but is also an indicator of poor attachment.

3. Confident and calm parents will appear comfortable holding their infant, and the child will appear to settle and relax during these sessions if secure.

4. It is possible to be overly attached, which can have just as many consequences as a child with little attachment. It is important for infants to learn to self-soothe, and inability to do so may be a sign of illness or other problems.

Page Ref: 174 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 8.4 Integrate pertinent mental health care into health supervision visits for newborns and infants.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 21) Observing interactions between family members can aid the pediatric nurse in identifying potential developmental risks. Which observations by the nurse may be cause for concern? Select all that apply.

1. The parents mention they recently moved and have no family or friends in the area.

2. The child appears unkempt and the parents are listless and appear disinterested.

3. Parents and their infant are alert, calm, and appropriate to the situation.

4. One parent appears excessively quiet and defers to the other when asked questions.

Answer: 1, 2, 4 Explanation: 1. This tells the nurse that the family has little to no support system. Providing information to the family on support groups, faith-based activities, and other resources may be helpful.

2. This may be a reg flag for depression in the parents and neglect of the infant.

3. This interaction is a classic example of a positive attachment between the parents and infant.

There is no need for concern based on these interactions.

4. Some cultural norms dictate one spouse deferring to another, but if this behavior is accompanied by lack of eye contact or mannerisms of fear, this may be a red flag for domestic violence.

Page Ref: 174-175 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 8.5 Evaluate data about the family and other social relationships to promote and maintain health of newborns and infants.

Principles of Pediatric Nursing, 8e (Ball et al.)

Chapter 9 Health Promotion and Maintenance: The Toddler and the Preschooler 1) Which is the priority nursing action when performing a physical assessment on a toddler?

1. Leaving intrusive procedures such as eye and ear examinations until the end 2. Explaining each part of the examination to the child before performing it 3. Performing the assessment from head to toe 4. Asking the mother to tell the child not to be afraid Answer: 1 Explanation: 1. Intrusive procedures such as examinations of the eyes, ears, throat, and genitals should be done last to decrease the anxiety of the child during the initial phases of the examination, which include heart and lungs.

2. A toddler is too young to understand the medical terminology.

3. Intrusive procedures such as examinations of the eyes, ears, throat, and genitals should be done last to decrease the anxiety of the child during the initial phases of the examination, which include heart and lungs.

4. Asking the mother to tell the child not to be afraid is an inappropriate response.

Page Ref: 182 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance 152 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 9.1 Describe the areas of assessment and intervention for health supervision visits for toddler and preschool children: growth and developmental surveillance, nutrition, physical activity, oral health, mental and spiritual health, family and social relations, disease prevention strategies, and injury prevention strategies.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 2) At which age will the nurse begin to calculate body mass index (BMI) as a part of the nursing assessment process?

1. 12 months 2. 18 months 3. 2 years 4. 4 years Answer: 3 Explanation: 1. While the nurse will plot a child's growth at 12 months of age, a BMI is not included in the physical assessment at this time.

2. While the nurse will plot the child's growth at 18 months of age, a BMI is not included in the physical assessment at this time.

3. BMI is first calculated at 2 years of age, and gives information about the relationship between the height and weight of the child. With this information, the nurse would be able to develop strategies that can reduce the incidence of obesity.

4. The nurse will not initiate BMI calculation for a 4 year old; this action should be implemented into the nursing assessment prior to 4 years of age.

Page Ref: 232 Cognitive Level: Understanding Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 9.1 Describe the areas of assessment and intervention for health supervision visits for toddler and preschool children: growth and developmental surveillance, nutrition, physical activity, oral health, mental and spiritual health, family and social relations, disease prevention strategies, and injury prevention strategies.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 3) During a well-child visit with a 4-year-old girl, the nurse notes that the parents speak harshly to the child and used negative remarks when speaking with the nurse. Which statement by the nurse would be beneficial in this situation?

1. "Perhaps you should leave the room so that I can speak with your child privately."

2. "I am going to refer you for counseling since your interactions with your child seem so negative."

3. Addressing the child, the nurse says, "Are you unhappy when mommy talks to you like this?"

4. "Let's talk privately. We should discuss the way you speak with your child and possible ways to be more positive."

Answer: 4 Explanation: 1. Since the child is only 4 years old, it would be difficult to ask the parent to leave the room. If the nurse wants to speak alone with the child, it would be best to escort the child to another area, and speak briefly with the child.

2. Referring to counseling without a discussion with the parent is not appropriate.

3. The nurse should not ask the child if she is "unhappy" with the parent.

4. The best approach to this encounter would be for the nurse to discuss concerns with the parent privately, since the nurse wants to help the parent develop a good relationship with the child. The child should not be a part of this conversation.

Page Ref: 187 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 9.2 State components of self-concept for preschool children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 4) Which action by the nurse is appropriate when teaching the parents of a 2-year-old child during a scheduled health maintenance visit?

1. Encouraging the parents to allow the child to pour liquids using a pitcher 2. Being sure that all major foods group have been introduced to the child 3. Teaching the parents that it is appropriate to switch from whole to 2% milk 4. Educating the child about food groups Answer: 3 Explanation: 1. It is not appropriate to encourage the parents to allow the child to pour liquids using a pitcher until 3 years of age.

2. The nurse should ensure that all major food groups have been introduced to the child at 1 year of age.

3. The nurse will teach the parents that it is appropriate to switch from whole to 2% milk during the 2-year-old's health maintenance visit.

4. The nurse would not educate the child about food groups until the age of 4 years.

Page Ref: 185 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 9.3 Plan health promotion and health maintenance strategies employed during health supervision visits of toddlers and preschoolers.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 5) The visiting nurse is evaluating the home environments of several preschool-age children as they relate to child safety. The nurse visits the home of each child and gathers the following data.

Which activity noted during the visit places a child at the greatest risk for bodily harm?

1. The parents are in a methadone program.

2. The parents consume alcohol on a daily basis.

3. The child watches television for 2 hours each day.

4. The child is permitted to swim in the family pool unsupervised.

Answer: 4 Explanation: 1. Drug and alcohol use or past use places the child at risk; however, this is not the priority risk assessed.

2. Drug and alcohol use or past use also place the child at risk; however, this is not the priority risk assessed.

3. A child who is allowed to watch excessive amounts of television each day is at risk for obesity and other health problems; however, this is not the priority risk assessed.

4. A child should be supervised while swimming at all times. This observation places the child at the greatest risk for bodily harm.

Page Ref: 190 Cognitive Level: Analyzing Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 9.4 Discuss the importance of family in child healthcare and include family assessment in each health supervision visit.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 6) The parents of a 2-year-old girl inquire about information to help their child transition to bed each night. Which response by the nurse is appropriate?

1. Let the child cry self to sleep a few nights to adjust to the transition.

2. Play a favorite video at bedtime on a television in the child's room to enhance relaxation.

3. Read a book to the child just before bedtime each night.

4. Let the child fall asleep while playing and then put the child in bed.

Answer: 3 Explanation: 1. A child of this age will not just learn to fall asleep on her own if left alone.

Letting the child cry for an extended period of time can affect attachment issues.

2. Having a television in a 2-year-old child's room is not a healthy practice. This can lead to decreased physical activity.

3. Developing a quiet routine just before bedtime can help calm the child and give an expectation to what will happen next: going to bed.

4. Letting the child fall asleep while playing is not healthy, as it allows the child to get to the point of exhaustion without any limits set.

Page Ref: 188 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 9.4 Discuss the importance of family in child healthcare and include family assessment in each health supervision visit.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 7) Parents of a preschool-age child report that they find it necessary to spank the child at least once a day. Which response by the nurse is appropriate based on this information?

1. "Can you try spanking the child only every other day for 1 week, and see how that affects your child's behavior?"

2. "Spanking is one form of discipline; however, you want to be sure that you do not leave any marks on the child."

3. "I think you are not parenting properly, so let's talk about ways to improve your parenting skills."

4. "Let's talk about other forms of discipline that have a more positive effect on the child."

Answer: 4 Explanation: 1. The behavior reported by the parents was excessive. The only appropriate response is to seek a more positive way to influence behavior in a child of this age. The nurse's response must reflect these feelings and should address other forms of discipline that have a more positive effect on the child. To suggest that spanking is an appropriate form of discipline is inappropriate, especially when the parent is describing daily spanking of the child.

2. The behavior reported by the parents was excessive. The only appropriate response is to seek a more positive way to influence behavior in a child of this age. The nurse's response must reflect these feelings and should address other forms of discipline that have a more positive effect on the child. To suggest that spanking is an appropriate form of discipline is inappropriate, especially when the parent is describing daily spanking of the child.

3. The behavior reported by the parents was excessive. The only appropriate response is to seek a more positive way to influence behavior in a child of this age. The nurse's response must reflect these feelings and should address other forms of discipline that have a more positive effect on the child. To suggest that spanking is an appropriate form of discipline is inappropriate, especially when the parent is describing daily spanking of the child.

4. The behavior reported by the parents was excessive. The only appropriate response is to seek a more positive way to influence behavior in a child of this age. The nurse's response must reflect these feelings and should address other forms of discipline that have a more positive effect on the child. To suggest that spanking is an appropriate form of discipline is inappropriate, especially when the parent is describing daily spanking of the child.

Page Ref: 187 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 9.5 Integrate pertinent mental healthcare into health supervision visits for toddlers and preschoolers.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 8) Which parental statement during a scheduled health maintenance assessment for a preschoolage child would cause the nurse concern?

1. "We have dinner together as a family each evening."

2. "We are so proud that our child is able to recognize letters of the alphabet."

3. "Our child wakes up each night screaming because of nightmares."

4. "Our child attends a daycare program 3 days per week."

Answer: 3 Explanation: 1. Parents are encouraged to spend time with their children each day. The statement about eating dinner together each evening as a family would not cause the nurse concern.

2. A preschool-age child should be able to recognize letters of the alphabet. Parents who verbalize pride in their child would not cause the nurse concern.

3. A child who awakens each night due to nightmares may be indicative of a mental illness. This statement would cause the nurse concern.

4. Many children attend daycare due to both parents in the house working. The nurse should further assess the interactions between the parents and the caregivers; however, this statement would not cause the nurse concern.

Page Ref: 188 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 9.6 Examine data about the family and other social relationships to prioritize interventions and to maintain health of toddlers and preschoolers.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 9) The nurse is caring for a preschool-age child. Which strategy will the nurse use to prevent disease development in this client?

1. Review immunization schedule.

2. Complete an electrocardiogram.

3. Schedule for serum blood tests.

4. Discuss need for daily activity.

Answer: 1 Explanation: 1. Toddlers and preschoolers are prone to many infectious diseases due to immature immune systems. At the end of the preschool period, a complete review of the immunization record is done so that any needed immunizations are administered before school entry.

2. There is no reason for an electrocardiogram.

3. Serum blood tests are not used as a disease prevention strategy.

4. There is no evidence that a discussion about daily activity is needed.

Page Ref: 189 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 9.1 Describe the areas of assessment and intervention for health supervision visits for toddler and preschool children: growth and developmental surveillance, nutrition, physical activity, oral health, mental and spiritual health, family and social relations, disease prevention strategies, and injury prevention strategies.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 10) The nurse is teaching the parents of a toddler-age child about injury prevention. Which statement by the parent indicates the need for further education?

1. "I will turn the handles of the pots outward while I am cooking dinner."

2. "We will make sure that our child always wears a life vest when we are out in the boat."

3. "I will keep all our medications out of reach, and ensure child-resistant containers."

4. "We will provide safe climbing toys for our child."

Answer: 1 Explanation: 1. Handles of the pots should be turned inward and not outward to prevent toddler injury. This statement indicates the need for further education.

2. A life vest should be worn by the toddler when near water or on a boat. This statement indicates correct understanding of the information presented.

3. All medications should be kept out of reach from the toddler, and the parents should ensure child-resistant containers are used. This statement indicates correct understanding of the information presented.

4. Parents should supervise toddlers closely, and provide safe climbing toys for the child. This statement indicates correct understanding of the information presented.

Page Ref: 190 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 9.1 Describe the areas of assessment and intervention for health supervision visits for toddler and preschool children: growth and developmental surveillance, nutrition, physical activity, oral health, mental and spiritual health, family and social relations, disease prevention strategies, and injury prevention strategies.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 11) Which assessment finding for a toddler-age child indicates an increased risk for an unhealthy self-concept?

1. A parent who praises the child for his or her accomplishments 2. A parent who is attempting potty training but who understands that accidents will happen 3. A parent who is observed spanking a child for taking a toy from another child in the waiting room 4. A parent who reads a book to the toddler-age child each night before bed to encourage cooperation Answer: 3 Explanation: 1. Praise from a parent to a toddler-age child for his or her accomplishments does not place the child at risk for an unhealthy self-concept.

2. A parent who attempts potty training for a toddler-age child but expects accidents to happen does not place the child at risk for an unhealthy self-concept.

3. Physical discipline is a risk factor for the toddler to develop an unhealthy self-concept.

4. A parent who reads a book to a toddler-age child each night to encourage cooperation is not at risk for an unhealthy self-concept.

Page Ref: 187 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 9.2 State components of self-concept for preschool children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 12) The nurse is teaching the parents of a toddler-age child information regarding toy and playground safety. Which parental statement indicates the need for further education?

1. "I allow my child to play with the packaging material for new toys."

2. "I will avoid buying my child toys that are battery operated."

3. "I allow my child to play with age-appropriate toys as indicated on the packaging."

4. "I don't let my child play on the playground without supervision."

Answer: 1 Explanation: 1. The toddler-age child should not be allowed to play with packaging material for new toys as this increases the risk of injury. This statement indicates the need for further education.

2. The toddler-age child should not be allowed to play with battery-operated toys. This is not appropriate until the child is 8 years of age. This statement indicates appropriate understanding of the information presented.

3. The toddler-age child should be provided with toys that are age-appropriate. A parent who buys the child toys based on the age range on the packaging is appropriate and does not indicate the need for further education.

4. The toddler-age child should not be allowed to play on the playground without supervision.

This statement indicates appropriate understanding of the information presented.

Page Ref: 194 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 9.1 Describe the areas of assessment and intervention for health supervision visits for toddler and preschool children: growth and developmental surveillance, nutrition, physical activity, oral health, mental and spiritual health, family and social relations, disease prevention strategies, and injury prevention strategies.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 13) The nurse is planning health promotion activities for a toddler-age child during a scheduled health maintenance visit. Which action by the nurse is appropriate during this visit?

1. Connecting developmental skills with risks for injury 2. Recognizing that childcare attendance increases the risk for communicable disease 3. Planning education for treatment of common disease processes 4. Illustrating developmental progression on a screening tool Answer: 4 Explanation: 1. Connecting developmental skills with risks for injury is an action that prevents disease and injury. This is not a health promotion activity.

2. Recognizing that attendance at a daycare center increases the risk for communicable disease is an action that prevents disease and injury. This is not a health promotion activity.

3. Planning treatment for common disease processes is an action that prevents disease and injury.

This is not a health promotion activity.

4. Illustrating developmental progression on a screening tool is a health promotion action.

Page Ref: 183 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 9.3 Plan health promotion and health maintenance strategies employed during health supervision visits of toddlers and preschoolers.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 14) Which action should the nurse include when providing education regarding methods to enhance health promotion during a scheduled health maintenance visit for a 4-year-old child?

1. Recognizing that food jags are common 2. Involving the child in snack selection and preparation 3. Encouraging the use of a high chair with a safety strap 4. Recommending the child consumes high-fat foods Answer: 2 Explanation: 1. Food jags are not common for a 4-year-old child. This is more common for the 2-year-old child.

2. A 4-year-old child should be involved in snack selection and preparation.

3. The use of a high chair with a safety strap is not information that should be included for a 4year-old child during a health maintenance visit. This is more appropriate for a toddler-age child.

4. Low-fat, not high-fat, foods should be encouraged during the health maintenance visit.

Page Ref: 185 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 9.3 Plan health promotion and health maintenance strategies employed during health supervision visits of toddlers and preschoolers.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 15) The nurse is conducting a physical assessment for a preschool-age child. When plotting the child's body mass index (BMI), the nurse notes that the child's BMI is at the 90th percentile.

Which action by the nurse is appropriate?

1. Referring the child to a nutritionist 2. Conducting a developmental assessment 3. Assessing the child's level of activity 4. Checking a blood glucose level Answer: 3 Explanation: 1. While the nurse will need to assess a detailed dietary intake for the child, it is not appropriate to refer the child to a nutritionist at this time.

2. There is no reason for the nurse to conduct a developmental assessment based on the current assessment data.

3. A child with a BMI that is 85% or greater should have a detailed dietary intake assessment conducted along with assessing the child's level of activity.

4. The current assessment data do not support the need to check the child's blood glucose level.

Page Ref: 182 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 9.1 Describe the areas of assessment and intervention for health supervision visits for toddler and preschool children: growth and developmental surveillance, nutrition, physical activity, oral health, mental and spiritual health, family and social relations, disease prevention strategies, and injury prevention strategies.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 16) Which will the nurse assess in the family of a 3-year-old child during a pediatric clinic visit scheduled due to regressive behavior? Select all that apply.

1. Change in parental marital status 2. Level of education for each parent 3. Health of child's siblings 4. Maternal depression 5. Child's exposure to communicable diseases Answer: 1, 3, 4 Explanation: 1. Changes that occur with the family members of a 3-year-old child could be the source of the regressive behavior being exhibited. It is appropriate for the nurse to assess for a change in parental marital status.

2. The nurse would not need to assess the level of education for each parent for a 3-year-old child exhibiting regressive behavior. This information will already be compiled in the child's medical record.

3. A change in the health of the child's siblings could cause regressive behavior. This is appropriate for the nurse to include in the family assessment.

4. Maternal depression can be associated with poor self-concept and could be a reason for regressive behavior. This is appropriate for the nurse to include in the family assessment.

5. While it is appropriate for the nurse to assess the child's exposure to communicable disease, this is not included in the family assessment for regressive behavior.

Page Ref: 188 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 9.4 Discuss the importance of family in child healthcare and include family assessment in each health supervision visit.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 17) Which assessment questions are appropriate when the nurse is assessing the mental health of a preschool-age client? Select all that apply.

1. "Is your child experiencing nightmares?"

2. "Does your child ask questions about the genitalia?"

3. "How do you implement punishment for your child when a rule is broken?"

4. "Is your child up-to-date on recommended immunizations?"

5. "Does your child wear safety equipment when riding a bicycle?"

Answer: 1, 2, 3 Explanation: 1. The nurse inquires about nightmares when assessing the mental health of a preschool-age client.

2. The nurse inquires about sexual exploration when assessing the mental health of a preschoolage client.

3. The nurse inquires about implementing punishment for broken rules when assessing the mental health of the preschool-age client.

4. Assessing immunization status is not included in a mental health assessment for a preschoolage client.

5. Assessing the use of safety equipment is not included in a mental health assessment for a preschool-age client.

Page Ref: 187 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 9.5 Integrate pertinent mental healthcare into health supervision visits for toddlers and preschoolers.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 18) Which nursing actions are appropriate when conducting a mental health assessment for a toddler-age child? Select all that apply.

1. Observing the child's interaction with family members 2. Asking the caregiver to describe the child's typical day 3. Giving the child a crayon to assess ability to use 4. Determining the number of hours the child sleeps each night 5. Inquiring about recent exposure to communicable diseases Answer: 1, 2, 3, 4 Explanation: 1. When conducting a mental health assessment for a toddler-age child, it is appropriate for the nurse to observe the child's interaction with family members.

2. When conducting a mental health assessment for a toddler-age child, it is appropriate for the nurse to ask the caregiver to describe the child's typical day.

3. When conducting a mental health assessment for a toddler-age child, it is appropriate to determine whether the child is mastering age-appropriate skills, such as the use of a crayon for a toddler-age child.

4. When conducting a mental health assessment for a toddler-age child, it is appropriate to inquire about the number of hours of sleep the child gets each night.

5. The nurse assesses exposure to communicable diseases during a typical health maintenance visit; however, this action is not appropriate when assessing the toddler's mental health.

Page Ref: 188, 189 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 9.5 Integrate pertinent mental healthcare into health supervision visits for toddlers and preschoolers.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 19) Which interventions will the nurse recommend for a toddler-age client who is biting other children at daycare? Select all that apply.

1. Using a time-out as a form of discipline for the child's behavior 2. Separating the child from the situation 3. Telling the child it is not okay to hurt another person 4. Inquiring whether the child is getting enough sleep 5. Implementing distraction to avert the behavior Answer: 1, 2, 3, 4 Explanation: 1. A time-out is an appropriate intervention for the nurse to suggest when a toddler-age child is exhibiting behaviors that include other people, such as biting.

2. Separation of the child from the situation is an appropriate intervention for the nurse to suggest when a toddler-age child is exhibiting behaviors that include other people, such as biting.

3. It is appropriate to encourage the parents to tell the child that the behavior is unacceptable when the child is exhibiting behaviors that include other people, such as biting.

4. When a child is exhibiting behaviors that include other people, such as biting, it is appropriate to assess the amount of sleep the child is getting each night. Lack of sleep is a common cause for behaviors such as biting.

5. Distraction is appropriate for undesirable behaviors exhibited by the child; however, this is not an appropriate when the child is exhibiting behaviors that include other people, such as biting.

Page Ref: 187 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 9.1 Describe the areas of assessment and intervention for health supervision visits for toddler and preschool children: growth and developmental surveillance, nutrition, physical activity, oral health, mental and spiritual health, family and social relations, disease prevention strategies, and injury prevention strategies.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 20) Which recommendations will the nurse make to the parents of a preschool-age child who is experiencing frequent nightmares? Select all that apply.

1. Reassure the child by back rubbing.

2. Repeat a nighttime routine, such a reading a story.

3. Bring the child to the parental bed.

4. Allow the child time to settle back into sleep.

5. Place a television in the child's room for distraction.

Answer: 1, 2, 4 Explanation: 1. It is appropriate for the parent to reassure the child by back rubbing when a nightmare occurs.

2. It is appropriate for the parent to repeat a nighttime ritual, such as reading a story.

3. It is not recommended for the parent to bring the child to the parental bed as the child may continue to awaken at night to continue this practice.

4. It is appropriate to allow the child time to settle back into sleep.

5. It is not recommended to place a television in the child's room as a form of distraction for the nightmare.

Page Ref: 188 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 9.1 Describe the areas of assessment and intervention for health supervision visits for toddler and preschool children: growth and developmental surveillance, nutrition, physical activity, oral health, mental and spiritual health, family and social relations, disease prevention strategies, and injury prevention strategies.

Principles of Pediatric Nursing, 8e (Ball et al.)

Chapter 10 Health Promotion and Maintenance for the School-Age Child and the Adolescent 1) The nurse develops and implements a health promotion plan for an adolescent client. Which information should the nurse include in the evaluation of the plan?

1. Methods to expand and sustain successful approaches 2. Instruction to the client on what is considered healthy behavior 3. Advice for promoting health behaviors that will maintain a healthy lifestyle 4. Information on the client's attitude toward health Answer: 1 Explanation: 1. When establishing youth programs, whether with individual adolescents or with groups, the nurse includes methods to expand and sustain successful approaches.

2. This is part of the plan but is not part of the evaluation of the plan.

3. The nurse will be looking for input into her plan, but this is not part of the evaluation step.

4. Understanding the attitude of the clients is important in the planning of the health promotion activity.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 10.2 Describe the general observations made of school-age children, adolescents, and families as they come to the "pediatric healthcare home" for health supervision visits.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 2) The nurse is assessing an adolescent client to determine relationships with others. Which nursing action is appropriate?

1. Telling the parents that information from the assessment will be shared with them after the examination 2. Providing separate time to communicate with both the adolescent and the parents 3. Avoiding asking the parents their opinions of the adolescent's friends 4. Telling the parents they are not allowed to come into the examination room Answer: 2 Explanation: 1. This is not always the case as teens are allowed a level of privacy in these assessments.

2. Provide time alone with both the adolescent and the parents so that everyone has time to talk freely and ask questions.

3. It is important to understand how the parents feel regarding the teen's friendships.

4. The teen and parents should be allowed time to discuss feelings separately.

Page Ref: 203 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 10.4 Apply assessment skills to plan data-gathering methods for nutrition, physical activity, oral health, and mental health status of youth.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 3) Which should the nurse keep in mind when providing care to an adolescent client during the initial visit?

1. The importance of explaining procedures and introducing personnel to adolescents.

2. Adolescents usually are quiet and will offer no opinions.

3. The importance of attending to and discharging the adolescent quickly.

4. Adolescents are comfortable with their surroundings.

Answer: 1 Explanation: 1. If the setting is new to the adolescent, explain the procedures and introduce personnel so the adolescent feels more at ease.

2. Adolescents are usually partners in healthcare and will usually engage in the discussions.

3. Taking time with adolescents is important to make them feel welcomed and not like they are a burden.

4. Some are comfortable and some are not, so you may have to work to make them feel comfortable.

Page Ref: 211 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 10.2 Describe the general observations made of school-age children, adolescents, and families as they come to the "pediatric healthcare home" for health supervision visits.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 4) Which nursing action is appropriate when providing care to an adolescent client who is accompanied to an appointment by a parent?

1. Instructing the parent to stay in the waiting room with the explanation that the adolescent will provide a report after the examination 2. Telling the parent it is against policy for a parent to accompany the adolescent to the examination room 3. Reassuring the parent that the nurse will discuss any parental concerns or questions after the examination 4. Allowing the parent to come into the examination room with the adolescent Answer: 3 Explanation: 1. Parents may accompany the patient to the examination especially if it is a medical concern, but the patient must always be offered some private time without parents present.

2. Parents may accompany the patient to the examination especially if it is a medical concern, but the patient must always be offered some private time without parents present.

3. If one or both parents come with the adolescent, be alert that you might need to provide some private time by asking the parents to wait outside for a moment. Reassure the parents that you will talk with them about any of their concerns and questions, and provide them with an opportunity to ask questions and get information as well.

4. Parents may accompany the patient to the examination especially if it is a medical concern, but the patient must always be offered some private time without parents present.

Page Ref: 211 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 10.2 Describe the general observations made of school-age children, adolescents, and families as they come to the "pediatric healthcare home" for health supervision visits.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 5) A school nurse is performing annual height and weight screening. The nurse notes that three adolescent girls who are close friends each lost 15 pounds over the past year. Which is the priority nursing action?

1. Obtaining a nutritional history for each of these adolescents 2. Referring these adolescents to the school psychologist 3. Calling the respective parents to discuss the eating patterns of each adolescent 4. Speaking with the adolescents in a group to discuss the problems associated with anorexia nervosa Answer: 1 Explanation: 1. The school nurse must evaluate why these three friends have all lost 15 pounds in 1 year. The best way to begin this assessment is to obtain a nutritional history for each client.

2. The situation must first be assessed prior to sending the students off to the psychologist.

3. The adolescents should be talked to first so that the nurse has a better understanding of the history. It will be important to talk with the parents also, but first a history of events needs to be discovered.

4. The adolescents should be given privacy in discussing the situation so that they are not feeling any undue pressure from the group setting.

Page Ref: 211 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 10.1 Identify the major health concerns of the school-age and adolescent years.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 6) The following information is collected during the nursing assessment: the adolescent's menses began when she was 12 years old; a current body mass index (BMI) of 27.5; inconsistent school performance over the last several years. Which is the priority area of teaching for this adolescent?

1. Menstrual cycle 2. Nutritional intake 3. School performance 4. Mental health status Answer: 2 Explanation: 1. Menstrual cycle is not a concern for this patient.

2. The BMI for this client is high, placing the adolescent at risk for cardiovascular disease, hypertension, and diabetes mellitus in later life. Therefore, nutritional intake is the most important topic to focus on with this client at this time.

3. School performance should be addressed but is not the priority teaching area for this client.

4. Mental health status should be evaluated for all adolescents but is not the priority for this client.

Page Ref: 211 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: I2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 10.1 Identify the major health concerns of the school-age and adolescent years.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 7) The nurse is assessing an adolescent patient during a scheduled health maintenance visit. The adolescent's mother is currently in the examination room with the patient. Which topic should the nurse avoid until the mother has left the examination room?

1. School performance 2. Cigarette smoking 3. School friends 4. Seat belt use Answer: 2 Explanation: 1. The topic of school performance is not one that the nurse needs to maintain confidentiality.

2. The nurse must maintain the nurse-client relationship, which is between the nurse and the adolescent, and the nurse must maintain confidentiality. Therefore, the nurse should refrain from asking any personal questions while the mother is in the room, such as those related to sexual activity, drug and alcohol use, and cigarette smoking.

3. The topic of school friends is not one that needs to be kept confidential between the nurse and the client, so it is ok to review in front of the parent.

4. The topic of seat belts is not one that needs to be kept confidential between the nurse and the client, so it is ok to review in front of the parent.

Page Ref: 204 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.A.9. Discuss principles of effective communication | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Practice: Communicate effectively with different individuals (team members, other care providers, patients, families, etc.) so as to minimize risks associated with handoffs among providers and across transitions in care. | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 10.3 Apply communication skills in interactions with school-age children and adolescents.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 8) The nurse is assessing an adolescent client during a scheduled health maintenance appointment. Which issues should the nurse address when the parents are not present?

1. The adolescent's role in the family 2. Teen job responsibilities 3. Possible domestic violence 4. Activities done as a family Answer: 3 Explanation: 1. This topic involves the parents, so it is ok to address while the parents are present.

2. This topic involves the parents, and allowing for both the teen and the parents to talk about it is important.

3. If domestic violence is suspected, it would be appropriate to ask these questions only when the teenager is alone with the nurse or healthcare provider.

4. This topic involves the parents and allowing for both the teen and the parents to talk about it is important.

Page Ref: 216 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.A.9. Discuss principles of effective communication | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Practice: Communicate effectively with different individuals (team members, other care providers, patients, families, etc.) so as to minimize risks associated with handoffs among providers and across transitions in care. | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 10.3 Apply communication skills in interactions with school-age children and adolescents.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 9) An adolescent with obesity who adamantly denies sexual activity has a positive pregnancy test. Which response by the nurse is most appropriate?

1. "When was your last menstrual period (LMP)?"

2. "Tell me how you feel about your body image."

3. "Let's discuss some activities that you have done within the past few months that could possibly lead to pregnancy."

4. "Why are you denying sexual intercourse?"

Answer: 3 Explanation: 1. Obesity can affect the teens menstrual period, so this question may not help the teen come to the realization of the positive pregnancy test.

2. The teens body image may be a problem but is not the priority at this time, so this response is not appropriate when discussing the pregnancy test results.

3. The nurse must help the adolescent realize that previous behaviors have led to a positive pregnancy test. The only response by the nurse that will accomplish this goal is to ask a direct question in which the nurse and client search for an answer.

4. Accusing the teen will not allow for therapeutic communication between the nurse and the teen.

Page Ref: 214 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 10.5 Synthesize data from history and examination of the school-age child and adolescent with knowledge of development to plan interventions appropriate during health supervision visits.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 10) A mother reports that her adolescent daughter is always late. The mother states, "She was born late and has been late every day of her life." Which response by the nurse is appropriate?

1. "Setting specific alarms and reinforcing the value of being 'on-time' may assist her to be more of an 'on-time' individual."

2. "Just let it go for now. Teachers and, in the future, employers will be the best people to help her be 'on-time.' " 3. "You need to establish specific time frames for your adolescent and be certain she adheres to them."

4. "You have a major problem. There must be a lot of screaming in your home."

Answer: 1 Explanation: 1. The best response is to help the mother find a way to help the teen deal with the problem of lateness.

2. This response does not validate how the mother is feeling and doesn't allow for a concrete way to address the situation.

3. This answer is close but doesn't give the parent some real life tips to help the adolescent be more on time.

4. This is not acknowledging the parent's feelings and is not appropriate Page Ref: 204 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 10.6 Plan with school-age children and adolescents to help them integrate activities to promote health and to prevent disease and injury.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 11) Which screening is appropriate for the school nurse to perform on all adolescent students?

1. Respiratory rate 2. Hepatitis B profile 3. Chest x-ray 4. Scoliosis Answer: 4 Explanation: 1. This will be part of a vital sign assessment but is not a screening tool for adolescents.

2. The vaccine records should be reviewed to confirm the patient has received the Hep B profile but is normally received prior to adolescents.

3. An x-ray is not part of a routine screening for adolescents.

4. Routine screening for adolescents includes checking for scoliosis, height, weight, and blood pressure measurements.

Page Ref: 216 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 10.1 Identify the major health concerns of the school-age and adolescent years.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 12) During a health maintenance visit, an adolescent states, "I have no friends in my new school and I no longer want to go to college. I know I will be lonely there, too." Which is the priority nursing action?

1. Stressing the importance of remaining in a close parent-child relationship during these stressful times 2. Promoting healthy mental health outcomes 3. Acknowledging the fact that it takes several months to make new friends at a new school due to adolescent exclusion behaviors 4. Helping the adolescent realize the value of postsecondary education Answer: 2 Explanation: 1. The adolescent is having some feelings and they need to be validated, so this is not the best answer as they are looking for friends not parents.

2. The adolescent is obviously lonely with the move to the new school. The nurse should focus on appropriate coping skills, which will enhance good mental health outcomes for the child.

3. The adolescent needs immediate coping skills; telling them to wait it out is not the best answer.

4. The adolescent is in crisis right now, so talking about the future is not the best answer. They need real-time help.

Page Ref: 216 Cognitive Level: Analyzing Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 10.6 Plan with school-age children and adolescents to help them integrate activities to promote health and to prevent disease and injury.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 13) The nurse is planning to teach a group of adolescents about what can happen when having unprotected sex. Which nursing action will allow effective communication with the group?

1. Offering personal opinions on the topic 2. Allowing for discussion among the participants 3. Lecturing on the topic for the allotted time without any discussion 4. Discussing sex education related to religious belief Answer: 2 Explanation: 1. Offering personal options on the topic will not allow for effective communication especially if they disagree with the opinion and now will not talk about it to avoid conflict.

2. Whatever the setting, the nurse partners with the adolescent, the parents, and other persons, such as teachers or school counselors, to plan appropriate goals and related interventions.

Appropriate interventions include applying communication skills effective with teens, such as listening to concerns, allowing for discussion, and bringing peers who have had experiences related to the topic being discussed.

3. Just lecturing and not allowing for discussion is not an effective communication tactic.

4. Bringing in religious beliefs will not establish effective communication as the group may have differing religious beliefs.

Page Ref: 218 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.A.9. Discuss principles of effective communication | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Practice: Communicate effectively with different individuals (team members, other care providers, patients, families, etc.) so as to minimize risks associated with handoffs among providers and across transitions in care. | Nursing/Integrated Concepts: Teaching and Learning Learning Outcome: 10.3 Apply communication skills in interactions with school-age children and adolescents.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 14) Which nursing action is the best when teaching adolescent health promotion and health maintenance topics?

1. Contacting the parents and asking what issues they have with their adolescents 2. Having the adolescents identify a personal health goal 3. Asking the advice of the counselors at school 4. Telling the adolescents information that will be included in the lecture Answer: 2 Explanation: 1. The focus should be on the adolescent's needs and not the parents' needs, the input would be helpful but is not the best course of action.

2. Teaching topics will be directed at both health promotion and health maintenance. A good starting point is to have the adolescent identify a personal health goal, and begin teaching there.

3. The input of the counselor is important in the planning but is not the best answer.

4. Allowing for the adolescents to share what they are looking to get out of the lecture is best before starting out saying what will be discussed.

Page Ref: 218 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.4 Diagnose actual or potential health problems and needs. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Implementation/Teaching and Learning Learning Outcome: 10.6 Plan with school-age children and adolescents to help them integrate activities to promote health and to prevent disease and injury.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 15) Which screenings are appropriate for an adolescent client who admits to being sexually active during a scheduled health maintenance visit? Select all that apply.

1. Herpes simplex virus 2. Gonorrhea 3. Chlamydia 4. Impetigo 5. Mononucleosis Answer: 1, 2, 3 Explanation: 1. Herpes simplex 1 and 2 can be sexually transmitted and should be included in the screening.

2. Some individuals with gonorrhea may display no symptoms. Because it is a sexually transmitted infection, screening for it would be appropriate.

3. Chlamydia is the most common sexually transmitted infection in the United States. Screening is appropriate.

4. This is a skin condition found mostly in young children, not a sexually transmitted disease.

5. This is not a sexually transmitted disease, so no need for screening during a health maintenance visit.

Page Ref: 216 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 10.5 Synthesize data from history and examination of the school-age child and adolescent with knowledge of development to plan interventions appropriate during health supervision visits.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 16) Which nursing action maintains confidentiality when performing height and weight measurements during a co-ed physical education class?

1. Having a student worker record the screening findings on the appropriate adolescent's record 2. Having a volunteer weigh and measure the adolescents and verbally give the findings to the nurse to calculate the body mass index and record 3. Providing a privacy screen and having the health aid record the findings directly on the record.

The nurse will then calculate body mass index.

4. Using a buddy system with the students, having the students measure each other, and then recording the findings.

Answer: 3 Explanation: 1. This action would not provide privacy from other students.

2. The information should not be shared out loud as it will not provide privacy.

3. A privacy screen and written responses will prevent other adolescents from hearing or seeing results.

4. This action would not provide privacy from other students.

Page Ref: 198 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 10.4 Apply assessment skills to plan data-gathering methods for nutrition, physical activity, oral health, and mental health status of youth.

17) The nurse is planning care for an overweight adolescent. Which topic may also be appropriate for the nurse to include in the adolescent's plan of care?

1. Substance abuse 2. School phobia 3. Spiritual distress 4. Negative self-esteem Answer: 4 Explanation: 1. The student is not suffering substance abuse, so this topic is not needed.

2. The student is not having school phobia, so this topic is not needed.

3. The student is not experiencing spiritual distress, so this is not the best answer.

4. Self-esteem is tied closely to body image, a common source of distress among obese adolescents. Therefore, the nurse will monitor the adolescent for issues with self-esteem.

Page Ref: 200 Cognitive Level: Analyzing Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Context and Environment: Practice: transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 10.1 Identify the major health concerns of the school-age and adolescent years.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 18) The school nurse is assessing an adolescent who reports getting less than 6 hours of sleep at night. Which consequences of inadequate sleep will the nurse include when responding to the adolescent? Select all that apply.

1. Hyperactivity 2. Increased nocturnal emissions 3. Increased risk of automobile accidents when driving 4. Moodiness 5. An inability to perform well at school Answer: 3, 4, 5 Explanation: 1. This is common in school-age children but not in adolescents.

2. This is common in puberty and is not increased by less sleep at night.

3. This is a possibility in the adolescent who is sleep deprived.

4. Parents often report that sleep-deprived adolescents tend to be moody and are difficult to communicate with.

5. Drowsiness will inhibit the performance of the adolescent.

Page Ref: 203 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 10.2 Describe the general observations made of school-age children, adolescents, and families as they come to the "pediatric healthcare home" for health supervision visits.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 19) Which teaching topics are appropriate for the nurse to include for an adolescent who admits to the use of chewing tobacco? Select all that apply.

1. Lung cancer 2. Nicotine addiction 3. Mouth cancers 4. Emphysema 5. Mouth ulcers Answer: 2, 3, 5 Explanation: 1. Lung cancer is related to smoking tobacco vs chewing tobacco.

2. Nicotine addiction occurs with chewing tobacco just as it does with smoking cigarettes.

3. Cancer of the mouth is associated with chewing tobacco.

4. This is caused by smoking not chewing tobacco.

5. Mouth ulcers occur in individuals who chew tobacco.

Page Ref: 214 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 10.6 Plan with school-age children and adolescents to help them integrate activities to promote health and to prevent disease and injury.

20) Which question is appropriate for the nurse to include in the assessment for an adolescent client related to developmental tasks?

1. "How are you adapting to the high school setting?"

2. "What type of relationship do you have with your friends?

3. "Have you thought about your future career goals?"

4. "Do you play any team sports?"

Answer: 2 Explanation: 1. This question is in the coping category and not developmental.

2. The primary task for the adolescent is to separate from parents, and develop positive peer relationships.

3. This is a thoughts question and not focused on developmental tasks.

4. This is a good question to develop therapeutic communication but not related to developmental tasks.

Page Ref: 216 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 10.4 Apply assessment skills to plan data-gathering methods for nutrition, physical activity, oral health, and mental health status of youth.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 21) The nurse notes dental issues during the assessment of an adolescent client. Which topics will the nurse explore further to determine the cause of the issues? Select all that apply.

1. Use of fluoridated water 2. Use of a mouth guard when playing physical sports 3. Anorexia nervosa 4. Bulimia nervosa 5. Use of daily vitamins Answer: 2, 3, 4, 5 Explanation: 1. Use of fluoridated water is a concern in young children, not adolescents who are grown.

2. Sports injuries can be the cause of dental issues without proper safety equipment, such as a mouth guard.

3. Dental injuries can be related to eating disorders.

4. Repeated vomiting can destroy enamel due to contact with acidic stomach juices.

5. A lack of certain vitamins can cause dental issues.

Page Ref: 214 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 10.5 Synthesize data from history and examination of the school-age child and adolescent with knowledge of development to plan interventions appropriate during health supervision visits.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 22) The nurse is planning care for an adolescent whose parents have both recently been laid off from their jobs. Which is a potential problem for the adolescent and family?

1. Problems in sleeping 2. Possible risky behavior 3. Insufficient food at home 4. Lack of information about growth and development Answer: 3 Explanation: 1. This is not a potential problem to a jobless family unit.

2. This is not a potential problem related to unemployed parents.

3. The family who has a change in finances may have difficulty with having sufficient food at home. This would be the priority problem for the adolescent. Sleeping, risky behavior, and information about growth and development are not as essential to the adolescent if a parent becomes unemployed.

4. This is not a potential problem related to unemployed parents.

Page Ref: 212 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.4 Diagnose actual or potential health problems and needs. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Diagnosis Learning Outcome: 10.5 Synthesize data from history and examination of the school-age child and adolescent with knowledge of development to plan interventions appropriate during health supervision visits.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 23) Which is the most appropriate assessment question for the nurse to ask when collecting nutritional data from an adolescent client?

1. "How do you feel about your weight and the way you look?"

2. "What did you have to eat so far today?"

3. "What is your favorite grocery store?"

4. "Do you eat school lunches or pack a lunch from home each day?"

Answer: 1 Explanation: 1. The best way to obtain information to include in the plan of care is to use a open ended question. It is also important to ask information about the way the child feels about his or her body image.

2. This is not the best answer and doesn't open the topic up for more discussion initially.

3. This is not the best answer and doesn't open the topic up for more discussion initially.

4. This is not the best answer and doesn't open the topic up for more discussion initially.

Page Ref: 214 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 10.2 Describe the general observations made of school-age children, adolescents, and families as they come to the "pediatric healthcare home" for health supervision visits.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 24) A nurse obtains a nutritional health history from a 10-year-old child. Which food increases the risk for dental cavities necessitating education regarding oral hygiene?

1. Sorbet and yogurt 2. Fluoridated water 3. Gummy bears and licorice 4. Peanuts and crackers Answer: 3 Explanation: 1. This food is healthy and doesn't stick to the teeth as much as others.

2. Fluoridated water helps prevent dental cavities.

3. Food items that stick to the teeth lead to dental cavities. Items such as gummy bears and licorice stick to the teeth and lead to dental cavities.

4. This is a healthy snack that will not increase the risk of dental cavities.

Page Ref: 201 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 10.2 Describe the general observations made of school-age children, adolescents, and families as they come to the "pediatric healthcare home" for health supervision visits.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 25) The mother of a 12-year-old child informs the nurse that the child's father died from sudden cardiac death at 44 years old. Which laboratory tests does the nurse anticipate will be prescribed by the healthcare provider?

1. Chest x-ray 2. Complete blood count (CBC) with differential 3. Electroencephalogram (EEG) 4. Lipid profile Answer: 4 Explanation: 1. Chest x-ray would not help identify any cardiac risk factors.

2. CBC would not identify any early cardiac risk factors.

3. EEG is used to study the brain's electroconductivity, not the hearts.

4. This child should have a lipid profile completed at 12 years old, and based on the results, further testing might be needed.

Page Ref: 212 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Reduction of Risk Potential Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 10.2 Describe the general observations made of school-age children, adolescents, and families as they come to the "pediatric healthcare home" for health supervision visits.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 26) Which will the nurse include in the assessment process for a school-age child who is exhibiting poor school performance? Select all that apply.

1. Hearing screen 2. Muscle tone 3. Dental inspection 4. Vision screen 5. Throat culture Answer: 1, 2, 4 Explanation: 1. Children with problems with vision, hearing, and muscle tone are at risk for poor school performance because most school activities involve listening, seeing, and kinetic activity. A hearing screen is appropriate for the nurse to include in the assessment process.

2. Children with problems with vision, hearing, and muscle tone are at risk for poor school performance because most school activities involve listening, seeing, and kinetic activity. A muscle tone assessment is appropriate for the nurse to include in the assessment process.

3. Dental problems are not risk factors for poor school performance.

4. Children with problems with vision, hearing, and muscle tone are at risk for poor school performance because most school activities involve listening, seeing, and kinetic activity. A vision screen is appropriate for the nurse to include in the assessment process.

5. A throat culture is not part of a screening for poor school performance.

Page Ref: 212 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 10.2 Describe the general observations made of school-age children, adolescents, and families as they come to the "pediatric healthcare home" for health supervision visits.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 27) The school nurse is planning an education program for fourth-grade children regarding prepubescent changes. Which nursing action will make the educational program successful?

1. Discussing program content with the parents 2. Talking to all of the classes at one time 3. Planning the program for after school 4. Having the parents present during the program Answer: 1 Explanation: 1. At this age, the information might be new to the child. Involving the parents might entail a preprogram discussion by the parents with the child, or giving the parents a guide to discuss and reinforce later. If the parents and child are able to communicate about the changes, this will promote communication throughout the rest of the growth of the child.

2. Smaller group settings are best for this topic to allow.

3. Planning the session during school hours will allow for attendance rates to be high and allow for a successful program.

4. By having the parents not be present, this gives the children time to process the information and ask questions without parents present. Then, when children are with parents at a later time, it will allow for a further discussion and reinforcement of the topic.

Page Ref: 203 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 10.6 Plan with school-age children and adolescents to help them integrate activities to promote health and to prevent disease and injury.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 28) During the psychosocial portion of the nursing assessment, a school-age child states, "I know I am not as good as them, so I just play by myself at recess every day." Which conclusion by the nurse is accurate?

1. The child has a good sense of self-worth.

2. The child has a poor body image.

3. The child has decreased self-esteem.

4. The child has a self-determined concept.

Answer: 3 Explanation: 1. The child is not interacting with others, so this is concerning that they do not think they are worthy.

2. Body image may be part of it but is not the most accurate reason why the child is not interacting.

3. The child's statement reveals no interaction with other children during play periods; therefore, the child's self-esteem is low.

4. This is not the reason for the child to not play with other children.

Page Ref: 202 Cognitive Level: Analyzing Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 10.4 Apply assessment skills to plan data-gathering methods for nutrition, physical activity, oral health, and mental health status of youth.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 29) An overweight school-age girl states, "I would like to be more active but my parents won't let me try out for the soccer team." Which is an appropriate nursing action based on this statement?

1. Referring the child to the school psychologist to discuss the weight issue 2. Telling the child to talk to the school nurse each day about the foods eaten 3. Encouraging the parents to investigate the option of ride sharing with a classmate's family 4. Suggesting that the family plan an activity night, and play board games together Answer: 3 Explanation: 1. The child is showing that she wants to be more active, so the psychologist is not warranted.

2. This tactic could cause more harm than good making the girl's relationship with food unhealthy.

3. Sharing rides with another family might allow the girl to get involved with a physical activity after school and still have the parents involved.

4. Board games are not bad but will not help the child increase her physical activity.

Page Ref: 213 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 10.4 Apply assessment skills to plan data-gathering methods for nutrition, physical activity, oral health, and mental health status of youth.

Principles of Pediatric Nursing, 8e (Ball et al.)

Chapter 11 Family Assessment and Concepts of Nursing Care in the Community 1) Which pediatric client will the community health nurse assess first?

1. A 6-year-old who is wheezing and short of breath.

2. A 2-year-old who has been pulling at his ear.

3. A 2-month-old with a 2-day history of diarrhea.

4. A 10-year-old with a sore throat and low-grade fever.

Answer: 1 Explanation: 1. A child who has symptoms of respiratory distress should be seen right away.

2. While the 2-year-old is exhibiting symptoms of an ear infection and needs to be seen; however, this is not the priority client for assessment.

3. While the 2-month-old with a 2-day history of diarrhea needs to be seen, this is not the priority client for assessment.

4. While a 10-year-old with a sore throat and low-grade fever need to be seen, this is not the priority client for assessment.

Page Ref: 233 Cognitive Level: Analyzing Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.5 199 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 Develop a plan of care. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 11.3 Assemble a list of family support services that might be available in a community.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 2) A community assessment conducted by the nurse reveals that the number of serious injuries in children has doubled in the past year. Which problem should the nurse use when planning care to address the increased number of injuries?

1. Family needs when a child is hospitalized 2. Use of bicycle helmets to reduce injuries 3. Incorrect use of child car seats 4. Ways to prevent injuries in children Answer: 4 Explanation: 1. This problem might be appropriate in a specific situation.

2. This problem might be appropriate in a specific situation.

3. This problem might be appropriate in a specific situation.

4. Ways to prevent injuries in children is general to the problem as a whole and is, therefore, the most appropriate to address the community's needs.

Page Ref: 224 Cognitive Level: Analyzing Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.4 Diagnose actual or potential health problems and needs. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Diagnosis Learning Outcome: 11.3 Assemble a list of family support services that might be available in a community.

3) Which must the nurse realize prior to accepting any assignment as a home health nurse?

1. All decisions will be made by the healthcare provider.

2. Independent decisions regarding emergency care of the child will be made by the nurse.

3. The family will adapt their lifestyle to the needs of the nurse.

4. The family is in charge.

Answer: 4 Explanation: 1. The home health nurse must realize that the family is in charge.

2. The family must provide informed consent for emergency care.

3. The nurse must be flexible and adaptable to the lifestyle of the family.

4. The home health nurse must realize that the family is in charge.

Page Ref: 233 Cognitive Level: Understanding Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 11.3 Assemble a list of family support services that might be available in a community.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 4) The home health nurse is providing care to a 2-week-old newborn, and notes that the baby has a necklace with a charm around the neck. The parents state that they believe the charm will keep the baby healthy. Which nursing action is most appropriate?

1. Report the parent to Social Services for endangering the child.

2. Respect the parents' wishes, and leave the necklace in place.

3. Remove the necklace, and inform the parents that it is dangerous.

4. Ask the parents to remove the necklace.

Answer: 2 Explanation: 1. The nurse should honor the practices of the family. To do otherwise would lead to loss of trust from the family. The nurse can provide anticipatory guidance to the family that includes safety principles as the infant grows.

2. Families of different cultural backgrounds might have specific beliefs about healthcare. These beliefs might differ from those of the nurse. The nurse should honor the practices of the family.

3. The nurse should honor the practices of the family. To do otherwise would lead to loss of trust from the family. The nurse can provide anticipatory guidance to the family that includes safety principles as the infant grows.

4. The nurse should honor the practices of the family. To do otherwise would lead to loss of trust from the family. The nurse can provide anticipatory guidance to the family that includes safety principles as the infant grows.

Page Ref: 225 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 11.4 Discuss the community healthcare settings where nurses provide health services to children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 5) A 2-month-old infant with bronchopulmonary dysplasia (BPD) is being prepared for discharge from the neonatal intensive care unit. The infant will continue to receive oxygen via nasal cannula at home. Prior to discharge, the home health nurse assesses the home. Which finding poses the greatest risk to this infant?

1. Paint peeling on the walls 2. A wood stove used for heating 3. A sibling who has an ear infection 4. Small toys strewn on the floor Answer: 2 Explanation: 1. Paint peeling from the wall will pose a choking risk to the older infant who is crawling.

2. Assessment of the home environment is essential prior to discharge of a medically fragile infant. The use of a wood stove poses great risk to the infant who already has fragile lungs and is a fire hazard when using oxygen in the home environment.

3. Ear infections are not contagious.

4. Small toy pieces will pose a choking risk to the older infant who is crawling.

Page Ref: 233 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 11.4 Discuss the community healthcare settings where nurses provide health services to children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 6) An adolescent client has a long leg cast secondary to a fractured femur. Which nursing action is most appropriate in order to effectively facilitate the adolescent's return to school?

1. Develop an individualized health plan (IHP) that focuses on long-term needs of the adolescent.

2. Meet with all of the other students prior to the student's return to school to emphasize the special needs of the injured teen.

3. Meet with teachers and administrators at the school to make sure entrances and classrooms are wheelchair accessible.

4. Meet with parents of the injured student to encourage homebound schooling until a short leg cast is applied.

Answer: 3 Explanation: 1. While an IHP might be developed, short-term needs would be the focus.

2. It is not necessary to meet with all of the students to discuss the adolescent's needs.

3. An adolescent with a long leg cast secondary to a fractured femur will be dependent on a wheelchair for mobility. It is essential that the environment be wheelchair accessible prior to the adolescent's return to school.

4. There is no reason to encourage the adolescent to stay at home for schooling if the child is ready to return.

Page Ref: 230 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 11.4 Discuss the community healthcare settings where nurses provide health services to children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 7) Which is the priority topic the nurse will include when teaching newly hired teachers at a child care center within the community?

1. How to take a temperature 2. The schedule for immunizations 3. How to interpret healthcare records 4. Principles of infection control Answer: 4 Explanation: 1. While the teachers may need to monitor a child's temperature while working at the center, this is not the priority topic for the nurse to include in the teaching session.

2. While the teachers may need to review immunization records for the children, this is not the priority topic for the nurse to include in the teaching session.

3. While the teachers may need to review and interpret the children's healthcare records, this is not the priority topic for the nurse to include in the teaching session.

4. It is essential that teachers know principles of infection control to decrease the spread of germs that can cause disease in young children; therefore, this is the priority topic for the nurse to include in the teaching session.

Page Ref: 230 Cognitive Level: Analyzing Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: II.B.4. Function competently within own scope of practice as a member of the healthcare team | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Teamwork: Knowledge: Scope of practice, roles, and responsibilities of healthcare team members, including overlaps | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 11.5 Compare the roles of the nurse in each identified community healthcare setting.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 8) In which situation will the school nurse collaborate with the family and other members of the healthcare team in order to develop an individualized health plan (IHP)?

1. For a child who recently developed a penicillin allergy 2. For a child who has been treated for head lice 3. For a child who has missed 2 weeks of school due to mononucleosis 4. For a child who is newly diagnosed with insulin-dependent diabetes mellitus.

Answer: 4 Explanation: 1. A child who is allergic to penicillin will not receive this medication anymore and, therefore, should not encounter any problems related to it at school.

2. A child who has been treated for head lice can return to school, and does not need an IHP. 3. While a child who has missed 2 weeks of school will need to make arrangements for makeup work, an IHP is not needed.

4. An IHP that ensures appropriate management of the child's healthcare needs must be developed for a child newly diagnosed with a chronic illness, such as diabetes.

Page Ref: 229 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: II.B.4. Function competently within own scope of practice as a member of the healthcare team | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Teamwork: Knowledge: Scope of practice, roles, and responsibilities of healthcare team members, including overlaps | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 11.5 Compare the roles of the nurse in each identified community healthcare setting.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 9) The telephone triage nurse receives a call from a parent who describes a crowing sound when the 18-month-old breathes, and the child is hard to wake up. Which is the appropriate nursing action?

1. Making an appointment for the child to see the healthcare provider 2. Obtaining the history of the illness from the parent 3. Advising the parent to hang up and call 911 4. Reassuring the parent and providing instructions on home care for the child Answer: 3 Explanation: 1. This action would be appropriate only in nonemergency situations.

2. This action would be appropriate only in nonemergency situations.

3. The nurse should immediately recognize the symptoms of severe upper respiratory distress, and advise the parent to call 911.

4. This action would be appropriate only in nonemergency situations.

Page Ref: 233 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: II.B.4. Function competently within own scope of practice as a member of the healthcare team | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Teamwork: Knowledge: Scope of practice, roles, and responsibilities of healthcare team members, including overlaps | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 11.5 Compare the roles of the nurse in each identified community healthcare setting.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 10) Which actions are expected for a nurse who works in the school environment? Select all that apply.

1. Developing a plan for emergency care of injured children 2. Teaching a class on wellness to teachers and staff 3. Prescribing antibiotics for streptococcal pharyngitis 4. Diagnosing an ear infection 5. Screening for head lice Answer: 1, 2, 5 Explanation: 1. Screening of students for certain conditions; educating students, teachers, and staff; and developing emergency plans are all roles of the school nurse.

2. Screening of students for certain conditions; educating students, teachers, and staff; and developing emergency plans are all roles of the school nurse.

3. Prescribing medication for a new illness is beyond the scope of practice for the school nurse unless the nurse is licensed as an advanced practice nurse.

4. Diagnosing acute illness is beyond the scope of practice for the school nurse unless the nurse is licensed as an advanced practice nurse.

5. Screening of students for certain conditions; educating students, teachers, and staff; and developing emergency plans are all roles of the school nurse.

Page Ref: 227, 229 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: II.B.4. Function competently within own scope of practice as a member of the healthcare team | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Teamwork: Knowledge: Scope of practice, roles, and responsibilities of healthcare team members, including overlaps | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 11.5 Compare the roles of the nurse in each identified community healthcare setting.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 11) A child who has had a tracheostomy for several years is scheduled to begin kindergarten in the fall. The teacher is concerned about this child being in the class, and consults the school nurse. Which nursing action is appropriate?

1. Making arrangements for the child to go to a special school 2. Recommending that the child be home schooled 3. Asking the parents of the child to provide a caregiver during school hour 4. Teaching the teacher how to care for the child in the classroom Answer: 4 Explanation: 1. Laws have been implemented to ensure that children with disabilities will receive a free education.

2. Laws have been implemented to ensure that all children with disabilities will receive a free education. While the parents may wish to home school their child, it is not appropriate for the nurse to recommend this to the parents.

3. Since the child has had a tracheostomy for several years, the child might need a little extra attention while in the school setting. If needed, a health aide may be assigned to the child, but this is not the responsibility of the parents.

4. Since the child has had a tracheostomy for several years, the child might need a little extra attention while in the school setting. The teacher should be taught how to care for the child, if needed, and taught the signs of distress.

Page Ref: 230 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: II.B.4. Function competently within own scope of practice as a member of the healthcare team | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Teamwork: Knowledge: Scope of practice, roles, and responsibilities of healthcare team members, including overlaps | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 11.5 Compare the roles of the nurse in each identified community healthcare setting.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 12) A child who is dependent on a ventilator is being discharged from the hospital. Which will the nurse recommend for the emergency plan of care for this family during the discharge instruction process?

1. Designating an emergency shelter site 2. Notifying the power company that the child is on life support 3. Acquiring a backup generator 4. Having an alternate heating source if power is lost Answer: 3 Explanation: 1. While this action is very important, it is most essential that the ventilator must have power to continue to function at all times.

2. While this action is very important, it is most essential that the ventilator must have power to continue to function at all times.

3. Prior to discharge to home, it is essential that the family acquire a generator so that the child's life support will continue to function effectively should power be lost.

4. While this action is very important, it is most essential that the ventilator must have power to continue to function at all times.

Page Ref: 234 Cognitive Level: Analyzing Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: V.C.4. Value vigilance and monitoring (even of own performance of care activities) by patients, families, and other members of the healthcare team | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Teamwork: Practice: Clarify roles and integrate the contributions of others who play a role in helping the patient/family achieve health goals | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 11.6 Review the special developmental needs of children to consider in disaster preparedness planning.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 13) Which aspect of an emergency medical services system (EMS) indicates the providers are prepared to provide emergency care to children?

1. Listing hospitals in the area that treat children 2. Having pediatric-sized equipment and supplies 3. Placing small stretchers in emergency vehicles 4. Educating staff related to assessment and treatment of children of all ages Answer: 4 Explanation: 1. While a list of hospitals that treat children is an essential part of an EMS system, the aspect that is most indicative that EMS providers actually are prepared to take care of children is evidence of education related to assessment and emergency treatment.

2. While size-appropriate equipment is an essential part of an EMS system, the aspect that is most indicative that EMS providers actually are prepared to take care of children is evidence of education related to assessment and emergency treatment.

3. While size-appropriate equipment is an essential part of an EMS system, the aspect that is most indicative that EMS providers actually are prepared to take care of children is evidence of education related to assessment and emergency treatment.

4. The aspect that is most indicative that EMS providers actually are prepared to take care of children is evidence of education related to assessment and emergency treatment.

Page Ref: 235 Cognitive Level: Analyzing Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: V.C.4. Value vigilance and monitoring (even of own performance of care activities) by patients, families, and other members of the healthcare team | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Teamwork: Practice: Clarify roles and integrate the contributions of others who play a role in helping the patient/family achieve health goals | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 11.6 Review the special developmental needs of children to consider in disaster preparedness planning.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 14) The nurse is planning care for a pediatric client who has a fractured femur and requires a spica cast after being involved in a motor vehicle accident. The client's adolescent brother was driving the car, which was a total loss. The client's father lost his job 3 weeks ago, and the mother has just accepted a temporary waitress job. Which is an appropriate problem for this child, and family, based on the current data?

1. Change in family functioning 2. Caregiver burden 3. Change in social interactions 4. Compromised family coping Answer: 4 Explanation: 1. The spica cast might require alteration in family functioning; however, the situation describes no signs and symptoms to indicate this. In addition, fractures generally are not considered a significant long-term disability.

2. The need for a spica cast is not considered a newly acquired disability. Nothing about the situation describes caregiver role strain.

3. Lack of family members and lack of respite support were not mentioned in the scenario.

4. The situation describes multiple changes, or stressors, in the family's situation that compromise family coping skills.

Page Ref: 224 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.4 Diagnose actual or potential health problems and needs. | NLN Competencies: NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Diagnosis Learning Outcome: 11.1 Contrast the categories of family strengths that help families cope with stressors.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 15) The nurse is developing an ecomap for a pediatric client and family. Which explanation should the nurse provide prior to beginning this task?

1. "It provides information about your family structure including family life events, health, and illness."

2. "It illustrates your family relationships and interactions with community activities including school, parental jobs, and children's activities."

3. "It is a short questionnaire of five questions that measures your family's growth, affection, and resolve."

4. "It is an assessment that consists of three categories of information about your family's strengths and problems."

Answer: 2 Explanation: 1. Information of this type is called a genogram.

2. This is the description of the ecomap.

3. The five-item questionnaire measuring family growth, affection, resolve, adaptability, and partnership is a Family Apgar.

4. This describes a Calgary Family Assessment Model.

Page Ref: 225 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Teamwork: Knowledge: Effective strategies for communicating with different members of the health team, including patients and families, nurses, and other health professionals | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 11.2 Summarize the advantages of using a family assessment tool.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 16) Which are resources that enable families to develop and adapt to stressors? Select all that apply.

1. Education 2. Communication 3. Prior experiences 4. Problem solving 5. Adequate finances Answer: 1, 3, 5 Explanation: 1. Education is a resource that enables families to develop and adapt to stressors.

2. While effective communication does enable families to develop and adapt to stressors, it is not considered a resource.

3. Prior experiences are a resource that enables families to develop and adapt to stressors.

4. While problem solving does enable families to develop and adapt to stressors, it is not considered a resource.

5. Adequate finances are a resource that enables families to develop and adapt to stressors.

Page Ref: 224 Cognitive Level: Understanding Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 11.1 Contrast the categories of family strengths that help families cope with stressors.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 17) Which nursing actions will allow a family to further develop resilience when faced with an illness of a child? Select all that apply.

1. Teaching skills to provide care 2. Suggesting adaptations related to discipline 3. Providing positive reinforcement 4. Recommending the use of defensive coping strategies 5. Focusing on the weaknesses Answer: 1, 2, 3 Explanation: 1. Most families have the capacity to develop resilience. One nursing action that can support the development of resilience to helping family members learn new skills. This occurs by teaching the family the skills they need to provide care.

2. Most families have the capacity to develop resilience. One nursing action that can support the development of resilience is to suggestion adaptations. This occurs by providing education related to alternative methods for discipline.

3. Most families have the capacity to develop resilience. One nursing action that can support the development of resilience is to provide positive reinforcement. This allows the family to gain confidence in their ability to manage the challenges of the child's health condition.

4. Defensive coping strategies promote dysfunction and not resilience.

5. While it is important to assess for family weaknesses, it is not appropriate to focus on these weakness when the goal is to develop resilience.

Page Ref: 224 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 11.1 Contrast the categories of family strengths that help families cope with stressors.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 18) The nurse is preparing to collect data for a family assessment. Which nursing actions are appropriate? Select all that apply.

1. Conducting interviews 2. Observing interactions 3. Reviewing reports from the healthcare provider 4. Monitoring daily living patterns 5. Asking a family friend his or her opinion of the family Answer: 1, 2, 3, 4 Explanation: 1. The nurse collects data when conducting a family assessment by conducting interviews with the members of the family.

2. The nurse collects data when conducting a family assessment by observing interactions between the members of the family.

3. The nurse collects data when conducting a family assessment by reviewing reports from the healthcare provider.

4. The nurse collects data when conducting a family assessment by monitoring daily living patterns among the family members.

5. Interviewing a family friend without first getting permission from the family is a confidentiality violation.

Page Ref: 225 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Teamwork: Knowledge: Effective strategies for communicating with different members of the health team, including patients and families, nurses, and other health professionals | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 11.2 Summarize the advantages of using a family assessment tool.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 19) The nurse is constructing a genogram as part of the family assessment process. Which will the nurse include in the genogram? Select all that apply.

1. Social class 2. Occupation 3. Place of residence 4. Social networks 5. Ethnicity Answer: 1, 2, 3, 5 Explanation: 1. Social class is included when constructing a family genogram.

2. Occupation is included when constructing a family genogram.

3. Place of residence is included when constructing a family genogram.

4. Social networks are explored through the use of a family ecomap, not a genogram.

5. Ethnicity is included when constructing a family genogram.

Page Ref: 225 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Teamwork: Knowledge: Effective strategies for communicating with different members of the health team, including patients and families, nurses, and other health professionals | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 11.2 Summarize the advantages of using a family assessment tool.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 20) The pediatric nurse is working as a first responder within the community after a tornado.

Which nursing actions are appropriate? Select all that apply.

1. Providing first aid to the walking wounded 2. Assessing for panic reactions 3. Allowing a child to leave the scene unaccompanied by an adult 4. Administering immunizations 5. Discussing the situation with the local media Answer: 1, 2, 4 Explanation: 1. A nurse who is functioning as a first responder after a natural disaster such as a tornado will provide first aid to the walking wounded.

2. A nurse who is functioning as a first responder after a natural disaster such as a tornado will assess for panic reactions.

3. It is not appropriate for the nurse to allow a child to leave the scene unaccompanied by an adult.

4. A nurse who is functioning as a first responder after a natural disaster such as a tornado will provide immunizations, if necessary.

5. It is not appropriate for the nurse to discuss the situation with the local media. A hospital representative is someone who can discuss the situation with the local media.

Page Ref: 235 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: V.C.4. Value vigilance and monitoring (even of own performance of care activities) by patients, families, and other members of the healthcare team | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Teamwork: Practice: Clarify roles and integrate the contributions of others who play a role in helping the patient/family achieve health goals | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 11.6 Review the special developmental needs of children to consider in disaster preparedness planning.

Principles of Pediatric Nursing, 8e (Ball et al.)

Chapter 12 Nursing Considerations for the Child and Family with a Chronic Condition 1) The nurse is providing care to several pediatric clients in the hospital setting. Which client diagnosis is capable of producing chronic limitations for the child?

1. Pneumonia from the bacillus Haemophilus influenzae 2. Respiratory syncytial virus 3. Streptococcus pneumoniae, a gram-positive diplococcus 4. Congenital heart defect Answer: 4 Explanation: 1. Pneumonia is not a chronic limitation.

2. Respiratory syncytial virus is a serious infection caused by a virus that affects infants. It does not result in permanent disability.

3. Streptococcus pneumoniae, a gram-positive diplococcus, is treatable and will not cause chronic limitation.

4. A congenital heart defect can leave a child with a permanent chronic condition.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and processes | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 12.1 Explain the causes of chronic conditions in children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 2) The nurse is providing care to several hospitalized pediatric clients. Which child has the greatest risk for a developmental disability?

1. An 18-month-old admitted with a diagnosis of drowning 2. A school-age child newly diagnosed with type 1 diabetes mellitus 3. A toddler with sepsis 4. A 2-year-old child with a fractured femur Answer: 1 Explanation: 1. Drowning indicates a period of time when the child was underwater and not breathing; near drowning can leave a child with a permanent chronic condition.

2. Diabetes is a chronic disease but does not lead to developmental disabilities.

3. Sepsis is treatable and will not result in a developmental disability.

4. A fractured femur is limiting to a child but will not leave the child with a chronic, limiting condition.

Page Ref: 240 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and processes | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 12.1 Explain the causes of chronic conditions in children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 3) The nurse is planning care for a school-age child who requires oxygen, enteral tube feedings, and IV medications during the school day. To which category of chronic illness does this child belong?

1. Dependent on special diet 2. Dependent on medical technology 3. Increased use of healthcare services 4. Functional limitations Answer: 2 Explanation: 1. While this child does have a special diet, this category is not comprehensive enough to describe the child's needs.

2. This child requires oxygen, enteral tube feedings, and IV medications, which indicates the child is dependent on medical technology.

3. While this child does have increased use of healthcare services, this category is not comprehensive enough to describe the child's needs.

4. While this child may have functional limitations, this category is not comprehensive enough to describe the child's needs.

Page Ref: 241 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and processes | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 12.2 Identify the categories of chronic conditions in children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 4) The nurse is partnering with the family of a hospitalized premature neonate who suffered an intraventricular hemorrhage (IVH). After 3 months in the neonatal intensive care unit (NICU), the infant is being discharged. Which activities will the nurse suggest to the family to help stimulate the infant's development? Select all that apply.

1. Using a day care for stimulation 2. Discouraging sibling interaction 3. Holding and rocking the infant 4. Interacting face to face 5. Talking softly and singing to the infant Answer: 3, 4, 5 Explanation: 1. A premature infant might not have a mature immune system; therefore, day care might present an infection issue. The needs of this child might not be met in a day care setting with many children.

2. Sibling interaction is important and should be encouraged.

3. Holding and rocking the infant stimulates the infant's sense of motion, facilitating parentinfant bonding.

4. Interacting face to face stimulates the infant's sense of vision, facilitating parent-infant bonding.

5. Talking softly and singing to the infant are activities that stimulate the infant's senses of hearing, touch, and motion, facilitating parent-infant bonding.

Page Ref: 244 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 12.3 Describe the nurse's role in caring for a child with a chronic condition.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 5) The nurse is providing care to a pediatric client who is newly diagnosed with a chronic condition. The parents ask, "When will our child be able to assume more responsibility for managing the disease?" Which age group will the nurse include in the response to the parents?

1. Preschooler 2. School-age 3. Adolescent 4. Toddler Answer: 2 Explanation: 1. Preschoolers do not have the cognitive and psychomotor skills for these tasks.

2. School-age children are developing a sense of industry and can begin assuming responsibility for self-care.

3. Adolescents should already be well accomplished at self-care.

4. Toddlers do not have the cognitive and psychomotor skills for these tasks.

Page Ref: 244 Cognitive Level: Understanding Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 12.3 Describe the nurse's role in caring for a child with a chronic condition.

6) Which intervention should the nurse include in the plan of care for an adolescent with a chronic condition?

1. Being more concerned for parents 2. Exhibiting less concern about appearance 3. Having an altered body image 4. Portraying a higher self-esteem Answer: 3 Explanation: 1. As adolescents develop a sense of identity, they are focused on themselves and the present.

2. Adolescents with chronic conditions will have a heightened concern about their appearance.

3. Adolescents with chronic conditions might have inaccurate assessments of their body image.

4. Adolescents with chronic conditions have low self-esteem when comparing their bodies with those of their peers.

Page Ref: 244 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 12.3 Describe the nurse's role in caring for a child with a chronic condition.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 7) The nurse is working with the parents of a child with a chronic condition. Which statement made by the child's parents indicates the need for intervention related to overwhelming caregiver burden?

1. "My mother moved in and helps us with the care of our family."

2. "I chose to quit my job to be home with my child, and my husband helps in the evening when he can."

3. "I have to care for my child day and night, which leaves little time for me."

4. "Our health insurer sent us a rejection letter for my child's brand-name medication, and we must fill out forms to get the generic."

Answer: 3 Explanation: 1. The family's pitching in to help indicates family support.

2. The mother chose to care for the child, and receives help from the husband.

3. No respite time from caregiving responsibilities could lead to overwhelming caregiver burden.

4. Substituting generic for brand-name medications will not result in caregiver burden.

Page Ref: 250 Cognitive Level: Analyzing Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 12.4 Assess the family of a child with a chronic condition.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 8) The nurse is planning care for the family of a child with a chronic illness. Which activities will the nurse recommend to decrease the risk for caregiver burden? Select all that apply.

1. Fostering social relationships 2. Exercising 3. Developing a hobby 4. Moving away 5. Sleeping more than 9 hours per 24-hour period Answer: 1, 2, 3 Explanation: 1. Fostering social relationships contributes to social and mental rest and restoration.

2. Exercising contributes to physical restoration.

3. Developing a hobby contributes to physical, spiritual, social, and mental rest and restoration.

4. Moving away is an avoidance behavior that does not address exhaustion from overwhelming caregiving responsibilities.

5. Sleeping more than the body requires is an avoidance behavior.

Page Ref: 250 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 12.5 Prepare the family of a child with a chronic condition to effectively care for the child in the home.

9) The nurse is conducting a nursing assessment of the parent and child with severe cerebral palsy during a routine clinic visit. Which nursing action is appropriate based on the current data?

1. Measuring the urine output 2. Measuring the child's head circumference 3. Observing the parent-child relationship 4. Observing how the child interacts during play Answer: 3 Explanation: 1. Measuring urine output is not important unless there are problems with the bladder.

2. Measuring the child's head circumference is not an important assessment at this time.

3. Observing the parent-child relationship is important to the success of health supervision for both the child and parents.

4. Playtime is not important during this time.

Page Ref: 243 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 12.4 Assess the family of a child with a chronic condition.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 10) The nurse is conducting an educational program for parents of children with chronic conditions. Which parental statement indicates the need for further instruction?

1. "I know my child will get better and not have to take any more medication."

2. "I know my child will need assistance with activities of daily living."

3. "I know my child may need specialized education."

4. "I know my child will have to stay on a special diet."

Answer: 1 Explanation: 1. Chronic conditions might require lifetime dependence on medication.

2. Children with chronic conditions typically need assistance with daily living activities.

3. A child with a chronic condition may require specialized education.

4. Depending on the diagnosis, children with chronic conditions might require a special diet.

Page Ref: 240 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Context and Environment: Practice: transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 12.4 Assess the family of a child with a chronic condition.

11) An adolescent diagnosed with type 1 diabetes mellitus (DM) is prescribed dietary restrictions and daily insulin injections. Which behavior does the nurse anticipate from the adolescent upon return to school?

1. Administering medication in front of peers 2. Teaching peers about the diagnosis 3. Acknowledging the condition to classmates 4. Exhibiting poor adherence to the prescribed treatment plan Answer: 4 Explanation: 1. Most adolescents do not want to be seen as "different" by their peers; therefore, it is unlikely that the adolescent will administer the prescribed insulin in front of the peer group.

2. Most adolescents do not want to be seen as "different" by their peers; therefore, it is unlikely that the adolescent will teach his or her peers about the disease process.

3. Adolescents will attempt to hide their health conditions from their classmates.

4. Adolescents have poorer eating habits than all other age groups, and adolescents with diabetes may not adhere to necessary dietary restrictions.

Page Ref: 244 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 12.6 Summarize nursing management for the child with a chronic condition to support transition to school and adult living.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 12) The nurse is caring for a 17-year-old client with a chronic condition who will be transitioning into adulthood. When planning care for this client, which should the nurse consider? Select all that apply.

1. Ability to work 2. Ability to live independently 3. Psychosocial needs 4. Parental needs 5. Sibling needs Answer: 1, 2, 3 Explanation: 1. The nurse must consider the client's ability to live independently when planning care for a client with a chronic condition who is transitioning into adulthood.

2. The nurse must consider the client's ability to live independently when planning care for a client with a chronic condition who is transitioning into adulthood.

3. The nurse must consider the client's ability to live independently when planning care for a client with a chronic condition who is transitioning into adulthood.

4. The parent's needs are not considered when planning care for a client with a chronic condition who is transitioning into adulthood.

5. The needs of the client's siblings are not considered when planning care for a client with a chronic condition who is transitioning into adulthood.

Page Ref: 250 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 12.6 Summarize nursing management for the child with a chronic condition to support transition to school and adult living.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 13) The nurse is providing care to a toddler-age client newly diagnosed with a chronic condition.

Which nursing action will prepare the family for providing care to the toddler once discharged from the hospital setting?

1. Suggesting that the parents use a mobile to provide sensory stimulation 2. Helping the parents recognize their child's capabilities 3. Allowing the child to choose the color of the gown during hospitalization 4. Suggesting the child be enrolled in a special camp to learn about the diagnosis Answer: 2 Explanation: 1. A mobile is not an appropriate toy to provide sensory stimulation to the toddler.

This suggestion is appropriate for an infant.

2. It is important for the nurse to help the parents recognize their child's capabilities and to encourage the parents to allow enough time to practice, and learn a new skill.

3. This is an appropriate nursing action when the child is hospitalized; however, this is not a nursing action that will prepare the family for providing care to the toddler with a chronic condition after discharge.

4. Enrollment in a special camp would be appropriate for a school-age child, not the toddler.

Page Ref: 241 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 12.5 Prepare the family of a child with a chronic condition to effectively care for the child in the home.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 14) After the infant is diagnosed with a chronic health condition, the family is assigned a nurse case manager. Which will the nurse include in the explanation to the infant's parents regarding this role?

1. Limiting the number of visits to the healthcare facility 2. Preventing duplication of services 3. Improving the quality of life for the child and parents 4. Recognizing the equipment needs of the child and providing assistance with equipment acquisition 5. Visiting the child in the home to assist with physical care Answer: 2, 3, 4 Explanation: 1. Although well-managed care may reduce illnesses and thus visits to the healthcare facility, limiting visits is not a function of the case manager.

2. Because many children who are chronically ill are seen by many healthcare providers and clinics, there is often a duplication of services. Case managing coordinates between the various clinics and healthcare providers to prevent duplication.

3. Case managing has many modes of improving the quality of life for children and parents. By coordinating care, the child can often be seen by several healthcare providers during the same visit, thus, improving the quality of life.

4. The case manager will assist the family in meeting the needs of the child, including helping with identifying and acquiring equipment necessary for caring for the child.

5. The case manager does not provide direct client care.

Page Ref: 245 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 12.3 Describe the nurse's role in caring for a child with a chronic condition.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 15) The nurse works in a clinic for medically fragile children who require home care. The nurse has noticed that a high percentage of the families parents divorce. In an attempt to reduce the divorce rate among the parents, the nurse creates an educational session for parents of medically fragile children. Which should be the focus of this session?

1. Communication 2. Financial stability 3. Ways to meet the child's physical needs 4. The state laws that have relevance to the medically fragile child.

Answer: 1 Explanation: 1. Both partners need to be able to communicate honestly and frequently to maintain the marriage relationship.

2. Finances will be a problem for the family as the cost of care of medically fragile child can be high. Nurses may refer to community resources but cannot solve all financial problems.

3. The nurse will teach parents how to meet the child's physical needs on a one-to-one basis, not in a group session.

4. This will not reduce the divorce rate.

Page Ref: 245 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Context and Environment: Practice: transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 12.4 Assess the family of a child with a chronic condition.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 16) The school nurse is reviewing the records of all incoming kindergarten students. Which students will require an individualized education plan (IEP)?

1. The child with diabetes controlled with insulin 2. The child with a casted arm due to a fracture 3. The child with a hearing deficit 4. The child with autism spectrum disorder 5. The child with an IQ of 60 Answer: 3, 4, 5 Explanation: 1. This child may need an individual health plan but does not require an IEP. 2. This is not a chronic problem and does not require an IEP. 3. This child will need modification of the educational plan in order to be successful.

4. The child diagnosed on the autism spectrum will have special educational needs that will be determined by the IEP. 5. The child with an IQ of 60 is intellectually disabled, and will require an IEP. Page Ref: 248 Cognitive Level: Analyzing Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 12.6 Summarize nursing management for the child with a chronic condition to support transition to school and adult living.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 17) Which nursing action is appropriate when preparing the family of a school-age child with a chronic illness to provide care in the home setting?

1. Teaching the family about appropriate sensory stimuli, such as a mobile 2. Educating the family to allow the child choices, such as which food to eat first 3. Preparing the family for the transition of care into adulthood 4. Encouraging interaction between the child and others with the same diagnosis Answer: 4 Explanation: 1. Teaching age-appropriate interventions is important; however, a mobile is an age appropriate toy for the infant, not the school-age child.

2. Providing choices is important for the preschool-age child, not the school-age child.

3. Preparing the family for the transition of care into adulthood is important for the adolescent, not school-age, patient.

4. School-age children should be encouraged to interact with other child who has the same diagnosis.

Page Ref: 250 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 12.5 Prepare the family of a child with a chronic condition to effectively care for the child in the home.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 18) The mother of an adolescent with multiple medical and developmental issues says to the nurse: "There are times that I think about just walking out of the house and not coming back."

Which problem is the mother demonstrating?

1. Fear 2. Anxiety 3. Lack of finances 4. Caregiver burden Answer: 4 Explanation: 1. There is no evidence that the mother is experiencing fear.

2. There is no evidence that the mother is experiencing anxiety.

3. There is no evidence that the mother is experiencing lack of finances.

4. The mother is experiencing caregiver burden, which is the unrelenting pressure and anxiety related to providing daily care to a child with disabilities while meeting other family obligations.

Page Ref: 302 Cognitive Level: Analyzing Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.4 Diagnose actual or potential health problems and needs. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Diagnosis Learning Outcome: 12.6 Summarize nursing management for the child with a chronic condition to support transition to school and adult living.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 19) A 3-year-old child, recently hospitalized for the exacerbation of a chronic illness, presents for a follow-up appointment at the pediatric clinic. The child's mother states, "He was potty trained before the hospital stay but now he is having daily accidents." Which response by the nurse is most appropriate?

1. "This is probably a reaction to the antibiotics and will disappear when the antibiotics are finished."

2. "Urinary incontinence is a common symptom of progression of cystic fibrosis. Be sure to notify the healthcare provider of this change."

3. "The child may have a urinary tract infection and needs to be evaluated."

4. "Children often regress after hospitalization. Be patient and remind him to go to the bathroom frequently."

Answer: 4 Explanation: 1. Antibiotic therapy does not cause incontinence.

2. Urinary incontinence is not a symptom of cystic fibrosis.

3. There are no symptoms of a urinary tract infection (UTI).

4. Regression is a common response to hospitalization.

Page Ref: 244 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 12.3 Describe the nurse's role in caring for a child with a chronic condition.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 20) The nurse learns that a newborn is diagnosed with phenylketonuria (PKU). Which is the most appropriate way to inform the newborn's parents about this diagnosis?

1. Calling the parents to provide the diagnosis over the phone 2. Mailing a certified letter explaining the diagnosis and requesting the parents make a pediatric office appointment 3. Planning a group meeting for all parents whose children received the diagnosis in the last two months 4. Scheduling an appointment for the parents to see the healthcare provider in person to discuss the diagnosis Answer: 4 Explanation: 1. Providing the parents information of a chronic health problem of their newborn should not be done over the phone.

2. This information should be provided to the parents in person.

3. This information should be shared on a one-to-one basis.

4. The appropriate environment allows for privacy and freedom from interruptions. The parents should be allowed other support people to be present as they request.

Page Ref: 245 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 12.4 Assess the family of a child with a chronic condition.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 21) The parents of a 4-month-old child learn that there will be long-term consequences due to the head injury sustained in a motor vehicle accident, including intellectual disability and cerebral palsy. The parents express anger at the diagnosis and project that anger on the nursing staff.

Which responses by the nursing staff are appropriate? Select all that apply.

1. Referring the family to the hospital administrator 2. Recognizing that the parents' anger is a normal response to the news 3. Continuing to provide physical and emotional care to the child and family 4. Offering hospital resources to the parents in addition to continued nursing support 5. Explaining to the family that you are sorry about their child's injury but suggest they transfer the child to another hospital for their own comfort Answer: 2, 3, 4 Explanation: 1. The hospital administrator will be unable to meet their needs or to calm their anger.

2. Parents grieve for the loss of the perfect child. This is a normal reaction.

3. The nursing staff will continue to provide physical and emotional care to the child and family.

4. It is appropriate to offer the hospital chaplain and other mental health workers in addition to continued support from the nursing staff.

5. This option is a resolution for the nursing staff but not for the parents.

Page Ref: 245 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 12.5 Prepare the family of a child with a chronic condition to effectively care for the child in the home.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 22) The nurse is assigned as the care coordinator for a child with special healthcare needs. Which actions by the nurse enhance the family's ability to participate in their child's care coordination?

Select all that apply.

1. Coordinating the healthcare team 2. Arranging the needed healthcare services 3. Modifying the home for care 4. Helping with decision making for meeting goals of care 5. Educating the family about the diagnosis Answer: 4, 5 Explanation: 1. Coordinating the healthcare team is one of the responsibilities of the nurse case coordinator. This is not an action that will enhance the family's ability to coordinate care for their child.

2. Arranging needed healthcare services is one of the responsibilities of the nurse case coordinator. This is not an action that will enhance the family ability to coordinate care for their child.

3. Modifying the home for care is one of the responsibilities of the nurse case coordinator. This is not an action that will enhance the family ability to coordinate care for their child.

4. The nurse case coordinator helps the family with decision making related to meeting the goals of care. This action enhances the family's ability to coordinate care for their child.

5. The nurse case coordinator educates the family about the child's diagnosis. This action enhances the family's ability to coordinate care for their child.

Page Ref: 245 Cognitive Level: Analyzing Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Teamwork: Ethical Comportment: Value and respect the perspectives, attributes, and expertise of all health team members, including the patient/family | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 12.7 Discuss the family's role in care coordination.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 23) The nurse care coordinator is supporting a family who wishes to become their child's care coordinator. Which statements will the nurse include in the teaching session to prepare the family for this task? Select all that apply.

1. "You won't need to set aside much time to properly coordinate your child's care."

2. "Care coordination requires ongoing assessment of your child's needs."

3. "Since you are the parent, you will not be required to use cost-efficient strategies when coordinating your child's care."

4. "Care coordination requires you to be educated regarding your child's diagnosis."

5. "There is a care coordination workshop provided by hospital educators that will help you to learn this role."

Answer: 2, 4, 5 Explanation: 1. Care coordination is time consuming. This statement is not appropriate for the nurse to include in the teaching session.

2. Care coordination requires ongoing assessment of the child's needs. This statement is appropriate to include in the teaching session.

3. All care coordination efforts should include the implementation of cost-efficient strategies for care. This statement is not appropriate for the nurse to include in the teaching session.

4. In order to be a successful care coordinator, it is essential to have an adequate knowledge base regarding the diagnosis. This statement is appropriate to include in the teaching session.

5. When parents wish to assume the role of care coordinator is often necessary that they receive extensive training, which is often provided by hospital educators. This statement is appropriate to include in the teaching session.

Page Ref: 246 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Teamwork: Ethical Comportment: Value and respect the perspectives, attributes, and expertise of all health team members, including the patient/family | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 12.7 Discuss the family's role in care coordination.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 24) The nurse of the family who is assuming the role of care coordinator is providing education regarding the use of a healthcare log. Which will the nurse encourage the family to include on this log? Select all that apply.

1. Role of each provider 2. Date of each appointment 3. Prescribed interventions 4. Future treatments 5. Out-of-pocket cost Answer: 1, 2, 3, 4 Explanation: 1. The nurse will encourage the family to include the role of each provider on the healthcare log.

2. The nurse will encourage the family to include the date of each appointment on the healthcare log.

3. The nurse will encourage the family to include the prescribed interventions on the healthcare log.

4. The nurse will encourage the family to include future treatments on the healthcare log.

5. Out-of-pocket cost is not something the nurse encourages the family to keep on the healthcare log.

Page Ref: 246 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Teamwork: Ethical Comportment: Value and respect the perspectives, attributes, and expertise of all health team members, including the patient/family | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 12.7 Discuss the family's role in care coordination.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 25) The nurse provides care to pediatric clients with chronic disease process. Which diagnoses does the nurse categorize as dependent on medications or special diets? Select all that apply.

1. Diabetes mellitus 2. Epilepsy 3. Celiac disease 4. Down syndrome 5. Traumatic brain injury Answer: 1, 2, 3 Explanation: 1. A child who is diagnosed with diabetes mellitus is categorized as dependent on medications or special diets.

2. A child who is diagnosed with epilepsy is categorized as dependent on medications or special diets.

3. A child who is diagnosed with celiac disease is categorized as dependent on medications or special diets.

4. A child who is diagnosed with Down syndrome is categorized as having functional limitations.

5. A child who is diagnosed with a traumatic brain injury is categorized as having functional limitations.

Page Ref: 241 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and processes | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 12.2 Identify the categories of chronic conditions in children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 26) The nurse provides care to pediatric clients with chronic disease process. Which diagnoses does the nurse categorize as needing increased use of healthcare services? Select all that apply.

1. Cancer 2. Sickle cell disease 3. Renal failure 4. Cystic fibrosis 5. Autism spectrum disorder Answer: 1, 2, 4 Explanation: 1. A child who is diagnosed with cancer is categorized as needing increased use of healthcare services.

2. A child who is diagnosed with sickle cell disease is categorized as needing increased use of healthcare services.

3. A child who is diagnosed with renal failure is categorized as being dependent on medical technology.

4. A child who is diagnosed with cystic fibrosis is categorized as needing increased use of healthcare services.

5. A child who is diagnosed with autism spectrum disorder is categorized as having functional limitations.

Page Ref: 241 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and processes | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 12.2 Identify the categories of chronic conditions in children.

Principles of Pediatric Nursing, 8e (Ball et al.)

Chapter 13 Nursing Considerations for the Hospitalized Child 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 Explanation: 1. Children in the "despair" stage appear sad, depressed, or withdrawn. A child who is lying in bed might be exhibiting any of these.

2. The young child who appears to be happy and content with everyone is in the "denial" stage, as is the child who does not cry if his parents return and leave again.

3. The young child who appears to be happy and content with everyone is in the "denial" stage, as is the child who does not cry if his parents return and leave again.

4. Screaming and crying are components of the "protest" stage.

Page Ref: 257 Cognitive Level: Applying 241 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Teamwork: Ethical Comportment: Value and respect the perspectives, attributes, and expertise of all health team members, including the patient/family | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 13.3 Describe the child's and family's adaption to hospitalization.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 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: 3 Explanation: 1. Infants do not fear disfigurement.

2. Infants and toddlers do not fear death.

3. In addition to separation anxiety, infants between 6 and 18 months of age might display stranger anxiety when confronted with strangers such as healthcare providers.

4. Infants and toddlers do not fear bodily injury.

Page Ref: 257 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Teamwork: Ethical Comportment: Value and respect the perspectives, attributes, and expertise of all health team members, including the patient/family | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 13.3 Describe the child's and family's adaption to hospitalization.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 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: 2 Explanation: 1. The physician does not make the decision whether the parents stay with the child; the parents make the decision.

2. Parents should be allowed to stay with their child if they wish to do so. This position is supported by the Emergency Nurses Association and is a key aspect of family-centered care.

3. Parents should be allowed to stay with their child if they wish instead of going to the waiting room where they lack privacy.

4. The parents need to make the decision about staying with their child without input from the nurse.

Page Ref: 258 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Teamwork: Ethical Comportment: Value and respect the perspectives, attributes, and expertise of all health team members, including the patient/family | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 13.4 Apply family-centered care principles to the hospital setting.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 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: 2 Explanation: 1. The 6-month-old child does not experience separation anxiety, which usually begins at around 1 year of age.

2. The young toddler is at the greatest risk. Toddlers are the group most at risk for a stressful experience when hospitalized. Separation from parents increases this risk greatly.

3. The 4-year-old child is past the age when separation anxiety would be most prevalent.

4. The 6-year-old child is attending school and is used to short periods of separation from parents.

Page Ref: 256 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Teamwork: Ethical Comportment: Value and respect the perspectives, attributes, and expertise of all health team members, including the patient/family | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 13.3 Describe the child's and family's adaption to hospitalization.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 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: 2 Explanation: 1. At this age, the child does not yet understand that he can become sick from exposure to someone else who is sick.

2. Preschoolers understand some aspects of being sick, but not the cause of illness. They are likely to think that they are sick as a result of something that they have done. They frequently will view illness as punishment.

3. Not eating the right foods can be a factor in some illnesses, but this thinking is beyond the level of a 4-year-old boy.

4. While not taking his vitamins can be a factor in some illnesses, this thinking is beyond the capabilities of a 4-year-old boy.

Page Ref: 258 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 13.1 Compare and contrast the child's understanding of health and illness according to the child's developmental level.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 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: 3 Explanation: 1. The child should be allowed to return to the playroom as soon as the procedure is completed; bringing toys to the bedside is unnecessary.

2. Scheduled respiratory treatments should be performed on time.

3. It is important for scheduled treatments to occur on time, so the child should go back to his room. He can return to the playroom as soon as the treatment is completed.

4. Procedures should not be performed in the playroom.

Page Ref: 266 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Teamwork: Ethical Comportment: Value and respect the perspectives, attributes, and expertise of all health team members, including the patient/family | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 13.5 Identify nursing strategies to minimize the stressors related to hospitalization.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 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: 3 Explanation: 1. The parents should be allowed to stay with their child on the unit.

2. The parents should be aware of the rules about rooming-in, but they should know first that they can stay.

3. The practice of rooming-in involves a parent's staying in the child's hospital room during the course of the child's hospitalization. Some hospitals provide cots, while others have special builtin beds on pediatric units.

4. The parents should be allowed to stay with their child.

Page Ref: 256 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Teamwork: Ethical Comportment: Value and respect the perspectives, attributes, and expertise of all health team members, including the patient/family | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 13.4 Apply family-centered care principles to the hospital setting.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 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: 2 Explanation: 1. Parents do not need to know the names of the medications the child will receive.

2. The nurse explains visual and auditory experiences, such as a surgical gown, cap, shoe covers, and the parents' role during induction. The nurse offers the parents an opportunity to ask questions and voice concerns.

3. The nurse should tell the parents what to expect but not how they will feel while they watch their child.

4. The nurse should never ignore a request made by parents.

Page Ref: 263 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Teamwork: Ethical Comportment: Value and respect the perspectives, attributes, and expertise of all health team members, including the patient/family | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 13.4 Apply family-centered care principles to the hospital setting.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 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: 2 Explanation: 1. Telling the mother she will be asked to leave will only worsen the situation.

2. Nursing techniques include informing the family of potential problems that could occur. If the child's condition changes, make every effort to inform the family immediately.

3. The mother is already angry because of the lack of information sharing. The nurse should not "pass the buck" to the healthcare provider.

4. The mother is already angry, and informing her that her behavior will upset the child will only anger her more.

Page Ref: 263 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Teamwork: Ethical Comportment: Value and respect the perspectives, attributes, and expertise of all health team members, including the patient/family | Nursing/Integrated Concepts: Implementation/Communication and Documentation Learning Outcome: 13.4 Apply family-centered care principles to the hospital setting.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 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: 3 Explanation: 1. Telling the parents that they cannot visit their child will only increase their anger.

2. Calling the healthcare provider might be appropriate at some point, but the nurse must assume the role of supporter in this situation to promote a sense of trust.

3. Hospitalization of the child in a PICU is a great stressor for parents. If the parents feel that they are not informed or involved in the care of their child, they might become angry and upset.

4. Calling the chaplain could be appropriate at some point, but the nurse needs to collaborate with the parents about the care the child receives.

Page Ref: 263 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Teamwork: Ethical Comportment: Value and respect the perspectives, attributes, and expertise of all health team members, including the patient/family | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 13.5 Identify nursing strategies to minimize the stressors related to hospitalization.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 11) Which 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: 1 Explanation: 1. The child should be allowed to cry or scream during the procedure.

2. The treatment room should be utilized for the procedure so that the hospital bed remains a safe place.

3. The nurse should avoid giving the child a choice if there is no choice.

4. While the toddler will need to be restrained, the parent should not be the one to do this.

Page Ref: 266 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Teamwork: Ethical Comportment: Value and respect the perspectives, attributes, and expertise of all health team members, including the patient/family | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 13.5 Identify nursing strategies to minimize the stressors related to hospitalization.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 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: 4 Explanation: 1. The nurse cannot know for certain that everything will be fine.

2. The pros and cons of the surgery would have been explained to the family prior to the decision to have the surgery. Restating the benefits will not reduce the stress of the client and family.

3. Telling them the surgeon is very good is not going to minimize stress for long. They need to be more familiar with what to expect in a familiar environment.

4. A variety of approaches can be used to provide information and allay fears. Tours of the hospital unit or surgical area are helpful. This activity assists the child and family to become familiar with the environment they will encounter.

Page Ref: 261 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Teamwork: Ethical Comportment: Value and respect the perspectives, attributes, and expertise of all health team members, including the patient/family | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 13.5 Identify nursing strategies to minimize the stressors related to hospitalization.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 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: 1 Explanation: 1. Many hospitals now allow parents to be present with their child during and after procedures. Parents often want to support their child, and their presence offers reassurance and comfort to the child.

2. When parents ask to be present for a procedure, they are doing so to be available to comfort the child, not to control the procedural outcome.

3. Parents might be in the medical field, but their primary concern is to comfort their child during the procedure.

4. The parents' first concern is to comfort their child, not supervising the nursing staff.

Page Ref: 262 Cognitive Level: Understanding Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Teamwork: Ethical Comportment: Value and respect the perspectives, attributes, and expertise of all health team members, including the patient/family | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 13.6 Integrate the concept of family presence during procedures and nursing strategies used to prepare the family.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 14) The parents have requested to be present during their child's procedure. In which way 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: 3 Explanation: 1. The nurse should not use medical terms to discuss the child's procedure.

2. In most circumstances, it is not only permitted but also desired to have the parents presence during a procedure.

3. Parents often want to support their child before and after procedures, and their presence offers reassurance and comfort to the child. Prepare family members for what to anticipate, and what is expected of them.

4. The nurse can speak to the family to prepare them and does not need to wait for the healthcare provider.

Page Ref: 262 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Teamwork: Ethical Comportment: Value and respect the perspectives, attributes, and expertise of all health team members, including the patient/family | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 13.6 Integrate the concept of family presence during procedures and nursing strategies used to prepare the family.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 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 main problem for this situation?

1. Parent anxiety 2. Prevent infection 3. Ineffective coping 4. Change in role expectation Answer: 1 Explanation: 1. While all of the problems might have been appropriate at some point, the current focus is the mother's anxiety about caring for the child at home. The priority of the nurse is relieving this anxiety.

2. The mother has demonstrated the ability to care for the wounds.

3. There is no evidence that the mother is having issues with coping.

4. There is no evidence that there is a change in role expectation.

Page Ref: 274 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.4 Diagnose actual or potential health problems and needs. | NLN Competencies: Teamwork: Ethical Comportment: Value and respect the perspectives, attributes, and expertise of all health team members, including the patient/family | Nursing/Integrated Concepts: Nursing Process: Diagnosis Learning Outcome: 13.7 Summarize strategies for preparing children and families for discharge from the hospital setting.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 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. Which information 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: 3 Explanation: 1. Starting an IV line is not within the family's responsibilities for home care.

2. The nurse can never assume the family members are familiar with the care required, even if they have been participating during the hospital stay.

3. Prior to discharge, the parents will need to learn about oxygen administration.

4. Removing a central line is not within the realm of what family members need to do at home.

Page Ref: 274 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Teamwork: Ethical Comportment: Value and respect the perspectives, attributes, and expertise of all health team members, including the patient/family | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 13.7 Summarize strategies for preparing children and families for discharge from the hospital setting.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 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: 1 Explanation: 1. Families need support and education as they continue to be anxious or stressed over their child's hospitalization. Standard discharge plans for routine hospital discharge include monitoring signs and symptoms specific to the condition and care at home.

2. The family does not need to know how to complete a medical examination on the child.

3. The family knows the child but needs teaching regarding the signs and symptoms to watch for in case of recurrence or complications arise.

4. This information was shared with the family as the tests were performed, and results received.

Page Ref: 274 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Teamwork: Ethical Comportment: Value and respect the perspectives, attributes, and expertise of all health team members, including the patient/family | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 13.7 Summarize strategies for preparing children and families for discharge from the hospital setting.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 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: 1, 4, 5 Explanation: 1. Infants in this age group do not recognize parents as separate from themselves so will not feel abandoned when parents do not stay.

2. Infants in this age group recognize object permanence and will be aware of the absence of their parents.

3. Both groups suffer from separation anxiety and fear of abandonment.

4. School-age children are accustomed to dealing with adults other than parents and can better tolerate separation.

5. Adolescents are able to understand separation and time and thus will not suffer from separation from parents.

Page Ref: 257 Cognitive Level: Understanding Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Teamwork: Ethical Comportment: Value and respect the perspectives, attributes, and expertise of all health team members, including the patient/family | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 13.3 Describe the child's and family's adaption to hospitalization.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 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 parent's absence."

Answer: 2, 3 Explanation: 1. The child will awaken and feel mom has disappeared. When mom returns, the child may be unwilling to fall asleep again for fear she will disappear again.

2. The child cannot tell time, so it is appropriate to associate time of return with an event that the child recognizes rather than give a specific time. It is appropriate for the mother to tell the child she is leaving and promise to return.

3. The child recognizes that mother will return for her clothing, and this may provide comfort.

4. The nurses need to know that the child is alone, but staffing demands will not allow a nurse to sit with the child during the parent's absence.

5. Whenever possible, the parents should be present when procedures are being performed.

Page Ref: 258 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Teamwork: Ethical Comportment: Value and respect the perspectives, attributes, and expertise of all health team members, including the patient/family | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 13.5 Identify nursing strategies to minimize the stressors related to hospitalization.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 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: 1 Explanation: 1. Planning a time to visit when the child is most comfortable will be the best for the client and the siblings.

2. Unless hospital policy prevents visitation by younger children, they should be allowed to visit.

3. Children should be prepared for a visit, but visits should be allowed. Children who cannot visit often imagine the situation is worse than it is.

4. All children may carry germs. Children should be assessed for signs of infection, but if they are free of symptoms, they should be allowed to visit.

Page Ref: 260 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Teamwork: Ethical Comportment: Value and respect the perspectives, attributes, and expertise of all health team members, including the patient/family | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 13.4 Apply family-centered care principles to the hospital setting.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 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: 1, 3, 4 Explanation: 1. The child does not need to understand the surgical activity while asleep.

2. Care must be utilized in selecting terminology for the child. To the child, the heart is not just a muscle, but the center of the child's love. A "broken" heart may be discarded.

3. This is appropriate as parents are the child's main source of support.

4. Children of this age often have security objects; the child should be allowed to hold the object for comfort. Care must be taken that the teddy bear be labeled and returned to the child after the surgical procedure.

5. The child is awake in the holding room. It is better to wait until the child is under anesthesia to insert the catheter.

Page Ref: 268 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Teamwork: Ethical Comportment: Value and respect the perspectives, attributes, and expertise of all health team members, including the patient/family | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 13.5 Identify nursing strategies to minimize the stressors related to hospitalization.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 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: 1, 2, 3 Explanation: 1. Exercise is an effective stress reducer.

2. Fully understanding his condition will reduce his stress.

3. Relaxation techniques can help reduce stress.

4. Keeping feelings and emotions in will increase stress in the adolescent.

5. Adolescents like to be in control of themselves and are working on separation from the parents, so it would be inappropriate to encourage the child to give control to others.

Page Ref: 266 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Teamwork: Ethical Comportment: Value and respect the perspectives, attributes, and expertise of all health team members, including the patient/family | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 13.5 Identify nursing strategies to minimize the stressors related to hospitalization.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 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: 1, 3 Explanation: 1. These activities will make the administration easier.

2. This would not be appropriate as it increases the volume that must be administered and may unfavorably change the taste of the drink.

3. The child is more willing to take the medication from the mother.

4. This would not be appropriate.

5. This could cause the child to choke on the medication and is inappropriate.

Page Ref: 265 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Teamwork: Ethical Comportment: Value and respect the perspectives, attributes, and expertise of all health team members, including the patient/family | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 13.5 Identify nursing strategies to minimize the stressors related to hospitalization.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 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. Use scrubs for the clients to play dress-up 4. Having the nurses avoid entering the client's room unless a procedure is to be performed Answer: 3 Explanation: 1. The sex of the nurse has not been shown to be a source of stress.

2. Staffing patterns will not allow a one-to-one nurse to client ratio on the regular pediatric unit.

3. Providing scrubs and uniforms for dress-up encourages dramatic play, which provides an outlet for anxiety in children dealing with stressful situations.

4. Nurses should visit when not performing procedures to allow the children to become familiar and comfortable with the nurses.

Page Ref: 271 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Teamwork: Ethical Comportment: Value and respect the perspectives, attributes, and expertise of all health team members, including the patient/family | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 13.5 Identify nursing strategies to minimize the stressors related to hospitalization.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 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: 1, 3, 4, 5 Explanation: 1. It is important for the nurse to encourage frequent family visits to decrease the sense of isolation that can occur for the pediatric client who is on contact precautions.

2. This nursing action is more appropriate for a client who is receiving rehabilitative care versus a client who is on contact precautions.

3. It is important for the nurse to provide age-appropriate stimulation and activities due to limited contact with other children and family members while on contact precautions.

4. It is important to allow parents to have physical contact with their child when the child is on contact precautions. PPE should be limited to only what is needed to protect the parent from being exposed to the communicable disease.

5. It is important for the nurse to educate the family regarding which PPE to use, and how to properly wear it when providing care to a child on contact precautions.

Page Ref: 263 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Teamwork: Ethical Comportment: Value and respect the perspectives, attributes, and expertise of all health team members, including the patient/family | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 13.2 Explain the effect of hospitalization on the child and family.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 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: 1, 2, 3 Explanation: 1. Separation anxiety is an infant stressor that the nurse should plan for when providing care to the hospitalized infant.

2. Stranger anxiety is an infant stressor that the nurse should plan for when providing care to the hospitalized infant.

3. A disrupted sleep-wake cycle is an infant stressor that the nurse should plan for when providing care to the hospitalized infant.

4. Loss of the control is a stressor for the hospitalized toddler, not the infant.

5. Fear of the dark is a stressor for the hospitalized toddler, not the infant.

Page Ref: 257 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Teamwork: Ethical Comportment: Value and respect the perspectives, attributes, and expertise of all health team members, including the patient/family | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 13.2 Explain the effect of hospitalization on the child and family.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 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: 1, 3, 4 Explanation: 1. Loss of privacy is a stressor the nurse should plan for when providing care to a hospitalized adolescent client.

2. Fear of the dark is a stressor for the hospitalized toddler and preschool-age client not the adolescent client.

3. Loss of identity is a stressor the nurse should plan for when providing care to a hospitalized adolescent client.

4. A fear of altered body image is a stressor the nurse should plan for when providing care to a hospitalized adolescent client.

5. Separation anxiety is a stressor for the hospitalized infant, toddler, and preschool-age child not the adolescent.

Page Ref: 257 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Teamwork: Ethical Comportment: Value and respect the perspectives, attributes, and expertise of all health team members, including the patient/family | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 13.2 Explain the effect of hospitalization on the child and family.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 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: 1, 2, 3, 4 Explanation: 1. Financial concerns related to the cost associated with care that is needed after discharge is one barrier to successful discharge planning when providing care to the pediatric client who is approaching discharge.

2. Parents who are not available for discharge instruction is one barrier to successful discharge planning when providing care to the pediatric client who is approaching discharge.

3. Not having the equipment the family will use after discharge is one barrier to successful discharge planning when providing care to the pediatric client who is approaching discharge.

4. Poor teamwork is one barrier to successful discharge planning when providing care to the pediatric client who is approaching discharge.

5. Insurance payment for services is not a known barrier to successful discharge planning when providing care to the pediatric client who is approaching discharge.

Page Ref: 274 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Teamwork: Ethical Comportment: Value and respect the perspectives, attributes, and expertise of all health team members, including the patient/family | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 13.7 Summarize strategies for preparing children and families for discharge from the hospital setting.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 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: 1, 2, 3 Explanation: 1. The nurse will educate the family regarding equipment that will be used after discharge. It is essential that the family perform a successful return demonstration.

2. The nurse will teach the family symptoms that indicate the client is experiencing distress, and include information on who to contact if these symptoms should occur.

3. The nurse will encourage the family to participate in a cardiopulmonary resuscitation course prior to discharge.

4. While it is appropriate for the nurse to educate the family on the Family Medical Leave Act (FMLA), it is not appropriate for the nurse to recommend that one parent take a leave of absence from work.

5. The nurse should encourage the family to participate in care coordination for their child if they indicate they would like to learn about this portion of the child's healthcare management.

Page Ref: 274 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Teamwork: Ethical Comportment: Value and respect the perspectives, attributes, and expertise of all health team members, including the patient/family | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 13.7 Summarize strategies for preparing children and families for discharge from the hospital setting.

Principles of Pediatric Nursing, 8e (Ball et al.)

Chapter 14 Pain Assessment and Management in Children 1) While making rounds, the nurse observes all of the following client behaviors. Which child should the nurse further evaluate for postoperative pain?

1. The 6-month-old in deep sleep.

2. The 2-year-old who is cooperative when the nurse takes vital signs.

3. The 4-year-old who is actively watching cartoons.

4. The 14-month-old who is thrashing his arms and legs.

Answer: 4 Explanation: 1. Children are unable to obtain deep sleep when experiencing acute pain.

2. When experiencing acute pain, children are less likely to cooperate with treatments.

3. It is difficult for children to concentrate when experiencing acute pain.

4. Young children in acute pain display a variety of behaviors, including loud crying, screaming, 270 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 thrashing their arms and legs, lack of cooperation, clinging behavior, and restlessness and irritability.

Page Ref: 282 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: I.A.3. Demonstrate comprehensive understanding of the concepts of pain and suffering, including physiologic models of pain and comfort. | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 14.2 Analyze the behaviors of an infant or a child to assess for pain.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 2) The nurse is taking care of a postoperative school-age child. The child's mother requests that the child not receive narcotics because she is afraid the child will become addicted. The nurse should explain that children who do not receive adequate pain control will be at risk for which complication?

1. Respiratory 2. Urinary 3. Cardiac 4. Bowel Answer: 1 Explanation: 1. The child with acute postoperative pain takes shallow breaths and suppresses coughing to avoid more pain. These self-protective actions increase the potential for respiratory complications.

2. Uncontrolled pain does not usually lead to urinary complications.

3. Uncontrolled pain does not lead to cardiac complications.

4. Uncontrolled pain does not frequently lead to bowel complications.

Page Ref: 280 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: I.A.3. Demonstrate comprehensive understanding of the concepts of pain and suffering, including physiologic models of pain and comfort. | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 14.2 Analyze the behaviors of an infant or a child to assess for pain.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 3) The nurse is caring for a postoperative toddler-age child. Which pain assessment tool should the nurse use to assess this child's pain?

1. Poker Chip Tool 2. Oucher Scale 3. Faces Pain Rating Scale 4. FLACC Behavioral Pain Assessment Scale Answer: 4 Explanation: 1. The Faces Scale, Oucher Scale, and Poker Chip Tool are all self-report scales and can usually be used with children 3 years and older.

2. The Faces Scale, Oucher Scale, and Poker Chip Tool are all self-report scales and can usually be used with children 3 years and older.

3. The Faces Scale, Oucher Scale, and Poker Chip Tool are all self-report scales and can usually be used with children 3 years and older.

4. The FLACC scale is an appropriate tool for infants, and young children who cannot report pain.

Page Ref: 282 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.4. Assess presence and extent of pain and suffering | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 14.3 Assess a young child's readiness to use a self-report pain scale.

4) A 5-year-old child is hospitalized with a fractured femur. Which tool should the nurse use to assess this child's pain?

1. CRIES Scale 2. Faces Pain Rating Scale 3. SUN Scale 4. PIPP Scale Answer: 2 Explanation: 1. The CRIES Scale was developed for preterm and full-term neonates.

2. A 5-year-old child should be able to use the Faces Scale to choose which face best matches the child's pain level.

3. The SUN Scale was developed for use in newborns.

4. The PIPP Scale was developed for premature infants.

Page Ref: 283 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.4. Assess presence and extent of pain and suffering | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 14.3 Assess a young child's readiness to use a self-report pain scale.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 5) During the nurse's initial assessment of a school-age child, the child reports a pain level of 6 out of 10. The child is lying quietly in bed watching television. Which nursing action is appropriate?

1. Reassess the child in 15 minutes to see if the pain rating has changed.

2. Administer the prescribed analgesic.

3. Do nothing, since the child appears to be resting.

4. Ask the child's parents if they think the child is hurting.

Answer: 2 Explanation: 1. There is no need to reassess, as the child needs pain medication now.

2. School-age children are old enough to report their pain level accurately. A pain score of 6 is an indication for prompt administration of pain medication. The child might be trying to be brave or might be lying still because movement is painful.

3. The child might be lying quietly because movement increases the pain.

4. School-age children can answer for themselves, and do not need the parents to answer for them.

Page Ref: 285 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: I.A.3. Demonstrate comprehensive understanding of the concepts of pain and suffering, including physiologic models of pain and comfort. | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 14.2 Analyze the behaviors of an infant or a child to assess for pain.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 6) A hospitalized 3-year-old child needs to have an IV restarted. The child begins to cry when carried into the treatment room by the mother. Which problem would address this situation?

1. Insufficient information about the procedure 2. Fear 3. Anxiety 4. Problems with coping Answer: 3 Explanation: 1. The scenario indicates that the child has been through this before, so insufficient information is not the most appropriate problem.

2. The child's fear is related not to the unfamiliar environment but to the anticipated pain of the IV stick.

3. This child is not old enough to understand the need for an IV infusion. The scenario indicates that the child has been through this painful procedure before, and the child's reaction to entering the treatment room is based on anticipation of repeat discomfort.

4. The child's behavior is appropriate for coping in this age child.

Page Ref: 279 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: I.C.8. Appreciate the role of the nurse in relief of all types and sources of pain or suffering | AACN 2021 Domains and Competencies: 2.4 Diagnose actual or potential health problems and needs. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Diagnosis Learning Outcome: 14.6 Plan nursing care for a child in acute pain that integrates pharmacologic interventions and developmentally appropriate nonpharmacologic (complementary) therapies.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 7) The nurse is providing care for a pediatric client in the intensive care unit (ICU) who has been on opioids for an extended period of time. Which assessment finding indicates to the nurse that the child is experiencing withdrawal symptoms related to the opioid weaning process?

1. Vomiting and abdominal cramps.

2. Bradycardia and pallor.

3. Decreased blood pressure and drowsiness.

4. Voracious appetite and hypotonicity.

Answer: 1 Explanation: 1. These are symptoms of withdrawal resulting from reducing the dose too quickly.

2. A child who is being withdrawn from opioids too quickly will be tachycardic and have hot flashes and sweating.

3. The child who is being withdrawn from opioids too quickly will be hypertensive and wakeful.

4. Nausea, abdominal pain, diarrhea, and hypertonicity would be symptoms of withdrawal.

Page Ref: 287 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: I.C.8. Appreciate the role of the nurse in relief of all types and sources of pain or suffering | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 14.4 Plan the nursing care for a child receiving an opioid analgesic.

8) An analgesic is prescribed for a postsurgical pediatric client to be administered every 3 to 4 hours. Which outcome can occur if the nurse is delayed in administering the prescribed analgesic?

1. Decrease in the chance of withdrawal symptoms 2. Decrease in the chance of addiction 3. Increase in the chance of breakthrough pain 4. Increase in the child's pain tolerance Answer: 3 Explanation: 1. A delay in giving pain medication will not decrease the chance of withdrawal symptoms if the medication is stopped without weaning.

2. Delaying the pain medication will not decrease the chance of addiction.

3. Analgesics may be given on a scheduled basis. Delays in giving analgesics increase the chance of breakthrough pain and the subsequent anticipation of pain.

4. Delaying the pain medication will not increase the child's pain tolerance.

Page Ref: 287 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: I.C.8. Appreciate the role of the nurse in relief of all types and sources of pain or suffering | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 14.4 Plan the nursing care for a child receiving an opioid analgesic.

9) The nurse is preparing to perform a heel stick on a neonate. Which complementary therapy 276 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 should the nurse implement to decrease pain during this quick but painful procedure?

1. Holding the newborn 2. Providing a sucrose pacifier to the newborn 3. Massaging the newborn 4. Swaddling the newborn Answer: 2 Explanation: 1. Massage and holding the infant are more appropriate following the procedure, or as an adjunct to pain medication for ongoing pain or distress.

2. Sucrose provides short-term, natural pain relief, and is most appropriate for use in neonates to decrease pain associated with a quick procedure.

3. Massage and holding the infant are more appropriate following the procedure, or as an adjunct to pain medication for ongoing pain or distress.

4. Swaddling for a neonate undergoing a quick painful procedure will not decrease the pain.

Page Ref: 289 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: I.B.7. Initiate effective treatments to relieve pain and suffering in light of patient values, preferences, and expressed needs | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 14.5 Examine the role of nonpharmacologic (complementary) interventions in effective pain management.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 10) A 6-year-old postoperative client's IV infiltrates and has to be restarted immediately for medication. There is no time for placing local anesthetic cream on the skin. Which complementary therapy would be helpful when placing this IV? 1. Restraints 2. Moderate sedation 3. Anesthesia 4. Distraction Answer: 4 Explanation: 1. Restraints are used only as a last resort and are not appropriate for an IV start.

2. Moderate sedation has its own side effects and possible complications and should not be used for quick procedures.

3. Drugs may not be used for quick procedures, such as a dressing change or an unexpected intravenous insertion, injection, or venipuncture.

4. Complementary therapies–especially guided imagery, relaxation techniques, and distraction– can reduce the anxiety associated with the anticipation of the procedure.

Page Ref: 288 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.C.8. Appreciate the role of the nurse in relief of all types and sources of pain or suffering | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 14.6 Plan nursing care for a child in acute pain that integrates pharmacologic interventions and developmentally appropriate nonpharmacologic (complementary) therapies.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 11) The pediatric nurse would expect that patient-controlled analgesia (PCA) would be most appropriate for which client?

1. 12-year-old client who is postoperative for spinal fusion for scoliosis 2. 10-year-old client who has a fractured femur and concussion from a bike accident 3. 5-year-old client who is postoperative for tonsillectomy 4. Developmentally delayed 16-year-old client who is postoperative for bone surgery.

Answer: 1 Explanation: 1. PCA is most appropriate in children 5 years old and older. Children must be able to press the button and understand that they will receive pain medicine by pushing the button.

2. Children who have suffered head trauma would not be candidates for PCA. 3. PCA generally is prescribed for clients who will be hospitalized for at least 48 hours.

4. Children who are developmentally delayed would not be candidates for PCA. Page Ref: 288 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: I.C.8. Appreciate the role of the nurse in relief of all types and sources of pain or suffering | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 14.4 Plan the nursing care for a child receiving an opioid analgesic.

279 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 12) Which statement by the parent of a preschool-age child would indicate the need for further teaching regarding pain management?

1. "I will call the office tomorrow if the pain medicine is not relieving the pain."

2. "I can expect my child to have some pain for the next few days."

3. "Because my child just had surgery today, I can expect the pain level to be higher tomorrow."

4. "I will plan to give my child pain medicine around the clock for the next day or so."

Answer: 3 Explanation: 1. If prescribed medication is not relieving the pain to a satisfactory level, the healthcare provider should be notified. This statement indicates the parent understands and does not need additional teaching.

2. The child is expected to have some pain for a few days after surgery. This statement indicates the parent understands the teaching.

3. Increasing pain can be a sign of complication and should be reported to the healthcare provider; therefore, the nurse should clarify expectations for pain control.

4. The child should receive pain medication on a scheduled basis. This statement indicates the parent understands the teaching.

Page Ref: 280 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: I.C.8. Appreciate the role of the nurse in relief of all types and sources of pain or suffering | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 14.6 Plan nursing care for a child in acute pain that integrates pharmacologic interventions and developmentally appropriate nonpharmacologic (complementary) therapies.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 13) The nurse is caring for a child who has been sedated for a painful procedure. Which is the priority nursing action?

1. Placing the child on a cardiac monitor 2. Allowing parents to stay with the child 3. Monitoring pulse oximetry 4. Assessing the child's respiratory effort Answer: 4 Explanation: 1. Although equipment is important and is used routinely during sedation, it does not replace the need for visual assessment.

2. Parents may be allowed to stay with the child, but assessment of breathing effort must take priority.

3. Although equipment is important and is used routinely during sedation, it does not replace the need for visual assessment.

4. When the child is sedated for a procedure, it is very important for the nurse to actually visualize the child and the child's effort of breathing.

Page Ref: 287 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: I.C.8. Appreciate the role of the nurse in relief of all types and sources of pain or suffering | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 14.7 Develop a nursing care plan for the child with a chronic painful condition.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 14) The nurse is planning care for a preschool-age child who is intellectually disabled and is scheduled for surgery the next day. Which should the nurse consider when choosing a pain assessment tool? Select all that apply.

1. The child's language skills 2. The child's ability to understand the concept of more and less 3. The child's ability to sit for a 10-minute evaluation 4. The child's ability to perceive pain 5. The child's ability to understand pain Answer: 1, 2 Explanation: 1. In order to report pain, the child needs adequate verbalization skills to communicate to the nurse.

2. The child who understands more or less can be given a three-option pain scale. The child who cannot understand more or less may need a behavioral pain scale.

3. The assessment does not require the child to sit still.

4. Children perceive pain. The issue is if the nurse can recognize the child's pain.

5. Children do not need to understand pain in order to feel pain.

Page Ref: 281 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.B.4. Assess presence and extent of pain and suffering | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 14.3 Assess a young child's readiness to use a self-report pain scale.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 15) The nurse administers IV morphine to a 4-year-old postoperative client. Which assessment finding requires further evaluation by the nurse?

1. Pulse decreased from 136 to 104 2. Blood pressure dropped from 110/72 to 90/55 3. Respiratory rate went from 42 to 16 4. Child pulls away from nurse who wants to assess surgical site Answer: 3 Explanation: 1. The normal pulse rate for children 2 to 5 years of age is between 70 and 120.

2. 90/55 is a normal finding for this age group.

3. This respiratory rate is on the low side for the age group and requires further evaluation to determine if the child's respirations are being depressed.

4. This is normal behavior for a 4-year-old child.

Page Ref: 287 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: I.C.8. Appreciate the role of the nurse in relief of all types and sources of pain or suffering | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 14.6 Plan nursing care for a child in acute pain that integrates pharmacologic interventions and developmentally appropriate nonpharmacologic (complementary) therapies.

16) The healthcare provider prescribes hydromorphine (Dilaudid) intravenously for the postoperative 4-year-old child. The therapeutic range for Dilaudid has been determined to be 0.01 to 0.015 mg/kg/dose every 3 to 4 hours. What is the maximum therapeutic dose of Dilaudid if the child weighs 30 pounds? Round your answer to the nearest hundredth.

Answer: 0.2 mg Explanation: 30 pounds divided by 2.2 pounds/kg = 13.64 kg 13.64 kg × 0.015 mg/kg = 0.2045, which rounds to 0.2 Your answer should have a 0 in front of the decimal and no 0 after the 2. Otherwise, you may contribute to a medication error.

Page Ref: 286 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: I.C.8. Appreciate the role of the nurse in relief of all types and sources of pain or suffering | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 14.4 Plan the nursing care for a child receiving an opioid analgesic.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 17) During shift report, the night nurse reports that a terminally ill child has developed tolerance to the prescribed morphine. Which concept should the nurse use when planning care for this child?

1. The child is physically dependent on morphine.

2. The child is addicted to morphine.

3. The child is showing physical signs of withdrawal.

4. The child will need more medication to achieve the same effect.

Answer: 4 Explanation: 1. While the child may be physically dependent, this is not the meaning of tolerance.

2. Addiction refers to a compulsive use of a substance despite harm. This is not the definition of tolerance.

3. Withdrawal occurs when the opioid is stopped suddenly. This is not the meaning of tolerance.

4. Tolerance occurs when the body has become accustomed to the presence of the drug in the system. When this happens, the child will need more of a drug or a stronger drug to get the same effect.

Page Ref: 287 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: I.A.3. Demonstrate comprehensive understanding of the concepts of pain and suffering, including physiologic models of pain and comfort. | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 14.1 Summarize the physiologic and behavioral consequences of pain in infants and children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 18) The 17-month-old toddler, diagnosed with terminal cancer, is experiencing constant pain.

Which prescription does the nurse anticipate from the healthcare provider for this toddler?

1. Patient-controlled analgesia (PCA) with the parents controlling the button that administers the dosage 2. Intravenously administered opioids on a scheduled basis 3. Intravenously administered opioids on a prn basis 4. Orally administered opioids on a prn basis Answer: 2 Explanation: 1. PCA should always be controlled by the individual receiving the medication. It is inappropriate to have the parents control the medication administration.

2. This provides continuous blood levels of the opioid.

3. By waiting until symptoms are present, the child's blood level will drop, making it more difficult to control the pain.

4. Parenteral administration controls pain more effectively than oral medication as oral absorption may be modified by stomach activities. In addition, providing analgesics on a scheduled basis is preferred over prn.

Page Ref: 287 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: I.C.8. Appreciate the role of the nurse in relief of all types and sources of pain or suffering | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 14.4 Plan the nursing care for a child receiving an opioid analgesic.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 19) Which distraction techniques should the nurse to use for a school-age child during a painful procedure? Select all that apply.

1. Blowing bubbles 2. Music therapy 3. Guided imagery 4. Hypnosis 5. Sucrose solution Answer: 1, 2, 3 Explanation: 1. Blowing bubbles or popping bubbles can be a distraction for a young school-age child.

2. Listening to music or singing can be used as distraction for this age group.

3. Guided imagery is a means of encouraging relaxation and mental images to manage pain.

4. Under hypnosis, the child is an altered state of awareness; this is not a form of distraction.

5. Sucrose solution is used for infants up to 12 months of age. This is a complementary therapy but not a method of distraction.

Page Ref: 293 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.C.8. Appreciate the role of the nurse in relief of all types and sources of pain or suffering | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 14.6 Plan nursing care for a child in acute pain that integrates pharmacologic interventions and developmentally appropriate nonpharmacologic (complementary) therapies.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 20) Which nonpharmacologic interventions are appropriate for the nurse to use when treating pediatric clients in pain? Select all that apply.

1. Regional nerve block 2. Cutaneous stimulation 3. Application of heat 4. Electroanalgesia 5. Use of EMLA cream Answer: 2, 3, 4 Explanation: 1. A regional nerve block involves injecting medications in an area that controls pain for a region of the body. It does not provide nonpharmacologic relief.

2. Massage and rubbing of the skin as well as swaddling and kangaroo care are nonpharmacologic means of relieving pain.

3. The use of heat (and cold) may help reduce pain sensations, and utilizes no pharmacologic agents.

4. Electrical stimulation to the skin uses the gate control theory to relieve pain.

5. EMLA cream is a mixture of lidocaine and prilocaine that is applied to the intact skin. It is a pharmacologic pain relief method.

Page Ref: 289 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Basic Care and Comfort Standards: QSEN Competencies: I.B.7. Initiate effective treatments to relieve pain and suffering in light of patient values, preferences, and expressed needs | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 14.5 Examine the role of nonpharmacologic (complementary) interventions in effective pain management.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 21) The nurse is providing care to a pediatric client who is receiving sedation for a painful procedure. Which are the priority nursing actions? Select all that apply.

1. Monitoring respirations 2. Assessing for manifestations of deep sedation 3. Ensuring a crash cart is available 4. Administering the prescribed opioid 5. Administering the prescribed benzodiazepine Answer: 1, 2, 3 Explanation: 1. A priority nursing action for a pediatric client who is receiving sedation for a painful procedure is to monitor the child's respirations.

2. A priority nursing action for a pediatric client who is receiving sedation for a painful procedure is to assess for manifestations associated with deep sedation.

3. A priority nursing action for a pediatric client who is receiving sedation for a painful procedure is ensuring a crash cart is available.

4. A priority nursing action for a pediatric client who is receiving sedation for a painful procedure is to have an opioid antagonist available, if respiratory depression occurs.

5. A priority nursing action for a pediatric client who is receiving sedation for a painful procedure is to have a benzodiazepine antagonist available, if needed.

Page Ref: 296 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: I.C.8. Appreciate the role of the nurse in relief of all types and sources of pain or suffering | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 14.8 Develop a nursing care plan for the child to be given sedation and analgesia for a medical procedure.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 22) Which are the priority nursing assessments when providing care to a pediatric client who is receiving sedation? Select all that apply.

1. Respiratory effort 2. Chest wall movement 3. Skin color 4. Level of consciousness 5. Pain Answer: 1, 2, 3, 4 Explanation: 1. A respiratory effort assessment is a nursing priority for the pediatric client who is receiving sedation.

2. Assessing chest wall movement is a nursing priority for the pediatric client who is receiving sedation.

3. Assessing skin color is a nursing priority for the pediatric client who is receiving sedation.

4. Assessing level of consciousness is a nursing priority for the pediatric client who is receiving sedation.

5. Assessing the client's pain is not a priority when providing care to a pediatric client who is receiving sedation.

Page Ref: 296, 297 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: I.C.8. Appreciate the role of the nurse in relief of all types and sources of pain or suffering | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 14.8 Develop a nursing care plan for the child to be given sedation and analgesia for a medical procedure.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 23) Which are discharge criteria the nurse includes in the plan of care for a client who has received sedation? Select all that apply.

1. Stable vital signs 2. Patent airway 3. Ability to sit up without assistance 4. Adequate fluid intake 5. Ability to urinate Answer: 1, 2, 3 Explanation: 1. Stable vital signs are a criterion for discharge for a pediatric client who has received sedation.

2. A patent airway is one criterion for discharge for the pediatric client who has received sedation.

3. The ability to sit up without assistance is one criterion for discharge for the pediatric client who has received sedation.

4. Fluid intake is not essential as some sedation medications stimulate vomiting.

5. Ability to urinate is not an essential criterion for discharge for the pediatric client who has received sedation.

Page Ref: 297 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: I.C.8. Appreciate the role of the nurse in relief of all types and sources of pain or suffering | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 14.8 Develop a nursing care plan for the child to be given sedation and analgesia for a medical procedure.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 24) Which pediatric diagnoses require the nurse to include interventions to treat chronic pediatric client pain in the plan of care? Select all that apply.

1. Juvenile idiopathic arthritis 2. Sickle cell disease 3. Attention deficit hyperactivity disorder (ADHD) 4. Cancer 5. Human immunodeficiency virus (HIV) Answer: 1, 2, 4 Explanation: 1. Juvenile idiopathic arthritis is a condition that necessitates the inclusion of interventions to treat chronic pain in the plan of care.

2. Sickle cell disease arthritis is a condition that necessitates the inclusion of interventions to treat chronic pain in the plan of care.

3. ADHD is not a condition that necessitates the inclusion of interventions to treat chronic pain in the plan of care.

4. Cancer is a condition that necessitates the inclusion of interventions to treat chronic pain in the plan of care.

5. HIV is a condition that necessitates the inclusion of interventions to treat chronic pain in the plan of care.

Page Ref: 295 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: I.C.8. Appreciate the role of the nurse in relief of all types and sources of pain or suffering | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 14.7 Develop a nursing care plan for the child with a chronic painful condition.

291 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 25) Which complementary pain management interventions should the nurse include in the plan of care for a pediatric client who is experiencing chronic pain? Select all that apply.

1. Hypnosis 2. Guided imagery 3. Patient-controlled analgesia (PCA) 4. Fentanyl patch 5. EMLA cream Answer: 1, 2 Explanation: 1. Hypnosis is a complementary intervention that is appropriate for the nurse to include in the plan of care for a pediatric client who is experiencing chronic pain.

2. Guided imagery is a complementary intervention that is appropriate for the nurse to include in the plan of care for a pediatric client who is experiencing chronic pain.

3. PCA is not a complementary pain management therapy.

4. Fentanyl patch is not a complementary pain management therapy.

5. EMLA cream is not a complementary pain management therapy.

Page Ref: 295 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Basic Care and Comfort Standards: QSEN Competencies: I.C.8. Appreciate the role of the nurse in relief of all types and sources of pain or suffering | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 14.7 Develop a nursing care plan for the child with a chronic painful condition.

Principles of Pediatric Nursing, 8e (Ball et al.)

Chapter 15 The Child With a Life-Threatening Condition and End-of-Life Care 1) Which problem would be a priority for an adolescent diagnosed with cystic fibrosis who is intubated with an endotracheal tube?

1. Fear 2. Anxiety 3. Loss of control 4. Potential for weight gain Answer: 3 Explanation: 1. The adolescent might be fearful however would not be able to articulate fears.

Addressing communication would help reduce the fear.

2. The adolescent might be anxious however cannot talk about it because of being intubated.

Addressing communication would help reduce the anxiety.

3. The adolescent values communication with peers, and might feel frustrated that she cannot speak to them while intubated.

4. The adolescent with cystic fibrosis is likely to be underweight, and is unlikely to take in more calories than needed while intubated.

Page Ref: 303 Cognitive Level: Analyzing Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.A.7. Explore ethical and legal implications of patient292 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 centered care | AACN 2021 Domains and Competencies: 2.4 Diagnose actual or potential health problems and needs. | NLN Competencies: Context and Environment: Practice: Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Diagnosis Learning Outcome: 15.1 Summarize the effects of a life-threatening illness or injury on children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 2) The emergency department (ED) nurse is talking with a preschooler about the death of the child's parents in a motor vehicle crash. Which aspect of the child's growth and development should the nurse take into consideration when formulating the client's plan of care?

1. Preschool-age children often believe that death is their fault.

2. Preschool-age children believe death is permanent.

3. Preschool-age children engage in reality-based thinking.

4. Preschool-age children may believe the parents will not come back home.

Answer: 1 Explanation: 1. Preschoolers engage in magical thinking, and might believe they wished or caused the death of their parents.

2. Preschoolers do not have a concept of death as permanent; therefore, they might expect their parents to return home.

3. Preschoolers engage in magical thinking, and might believe they wished or caused the death of their parents.

4. Preschoolers do not have a concept of death as permanent; therefore, they might expect their parents to return home.

Page Ref: 317 Cognitive Level: Analyzing Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.A.7. Explore ethical and legal implications of patientcentered care | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Context and Environment: Practice: Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 15.1 Summarize the effects of a life-threatening illness or injury on children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 3) A 16-year-old has a stiff neck, headache, fever of 103°F, and the nurse notes purpuric lesions on the child's legs. Although the adolescent's physical needs take priority at the present time, the nurse can expect which psychologic stressor to be the most significant for this adolescent?

1. Fear of getting behind in schoolwork 2. Separation from friends and permanent changes in appearance 3. Separation from parents and home 4. Fear of painful procedures and bodily mutilation Answer: 2 Explanation: 1. School-age children are developing a sense of industry, and fear getting behind in schoolwork.

2. Adolescents are developing their identity, and rely mostly on their friends. They are concerned about their appearance and how they look compared with their peers.

3. Separation from parents and home is the main psychological stressor for infants and toddlers.

4. Preschoolers fear pain and bodily mutilation.

Page Ref: 312 Cognitive Level: Analyzing Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.A.7. Explore ethical and legal implications of patientcentered care | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 15.1 Summarize the effects of a life-threatening illness or injury on children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 4) A school bus carrying children in grades K-12 crashed into a ravine. The critically injured children are transported by ambulance and admitted to the pediatric intensive care unit (PICU).

Which action should the nurse take to calm the frightened children?

1. Explain that the equipment being used is state-of-the-art.

2. Tell the children that the providers are competent.

3. Call the children's parents to come to the unit.

4. Assure the children that the nurses are caring.

Answer: 3 Explanation: 1. Children often cannot recognize or care about state-of-the-art equipment.

2. Healthcare providers, no matter how competent or caring, cannot substitute for parents.

3. A sense of physical and psychologic security is best achieved by the presence of parents.

Children at all developmental levels look first to their parents or whoever acts as their parents for safety and security.

4. Healthcare providers, no matter how competent or caring, cannot substitute for parents.

Page Ref: 303 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.A.7. Explore ethical and legal implications of patientcentered care | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 15.1 Summarize the effects of a life-threatening illness or injury on children.

296 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 5) The nurse is working with children in hospice care. The mother of a young child with cancer is frustrated with "waiting" for things to happen or change. Which feeling is the mother experiencing?

1. Actual loss 2. Perceived loss 3. Anticipatory waiting 4. Loss Answer: 3 Explanation: 1. Actual loss is a real loss objectively confirmed by others.

2. A perceived loss is subjectively experienced by a person, but cannot be confirmed by others.

3. Anticipatory waiting is a feeling that life is suspended in time. A great deal of time is waiting for test results, a change in condition, or decisions about treatment.

4. Loss is a general term for something of value being changed, no longer available, or no longer able to be experienced by an individual.

Page Ref: 306 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: RelationshipCentered Care: Practice: Promote and accept the patient's emotions; accept and respond to distress in patient and self; facilitate hope, trust, and faith | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 15.2 Examine the family's experience and reactions to having a child with a life-threatening illness or injury.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 6) A school-age child is admitted to the hospital with a fractured femur and head trauma. The child was not wearing a helmet while riding a new bicycle on the highway, and collided with a car. Which problems should the nurse include in the plan of care with regard to the child's parents? Select all that apply.

1. Coping with changes 2. Possible role changes 3. Guilt 4. Lack of knowledge 5. Anger Answer: 1, 2, 3, 5 Explanation: 1. This problem is appropriate for the child's parents in this situation.

2. This problem is appropriate for the child's parents in this situation.

3. This problem is appropriate for the child's parents in this situation.

4. The problem of lack of knowledge is not possible in this situation. Although planning for discharge begins with admission, it is too early to begin teaching the parents about home care.

The astute and experienced nurse is prepared to recognize current problems, and intervene appropriately.

5. This problem is appropriate for the child's parents in this situation.

Page Ref: 306 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.4 Diagnose actual or potential health problems and needs. | NLN Competencies: Relationship-Centered Care: Practice: Promote and accept the patient's emotions; accept and respond to distress in patient and self; facilitate hope, trust, and faith | Nursing/Integrated Concepts: Nursing Process: Diagnosis Learning Outcome: 15.2 Examine the family's experience and reactions to having a child with a life-threatening illness or injury.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 7) The parents of a 2-year-old child who sustained severe head trauma from falling out of a second-story window are arguing in the pediatric intensive care unit (PICU), and are blaming each other for the child's accident. Which problem explains the family's reaction?

1. Conflict with parental role 2. Anxiety 3. Hopelessness 4. Problems with coping Answer: 4 Explanation: 1. Conflict with the parental role focuses on the parent and not on the family as a whole.

2. Parents might be experiencing anxiety, but they are not coping well as a family unit.

3. Parents might be experiencing hopelessness, but they are not coping well as a family unit.

4. The parents are displaying ineffective coping behaviors as a family.

Page Ref: 308 Cognitive Level: Analyzing Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.C.1. Value seeing healthcare situations "through patients' eyes" | AACN 2021 Domains and Competencies: 2.4. Diagnose actual or potential health problems and needs. | NLN Competencies: Relationship-Centered Care: Practice: Promote and accept the patient's emotions; accept and respond to distress in patient and self; facilitate hope, trust, and faith | Nursing/Integrated Concepts: Nursing Process: Diagnosis Learning Outcome: 15.3 Identify the coping mechanisms used by the child and family in response to stress.

8) Which nursing intervention should the nurse include in the plan of care for a child who is sedated, unconscious, and on a mechanical ventilator?

1. Out-of-bed transfer to wheelchair 2. Whirlpool baths 3. Maintenance of intravenous (IV) hydration 4. Active range-of-motion (ROM) exercises Answer: 3 Explanation: 1. The child would not be permitted to be transferred to a wheelchair.

2. The child would not be permitted to be transferred to take whirlpool baths.

3. The child who is unconscious is unable to take anything by mouth, and will need IV therapy for hydration.

4. The nurse may perform passive ROM exercises on the child, but the child is incapable of doing active ROM exercises.

Page Ref: 304 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: I.C.1. Value seeing healthcare situations "through patients' eyes" | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Relationship-Centered Care: Practice: Promote and accept the patient's emotions; accept and respond to distress in patient and self; facilitate hope, trust, and faith | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 15.3 Identify the coping mechanisms used by the child and family in response to stress.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 9) A 10-year-old child is transported to the emergency department (ED) by ambulance from the scene of a motor vehicle crash. The child is alert and oriented ×3; pulse, respirations, and blood pressure are stable; neck and back are immobilized on a backboard. The nurse sees no obvious bleeding. The child states," I can't move or feel my legs." Which injury does the nurse suspect based on the current data?

1. Spinal cord injury 2. Traumatic shock 3. Traumatic brain injury 4. Ruptured spleen Answer: 1 Explanation: 1. Spinal cord injury results in paralysis and anesthesia of the affected body parts below the level of the lesion.

2. Traumatic shock results in initially increasing then decreasing pulse and respirations and falling blood pressure.

3. Altered levels of consciousness could indicate traumatic brain injury.

4. The child might have a ruptured spleen, but it is not evident from the data given in this scenario.

Page Ref: 302 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Relationship-Centered Care: Ethical Comportment: Appreciate the patient as a whole person, with his or her own life story and ideas about the meaning of health or illness | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 15.4 Develop a nursing care plan for the child with a life-threatening illness or injury.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 10) A preschool-age child with severe head trauma is intubated and on a respirator. The child has three flat electroencephalograms (EEGs) completed 24 hours apart. The electrocardiogram (ECG) shows a rate of 90 beats per minute in a normal sinus rhythm. Which term should the nurse use when documenting these findings?

1. Imminent death 2. Brain death 3. Natural death 4. Heart—lung death Answer: 2 Explanation: 1. Imminent death means physical death is inevitable within a period of time.

2. Cerebral death, or brain death, is the irreversible cessation of all brain functions, including those of the cerebral cortex and brainstem, manifested by the absence of brain waves on EEG. 3. Natural death is allowing cessation of all body functions without extraordinary medical interventions.

4. Heart-lung death, the irreversible cessation of cardiorespiratory functions, has not occurred because the child is being mechanically ventilated.

Page Ref: 310 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity Standards: QSEN Competencies: I.B.5. Assess levels of physical and emotional comfort | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: Apply professional standards; show accountability for nursing judgment and actions; develop advocacy skills | Nursing/Integrated Concepts: Nursing Process: Implementation/Communication and Documentation Learning Outcome: 15.5 Apply assessment skills to identify the physiologic changes that occur in the dying child.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 11) A female client arrived by life flight to the hospital after experiencing multiple traumas in a motor vehicle crash involving a suspected drunk driver. Which statement is the most important for the nurse to make to the parents before they see their child?

1. "You should press charges against the drunk driver."

2. "Your child's condition is very critical; her face is swollen, and she might not look like herself."

3. "Your child's leg was crushed, and might have to be amputated."

4. "Don't worry, everything will be okay. We will take excellent care of your child."

Answer: 2 Explanation: 1. The nurse supports the family, but remains nonjudgmental about accident details.

2. The priority is to prepare the parents for the child's changed appearance.

3. The priority is to prepare the parents for the child's changed appearance. Truthful statements about the child's condition can be introduced after the parents have seen the child and grasped the situation.

4. The priority is to prepare the parents for the child's changed appearance. The nurse must not offer false reassurance or project future stressful events.

Page Ref: 306 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: Apply professional standards; show accountability for nursing judgment and actions; develop advocacy skills | Nursing/Integrated Concepts: Implementation/Communication and Documentation Learning Outcome: 15.6 Develop a nursing care plan to provide family-centered care for the dying child and family.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 12) A school-age child diagnosed with congenital heart block codes in the emergency department. The parents witness this and stare at the resuscitation scene unfolding before them.

Which is the best nursing intervention in this situation?

1. Asking the parents to help bag the child 2. Asking the parents to sit near the child's face and touch their child 3. Asking the parents to stand at the foot of the cart to watch 4. Asking the parents to leave the room Answer: 2 Explanation: 1. Parents never should be asked to take part in emergency efforts unless absolutely necessary.

2. Parents should be helped to support their child through emergency procedures, if they are able.

3. Merely watching the resuscitation serves no purpose for the child.

4. If the parents interfere with resuscitation efforts, or are unable to tolerate the situation, they can be asked to leave later.

Page Ref: 308 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: Apply professional standards; show accountability for nursing judgment and actions; develop advocacy skills | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 15.6 Develop a nursing care plan to provide family-centered care for the dying child and family.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 13) An adolescent experiencing status asthmaticus is rushed to the emergency department by ambulance. The parents arrive and ask to see their child. The triage nurse at the reception desk knows that the adolescent was pronounced dead on arrival. Which is the best action by the triage nurse at this time?

1. Ask the parents to please take a seat in the waiting room.

2. Immediately escort the parents to a quiet, private room.

3. Tell the parents that they must wait because only the healthcare provider can talk with them.

4. Immediately tell the parents, "I'm sorry, but your child didn't make it."

Answer: 2 Explanation: 1. Asking parents to wait is uncaring and insensitive.

2. The best nursing intervention is to give the parents an appropriate environment before they are told the news, so that they can begin grieving privately.

3. Nurses as well as other healthcare providers are capable of breaking bad news to families with caring and empathy.

4. Telling the parents the news in public is uncaring and insensitive.

Page Ref: 316 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: Apply professional standards; show accountability for nursing judgment and actions; develop advocacy skills | Nursing/Integrated Concepts: Implementation/Communication and Documentation Learning Outcome: 15.6 Develop a nursing care plan to provide family-centered care for the dying child and family.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 14) Which strategies would be helpful for nurses who work with terminally ill children to avoid burnout? Select all that apply.

1. Participating in a mentoring relationship with experienced hospice nurses 2. Participating in support groups with mental health professionals 3. Participating in team decisions regarding the dying child's plan of care 4. Declining the family's invitation to attend the child's funeral 5. Planning the child and family's care alone as the primary nurse Answer: 1, 2, 3 Explanation: 1. Team decisions, mentorship, and support groups all alleviate the responsibility of providing nursing care and coping with the death of a child alone.

2. Team decisions, mentorship, and support groups all alleviate the responsibility of providing nursing care and coping with the death of a child alone.

3. Team decisions, mentorship, and support groups all alleviate the responsibility of providing nursing care and coping with the death of a child alone.

4. Distancing oneself from the family can result in unresolved grief.

5. Planning the child's care alone might result in an excessive burden of guilt.

Page Ref: 318 Cognitive Level: Understanding Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: II.C.1. Acknowledge own potential to contribute to effective team functioning | AACN 2021 Domains and Competencies: 10.1 Demonstrate a commitment to personal health and well‐being. | NLN Competencies: Relationship-Centered Care: Practice: respond to moral and ethical challenges. | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 15.8 Evaluate strategies to support nurses who care for children who die.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 15) Which topics should the nurse include in a discussion with parents of a terminally ill child regarding parental feelings that may occur upon the child's death? Select all that apply.

1. Loneliness 2. Guilt 3. Anger 4. High energy 5. Depression Answer: 1, 2, 3, 5 Explanation: 1. The intense pain and shock initially felt by parents gradually give way to feelings of anger, guilt, depression, and loneliness.

2. The intense pain and shock initially felt by parents gradually give way to feelings of anger, guilt, depression, and loneliness.

3. The intense pain and shock initially felt by parents gradually give way to feelings of anger, guilt, depression, and loneliness.

4. High energy is not felt during the mourning period.

5. The intense pain and shock initially felt by parents gradually give way to feelings of anger, guilt, depression, and loneliness.

Page Ref: 316 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Context and Environment: Ethical Comportment: Examine personal beliefs, values, and biases with regard to respect for persons, human dignity, equality, and justice; explore ideas of nurse caring and compassion. | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 15.7 Plan bereavement support for the parents and siblings after the death of a child.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 16) The nurse is speaking with a preschool-age child whose sibling recently died. Which feelings should the nurse anticipate from the preschool-age child?

1. The child may feel that his or her bad behavior caused the sibling's death as a punishment.

2. The child may feel that the sibling died as a result of a fight.

3. The child may feel that having bad thoughts about the sibling caused the death.

4. The child may feel that the sibling died because the parents did not like that sibling.

Answer: 3 Explanation: 1. Preschool-age children do not have a fear of being bad and the sibling's subsequently being punished.

2. Fighting is normal, and preschool-age children do not have those thoughts.

3. Preschool-age children might fear that they caused their brother or sister to be injured or become ill, or they may worry that bad thoughts on their part brought on the illness.

4. Preschool-age children are more likely to believe that they somehow were the cause of their sibling's death, not their parents.

Page Ref: 309 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Context and Environment: Ethical Compartment: Examine personal beliefs, values, and biases with regard to respect for persons, human dignity, equality, and justice; explore ideas of nurse caring and compassion. | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 15.7 Plan bereavement support for the parents and siblings after the death of a child.

307 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 17) The mother of a dying 3-year-old child posts on Facebook: "Family and friends. Michael's heart is giving out. Looks like it will be tonight. He is surrounded by family and not in pain. I treasure every minute of being his mother. Pray for us." Which reaction to a life-threatening illness is the mother experiencing?

1. Shock and disbelief 2. Anticipatory waiting 3. Anger and guilt 4. Readjustment or mourning Answer: 2 Explanation: 1. The mother is not demonstrating shock or disbelief.

2. The mother is demonstrating waiting for her child to be at peace.

3. The mother is not demonstrating anger or guilt.

4. The mother is not demonstrating readjustment or mourning since her child is still alive.

Page Ref: 306 Cognitive Level: Analyzing Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Ethical Compartment: Examine personal beliefs, values, and biases with regard to respect for persons, human dignity, equality, and justice; explore ideas of nurse caring and compassion. | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 15.7 Plan bereavement support for the parents and siblings after the death of a child.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 18) The nurse is leading a recovery group of parents who have lost a child. As the opening topic for the night's discussion, the nurse reviews information about the grief process to the parents and talks about how different people grieve. Which parental statement indicates the need for more education regarding the grieving process?

1. "I understand that everyone grieves differently."

2. "Looking back, I realize why I became so angry when the doctors didn't cure my daughter."

3. "It's been 6 months since my son died, so why isn't my wife ready to move on with our lives?"

4. "I'm glad you described some common grief reactions. I thought I was going crazy for a while."

Answer: 3 Explanation: 1. This statement is accurate. This father understands this concept correctly.

2. Anger is a part of the grief process. This father has been able to look at his own behavior and recognize it as normal.

3. There is no standard period of grief. It is individual. This father has not heard the nurse's discussion.

4. This father has applied the knowledge of grief behaviors to his own behavior. He understands the discussion.

Page Ref: 316 Cognitive Level: Analyzing Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Ethical Compartment: Examine personal beliefs, values, and biases with regard to respect for persons, human dignity, equality, and justice; explore ideas of nurse caring and compassion. | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 15.7 Plan bereavement support for the parents and siblings after the death of a child.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 19) The nurse is providing care to a child who is nearing death. Which nursing actions may offer the family support?

1. Using active listening techniques 2. Looking the parents in the eye when talking 3. Refusing to cry while in the child's room 4. Offering to call and notify family 5. Avoiding being in the room to allow the family to grief Answer: 1, 2, 4 Explanation: 1. Active listening encourages the parents to talk if they feel the need.

2. This behavior indicates willingness to listen.

3. This is no longer considered inappropriate, and allows the parents to know that the nurse feels sadness at the loss.

4. This would be appropriate and helpful to the parents.

5. The nurse should provide support to the parents. Often just sitting in the room quietly is an appropriate intervention.

Page Ref: 311 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Ethical Compartment: Examine personal beliefs, values, and biases with regard to respect for persons, human dignity, equality, and justice; explore ideas of nurse caring and compassion. | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 15.7 Plan bereavement support for the parents and siblings after the death of a child.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 20) The nurse is having difficulty coping with the impending death of a child. With which person should the nurse consult during this difficult situation?

1. Other staff nurses 2. Hospice nurses 3. Unit nurse manager 4. Nurse's spouse Answer: 2 Explanation: 1. Coworkers will also have a difficult time with the death.

2. Mentorship with experienced hospice nurses as well as additional educational experiences could help promote professional nursing care.

3. The unit manager also might have a difficult time with the impending death.

4. The spouse might not fully understand why this is affecting the nurse.

Page Ref: 318 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: II.C.1. Acknowledge own potential to contribute to effective team functioning | AACN 2021 Domains and Competencies: 10.1 Demonstrate a commitment to personal health and well‐being. | NLN Competencies: Relationship-Centered Care: Practice: respond to moral and ethical challenges. | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 15.8 Evaluate strategies to support nurses who care for children who die.

21) The nurse is taking care of a child who is showing signs of imminent death. Which manifestations should the nurse expect to assess related to the cardiovascular system?

1. An increase in the volume of Korotkoff sounds 2. Cool and clammy skin, mottling 3. Peripheral pulses will remain when the heartbeat is not heard on auscultation.

4. An increase in cardiac output Answer: 2 Explanation: 1. A change in pulse pressure and a decrease in the volume of Korotkoff sounds indicate imminent death.

2. Peripheral circulation decreases, leading to diaphoresis, clammy and cool skin, and changes in skin coloring such as mottling or cyanosis.

3. The heart rate might initially increase as hypoxia develops, then the heart rate and blood pressure decrease, resulting in decreased cardiac output.

4. The heart rate and blood pressure decrease, resulting in decreased cardiac output, which is a sign of imminent death.

Page Ref: 313 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: I.B.5. Assess levels of physical and emotional comfort | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: Apply professional standards; show accountability for nursing judgment and actions; develop advocacy skills | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 15.5 Apply assessment skills to identify the physiologic changes that occur in the dying child.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 22) The nurse is doing a follow-up home visit to a family who lost their 3-month-old infant to SIDS 8 weeks ago. The mother answers the door in her nightgown, with hair uncombed. During the interview, the mother states: "I don't see the point of getting dressed each day." Which stage of grief will the nurse document based on the current data?

1. Return to life 2. Guilt 3. Anger 4. Depression Answer: 4 Explanation: 1. The mother's behavior does not indicate returning to life.

2. In this stage of grief behavior, the mother would be making statements such as, "If only…" or "what if …."

3. The mother is not expressing any anger.

4. The mother is demonstrating depression as daily activities seem pointless during this stage.

Page Ref: 316 Cognitive Level: Analyzing Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: Apply professional standards; show accountability for nursing judgment and actions; develop advocacy skills | Nursing/Integrated Concepts: Assessment/Communication and Documentation Learning Outcome: 15.6 Develop a nursing care plan to provide family-centered care for the dying child and family.

312 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 23) The nurse is providing care to a child who was admitted to the pediatric intensive care unit (PICU) after a motor vehicle crash. Which interventions should the nurse include in the plan of care to allow the parents to participate in their child's care? Select all that apply.

1. Encouraging the parents to brush the child's hair 2. Teaching the parents how to perform range of motion exercises with their child 3. Allowing the parents to read to their child 4. Explaining the child's condition to the parents 5. Providing permission for the parents to remain at the child's bedside Answer: 1, 2, 3 Explanation: 1. Encouraging the parents to brush the child's hair is an intervention that allows the parents to participate in their child's care.

2. Teaching the parents how to perform range of motion exercises with their child is an intervention that allows the parents to participate in their child's care.

3. Allowing the parents to read to their child is an intervention that allows the parents to participate in their child's care.

4. Explaining the child's condition to the parents is an intervention that provides information; however, it does not allow the parents to participate in their child's care.

5. Providing permission for the parents to remain at the child's besides allow the parents to be close to their child; however, it does not allow the parents to participate in their child's care.

Page Ref: 307, 308 Cognitive Level: Analyzing Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Relationship-Centered Care: Ethical Comportment: Appreciate the patient as a whole person, with his or her own life story and ideas about the meaning of health or illness | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 15.4 Develop a nursing care plan for the child with a life-threatening illness or injury.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 24) Which defense mechanisms should the nurse include in the parental teaching session regarding common pediatric responses to a life-threatening illness? Select all that apply.

1. Regression 2. Anticipating 3. Denial 4. Repression 5. Bargaining Answer: 1, 3, 4, 5 Explanation: 1. Regression is a common defense mechanism portrayed by the pediatric client in response to a life-threatening illness.

2. Anticipating is a coping mechanism, not a defense mechanism, that may be portrayed by the pediatric client in response to a life-threatening illness.

3. Denial is a common defense mechanism portrayed by the pediatric client in response to a lifethreatening illness.

4. Repression is a common defense mechanism portrayed by the pediatric client in response to a life-threatening illness.

5. Bargaining is a common defense mechanism portrayed by the pediatric client in response to a life-threatening illness.

Page Ref: 302 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.C.1. Value seeing healthcare situations "through patients' eyes" | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Relationship-Centered Care: Practice: Promote and accept the patient's emotions; accept and respond to distress in patient and self; facilitate hope, trust, and faith | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 15.3 Identify the coping mechanisms used by the child and family in response to stress.

314 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 25) Which respiratory findings assessed by the nurse indicate that a child is close to death?

Select all that apply.

1. Tachypnea 2. Dyspnea 3. Diaphoresis 4. Confusion 5. Accumulation of secretions in the throat Answer: 1, 2, 5 Explanation: 1. Tachypnea is a respiratory finding that may indicate the child is close to death.

2. Dyspnea is a respiratory finding that may indicate the child is close to death.

3. Diaphoresis is a cardiovascular, not respiratory, finding indicating the child is close to death.

4. Confusion is a neurologic, not respiratory, finding indicate the child is close to death.

5. As the child approaches death, the muscles relax and secretions accumulate in the oropharynx and bronchi, causing noisy breathing as air passes through the secretions.

Page Ref: 313 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: I.B.5. Assess levels of physical and emotional comfort | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: Apply professional standards; show accountability for nursing judgment and actions; develop advocacy skills | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 15.5 Apply assessment skills to identify the physiologic changes that occur in the dying child.

315 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 26) Which assessment findings may indicate to the nurse that the child is experiencing renal failure and is close to death? Select all that apply.

1. Decreased oral fluid intake 2. Decreased urine production 3. Increased urinary incontinence 4. Urinary stones noted 5. Increased diaphoresis Answer: 2, 3 Explanation: 1. Decreased oral intake is a gastrointestinal, not urinary, manifestation associated with impending death.

2. Decreased urine output is a clinical manifestation associated with renal failure that occurs with impending death.

3. Increased urinary incontinence is a clinical manifestation associated with renal failure that occurs with impending death.

4. Urinary stones are not a clinical manifestation associated with renal failure that occurs with impending death.

5. Increased diaphoresis is a cardiovascular, not renal, manifestation associated with impending death.

Page Ref: 313 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: I.B.5. Assess levels of physical and emotional comfort | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: Apply professional standards; show accountability for nursing judgment and actions; develop advocacy skills | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 15.5 Apply assessment skills to identify the physiologic changes that occur in the dying child.

316 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 27) Which support groups should the nurse include in a bereavement package for a family who suddenly lost an adolescent in a motor vehicle crash? Select all that apply.

1. Compassionate Friends 2. First Candle 3. Al Anon 4. Infant Loss Support 5. Rachel's Vineyard Answer: 1, 2 Explanation: 1. Compassionate Friends is a support group the nurse should include in a bereavement package for a family who suddenly lost a child in a motor vehicle crash.

2. First Candle is a support group the nurse should include in a bereavement package for a family who suddenly lost a child in a motor vehicle crash.

3. Al Anon is a support group appropriate for the family of an alcoholic client.

4. Infant Loss Support is an appropriate support group to provide to a family who has suffered the loss of a newborn or infant.

5. Rachel's Vineyard is a support group that assists those grieving due to loss via abortion.

Page Ref: 316 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Ethical Comportment: Examine personal beliefs, values, and biases with regard to respect for persons, human dignity, equality, and justice; explore ideas of nurse caring and compassion | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 15.7 Plan bereavement support for the parents and siblings after the death of a child.

Principles of Pediatric Nursing, 8e (Ball et al.)

Chapter 16 Social and Environmental Influences on the Child 1) Which adolescent behavior, reported by a parent, would cause the nurse to suspect possible substance abuse?

1. Becoming very involved with friends and in activities related to basketball 2. Becoming moody, crying, and weeping one minute and then cheerful and excited the next 3. Receiving numerous detentions for sleeping in class 4. Wearing baggy, oversized clothing and dyeing hair black Answer: 3 Explanation: 1. Periodically, distancing themselves from their parents and preferring involvement with their peers are normal adolescent behaviors.

2. Mood swings are normal adolescent behaviors.

3. Even though most teens do prefer staying up late, they are not usually so tired that they fall asleep during the day, especially while engaged in classroom activities. This behavior is abnormal and could indicate involvement with substance abuse or an underlying pathology.

4. Experimentation with different clothes and hair is a normal adolescent behavior.

Page Ref: 342 Cognitive Level: Analyzing 317 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.A.5. Examine common barriers to active involvement of patients in their own healthcare processes | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Personal and Professional Development: Ethical Compartment: Demonstrate respect for all persons, and for human dignity, equality, and justice | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 16.3 Examine the effects of substance use, physical activity, and other lifestyle patterns on health.

318 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 2) During a well-child examination, the parents of a 4-year-old client inform the nurse that they are thinking of buying a television for their child's bedroom and ask for advice as to whether this is appropriate. Which response by the nurse is most appropriate?

1. "It is okay for children to have a television in their room as long as you limit the amount of time they watch it to less than 2 hours per day."

2. "Research has shown that watching educational television shows improves a child's performance in school."

3. "Don't buy a television for your child's room; he is much too young for that."

4. "Research has shown that children with a television in their bedroom spend significantly less time playing outside than other children."

Answer: 4 Explanation: 1. This information is correct in that limiting television viewing to less than 2 hours per day is appropriate, but the probability of this occurring with a television in the child's room is low; the child will most likely be watching much more than 2 hours per day.

2. This statement might encourage the parents to allow the child to watch more television, and the child's developmental need for physical activity is greater than the benefit that he might obtain by watching educational programs.

3. This statement does not give parents a rationale, and it might seem opinionated to them.

4. Young children need to be physically active at this age. Research has shown that children with a television in their bedroom spend significantly less time playing outside than do other children, and physical inactivity in children has been linked to many chronic diseases, such as obesity and type 2 diabetes. Telling parents this is the best response because it gives the parents an evidencebased reason for not placing a television in the child's room.

Page Ref: 331 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Personal and Professional Development: Ethical Compartment: Demonstrate respect for all persons, and for human dignity, equality, and justice | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 16.1 Identify major social and environmental factors that influence the health and development of children and adolescents.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 3) A mother of two children, an 8-year-old and a 10-year-old, tells you that her husband has recently been deployed to the Middle East. The mother is concerned about the children's constant interest in watching TV news coverage of activities in the Middle East. Which suggestion by the nurse to the mother is most appropriate?

1. "Spend time with your children, and take cues from them about how much they want to discuss."

2. "Allow the children to watch as much television as they want. This is how they are coping with their father's absence."

3. "The less that you discuss this, the quicker the children will adjust to their father's absence.

Try to keep them busy, and use distractions to keep their mind off of it."

4. "It will just take some time to adjust to their father's absence and then everything will return to normal."

Answer: 1 Explanation: 1. Children need to be able to discuss their feelings and concerns with an adult; otherwise, their emotional distress could increase.

2. Constant viewing of the TV coverage of the war might increase the children's anxiety and fear for their father's safety.

3. Children need to be able to discuss their feelings and concerns with an adult; otherwise, their emotional distress could increase.

4. The mother should be aware that even though the children might appear to have adjusted, there could be delayed reactions or regressions in behavior.

Page Ref: 322 Cognitive Level: Analyzing Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Personal and Professional Development: Ethical Compartment: Demonstrate respect for all persons, and for human dignity, equality, and justice | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 16.1 Identify major social and environmental factors that influence the health and development of children and adolescents.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 4) A 7-year-old child is seen in the pediatric clinic 3 times in the last 2 months for complaints of abdominal pain. On each occasion, the physical examination and all ordered laboratory work have been normal. Which is the priority nursing assessment at this time?

1. The child's normal eating habits 2. Recent viral illnesses or other infectious symptoms 3. Review of the child's immunization history 4. Changes in school or home life Answer: 4 Explanation: 1. Because of the abdominal complaints, the child's eating habits would have already been discussed.

2. With normal blood work and tests, the chance of any illness over the last few months is unlikely.

3. The immunization history would have been reviewed on the previous visits.

4. With a normal examination and laboratory work, there is a high probability that this child's abdominal pain is stress related, and it is the most important to identify the possible stressors in this child's life to aid in diagnosis and treatment. Asking about changes in home or school life is most likely to get to information about recent stresses in the child's life.

Page Ref: 339 Cognitive Level: Analyzing Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Personal and Professional Development: Ethical Compartment: Demonstrate respect for all persons, and for human dignity, equality, and justice | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 16.1 Identify major social and environmental factors that influence the health and development of children and adolescents.

321 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 5) The nurse is providing care to homeless adolescents at an outreach clinic. Which concept is important for the nurse to consider when providing care to this population?

1. Teens who are homeless will get a job and somewhere to live.

2. Teens who are homeless will seek help when needed.

3. Teens who are homeless will not be fearful of authority figures.

4. Teens who are homeless are most likely to have unprotected sex.

Answer: 4 Explanation: 1. Homeless teens are less likely to obtain employment and a place to live, as often these teens do not have the skills to be able to accomplish such tasks.

2. Homeless teens are less likely to seek help when needed, frequently because of mistrust of others.

3. Homeless teens are generally fearful and distrustful of authority figures.

4. Teens who are homeless are more likely to engage in risky behaviors, such as unprotected sex with multiple partners and substance abuse. They are more likely to need emergency care, to be depressed, and to become pregnant than are other teens.

Page Ref: 323 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.A.5. Examine common barriers to active involvement of patients in their own healthcare processes | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Personal and Professional Development: Ethical Compartment: Demonstrate respect for all persons, and for human dignity, equality, and justice | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 16.3 Examine the effects of substance use, physical activity, and other lifestyle patterns on health.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 6) A parent is concerned about her 8-year-old child's recent behavior and calls the nurse for advice. According to the parent, her child is constantly crying, is not sleeping well, has withdrawn from activities, and does not want to attend school. Which should the nurse explore in more detail with the parent?

1. Bullying 2. Sexual abuse 3. Lead poisoning 4. Drug abuse Answer: 1 Explanation: 1. Physical complaints, suicidal thoughts, and other problems can result from bullying.

2. Sexual abuse should be suspected if the child is experiencing vaginal discharge or excessive sexual curiosity for age.

3. Lead poisoning can lead to physical symptoms, including neurologic deficits, but would not include the signs of emotional distress that the child is exhibiting.

4. Drug abuse is more likely to occur in an adolescent than a child of this age.

Page Ref: 336 Cognitive Level: Analyzing Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.B.10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management | AACN 2021 Domains and Competencies 2.3 Integrate assessment skills in practice. | NLN Competencies: Knowledge and Science: Knowledge: Relationships between knowledge/science and quality and safe patient care | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 16.6 Explore the nursing role in prevention and treatment of child abuse and neglect and other forms of violence.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 7) A high school student calls to ask the nurse for advice on how to care for a new navel piercing. Which response by the nurse is appropriate?

1. "Avoid contact with another person's bodily fluids until the area is well healed."

2. "Do not move or turn the jewelry for the first 3 days."

3. "Apply lotion to the area, rubbing gently, to prevent skin from becoming dry and irritated."

4. "Apply warm soaks to the area for the first 2 days to minimize swelling."

Answer: 1 Explanation: 1. Until the piercing has healed, it is a nonintact area of skin that has potential for infection, especially from contact with bodily fluids from someone else.

2. The jewelry needs to be gently rotated several times per day to aid with healing.

3. Lotion can provide a medium for bacteria, and rubbing at the site can cause irritation to the area.

4. Ice, not warm soaks, should be applied to the area for the first two days to minimize the swelling.

Page Ref: 333 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Personal and Professional Development: Ethical Compartment: Demonstrate respect for all persons, and for human dignity, equality, and justice | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 16.2 Apply the ecological model and resiliency theory to assessment of the social and environmental factors in children's lives.

324 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 8) The school nurse is planning a smoking prevention program for middle school students.

Which is most likely to be effective in preventing this population from smoking?

1. A demonstration of the pathophysiology of the effects of smoking tobacco on the body given by the school's biology teacher 2. A talk on the importance of not smoking given by a local high school basketball star 3. Colorful posters with catchy slogans displayed throughout the school 4. A pledge campaign during which students sign contracts saying that they will not use tobacco products Answer: 2 Explanation: 1. A physical demonstration may help the children recognize the long-term effects of smoking, but information from adults is not likely to influence children of this age more than the pressure of their peers will.

2. While all of the strategies are good, the most effective would be to have a local high school basketball star come to talk to the students about the importance of not smoking because students at this age are more likely to listen to and attempt to emulate someone of their own peer group.

3. Information from posters is not likely to influence children of this age more than the pressure of their peers will.

4. Information from signed contracts is not likely to influence children of this age more than the pressure of their peers will.

Page Ref: 335 Cognitive Level: Analyzing Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.A.5. Examine common barriers to active involvement of patients in their own healthcare processes | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Personal and Professional Development: Ethical Compartment: Demonstrate respect for all persons, and for human dignity, equality, and justice | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 16.3 Examine the effects of substance use, physical activity, and other lifestyle patterns on health.

325 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 9) Which is the priority nursing action when working with a parent who is suspected of Munchausen syndrome by proxy?

1. Try to keep the parent separated from the child as much as possible.

2. Explain to the child that the parent is causing the illness and that the healthcare team will prevent the child from being harmed.

3. Carefully document parent—child interactions.

4. Confront the parent with concerns of possible abuse.

Answer: 3 Explanation: 1. Separating the parent from the child might alienate the parent and cause her to leave with the child.

2. Talking to the child about the healthcare team's suspicions could be confusing and frightening for the child.

3. Munchausen syndrome by proxy is very difficult to prove, and evidence provided by the careful documentation of the nursing staff can be very influential. Care must be taken not to make the parent suspicious and to keep the child in the hospital until enough evidence is collected.

4. Confronting the parent might alienate the parent and cause her to leave with the child.

Page Ref: 345 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.B.10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Knowledge and Science: Knowledge: Relationships between knowledge/science and quality and safe patient care | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 16.6 Explore the nursing role in prevention and treatment of child abuse and neglect and other forms of violence.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 10) An infant presents to the emergency department (ED) with physical injuries. The nurse is taking the child's history. Which parental statement would cause the nurse to be suspicious of abuse?

1. "I was walking up the steps and slipped on the ice and fell while carrying my baby."

2. "The baby's 18-month-old brother was trying to pull the baby out of the crib and dropped the baby on the floor."

3. "I placed the baby in the infant swing. His 6-year-old brother was running through the house and tripped over the swing, causing it to fall."

4. "I did not realize that my baby was able to roll over yet, and I was just gone a minute to check on dinner when the baby rolled off of the couch and onto our tile floor."

Answer: 2 Explanation: 1. This statement is plausible from a developmental perspective; therefore, the nurse would not be suspicious of abuse.

2. Developmentally, it would be very difficult for an 18-month-old child to pull an infant out of a crib.

3. This statement is plausible from a developmental prospective; therefore, the nurse would not be suspicious of abuse.

4. This statement is plausible from a developmental prospective; therefore, the nurse would not be suspicious of abuse.

Page Ref: 343 Cognitive Level: Analyzing Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.B.10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Knowledge and Science: Knowledge: Relationships between knowledge/science and quality and safe patient care | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 16.6 Explore the nursing role in prevention and treatment of child abuse and neglect and other forms of violence.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 11) While taking the history of a 10-year-old child, the parents admit to owning firearms. Which information should the nurse suggest to enhance the child's safety based on this information?

1. Keeping all the guns put away and out of the child's reach 2. Taking the child to a shooting range for lessons on how to use a gun properly 3. Storing the guns and ammunition in the same place 4. Using a gun lock on all firearms in the house Answer: 4 Explanation: 1. A 10-year-old child is able to reach any area of the house; more precautions need to be taken.

2. Teaching gun safety is appropriate to a family that has guns; however, it is not sufficient to protect the child. The guns must be secured at all times the adults are not supervising the guns.

3. It is recommended that guns and ammunitions be stored separately.

4. Statistics show that about 75% of unintentional deaths and suicides are committed with firearms found in the home. The safety measures of using a gun lock, keeping the gun and ammunition separate, and putting the guns in a locked cabinet will at least make the guns less accessible.

Page Ref: 335 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: I.B.10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Knowledge and Science: Knowledge: Relationships between knowledge/science and quality and safe patient care | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 16.6 Explore the nursing role in prevention and treatment of child abuse and neglect and other forms of violence.

328 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 12) The nurse is providing care to a 3-year-old client whose mother states, "I am not sure that I have enough money to buy both food for the rest of the month and the antibiotic for my child's ear infection." Which nursing intervention would be beneficial for the child and this family?

1. Talking with the mother about keeping the child's ear clean by using a Q-tip 2. Putting the mother in contact with a local agency that provides food on a regular basis to needy families and helps them access other resources in the community 3. Providing the mother with samples of food and food stamps for the child 4. Giving the mother free samples of an antibiotic Answer: 2 Explanation: 1. Cleaning the ear with a Q-tip will not clear the ear infection.

2. Putting the mother in contact with a local agency is most likely to meet the family's basic need for food and possibly connect the mother to a resource that could supply her with the antibiotic for her child.

3. The nurse will have neither food samples nor food stamps at her disposal.

4. The course of treatment is usually 10 days. Free samples may not be for the appropriate antibiotic or be sufficient to treat the infection. A better intervention will be to provide help that will extend beyond the immediate period.

Page Ref: 324 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: I.B.10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Personal and Professional Development: Ethical Compartment: Demonstrate respect for all persons, and for human dignity, equality, and justice | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 16.7 Plan nursing interventions for children related to social and environmental situations.

329 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 13) The mother of an infant reports picking up the baby from day care and notices marks on the baby's body. Which action should the nurse take when the mother asks what should be done?

1. Report the facility to child protective services.

2. Ask the mother to talk with the director of the day care facility.

3. Ask the mother if anyone else could have caused the marks.

4. Suggest the baby be taken for a full examination.

Answer: 1 Explanation: 1. Any professional who works with children and reasonably suspects that a child has been abused is required to report suspicions of abuse or neglect to the local agency for child protective services. Reports made in good faith are not liable to countersuits.

2. Professionals who suspect abuse and do not report it may be held responsible by the judicial system. In some states, all citizens are mandated to report suspected abuse.

3. The mother is reporting the marks. It is unlikely someone else in the home caused the marks.

4. There is no evidence that the child has been harmed. A full examination may be suggested after the baby's marks are reported.

Page Ref: 343 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: patient/family/community preferences, values; coordination and integration of care; information, communication, and education; physical comfort and emotional support; involvement of family and friends; transition and continuity | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Personal and Professional Development: Ethical Compartment: Demonstrate respect for all persons, and for human dignity, equality, and justice | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 16.2 Apply the ecological model and resiliency theory to assessment of the social and environmental factors in children's lives.

330 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 14) The pediatric public health nurse visits a facility for the homeless. Which types of medical issues will the nurse assess these children for based on the current data? Select all that apply.

1. Dental caries 2. Infections secondary to tattoos 3. Lack of immunizations 4. Nutritional deficits 5. Munchausen syndrome by proxy Answer: 1, 3, 4 Explanation: 1. Children who are homeless do not have the facilities or the supplies to care for their teeth, and do not see a dentist on a regular basis.

2. This is not a specific problem related to homelessness, and many states prohibit tattooing of children.

3. Homelessness often leads to lack of medical care, and some of the children may not be current on their immunizations.

4. The family that is homeless often has difficulty with maintaining adequate nutrition.

5. This is not a common problem for the homeless child.

Page Ref: 324 Cognitive Level: Analyzing Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: I.B.10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Personal and Professional Development: Ethical Compartment: Demonstrate respect for all persons, and for human dignity, equality, and justice | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 16.7 Plan nursing interventions for children related to social and environmental situations.

331 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 15) A child is brought to the emergency department in a coma. The mother thinks the child may have ingested a poison. Which will the nurse assess based on this information? Select all that apply.

1. For oral burns 2. The child's breath 3. The child's vomitus 4. Hair samples 5. Blood and urine toxicology screens Answer: 1, 2, 3, 5 Explanation: 1. Corrosives often leave evidence of burns on the mouth and gums.

2. The breath may have characteristic odors that may help identify the poison.

3. The vomitus may contain leaves, indicating the child has eaten a plant or other items that may provide information on the toxin.

4. Hair samples can be used to test drug use over a period of time. It would not contain any valuable information for this child.

5. These tests will look for a wide variety of toxins.

Page Ref: 347 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: V.C.4. Value vigilance and monitoring (even of own performance of care activities) by patients, families, and other members of the healthcare team | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Knowledge and Science: Knowledge: Relationships between knowledge/science and quality and safe patient care | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 16.5 Evaluate the environment for hazards to children, such as exposure to harmful substances and potential for poisoning.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 16) A child is admitted to the hospital with a diagnosis of lead poisoning. Which should be included in the home assessment to determine the probable source of the lead poisoning?

1. The home's foundation for a possible radon leak 2. The home's water pipes 3. The dirt surrounding the house 4. The presence of imported toys or antique baby furniture 5. Gas stored in cans in the garage.

Answer: 2, 3, 4 Explanation: 1. Radon is not a source of lead.

2. Older water pipes were made from lead, which leaches out into the water.

3. Children who eat dirt may acquire lead poisoning due to contamination with fumes from lead gas.

4. Toys imported from other countries and old furniture may have lead paint. The child can be exposed if the child puts these objects in the mouth.

5. Most gas is now not lead based. If the child were to drink the gas from the cans, the problem would be the hydrocarbons, not the lead.

Page Ref: 350 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: I.B.10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Personal and Professional Development: Ethical Compartment: Demonstrate respect for all persons, and for human dignity, equality, and justice | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 16.7 Plan nursing interventions for children related to social and environmental situations.

333 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 17) A child is admitted to the hospital unit for physical injuries. The mother's boyfriend is suspected of child abuse. Which is the primary role of the nurse in addition to reporting the information to the proper authorities?

1. Gathering information about how the injuries occurred.

2. Collecting evidence against the suspected abuser.

3. Encouraging the child to talk about his experience.

4. Protecting the child from further injury.

Answer: 4 Explanation: 1. This is not a priority role for the nurse.

2. This would be a police function, not the nurse's responsibility.

3. The nurse and the psychologist will be meeting with the child to help the child work through the experience, but this is not the priority action for the nurse.

4. The nurse will monitor the child while in the presence of visitors. In addition, the nurse will talk with the social worker to assist in providing for the child's safety in the future. This is a priority.

Page Ref: 344 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: I.B.10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Knowledge and Science: Knowledge: Relationships between knowledge/science and quality and safe patient care | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 16.6 Explore the nursing role in prevention and treatment of child abuse and neglect and other forms of violence.

334 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 18) The school nurse recognizes that many adolescents who are currently pregnant are hiding their pregnancies from adults, both at school and at home. Which should the nurse educate the adolescents about based on the current data?

1. Safe haven laws 2. Birth control available to all teenagers 3. Domestic abuse protection 4. The father's financial responsibility for the infant Answer: 1 Explanation: 1. Safe haven laws provide for unwanted babies to be left in certain locations without legal repercussions to the mother.

2. A pregnant teenager does not need to know about birth control at this time.

3. This is not the primary information that needs to be given to pregnant teenagers.

4. Most teenagers are aware that the fathers are financially responsible. This is not information that is needed now.

Page Ref: 340 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: I.B.10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Personal and Professional Development: Ethical Compartment: Demonstrate respect for all persons, and for human dignity, equality, and justice | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 16.7 Plan nursing interventions for children related to social and environmental situations.

335 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 19) A child is admitted to the emergency department (ED) for scald burns to the buttocks and thighs. According to the mother, she was preparing the child's bath and before she could test the water, the child fell in and was scalded. Which would cause the nurse to suspect abuse?

1. The burns are uneven, with some burns deeper than others.

2. The child's hands and feet are free of burns.

3. In addition to the main burn site, there are splash burns surrounding the area.

4. The mother was home alone with the child.

Answer: 2 Explanation: 1. This might occur in an accidental scald burn.

2. Someone who falls in hot water would immediately try to get out by using the hands and feet.

3. This would be a logical finding.

4. It is not unusual for a mother to be home alone with a child.

Page Ref: 341 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: I.B.10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Knowledge and Science: Knowledge: Relationships between knowledge/science and quality and safe patient care | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 16.6 Explore the nursing role in prevention and treatment of child abuse and neglect and other forms of violence.

20) Which characteristics of abusers should the nurse include in the teaching session for elementary school teachers regarding child abuse? Select all that apply.

1. Physical illness 2. Alcoholism 3. Many friends and families nearby 4. Unrealistic expectations for their child 5. The abuser has no relationship to the child.

Answer: 2, 4 Explanation: 1. This is not a common finding in abusers.

2. Drug addiction and alcoholism are common findings in the abuser.

3. The child abuser is often socially isolated.

4. Abusive parents often feel the child is misbehaving for activities, such as soiling their diapers.

5. Most abusers are parents or people who have contact with the child on a regular basis.

Page Ref: 341 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.B.10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Knowledge and Science: Knowledge: Relationships between knowledge/science and quality and safe patient care | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 16.6 Explore the nursing role in prevention and treatment of child abuse and neglect and other forms of violence.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 21) A recently divorced mother who must return to work is concerned about the effects of placing her child in day care full time. In counseling the mother, the nurse knows that which factor is the most influential in determining whether day care has a positive or negative effect on the child?

1. The amount of time that the children spend playing outside 2. The closeness of the parent-child relationship 3. The ratio of day care workers to children 4. The cleanliness of the day care facility Answer: 2 Explanation: 1. While the amount of time children are able to spend playing outdoors can contribute to whether child care is a positive or negative experience, the closeness of the parent—child relationship is more likely to impact how resilient the child is, and this has a greater impact on the effects of the child care experience.

2. The closeness of the parent-child relationship is more likely to impact how resilient the child is, and this has a greater impact on the effects of the child care experience.

3. While the ratio of day care workers to children can contribute to whether child care is a positive or negative experience, the closeness of the parent-child relationship is more likely to impact how resilient the child is, and this has a greater impact on the effects of the child care experience.

4. While the cleanliness of the facility can contribute to whether child care is a positive or negative experience, the closeness of the parent-child relationship is more likely to impact how resilient the child is, and this has a greater impact on the effects of the child care experience.

Page Ref: 322 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.A.5. Examine common barriers to active involvement of patients in their own healthcare processes | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Personal and Professional Development: Ethical Compartment: Demonstrate respect for all persons, and for human dignity, equality, and justice | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 16.3 Examine the effects of substance use, physical activity, and other lifestyle patterns on health.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 22) Which clinical manifestations should the nurse anticipate when providing care to a pediatric client who huffing glue? Select all that apply.

1. Impaired coordination 2. Elevated liver enzymes 3. Delirium 4. Dementia 5. Giddiness Answer: 1, 2, 3 Explanation: 1. Impaired coordination is a clinical manifestation that the nurse anticipates for a client who abuses volatile inhalants, such as glue.

2. Elevated liver enzymes are a clinical manifestation that the nurse anticipates for a client who abuses volatile inhalants, such as glue.

3. Delirium is a clinical manifestation that the nurse anticipates for a client who abuses volatile inhalants, such as glue.

4. Dementia is not a clinical manifestation that the nurse anticipates for a client who abuses volatile inhalants, such as glue.

5. Giddiness is not a clinical manifestation that the nurse anticipates for a client who abuses volatile inhalants, such as glue.

Page Ref: 330 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: I.A.5. Examine common barriers to active involvement of patients in their own healthcare processes | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Personal and Professional Development: Ethical Compartment: Demonstrate respect for all persons, and for human dignity, equality, and justice | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 16.3 Examine the effects of substance use, physical activity, and other lifestyle patterns on health.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 23) Which nursing interventions should the nurse implement for a school-age child who is the victim of physical abuse by a parent? Select all that apply.

1. Referring members of the family for appropriate counseling 2. Protecting the child from further injury 3. Allowing the child to wear clothing during the examination process 4. Discouraging parental participation in the plan of care 5. Documenting the child's response to parental interaction Answer: 1, 2, 3, 5 Explanation: 1. It is appropriate for the nurse to refer members of the family for appropriate counseling.

2. It is appropriate for the nurse to protect the child from further injury.

3. It is appropriate for the nurse to allow the child to wear clothing during the examination process.

4. The nurse should encourage the parents to participate in the child's plan of care; however, the nurse should closely monitor interactions between the child and parent.

5. It is appropriate for the nurse to document the child's response to parental interaction.

Page Ref: 343, 344 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.B.10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Personal and Professional Development: Ethical Compartment: Demonstrate respect for all persons, and for human dignity, equality, and justice | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 16.4 Plan nursing interventions for children who experience violence.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 24) The nurse is providing care to a child who is admitted to the hospital due to environmental exposure to a toxic agent. Which questions should the nurse ask the child and the parent during the assessment process?

1. "Do you work around harmful substances that could have been brought to the home environment?"

2. "What year was your home built?"

3. "Does your child have a hobby that includes working with glue?"

4. "Does your home have a smoke detector?"

5. "Does your home have a carbon monoxide detector?"

Answer: 1, 2, 3, 5 Explanation: 1. It is appropriate for the nurse to ask the parents if any harmful substances could be brought home from the job.

2. Many homes built before the 1970s were painted with lead paint. This is an appropriate question for the nurse to ask during the assessment process.

3. It is appropriate for the nurse to assess the use of glue to determine environmental exposure to a toxic agent.

4. Asking the family about a smoke detector is important to determine if there are safety features in the house. This question will not assess the child's risk for environmental exposure to a toxic agent.

5. Carbon monoxide could lead to environmental exposure to the child leading to toxicity. This question is appropriate for the nurse to include in the assessment process.

Page Ref: 346 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment Standards: QSEN Competencies: V.C.4. Value vigilance and monitoring (even of own performance of care activities) by patients, families, and other members of the healthcare team | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Knowledge and Science: Knowledge: Relationships between knowledge/science and quality and safe patient care | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 16.5 Evaluate the environment for hazards to children, such as exposure to harmful substances and potential for poisoning.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 25) The nurse is providing care to a pediatric client who is homeless. Which nursing actions will decrease the risk for the child developing an infectious disease? Select all that apply.

1. Teaching hygienic methods 2. Arranging for medications, as needed 3. Evaluating the family for food security 4. Performing a nutritional assessment 5. Teaching oral hygiene Answer: 1, 2 Explanation: 1. Teaching hygienic measures is an appropriate nursing action to decrease the child's risk for developing an infectious disease.

2. Arranging for medications, as needed, is an appropriate nursing action to decrease the child's risk for developing an infectious disease.

3. Evaluating the family for food security is an appropriate nursing action to assess nutritional deficits.

4. Performing a nutritional assessment is an appropriate nursing action to assess nutritional deficits.

5. Teaching oral hygiene is an appropriate nursing action to address dental care problems.

Page Ref: 324 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Personal and Professional Development: Ethical Compartment: Demonstrate respect for all persons, and for human dignity, equality, and justice | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 16.7 Plan nursing interventions for children related to social and environmental situations.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 26) The nurse is assessing a child and suspects the child's mother is abusing an opiate. Which clinical manifestations exhibited by the child's mother lead the nurse to this conclusion?

1. Constricted pupils 2. Mood swings 3. Impaired memory 4. Tremors 5. Psychosis Answer: 1, 2, 3 Explanation: 1. Constricted pupils are a clinical manifestation associated with opiate abuse.

2. Mood swings are a clinical manifestation associated with opiate abuse.

3. Impaired memory is a clinical manifestation associated with opiate abuse.

4. Tremors are a clinical manifestation associated with alcohol, not opiate, abuse.

5. Psychosis is a clinical manifestation associated with hallucinogen, not opiate, abuse.

Page Ref: 330 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: V.C.4. Value vigilance and monitoring (even of own performance of care activities) by patients, families, and other members of the healthcare team | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Knowledge and Science: Knowledge: Relationships between knowledge/science and quality and safe patient care | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 16.5 Evaluate the environment for hazards to children, such as exposure to harmful substances and potential for poisoning.

Principles of Pediatric Nursing, 8e (Ball et al.)

Chapter 17 Immunizations and Communicable Diseases 1) The nurse is providing information to a group of new mothers. Which rationale, indicating increased susceptibility for infant infection, should the nurse include in the teaching session?

1. Low levels of antibodies 2. High levels of maternal antibodies to diseases to which the mother has been exposed 3. Passive transplacental immunity from maternal immunoglobulin G 4. Exposure to microorganisms during the birth process Answer: 1 Explanation: 1. The infant's immune system is not fully developed at birth, and the infant has low levels of antibodies due to lack of exposure to antigens.

2. Newborns and young infants do have high levels of maternal antibodies, but this answer is incorrect because it does not explain the susceptibility of newborns and young infants to infection.

3. Newborns and young infants do have passive transplacental immunity, but this answer is incorrect because it does not explain the susceptibility of newborns and young infants to infection.

4. Newborns and young infants do have exposure to microorganisms during the birth process, but this answer is incorrect because it does not explain the susceptibility of newborns and young infants to infection.

Page Ref: 356 Cognitive Level: Analyzing 342 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: V.C.5. Value relationship between national safety campaigns and implementation in local practices and practice settings | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 17.1 Compare the vulnerability of young children and adults to communicable diseases.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 2) The nurse is providing education to a group of new mothers regarding immunity and infection.

Which information regarding the development of immunity should the nurse include in the teaching session?

1. Acquired through immunization or exposure to the natural disease 2. Acquired through exposure to diseases from family members 3. Acquired through diseases from other children 4. Newborns being born with diseases already in their systems Answer: 1 Explanation: 1. As children grow, they develop immunity through immunization or exposure to the natural disease. As children mature and become more active, they interact more frequently with other children and adults and increase their exposure to infectious agents.

2. Children cannot acquire diseases from family members who have had the disease 3. Acquiring disease from other children would not give children immunity.

4. Newborns are not born with diseases in their systems.

Page Ref: 356 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: V.C.5. Value relationship between national safety campaigns and implementation in local practices and practice settings | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 17.1 Compare the vulnerability of young children and adults to communicable diseases.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 3) The nurse is teaching the mother of a newborn how the immune system functions. Which statement regarding the process that occurs when healthy children are exposed to infection indicates accurate understanding of the information presented?

1. "Children who are exposed to infection naturally develop antibodies."

2. "Children who are exposed to infection are found to be healthier."

3. "Children who are exposed to infection will acquire terminal illnesses."

4. "Children who are exposed to infection will have weakened immune systems."

Answer: 1 Explanation: 1. As healthy children are exposed to more infections, they naturally develop antibodies.

2. Being exposed to infections will not lead to healthy children.

3. Exposure to infections will not lead children to acquire terminal illnesses.

4. Exposure to infectious disease will not weaken children's immune systems.

Page Ref: 356 Cognitive Level: Analyzing Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: V.C.5. Value relationship between national safety campaigns and implementation in local practices and practice settings | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 17.1 Compare the vulnerability of young children and adults to communicable diseases.

4) Which common mode of infectious disease should the nurse include in a teaching session with parents within the community?

1. Playing with the same toy 2. Coughing without covering the mouth 3. Sitting together eating meals 4. Playing board games Answer: 2 Explanation: 1. Microorganisms might be left on toys that children share, but this is not the most common mode of transmission of infectious diseases.

2. The fecal-oral and respiratory routes are the most common sources of transmission in children.

3. Eating together will not transmit infectious disease.

4. Playing with board games will not transmit infectious disease.

Page Ref: 357 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: V.C.5. Value relationship between national safety campaigns and implementation in local practices and practice settings | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 17.2 Propose strategies to control the spread of infection in healthcare and community settings.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 5) The nurse is teaching a preschool-age child and parents the importance of hand washing after using the toilet. Which rationale for this practice should the nurse include in the teaching session?

1. Children's immune systems are not fully developed.

2. It is the main way to limit the transmission of disease.

3. Not all bathrooms are clean.

4. Children do not like to have dirty hands.

Answer: 2 Explanation: 1. Underdeveloped immune systems will not transmit disease.

2. The fecal-oral and respiratory routes are the most common sources of transmission in children.

3. Children usually do not wash their hands after toileting unless they are closely supervised.

4. This is not a reason for washing hands after using the toilet.

Page Ref: 357 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: V.C.5. Value relationship between national safety campaigns and implementation in local practices and practice settings | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 17.2 Propose strategies to control the spread of infection in healthcare and community settings.

6) The nurse is teaching parents how to prevent the spread of infectious disease. Which health promotion strategy the nurse should recommend for all age groups of children?

1. Decreasing environmental exposure to pathogens 2. Performing hand hygiene 3. Ensuring all toys are clean and free from germs 4. Keeping child away from sick adults Answer: 2 Explanation: 1. It is not possible to keep children free from colds.

2. Proper hand hygiene is one of the most important health promotion strategies for all age groups of children as well as child care providers.

3. Keeping all toys clean and free from germs is not possible.

4. It is not always possible to keep children away from sick adults.

Page Ref: 357 Cognitive Level: Analyzing Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: V.C.5. Value relationship between national safety campaigns and implementation in local practices and practice settings | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 17.2 Propose strategies to control the spread of infection in healthcare and community settings.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 7) A child who has not had a tetanus immunization steps on a rusty nail. Which term should the nurse use to identify the tetanus immunization when teaching the parents about the vaccine?

1. Toxoid 2. Live virus 3. Killed virus 4. Recombinant Answer: 1 Explanation: 1. Toxoids are chemicals normally associated with a disease that stimulate the production of immunity. A tetanus immunization is an example of a toxoid vaccine.

2. A live virus vaccine contains a microorganism that is live but attenuated, or in a weakened form. A varicella immunization is an example of a live virus vaccine.

3. A killed virus vaccine contains a microorganism that has been killed but is still capable of causing the human body to produce antibodies. This term is used to describe an inactivated poliovirus vaccine.

4. A recombinant vaccine used a genetically altered organism. A hepatitis B immunization is an example of this type vaccine.

Page Ref: 357 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: V.C.5. Value relationship between national safety campaigns and implementation in local practices and practice settings | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 17.4 Develop a nursing care plan for children in each age group needing immunizations.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 8) The nurse prepares a DTaP (diphtheria, tetanus toxoid, and acellular pertussis) immunization for a 6-month-old infant. Which nursing action is accurate to safely administer this vaccine to the infant?

1. Administering the vaccine by ID (intradermal) injection 2. Administering the vaccine by SQ (subcutaneous) injection 3. Administering the vaccine by IM (intramuscular) injection 4. Administering the vaccine via a nasal spray Answer: 3 Explanation: 1. DTaP is not administered by an ID injection.

2. DTaP is not administered by a SQ injection.

3. DTaP is administered by an IM injection.

4. DTaP is not administered via a nasal spray.

Page Ref: 413 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: V.C.5. Value relationship between national safety campaigns and implementation in local practices and practice settings | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 17.4 Develop a nursing care plan for children in each age group needing immunizations.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 9) A mother refuses to have her child immunized with the measles, mumps, and rubella (MMR) vaccine because she believes that letting her infant get these diseases will help him fight off other diseases later in life. Which is an appropriate response by the nurse?

1. Telling the mother that by not immunizing the child, she may be exposing pregnant women to the virus, which could cause fetal harm 2. Honoring the mother's request because she is the parent 3. Telling the mother that she is wrong and should have her child immunized 4. Explaining the potential complications of measles, mumps, and rubella infections Answer: 4 Explanation: 1. This mother is not concerned about other women; she is concerned about what is the best for her child.

2. Nurses are responsible for helping parents make informed decisions. It is important that the mother has all the facts before she makes a decision.

3. The mother has the right to make the decisions for her child. The nurse's role is not to tell the parents what to do but to give them the information they need to make decisions.

4. Explaining that if her child contracts measles, mumps, or rubella, the child could have very serious and permanent complications from these diseases is correct; measles, mumps, and rubella all have potentially serious sequelae, such as encephalitis, brain damage, and deafness.

Page Ref: 374, 376, 379 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: V.C.5. Value relationship between national safety campaigns and implementation in local practices and practice settings | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 17.4 Develop a nursing care plan for children in each age group needing immunizations.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 10) The pediatric clinic has set a goal that 95% or more of the children attending the clinic will be fully immunized. Which should the clinic nurses teach the families to meet this goal?

1. The benefits of immunizations outweigh the risks of communicable diseases.

2. Immunizations should be completed by the time the child starts school.

3. Once a child receives a vaccination, that individual has lifelong immunity against that disease.

4. Vaccinations are 100% safe.

Answer: 1 Explanation: 1. The risks and benefits of vaccines far outweigh the risks from communicable diseases and resulting complications.

2. The immunization schedule is not completed by the time the child starts school.

Immunizations continue throughout the life of the individual.

3. It is important that the families realize that to be fully protected, many vaccinations will need to be repeated at specified times.

4. Vaccinations can cause illness or injury. No medication is 100% safe.

Page Ref: 367 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: V.C.5. Value relationship between national safety campaigns and implementation in local practices and practice settings | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Implementation/Teaching/Learning Learning Outcome: 17.4 Develop a nursing care plan for children in each age group needing immunizations.

11) A mother brings in her 4-month-old infant for a routine checkup and vaccinations. The mother reports that her child was exposed to the flu. Which nursing action is accurate based on the current data?

1. Withhold the DTaP vaccination but give the others as scheduled.

2. Give the infant the flu vaccination but withhold the others.

3. Give the vaccinations as scheduled.

4. Withhold the vaccinations.

Answer: 3 Explanation: 1. There is no reason to withhold any of the vaccinations due at this time.

2. The flu vaccination would not routinely be given to a 4-month-old infant.

3. Giving the vaccine as scheduled will keep the infant properly immunized.

4. Recent exposure to an infectious disease is not a reason to defer a vaccine.

Page Ref: 358 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: V.C.5. Value relationship between national safety campaigns and implementation in local practices and practice settings | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 17.4 Develop a nursing care plan for children in each age group needing immunizations.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 12) Which should the nurse use when reconstituting vaccines?

1. The diluents provided 2. Normal saline 3. Any solution available 4. Sterile water Answer: 1 Explanation: 1. When reconstituting vaccines, it is important to use the solution provided, and follow the manufacturer's directions.

2. Not all medications are compatible with normal saline.

3. Only use what is suggested by the manufacturer.

4. Unless otherwise suggested, use what is suggested by the manufacturer.

Page Ref: 369 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: V.C.5. Value relationship between national safety campaigns and implementation in local practices and practice settings | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 17.5 Design a plan to maintain the potency of vaccines.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 13) A parent reports that her 5-year-old child, who has had all recommended immunizations, had a mild fever 1 week ago and now has bright red cheeks and a lacy red maculopapular rash on the trunk and arms. Which diagnosis does the nurse anticipate based on the current data?

1. Rubeola (measles) 2. German measles (rubella) 3. Chickenpox (varicella) 4. Fifth disease (erythema infectiosum) Answer: 4 Explanation: 1. Children with rubeola have a high temperature and a blotchy maculopapular rash. Because there is a vaccination for rubeola, it is unlikely the child has it.

2. The rash of rubella is a pink, maculopapular rash that begins on the face and progresses downward to the trunk and extremities. The child is fully vaccinated, making this unlikely.

3. Varicella (chickenpox) and rubella (German measles) are unlikely if the child has had all recommended immunizations.

4. Fifth disease manifests first with a flu-like illness, followed by a red "slapped-cheek" sign.

Then, a lacy maculopapular erythematous rash spreads symmetrically from the trunk to the extremities, sparing the soles and palms.

Page Ref: 373 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: V.C.5. Value relationship between national safety campaigns and implementation in local practices and practice settings | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 17.7 Describe the medical and nursing management of common communicable diseases.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 14) The nurse is providing care to a child who is diagnosed with Lyme disease. The mother wants to know how to protect her other children from contracting this disease from the infected child. Which should the nurse include in the teaching session regarding the transmission of this disease process?

1. Lyme disease is passed from person to person.

2. Lyme disease is passed from animals to person.

3. Lyme disease is passed from adults to children.

4. Lyme disease is passed from person to insects.

Answer: 2 Explanation: 1. Some infectious diseases are transmitted by insects or animals and are not communicable from person to person. Lyme disease is not communicable from person to person.

2. Zoonosis describes infectious diseases that are transmitted by animals and are not communicable from person to person. Lyme disease is an example of this type of infectious disease.

3. Some infectious diseases are transmitted by insects or animals and are not communicable from person to person. Lyme disease is not communicable from adults to children.

4. Some infectious diseases are transmitted by insects or animals and are not communicable from person to person. Lyme disease is not passed from people to insects.

Page Ref: 381 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: V.C.5. Value relationship between national safety campaigns and implementation in local practices and practice settings | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 17.6 Differentiate between common communicable diseases and vectorborne diseases.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 15) A 2-year-old child with a fever is prescribed amoxicillin clavulanate 250 mg/5 mL 3 times daily by mouth for 10 days for otitis media. Which is the priority teaching instruction for the parents of this child?

1. Giving the antibiotic for the full 10 days 2. Measuring the prescribed dose in a household teaspoon 3. Spreading the dose evenly during daylight hours 4. Stopping the antibiotic when the child is afebrile Answer: 1 Explanation: 1. Antibiotics must be administered for the full number of days ordered to prevent mutation of resistant strains of bacteria.

2. A household teaspoon could contain less than 5 mL, and the full dose must be given.

3. The antibiotic should be administered around the clock to maintain a blood level.

4. Stopping the antibiotic before the prescribed time will permit remaining bacteria to reproduce, and the otitis media will return, possibly with antibiotic-resistant organisms.

Page Ref: 380 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: V.C.5. Value relationship between national safety campaigns and implementation in local practices and practice settings | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning Learning Outcome: 17.7 Describe the medical and nursing management of common communicable diseases.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 16) Which is the priority nursing action when it is suspected that an infectious agent has been used as a weapon by terrorists?

1. Separating clients according to age 2. Initiating airborne and contacts precautions 3. Separating clients according to level of development 4. Disposing of blood-contaminated needles in the lead-lined container Answer: 2 Explanation: 1. Separating clients according to age will do nothing to stop terrorism.

2. When clients present with the same type of infectious symptoms, the priority nursing action is to initiate airborne and contact precautions prior to diagnosis.

3. Separating clients according to level of development will do nothing to stop terrorism.

4. Proper disposal of blood-contaminated needles in the sharps container is appropriate nursing actions but does not relate to terrorism.

Page Ref: 387 Cognitive Level: Analyzing Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: V.C.5. Value relationship between national safety campaigns and implementation in local practices and practice settings | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 17.7 Describe the medical and nursing management of common communicable diseases.

17) Which parental action indicates accurate understanding of information presented by the nurse to treat a fever related to otitis media?

1. Putting the child in a tub of cold water to reduce the fever 2. Alternating acetaminophen with ibuprofen every 2 hours 3. Offering generous amounts of fluids frequently 4. Using aspirin every 4 hours to reduce the fever Answer: 3 Explanation: 1. Putting the child in a tub of cold water will chill the child and cause shivering, a response that will increase body temperature.

2. Alternating acetaminophen with ibuprofen every 2 hours could result in an overdose.

3. The body's need for fluids increases during a febrile illness.

4. Aspirin has been associated with Reye syndrome and should not be given to children with a febrile illness unless prescribed by the healthcare provider.

Page Ref: 384 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: V.C.5. Value relationship between national safety campaigns and implementation in local practices and practice settings | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 17.8 Create a parent teaching plan that includes important considerations in administering antipyretics to infants and children with a fever.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 18) Which nursing action is most appropriate to decrease the risk of transmitting viral infections by clients and family members at a local clinic?

1. Sanitizing toys, telephones, and doorknobs to kill pathogens 2. Teaching parents safe food preparation and storage 3. Withholding immunizations for children with compromised immune systems 4. Allowing all children to congregate in the same waiting room Answer: 1 Explanation: 1. Sanitizing toys and all contact surfaces, separating children with infections, and teaching children to wash their hands all control the growth and spread of microorganisms.

2. Teaching parents safe food preparation and storage is another tool to prevent the spread of microorganisms, but it is not related to the flu virus.

3. Immunizations should not be withheld from immunocompromised children, and this is not an infection-control strategy.

4. Children should be separated in different waiting rooms when seeking care at a pediatric clinic.

Page Ref: 357 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: V.C.5. Value relationship between national safety campaigns and implementation in local practices and practice settings | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 17.7 Describe the medical and nursing management of common communicable diseases.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 19) The mother of an immunocompromised child expresses concern that her child will "catch" a disease from the scheduled vaccination. Which vaccines should be administered to this child as they carry no risk for acquiring the infection?

1. Toxoid 2. Killed virus vaccine 3. Live virus vaccine 4. Attenuated vaccine 5. Immunoglobulins Answer: 1, 2, 5 Explanation: 1. A toxoid is not an organism but a chemical produced by the organism. The toxoid has been treated to weaken its toxic effect.

2. The immunization contains organisms that are dead and incapable of reproducing.

3. This immunization contains live but weakened organisms. These organisms can mutate and reproduce and may cause disease in a weakened immune system.

4. An attenuated vaccine is the same as a live virus vaccine.

5. Immunoglobulins are the antibodies produced by others against a disease. They do not contain the live or killed virus.

Page Ref: 357-358 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: V.C.5. Value relationship between national safety campaigns and implementation in local practices and practice settings | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 17.4 Develop a nursing care plan for children in each age group needing immunizations.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 20) Which nursing actions allow a child to acquire active immunity against a disease?

1. Administering a dose of immunoglobulins 2. Administering a killed virus vaccine 3. Administering a toxoid vaccine 4. Administering antibiotic therapy 5. Administering antiviral therapy Answer: 2, 3 Explanation: 1. Immunoglobulins provide passive immunity. No active immunity is acquired.

2. A killed virus vaccine will stimulate antibody production in the child, which is active immunity.

3. A toxoid vaccine will also stimulate antibody production in the child.

4. Antibiotic therapy provides no immunity.

5. Antiviral therapy provides no immunity.

Page Ref: 357-358 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: V.C.5. Value relationship between national safety campaigns and implementation in local practices and practice settings | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 17.4 Develop a nursing care plan for children in each age group needing immunizations.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 21) The nurse is preparing to administer a vaccine to a 14-month-old toddler. Which assessment factor would warrant a delay in the scheduled vaccination during the well-child visit?

1. The child is allergic to a substance in the vaccine.

2. The child has a low-grade fever and a runny nose.

3. The child received a dose of immune globulin 2 months ago.

4. The child is on antibiotics.

Answer: 3 Explanation: 1. A vaccine allergy contradicts the administration of the vaccine for life. This factor does not warrant a delay. The child should not receive the vaccine at the next well-child visit or at any other time.

2. A mild upper respiratory infection would not be a contraindication for vaccine administration.

3. The antibodies in the immune globulin will prevent the child from developing immunity to the vaccination. By the next well-child visit, the immune globulins will not prevent immunity from developing.

4. Antibiotic administration will not prevent the development of active immunity.

Page Ref: 366 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: V.C.5. Value relationship between national safety campaigns and implementation in local practices and practice settings | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 17.4 Develop a nursing care plan for children in each age group needing immunizations.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 22) Which statement regarding what was found during the nurse's daily check of the vaccine refrigerator would cause concern about the potency of the vaccines?

1. The vaccine was frozen as labeled.

2. The vaccines have been stored in a refrigerator where the temperature has been maintained between 35 and 46° F. 3. The vaccine's expiration date expires within the next month.

4. The vaccine is stored in the door of the refrigerator.

Answer: 4 Explanation: 1. Some vaccines are stored in the freezer.

2. This is appropriate to maintain potency.

3. The vaccine is still effective until the expiration day.

4. The door will not maintain the temperature of the vaccine. Vaccines should be stored in the middle of the refrigerator.

Page Ref: 367 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: V.C.5. Value relationship between national safety campaigns and implementation in local practices and practice settings | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 17.5 Design a plan to maintain the potency of vaccines.

23) Which vaccine reaction, noted by the mother during a telephone conversation with a nurse, would require activation of emergency medical services?

1. A few hives are noted around the injection site.

2. The child is running a slight temperature.

3. The child has swelling of the face.

4. Fever and joint pains occurring within hours of the vaccination.

Answer: 3 Explanation: 1. This is a mild allergic reaction and does not require calling 911.

2. A slight temperature does not require calling 911.

3. This could be the onset of anaphylaxis, and immediate response is essential to the survival of the child. The mother should call 911.

4. This is a common reaction to immunizations and does not indicate anaphylaxis.

Page Ref: 361 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: V.C.5. Value relationship between national safety campaigns and implementation in local practices and practice settings | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 17.4 Develop a nursing care plan for children in each age group needing immunizations.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 24) The nurse administers the flu vaccine to a school-age child. Which should the nurse include in the documentation for the administration of this vaccine? Select all that apply.

1. The date of the last flu vaccine 2. The site of the vaccination 3. The lot number of the vaccine 4. The date and time of administration.

5. Who assisted in restraining the child Answer: 2, 3, 4 Explanation: 1. This information is not pertinent.

2. The site should be recorded.

3. This information should be recorded in case a problem develops.

4. This should be recorded.

5. This information is not pertinent.

Page Ref: 368 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: V.C.5. Value relationship between national safety campaigns and implementation in local practices and practice settings | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation/Communication and Documentation Learning Outcome: 17.4 Develop a nursing care plan for children in each age group needing immunizations.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 25) There has been an outbreak of communicable diseases in the community. To reduce parental anxiety, the nurse presents information about disease at the school's Parent Teacher Association meeting. Which vectorborne diseases, not communicable from person to person, should the nurse include in the teaching session? Select all that apply.

1. Measles 2. Whooping cough 3. Rocky Mountain spotted fever 4. Malaria 5. Lyme disease Answer: 3, 4, 5 Explanation: 1. Rubeola, or measles, is caused by a virus and is transmitted person to person.

2. Pertussis, or whooping cough, is caused by a gram-positive coccobacillus called Bordetella pertussis and is spread person to person.

3. Rocky mountain spotted fever is a vectorborne disease spread by a tick.

4. Malaria is transmitted by a female infected female mosquito.

5. Lyme disease is a vectorborne disease spread by a tick.

Page Ref: 381-383 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: V.C.5. Value relationship between national safety campaigns and implementation in local practices and practice settings | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 17.4 Develop a nursing care plan for children in each age group needing immunizations.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 26) Which medication should the nurse include in a pamphlet to educate parents about methods to reduce the risk of children developing Reye syndrome?

1. Antibiotics 2. Acetaminophen 3. Ibuprofen 4. Aspirin Answer: 4 Explanation: 1. Antibiotics are not associated with Reye syndrome.

2. Acetaminophen is not associated with Reye syndrome.

3. Ibuprofen use is not associated with Reye syndrome.

4. Administering aspirin to a child with a viral illness has been found to be associated with Reye syndrome.

Page Ref: 370 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: V.C.5. Value relationship between national safety campaigns and implementation in local practices and practice settings | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 17.8 Create a parent teaching plan that includes important considerations in administering antipyretics to infants and children with a fever.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 27) Which communicable diseases, preventable through childhood immunization, should the nurse include in a presentation to families at a local community center wellness fair? (Select all that apply.)

1. Measles 2. Chickenpox 3. Fifth disease 4. Mononucleosis 5. Whooping cough Answer: 1, 2, 5 Explanation: 1. Measles is a communicable disease that can be prevented through childhood immunization.

2. Chickenpox is a communicable disease that can be prevented through childhood immunization.

3. Fifth disease, while a communicable disease, is not preventable through childhood immunization.

4. Mononucleosis, while a communicable disease, is not preventable through childhood immunization.

5. Whooping cough, or pertussis, is a communicable disease that can be prevented through childhood immunization.

Page Ref: 358, 360-361 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: V.C.5. Value relationship between national safety campaigns and implementation in local practices and practice settings | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 17.3 Examine the role that vaccines play in reducing and eliminating communicable diseases.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 28) Which live virus vaccines should the nurse teach to parents as being used to decrease the risk of communicable diseases? Select all that apply.

1. Poliovirus 2. Tetanus 3. Measles 4. Varicella 5. Hepatitis B Answer: 3, 4 Explanation: 1. Poliovirus is an example of a killed virus vaccine that is used to decrease the risk of communicable diseases.

2. Tetanus is an example of a toxoid vaccine that is used to decrease the risk of communicable diseases.

3. Measles is an example of a live virus vaccine that is used to decrease the risk of communicable diseases.

4. Varicella is an example of a live virus vaccine that is used to decrease the risk of communicable diseases.

5. Hepatitis B is an example of a recombinant vaccine that is used to decrease the risk of communicable diseases.

Page Ref: 360-361 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: V.C.5. Value relationship between national safety campaigns and implementation in local practices and practice settings | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 17.3 Examine the role that vaccines play in reducing and eliminating communicable diseases.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 29) Which recombinant vaccines should the nurse teach to parents as being used to decrease the risk of communicable diseases? Select all that apply.

1. Poliovirus 2. Tetanus 3. Measles 4. Acellular pertussis 5. Hepatitis B Answer: 4, 5 Explanation: 1. Poliovirus is an example of a killed virus vaccine that is used to decrease the risk of communicable diseases.

2. Tetanus is an example of a toxoid vaccine that is used to decrease the risk of communicable diseases.

3. Measles is an example of a live virus vaccine that is used to decrease the risk of communicable diseases.

4. Acellular pertussis is an example of a recombinant vaccine that is used to decrease the risk of communicable diseases.

5. Hepatitis B is an example of a recombinant vaccine that is used to decrease the risk of communicable diseases.

Page Ref: 358 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: V.C.5. Value relationship between national safety campaigns and implementation in local practices and practice settings | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 17.3 Examine the role that vaccines play in reducing and eliminating communicable diseases.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 30) Which vaccines should the nurse prepare to administer to a 6-month-old infant during a scheduled well-child visit? Select all that apply.

1. DTaP vaccine 2. Hib vaccine 3. HPV4 vaccine 4. MMR vaccine 5. PCV13 vaccine Answer: 1, 2, 5 Explanation: 1. The DTaP vaccine is appropriate for the nurse to administer to a 6-month-old infant during a scheduled well-child visit.

2. The Hib vaccine is appropriate for the nurse to administer to a 6-month-old infant during a scheduled well-child visit.

3. The HPV4 vaccine is not appropriate to administer to a 6-month-old infant during a scheduled well-child visit. This vaccine is not administered until a child is 11 to 12 years of age.

4. The MMR vaccine is not appropriate to administer to a 6-month-old infant during a scheduled well-child visit. This vaccine is not administered until a child is 12 to 15 months of age.

5. The PCV13 vaccine is appropriate for the nurse to administer to a 6-month-old infant during a scheduled well-child visit.

Page Ref: 362 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: V.C.5. Value relationship between national safety campaigns and implementation in local practices and practice settings | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 17.4 Develop a nursing care plan for children in each age group needing immunizations.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 31) Which vaccines should the nurse prepare to administer to an 11-year-old child during a scheduled well-child visit? Select all that apply.

1. DTaP vaccine 2. Hib vaccine 3. HPV4 vaccine 4. MMR vaccine 5. MenACWY-D Answer: 3, 5 Explanation: 1. The DTaP vaccine is not appropriate for the nurse to administer to an 11-yearold child during a scheduled well-child visit.

2. The Hib vaccine is not appropriate for the nurse to administer to an 11-year-old child during a scheduled well-child visit.

3. The HPV4 vaccine is appropriate to administer to an 11-year-old child during a scheduled well-child visit.

4. The MMR vaccine is not appropriate for the nurse to administer to an 11-year-old child during a scheduled well-child visit.

5. The MenACWY-D vaccine is appropriate to administer to an 11-year-old child during a scheduled well-child visit.

Page Ref: 362 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: V.C.5. Value relationship between national safety campaigns and implementation in local practices and practice settings | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 17.4 Develop a nursing care plan for children in each age group needing immunizations.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 32) The parent of a child with sepsis asks how the condition developed. Which response should the nurse make?

1. "It is considered a genetic illness."

2. "It is unknown how sepsis develops in a child."

3. "Your child had an illness for a long time that was treated."

4. "There are several reasons, but it is caused by a response to an infection."

Answer: 4 Explanation: 1. Sepsis is not a genetic condition.

2. There are specific reasons for sepsis to develop.

3. There is not enough evidence that the child had a long-standing untreated infection.

4. Sepsis is caused by the effects of the infectious agent and its toxins. Significant events that lead to the development of sepsis include: an infectious agent causes severe tissue injuries that result in multiple system organ failure, the child's excessive inflammatory response triggers a secondary response, or counterregulatory mechanisms are ineffective.

Page Ref: 386 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: V.C.5. Value relationship between national safety campaigns and implementation in local practices and practice settings | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 17.9 Analyze the pathophysiology of sepsis to guide the nursing management of infants and children with this disorder.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 33) The nurse is caring for a school-age child with a high fever. Which additional symptom indicates to the nurse that the client may have septic shock?

1. Tachypnea 2. Tachycardia 3. Mottle extremities 4. Increased urine output 5. Prolonged capillary refill time Answer: 1, 2, 3, 5 Explanation: 1. Tachypnea is a sign of septic shock.

2. Tachycardia is a sign of septic shock.

3. Mottled extremities is a sign of septic shock.

4. Decreased and not increased urine output is a sign of septic shock.

5. Prolonged capillary refill time is a sign of septic shock.

Page Ref: 386 Cognitive Level: Analyzing Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: V.C.5. Value relationship between national safety campaigns and implementation in local practices and practice settings | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 17.9 Analyze the pathophysiology of sepsis to guide the nursing management of infants and children with this disorder.

Principles of Pediatric Nursing, 8e (Ball et al.)

Chapter 18 The Child with Alterations in Fluid, Electrolyte, and Acid-Base Balance 1) A 4-year-old child is admitted to the hospital secondary to dehydration. Laboratory tests indicate a high hemoglobin and hematocrit, and the serum sodium is below normal levels. Which condition does the nurse suspect based on the current data?

1. Hypernatremia 2. Metabolic acidosis 3. Hypotonic dehydration 4. Isotonic dehydration Answer: 3 Explanation: 1. Hypernatremia is a condition where the body fluids are too concentrated, and there is an excess of sodium.

2. Metabolic acidosis refers to a condition where the pH of the blood is acidic.

3. This occurs when fluid loss is characterized by a proportionately greater loss of sodium than water. Serum sodium is below normal levels. Hemoglobin and hematocrit will be high due to the loss of serum water.

4. This occurs when fluid loss is not balanced by intake, and the losses of water and sodium are in proportion.

Page Ref: 393 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Reduction of Risk Potential Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, 370 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 18.3 Interpret threats to fluid and electrolyte balance in children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 2) The nurse is taking care of four different pediatric clients. Which child is at greatest risk for dehydration?

1. 7-year-old child with migraine headaches 2. 4-year-old child with a broken arm 3. 2-year-old child with cellulitis of the left leg 4. 18-month-old child with tachypnea Answer: 4 Explanation: 1. The pediatric client with a chronic or acute condition that does not directly affect the GI or electrolyte system is at a lower risk than is a toddler with a condition that increases insensible water loss.

2. The pediatric client with an acute condition that does not directly affect electrolytes is at a lower risk than is a client with a condition that increases insensible water loss.

3. The pediatric client with an acute condition, such as a client with cellulitis that does not affect the GI or electrolyte system, is at a lower risk than is a toddler with a condition that increases insensible water loss.

4. The pediatric client with the greatest risk is under 2 years of age and with a condition that increases insensible fluid loss.

Page Ref: 392 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 18.5 Analyze assessment findings to recognize fluid-electrolyte problems and acid-base imbalance in children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 3) Which parental statement indicates correct understanding of preventive techniques for heatrelated illnesses when children exercise?

1. "Wearing dark clothing during exercise is recommended."

2. "Water is the fluid of choice to replenish fluids."

3. "During activity, stop for fluids every 15 to 20 minutes."

4. "Hydration should occur at the end of an exercise session."

Answer: 3 Explanation: 1. Light-colored, light clothing is best to wear during exercise activities; wearing of dark colors can increase sweating.

2. A combination of water and sports drinks is the best to replace fluids during exercise.

3. During activity, stopping for fluids every 15 to 20 minutes is recommended.

4. Hydration should occur before and during the activity, not just at the end.

Page Ref: 397 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 18.6 Plan appropriate nursing interventions for children experiencing fluidelectrolyte problems and acid-base imbalance.

4) The nurse is assessing an infant brought to the clinic because of diarrhea. The infant is alert but has dry mucous membranes. Which additional assessment data indicates to the nurse that the infant is experiencing an early to moderate stage of dehydration?

1. Bradycardia 2. Tachycardia 3. Increased blood pressure 4. Normal fontanels Answer: 2 Explanation: 1. Bradycardia is not a sign of dehydration.

2. Tachycardia is a sign that indicates moderate dehydration.

3. In dehydration, the blood pressure is hypotensive.

4. Fontanels would be sunken in moderate dehydration.

Page Ref: 395 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 18.5 Analyze assessment findings to recognize fluid-electrolyte problems and acid-base imbalance in children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 5) In the morning, a nurse receives change-of-shift report on four pediatric clients, each of whom has some form of fluid-volume excess. Which child should the nurse see first?

1. The child with tachypnea and pulmonary congestion 2. The child with hepatomegaly and normal respiratory rate 3. The child with dependent and sacral edema and regular pulse 4. The child with periorbital edema and normal respiratory rate Answer: 1 Explanation: 1. A child with respiratory distress should be the first client the nurse checks after receiving a report.

2. The child with hepatomegaly and normal respiratory rate is more stable than the child with tachypnea and pulmonary congestion.

3. The child with dependent and sacral edema and regular pulse is more stable than the child with tachypnea and pulmonary congestion.

4. The child with periorbital edema and normal respiratory rate is more stable than the child with tachypnea and pulmonary congestion.

Page Ref: 400 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 18.6 Plan appropriate nursing interventions for children experiencing fluidelectrolyte problems and acid-base imbalance.

6) The nurse is caring for a child on bed rest who has severe edema in a left lower extremity due to blocked lymphatic drainage. Which problem would take priority?

1. Possible change in skin integrity 2. Change in self-perception of body 3. Not enough intake of calories 4. Inability to complete activities Answer: 1 Explanation: 1. The highest priority problem is skin integrity.

2. Body image would not take priority over the integrity of the skin for this scenario.

3. Nutrition would not take priority over the integrity of the skin for this scenario.

4. Activity intolerance would not take priority over the integrity of the skin for this scenario.

Page Ref: 402 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.4 Diagnose actual or potential health problems and needs. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Diagnosis Learning Outcome: 18.5 Analyze assessment findings to recognize fluid-electrolyte problems and acid-base imbalance in children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 7) The nurse is planning care for a child with hyponatremia. For which potential finding should the nurse monitor this client?

1. Seizures 2. Respiratory distress 3. Hyperthermia 4. Bradycardia Answer: 1 Explanation: 1. A child with hyponatremia is at risk for seizures.

2. Respiratory distress is not a risk of hyponatremia.

3. Hyperthermia is not a risk of hyponatremia.

4. Bradycardia is not a risk of hyponatremia.

Page Ref: 459-460 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 18.5 Analyze assessment findings to recognize fluid-electrolyte problems and acid-base imbalance in children.

8) The nurse is planning care for a child with hyperkalemia. Which manifestation requires immediate intervention by the nurse?

1. Hyperthermia 2. Respiratory distress 3. Seizures 4. Cardiac arrhythmias Answer: 4 Explanation: 1. Excessive potassium is unrelated to the body temperature.

2. Potassium is needed for contractility of heart and skeletal muscles but not for the muscles of respiration.

3. Seizures are not an adverse outcome of hyperkalemia.

4. A child with hyperkalemia is at risk for cardiac problems that can be life threatening, such as arrhythmias.

Page Ref: 406 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 18.5 Analyze assessment findings to recognize fluid-electrolyte problems and acid-base imbalance in children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 9) A child with croup has an increased PCO2, a decreased pH, and a normal HCO3 blood gas value. Which condition should the nurse report to the healthcare provider based on these data?

1. Uncompensated metabolic alkalosis 2. Uncompensated metabolic acidosis 3. Uncompensated respiratory acidosis 4. Uncompensated respiratory alkalosis Answer: 3 Explanation: 1. Uncompensated metabolic alkalosis has an increased pH, normal PCO2, and increased HCO3.

2. Uncompensated metabolic acidosis has a decreased pH, normal PCO2, and normal HCO3.

3. If the pH is decreased and the PCO2 is increased with a normal HCO3, it is uncompensated respiratory acidosis. Also, croup can be a disease process that causes respiratory acidosis.

4. Uncompensated respiratory alkalosis has an increased pH, decreased PCO2, and normal HCO3.

Page Ref: 416 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Assessment/Communication and Documentation Learning Outcome: 18.5 Analyze assessment findings to recognize fluid-electrolyte problems and acid-base imbalance in children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 10) The nurse is expecting the admission of a child with severe isotonic dehydration. Which intravenous fluid prescription does the nurse anticipate for this child?

1. 0.9% normal saline (NS) 2. D5 0.2% (1/4) normal saline 3. D5W 4. Albumin Answer: 1 Explanation: 1. 0.9% normal saline (NS) is an isotonic fluid and maintains Na and chloride at present levels.

2. D5 0.2% (1/4) normal saline would not be used initially but later, as maintenance fluids.

3. D5W can lower sodium levels, and so it would not be used to replace fluids in severe isotonic dehydration.

4. Albumin is used to restore plasma proteins.

Page Ref: 396 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Basic Care and Comfort Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 18.6 Plan appropriate nursing interventions for children experiencing fluidelectrolyte problems and acid-base imbalance.

11) A 6-year-old child is diagnosed with hypokalemia. Which menu choice should the nurse encourage for this child?

1. Pizza with a fruit plate 2. Chicken strips with chips 3. Fajita with rice 4. A hamburger with French fries Answer: 1 Explanation: 1. Pizza with a fruit plate should be encouraged because fruits (bananas, apricots, cantaloupe, cherries, peaches, and strawberries) have high amounts of potassium, and a child is likely to eat this combination.

2. Chicken strips and chips are not good sources of potassium.

3. The nurse is looking for potassium-rich foods that are attractive to children. This choice does not meet the requirement.

4. A hamburger and French fries do not provide potassium.

Page Ref: 408 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Basic Care and Comfort Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 18.6 Plan appropriate nursing interventions for children experiencing fluid377 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 electrolyte problems and acid-base imbalance.

12) A child is admitted to the hospital for hypercalcemia and is placed on diuretic therapy.

Which diuretic would the nurse expect to give?

1. Furosemide (Lasix) 2. Hydrochlorothiazide (Aquazide) 3. Spironolactone (Aldactone) 4. Mannitol (Osmitrol) Answer: 1 Explanation: 1. Furosemide (Lasix) is the diuretic used to aid in excretion of calcium.

2. Thiazide diuretics (like hydrochlorothiazide) decrease calcium excretion and should not be given to the hypercalcemic client.

3. Spironolactone (Aldactone) is a potassium-sparing diuretic. While there is a net increase in calcium in the urine, it is not as effective an option as furosemide.

4. Mannitol (Osmitrol) is a diuretic used to decrease cerebral edema and is not routinely used to aid in excretion of calcium.

Page Ref: 410 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 18.6 Plan appropriate nursing interventions for children experiencing fluidelectrolyte problems and acid-base imbalance.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 13) The nurse is completing the intake and output record for a child admitted for fluid volume deficit. The child has had the following intake and output during the shift: Intake: 4 oz of Pedialyte One-half of an 8-oz cup of clear orange Jell-O Two graham crackers 200 mL of D51/2 sodium chloride IV Output: 345 mL of urine 50 mL of loose stool How many milliliters should the nurse document as the client's total intake? Give the numerical answer only. Do not include any units of measurement.

Answer: 440 mL Explanation: The child takes in 120 mL of Pedialyte and 120 mL of Jell-O for a total of 240 mL. With 200 mL of IV fluids, the total intake is 440 mL. Page Ref: 396 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Basic Care and Comfort Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 18.6 Plan appropriate nursing interventions for children experiencing fluidelectrolyte problems and acid-base imbalance.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 14) A child is being treated for dehydration with intravenous fluids. The child currently weighs 13 kg and is estimated to have lost 7% of his normal body weight. The nurse is double-checking the IV rate the healthcare provider prescribed. The formula the healthcare provider used was for maintenance fluids: 1000 mL for 10 kg of body weight plus 50 mL for every kilogram over 10 for 24 hours. Replacement fluid is the percentage of lost body weight × 10 per kg of body weight. According to the calculation for maintenance plus replacement fluid, which hourly IV rate will the nurse implement for 24 hours?

1. 88 mL/hr 2. 86 mL/hr 3. 81 mL/hr 4. 83 mL/hr Answer: 2 Explanation: 1. Maintenance need for 13 kg is 1000 + (50 [×] 3), or 1150 mL/24 hours. Add to this, the replacement fluid loss = 7 (% of total body weight lost) × 10 = 70 mL/kg/24 hours (70 × 13 = 910). 1,150 + 910 = 2060 for 24 hours. 2060/24 = 86 mL per hour.

2. Maintenance need for 13 kg is 1000 + (50 [×] 3), or 1150 mL/24 hours. Add to this, the replacement fluid loss = 7 (% of total body weight lost) × 10 = 70 mL/kg/24 hours (70 × 13 = 910). 1150 + 910 = 2060 for 24 hours. 2060/24 = 86 mL per hour.

3. Maintenance need for 13 kg is 1000 + (50 [×] 3), or 1150 mL/24 hours. Add to this, the replacement fluid loss = 7 (% of total body weight lost) × 10 = 70 mL/kg/24 hours (70 × 13 = 910). 1150 + 910 = 2060 for 24 hours. 2060/24 = 86 mL per hour.

4. Maintenance need for 13 kg is 1000 + (50 [×] 3), or 1150 mL/24 hours. Add to this, the replacement fluid loss = 7 (% of total body weight lost) × 10 = 70 mL/kg/24 hours (70 × 13 = 910). 1150 + 910 = 2060 for 24 hours. 2060/24 = 86 mL per hour.

Page Ref: 396 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 18.6 Plan appropriate nursing interventions for children experiencing fluidelectrolyte problems and acid-base imbalance.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 15) A 9-month-old infant is hospitalized with vomiting and diarrhea. The mother questions why her child needed hospitalization since her school-age nephew had the same symptoms and was treated at home. Which should the nurse include in the explanation to the infant's mother? Select all that apply.

1. Infants have a lower proportion of their body weight as water.

2. The percentage of extracellular fluid is higher in the infant than the school-age child.

3. School-age children have a larger body surface area.

4. The school-age child's kidneys are more mature and better able to conserve water.

5. The metabolic rate of the school-age child is higher.

Answer: 2, 4 Explanation: 1. Infants have a higher percentage of body weight as water.

2. This statement is accurate.

3. Body surface area (BSA) is an assessment of skin surface. BSA compares the height and weight of the child and is greatest in infancy.

4. This statement is accurate.

5. Infants have a higher metabolic rate than a school-age child.

Page Ref: 392 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 18.1 Describe normal fluid and electrolyte status for children at various ages.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 16) As a result of opioid administration, a child's respirations are slow and shallow. Which should the nurse anticipate when assessing the child's arterial blood gas?

1. Increased PCO2 and respiratory acidosis 2. Decreased PCO2 and respiratory alkalosis 3. Low pH and low PCO2 4. High pH and high PCO2 Answer: 1 Explanation: 1. Due to inadequate respirations, the child retains CO2, and develops respiratory acidosis.

2. This statement is incorrect as the child retains carbon dioxide.

3. The pH would be acidic, but the pH would be high.

4. The child would have a low pH (acidosis) and high PCO2.

Page Ref: 416 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Reduction of Risk Potential Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 18.5 Analyze assessment findings to recognize fluid-electrolyte problems and acid-base imbalance in children.

17) Which rationale will the nurse provide when asked why the specific gravity for infants is lower than for older children?

1. The infant has a greater body surface area.

2. The infant has a higher basal metabolic rate.

3. The infant has a greater percentage of body weight that is water.

4. The infant's kidneys are less able to concentrate urine.

Answer: 4 Explanation: 1. Although this is true, it does not explain the lower specific gravity.

2. This statement is true but does not explain the specific gravity differences.

3. Although the statement is true, it does not explain the specific gravity differences.

4. This statement is accurate, and explains why the specific gravity of the infant's urine is closer to water than an older child's urine specific gravity.

Page Ref: 393 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and processes | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Implementation/Teaching and Learning Learning Outcome: 18.2 Identify regulatory mechanisms for fluid and electrolyte balance.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 18) Which is the priority nursing assessment when providing care for an infant at risk for dehydration?

1. Urine output 2. Urine specific gravity 3. Vital signs 4. Daily weight Answer: 4 Explanation: 1. The infant is unable to concentrate urine, and will continue to void dilute urine.

Therefore, this is not the priority nursing assessment for an infant at risk for dehydration.

2. The infant's kidney is immature and unable to concentrate urine. Therefore, this is not the priority nursing assessment for an infant at risk for dehydration.

3. Pulse will elevate and blood pressure may drop, but the other vital sign findings will remain unchanged. However, this is not the best assessment of dehydration.

4. Daily weights on an infant provide the most accurate assessment of fluid balance.

Page Ref: 396 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Reduction of Risk Potential Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 18.5 Analyze assessment findings to recognize fluid-electrolyte problems and acid-base imbalance in children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 19) Which health problem increases a child's risk of developing respiratory acidosis? Select all that apply.

1. Aspiration 2. Epiglottitis 3. Sepsis 4. Meningitis 5. Cystic fibrosis Answer: 1, 2, 5 Explanation: 1. Aspiration places the pediatric client at risk for respiratory acidosis.

2. Epiglottitis places the pediatric client at risk for respiratory acidosis.

3. Sepsis places the pediatric client at risk for respiratory alkalosis.

4. Meningitis places the pediatric client at risk for respiratory alkalosis.

5. Cystic fibrosis places the pediatric client at risk for respiratory acidosis.

Page Ref: 417 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 18.4 Describe acid-base balance, and recognize disruptions common in children.

20) Which health problem increases a child's risk for respiratory alkalosis? Select all that apply.

1. Aspiration 2. Epiglottitis 3. Sepsis 4. Meningitis 5. Cystic fibrosis Answer: 3, 4 Explanation: 1. Aspiration places the pediatric client at risk for respiratory acidosis.

2. Epiglottitis places the pediatric client at risk for respiratory acidosis.

3. Sepsis places the pediatric client at risk for respiratory alkalosis.

4. Meningitis places the pediatric client at risk for respiratory alkalosis.

5. Cystic fibrosis places the pediatric client at risk for respiratory acidosis.

Page Ref: 418 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 18.4 Describe acid-base balance, and recognize disruptions common in children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 21) The nurse is assessing a pediatric client who is experiencing metabolic acidosis. Which assessment questions should the nurse include when interviewing the child's parents? Select all that apply.

1. "Has your child consumed any aspirin?"

2. "Has your child consumed any boric acid?"

3. "Has your child consumed any antifreeze?"

4. "Has your child consumed any baking soda?"

5. "Has your child consumed any antacids?"

Answer: 1, 2, 3 Explanation: 1. An overdose of aspirin is associated with metabolic acidosis.

2. Consumption of boric acid can cause metabolic acidosis.

3. Accidental consumption of antifreeze can cause metabolic acidosis.

4. Consumption of baking soda is associated with metabolic alkalosis.

5. Consumption of antacids is associated with metabolic alkalosis.

Page Ref: 419 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 18.4 Describe acid-base balance, and recognize disruptions common in children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 22) The nurse is assessing a pediatric client who is experiencing metabolic alkalosis. Which assessment questions should the nurse include when interviewing the child's parents? Select all that apply.

1. "Has your child consumed any aspirin?"

2. "Has your child consumed any boric acid?"

3. "Has your child consumed any antifreeze?"

4. "Has your child consumed any baking soda?"

5. "Has your child consumed any antacids?"

Answer: 4, 5 Explanation: 1. An overdose of aspirin is associated with metabolic acidosis.

2. Consumption of boric acid can cause metabolic acidosis.

3. Accidental consumption of antifreeze can cause metabolic acidosis.

4. Consumption of baking soda is associated with metabolic alkalosis.

5. Consumption of antacids is associated with metabolic alkalosis.

Page Ref: 420 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 18.4 Describe acid-base balance, and recognize disruptions common in children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 23) Which age-appropriate techniques should the nurse implement in order to encourage a young child to participate in deep breathing exercises? Select all that apply.

1. Showing the child how to use the "blow bottle" 2. Using a pinwheel that the child plays with and asking the child to blow until it turns 3. Asking the child to blow bubbles in a glass of water using a straw 4. Having the child blow scraps of paper across the bedside table with a straw 5. Telling the child that a "shot" will be needed if the child does not follow the nurse's directions Answer: 2, 3, 4 Explanation: 1. A blow bottle is appropriate for an older pediatric client, not a young child.

2. Asking the young child to blow on a pinwheel is an age-appropriate intervention to facilitate deep breathing.

3. Asking the child to blow bubbles into a glass of water is an age-appropriate intervention to facilitate deep breathing.

4. Having the child blow scraps of paper across the bedside table with a straw is an ageappropriate intervention to facilitate deep breathing.

5. Telling the child that an injection will be administered if the nurse's directions are not followed is not therapeutic nor age appropriate.

Page Ref: 418 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 18.4 Describe acid-base balance, and recognize disruptions common in children.

Principles of Pediatric Nursing, 8e (Ball et al.)

Chapter 19 The Child with Alterations in Eye, Ear, Nose, and Throat Function 1) Which rationale explains why young children are more prone to otitis media that the nurse should include in the teaching session with a parent?

1. The eustachian tube is shorter, wider, and horizontal in younger children.

2. The eustachian tube is shorter, more narrow, and horizontal in younger children.

3. The eustachian tube is longer, wider, and vertical in younger children.

4. The eustachian tube is longer, more narrow, and vertical in younger children.

Answer: 1 Explanation: 1. The eustachian tube, which connects the nasopharynx to the middle ear, is proportionately shorter, wider, and more horizontal in infants and young children than in older children or adults. This promotes an increase in the incidence of ear infections.

2. Although the eustachian tube is shorter and horizontal in younger children, it is wider, not more narrow in younger children.

3. The eustachian tube is shorter, not longer, more narrow, not wider and is horizontal not vertical in younger children.

4. The eustachian tube is shorter, wider, and horizontal, not longer, more narrow, or vertical in younger children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 Page Ref: 424 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Implementation/Teaching and Learning Learning Outcome: 19.1 Identify anatomy, physiology, and pediatric differences in the eye, ear, nose, and throat of children and adolescents.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 2) Which neonate requires a close nursing assessment for the development of retinopathy of prematurity (ROP)?

1. 28-weeks'-gestation infant who has been on long-term oxygen and weighed 1400 g 2. 32-weeks'-gestation infant of African heritage with a congenital heart defect who needed no oxygen and weighed 1850 g 3. 28-weeks'-gestation female infant who was on short-term oxygen, weighed 1420 g, and was treated with phototherapy 4. 36-weeks'-gestation, small-for-gestational-age infant who was in an oxyhood for 12 hours, and weighed 1800 g Answer: 1 Explanation: 1. The 28-weeks'-gestation infant on oxygen weighing 1400 g has the greatest risk of retinopathy of prematurity because of gestational age (28 weeks or less), weight (less than 1600 g), and oxygen therapy.

2. This infant is 32 weeks'- gestation and is not the most at risk for retinopathy of prematurity because of gestational age (greater than the 31 weeks), weight (greater than 1600 grams), and no needed oxygen.

3. This infant is 28 weeks'- gestation and is not the most at risk for retinopathy of prematurity because of weight (greater than 1600 grams).

4. This infant is 36 weeks'- gestation and is not the most at risk for retinopathy of prematurity because of gestational age (greater than 31 weeks) and weight (greater than 1600 grams).

Page Ref: 430 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 19.2 Describe abnormalities of the eyes, ears, nose, throat, and mouth in children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 3) Which is the priority nursing assessment for a pediatric client who is postoperative for tonsillectomy?

1. Arrhythmias 2. Dehydration 3. Increased blood sugar 4. Increased urinary output Answer: 2 Explanation: 1. Arrhythmias are not common after a tonsillectomy.

2. The child is at risk for dehydration due to deficient fluid volume related to inadequate intake after surgery. The child will anticipate having pain if she tries to swallow.

3. Blood sugar changes are not common after a tonsillectomy.

4. Urinary output will not be increased after a tonsillectomy.

Page Ref: 450 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 19.2 Describe abnormalities of the eyes, ears, nose, throat, and mouth in children.

4) A neonate is diagnosed with a herpes simplex viral infection of the eye. Which medication should the nurse prepare to administer?

1. Oral erythromycin 2. Fluoroquinolone eyedrops or ointment 3. Parenteral acyclovir (Zovirax) and vidarabine (VIRA-A) ophthalmic ointment 4. Intravenous penicillin Answer: 3 Explanation: 1. Oral erythromycin is not an option for a neonate with herpes simplex infection of the eye. Chlamydial infections are treated with oral erythromycin.

2. Fluoroquinolones are used to treat bacterial conjunctivitis.

3. Neonatal herpes simplex virus is treated vigorously with parenteral acyclovir for 14 days or longer and topical ophthalmic medication (trifluridine, iododeoxyuridine, or vidarabine).

4. Intravenous penicillin is not used to treat neonatal herpes simplex virus.

Page Ref: 426 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 19.4 Plan nursing care for children with vision or hearing impairments.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 5) A nurse is caring for a visually impaired 20-month-old client who has not begun to walk.

Which problem would be appropriate for this child?

1. Problems with dressing 2. Poor muscle development 3. Change in appetite 4. Problem with development Answer: 4 Explanation: 1. This child should be taught specific techniques for dressing. This is not associated with not walking.

2. This child should have no concern with muscle development.

3. This child should have no change in appetite.

4. A 20-month-old child who is not walking is experiencing delayed development. Toddlers generally walk by 15 months of age.

Page Ref: 434 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.4 Diagnose actual or potential health problems and needs. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Diagnosis Learning Outcome: 19.4 Plan nursing care for children with vision or hearing impairments.

6) A nurse is caring for a visually impaired school-age child. Which is the priority nursing intervention during the admission process to the hospital?

1. Explaining playroom policies 2. Orienting the child to where furniture is placed in the room 3. Taking the child on a tour of the unit 4. Letting the child touch equipment that will be used during the child's hospitalization Answer: 2 Explanation: 1. Playroom policies are not the priority because the child's safety in their room is more important.

2. The priority intervention is to orient the child to furniture placement in the room. This is priority because it addresses basic safety for a visually impaired client.

3. The child will spend the most time in their room therefore orienting them to where the furniture is in their room is more important than the unit.

4. Touching the equipment is not a safety issue, making it not the priority.

Page Ref: 435 Cognitive Level: Analyzing Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 19.4 Plan nursing care for children with vision or hearing impairments.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 7) Which should the nurse include in the discharge instructions for the parents of an infant who is diagnosed with acute otitis media?

1. Keep the baby in a flat position during sleep.

2. Administer a decongestant.

3. Place the baby to sleep with a pacifier.

4. Administer acetaminophen (Tylenol) to relieve discomfort.

Answer: 4 Explanation: 1. No certain position is necessary to care for an infant who is diagnosed with acute otitis media.

2. Neither decongestants nor antihistamines have been shown to be effective in the treatment of otitis media with or without effusion.

3. A pacifier is not needed to help care for an infant who is diagnosed with acute otitis media, and placing infants or toddlers to sleep with a pacifier may increase the incidence of otitis media.

4. An infant with a bulging tympanic membrane because of acute otitis media will have pain.

Parents are taught to administer acetaminophen (Tylenol) to relieve the discomfort associated with acute otitis media.

Page Ref: 438 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 19.5 Apply current recommendations when implementing care and teaching for children with abnormalities of eyes, ears, nose, throat, and mouth.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 8) Which parental statements indicate correct understanding of the care that is needed for a pediatric client after the insertion of tympanostomy tubes? Select all that apply.

1. "It is important to limit my child's diet after surgery and only allow soft, bland foods."

2. "I should restrict my child to quiet activities after surgery."

3. "I should plan to administer a decongestant to my child for 1 to 2 weeks following surgery."

4. "It is important for my child to drink plenty of fluids after the procedure."

5. "I will remind my child to use ear plugs prior to showering and swimming."

Answer: 2, 4, 5 Explanation: 1. The child should drink generous amounts of fluids and reestablish a regular diet as tolerated.

2. The correct responses include encouraging the children to drink generous amounts of water, restricting the children to quiet activities after surgery, and avoiding water in the children's ears at bath time.

3. Decongestants are not prescribed for the child after the insertion of tympanostomy tubes.

4. The correct responses include encouraging the children to drink generous amounts of water, restricting the children to quiet activities after surgery, and avoiding water in the children's ears at bath time.

5. The correct responses include encouraging the children to drink generous amounts of water, restricting the children to quiet activities after surgery, and avoiding water in the children's ears at bath time.

Page Ref: 439 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 19.5 Apply current recommendations when implementing care and teaching for children with abnormalities of eyes, ears, nose, throat, and mouth.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 9) Which nursing action is appropriate when providing care to a child with a mild hearing loss who reads lips to enhance adaptation during hospitalization?

1. Touching the child lightly before speaking 2. Using a picture board as the main means of communication 3. Speaking in a loud voice while facing the child 4. Speaking directly to the parents for communication Answer: 1 Explanation: 1. The nurse can facilitate hospital adaptation of a child who has a hearing loss and can lip-read by obtaining the child's visual attention by lightly touching the child before communicating.

2. A picture board may be helpful but should not be the primary form of communication.

3. The nurse should speak to the child at a normal rate and tone.

4. The nurse should speak to the patient, not the parents when providing care to the child.

Page Ref: 443 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 19.5 Apply current recommendations when implementing care and teaching for children with abnormalities of eyes, ears, nose, throat, and mouth.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 10) Which is an appropriate nursing intervention for a child who experiences epistaxis?

1. Laying the child down and applying a warm pack.

2. Tilting the child's head back, squeezing the bridge of the nose, and applying a warm moist pack to the nose.

3. Tilting the child's head forward, squeezing the nares below the nasal bone, and applying ice to the nose.

4. Immediately packing the nares with a cotton ball soaked with phenylephrine (NeoSynephrine).

Answer: 3 Explanation: 1. The nurse should sit the child upright with head tilted slightly forward so blood does not run down the nasopharynx and apply an ice pack or cold compress to the bridge of the nose or the back of the neck.

2. The nurse should apply steady pressure to both nostrils just below the nasal bone with the thumb and forefinger for 15 to 20 minutes and apply an ice pack or cold compress to the bridge of the nose or the back of the neck.

3. The correct initial treatment for a nosebleed is to tilt the head forward, squeeze the nares below the nasal bone for 10 to 15 minutes, and apply ice to the nose or back of the head.

4. The nurse should press a roll of cotton under the upper lip to compress the labial artery and avoid any anticoagulant medications.

Page Ref: 446 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 19.5 Apply current recommendations when implementing care and teaching for children with abnormalities of eyes, ears, nose, throat, and mouth.

395 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 11) Which parental statement indicates correct understanding of discharge instructions for a pediatric client after a tonsillectomy?

1. "We will call the healthcare provider for any indication of ear pain."

2. "We will be sure to give our child adequate amounts of citrus juices."

3. "We will plan on administering acetaminophen (Tylenol) for pain."

4. "We will keep our child on bed rest for 10 days after the surgery."

Answer: 3 Explanation: 1. Children may experience ear pain, especially when swallowing, between 4 and 8 days after tonsillectomy.

2. Citrus juices should be avoided as they may produce a burning sensation in the throat.

3. Acetaminophen (Tylenol) is recommended for pain after a tonsillectomy.

4. Children do not need to be confined to bed, but they should avoid vigorous exercise for the first week after surgery.

Page Ref: 450 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 19.5 Apply current recommendations when implementing care and teaching for children with abnormalities of eyes, ears, nose, throat, and mouth.

12) Which information should the nurse include in a teaching session regarding treatment for the common cold in the pediatric population?

1. Aspirin should be taken for alleviation of fever if the common cold is contracted.

2. Antibiotics will eliminate the nasopharyngitis virus.

3. Vaccinations can prevent contraction of a nasopharyngitis virus.

4. Proper hand washing can prevent the spread of the common cold.

Answer: 4 Explanation: 1. Aspirin is not recommended because of its association with Reye syndrome in the pediatric population.

2. For viral pharyngitis, symptomatic treatment alone is used.

3. There is no vaccination that can prevent contraction of a nasopharyngitis virus.

4. Proper hand washing should be taught to school-age children to reduce the spread of the "common cold" virus.

Page Ref: 448 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 19.6 Integrate preventive and treatment principles when implementing health promotion for children related to eyes, ears, nose, and throat.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 13) Which assessment finding is considered normal for a school-age client?

1. Tonsils are large and seem to fill the throat.

2. Child is complaining of sore throat and drooling.

3. White patches are observed on the tonsils.

4. Throat appears red, and child has a low-grade fever.

Answer: 1 Explanation: 1. This is a normal finding as the tonsillar material grows faster than the child, and reaches adult size in this age group. It is not a reason to refer the child for follow-up.

2. Pain such as a sore throat or drooling is not normal for a school-age child.

3. White patches on the tonsils is not a normal assessment finding for a school-age child.

4. A school-age child whose throat appears red and has a low grade fever has symptoms of acute pharyngitis which is not considered normal.

Page Ref: 449 Cognitive Level: Understanding Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 19.1 Identify anatomy, physiology, and pediatric differences in the eye, ear, nose, and throat of children and adolescents.

14) Which topics should the nurse include in a teaching session to the parents of a 10-month-old infant who experiences frequent ear infections? Select all that apply.

1. Prohibiting tobacco smoke in the home 2. Avoiding use of a pacifier while the child is sleeping 3. Breastfeeding the infant 4. Cleaning the child's ears nightly with peroxide 5. Avoiding use of wood-burning stoves Answer: 1, 2, 3, 5 Explanation: 1. This has been shown to decrease the incidence of otitis media.

2. The use of a pacifier for the sleeping baby has been associated with otitis media.

3. Breastfeeding appears to be a protective factor for preventing ear infections.

4. This is not a recommended intervention for an infant.

5. Wood-burning stoves are associated with higher rates of otitis media.

Page Ref: 439 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 19.6 Integrate preventive and treatment principles when implementing health promotion for children related to eyes, ears, nose, and throat.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 15) For which reason should a healthcare provider recommend to a preschool-age male client with a documented hearing loss attend preschool at least 2 days per week?

1. Help the child recognize his hearing deficit.

2. Increase the child's socialization skills.

3. Improve the child's immunity by increased exposure to organisms.

4. Teach other children that children are different.

Answer: 2 Explanation: 1. Attending preschool will not help the child recognize his hearing deficit.

2. By increasing the interaction with other children, the hearing-impaired child will improve his socialization skills.

3. The healthcare provider should encourage disease prevention not exposure to organisms.

4. This is not the job of a preschooler.

Page Ref: 445 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 19.4 Plan nursing care for children with vision or hearing impairments.

16) Which screening tool should the nurse use to screen a pediatric client for esotropia?

1. Examine the eye with an otoscope.

2. Check for the "red reflex" in the eyes.

3. Perform the cover-uncover test.

4. Use a tonometer to evaluate the eyes.

Answer: 3 Explanation: 1. An otoscope would not detect strabismus.

2. The "red reflex" does not indicate the client has or does not have esotropia.

3. When one eye is covered while the child is looking at an object, the uncovered eye will deviate from the location; this tool is used to detect strabismus 4. A tonometer is not a tool to diagnose esotropia.

Page Ref: 428 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 19.3 Implement screening programs to identify children with vision and hearing abnormalities.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 17) Which is a priority nursing assessment the nurse includes in the plan of care for a pediatric client who has received a cochlear implant?

1. Ringing in the ears 2. Pharyngitis 3. Hearing loss 4. Measles Answer: 4 Explanation: 1. This is a common problem for patients who have received a cochlear implant.

2. Pharyngitis is not a common after a cochlear implant.

3. A cochlear implant should help with hearing loss; therefore, the nurse should not expect hearing loss in their patient.

4. All children with cochlear implants should have pneumococcal vaccine (PCV7 for under 5 years of age or PPV23 for over 5 years). The immunization should be completed 2 weeks before surgery for cochlear implant. Children should be current on all immunizations, but rubella, mumps, and measles are especially important, as infections with these diseases could cause further hearing loss.

Page Ref: 444 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 19.4 Plan nursing care for children with vision or hearing impairments.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 18) Which nursing actions are appropriate when providing care to a 12-year-old client who has lost several teeth as a result of a facial injury? Select all that apply.

1. Not worrying about the tooth loss, as children this age still have their "baby " teeth 2. Only handling the lost tooth by the roots and avoiding touching the crown of the tooth 3. Rinsing the lost tooth with sterile saline 4. Placing the tooth back into its socket and taking the child to an emergency dental facility 5. Keeping the tooth clean and dry during transport to an emergency dental facility Answer: 3, 4 Explanation: 1. The nurse should provide immediate care to ensure best possibility of survival for the tooth. A 12 year old will have permanent teeth, not baby teeth.

2. The nurse should handle the tooth only by the crown (its top) rather than the root to avoid further damage.

3. This is appropriate, as there is hope that the tooth can be reimplanted.

4. This is an appropriate way to manage the tooth.

5. The nurse should insert the tooth back into the socket if possible or keep moist rather than dry.

Page Ref: 451 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 19.6 Integrate preventive and treatment principles when implementing health promotion for children related to eyes, ears, nose, and throat.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 19) Which parental statements indicate correct understanding of the anatomy and physiology of the infant's mouth, nose, and throat? Select all that apply.

1. "My baby will breathe through her mouth during the first 3 months of life."

2. "When my baby has a cold, she may have trouble with bottle feedings."

3. "My baby's tonsils will be largest during infancy."

4. "I should expect my baby's first tooth to erupt during the first 6 months of life."

5. "I should expect my baby to lose her first tooth during the first year of life."

Answer: 2, 4 Explanation: 1. Up to 6 months of age (not 3 months), infants breathe primarily through the nose and not through the mouth.

2. Infants often have difficulty with oral feedings when the nasal passage is blocked. This statement indicates correct understanding.

3. Tonsils are normally large during school age, not infancy.

4. First teeth often erupt during the first 6 months of life. This statement indicates correct understanding.

5. The first loss of tooth begins at about 6 years of age.

Page Ref: 425, 446 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 19.1 Identify anatomy, physiology, and pediatric differences in the eye, ear, nose, and throat of children and adolescents.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 20) Which common eye disorders should the nurse include in a teaching session for the parents of pediatric clients? Select all that apply.

1. Hyperopia 2. Myopia 3. Astigmatism 4. Strabismus 5. Cataracts Answer: 1, 2, 3 Explanation: 1. Hyperopia, or farsightedness, is a common eye disorder seen in the pediatric population.

2. Myopia, or nearsightedness, is a common eye disorder seen in the pediatric population.

3. Astigmatism, or blurred vision, is a common eye disorder seen in the pediatric population.

4. Strabismus is only seen in up to 4% of children.

5. Cataracts are seen in 1-2/10,000 newborns and are not a common eye disorder in children.

Page Ref: 427 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Implementation/Teaching and Learning Learning Outcome: 19.2 Describe abnormalities of the eyes, ears, nose, throat, and mouth in children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 21) Which visual screenings should the school nurse conduct when conducting annual assessments for school-age children? Select all that apply.

1. Light reflex assessment 2. Cover-uncover test 3. Acuity testing 4. Visualization of the tympanic membrane 5. Cranial nerve VIII testing Answer: 1, 2, 3 Explanation: 1. An annual light reflex assessment is an appropriate visual screening for the school-age child.

2. An annual cover-uncover test is an appropriate visual screening for the school-age child.

3. An annual acuity test is an appropriate visual screening for the school-age child.

4. The tympanic membrane is in the ear therefore would not be part of a visual screen.

5. Cranial nerve testing is not part of a visual screen.

Page Ref: 428 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 19.3 Implement screening programs to identify children with vision and hearing abnormalities.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 22) Which should the nurse include in the plan of care for a pediatric client who is diagnosed with periorbital ecchymosis? Select all that apply.

1. Apply ice to the site for 5 to 15 minutes every hour for the first 1 to 2 days.

2. Apply warm compresses beginning on day 3.

3. Apply antibiotic ointment to the conjunctiva for 7 to 10 days.

4. Apply a patch to the affected eye for 5 to 7 days.

5. Apply antibiotic drops to the conjunctiva for 7 to 10 days.

Answer: 1, 2 Explanation: 1. Ice should be applied to the injured eye for 5 to 15 minutes every hour for the first 1 to 2 days.

2. Warm compresses should be applied to the injured eye beginning on day 3.

3. Antibiotic ointment is not indicated for a client diagnosed with periorbital ecchymosis.

4. A patch is not needed to care for a patient diagnosed with periorbital ecchymosis.

5. Antibiotic drops are not indicated for a client diagnosed with periorbital ecchymosis.

Page Ref: 436 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 19.4 Plan nursing care for children with vision or hearing impairments.

23) Which should the nurse include in the plan of care for a pediatric client diagnosed with otitis media with effusion? Select all that apply.

1. Administration of antibiotic drops per order 2. Administration of pain relief measures 3. Assessment of hearing acuity over several months 4. Assessment of speech 5. Assessment of development Answer: 2, 3, 4, 5 Explanation: 1. The clinical therapy for a client diagnosed with otitis media with effusion is symptomatic treatment and pain relief not antibiotic drops.

2. Measures to address comfort should be included in the child's plan of care.

3. Hearing acuity assessments should be included in the child's plan of care.

4. Speech assessment should be included in the child's plan of care.

5. Assessment of development should be included in the child's plan of care.

Page Ref: 438 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 19.5 Apply current recommendations when implementing care and teaching for children with abnormalities of eyes, ears, nose, throat, and mouth.

404 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 Principles of Pediatric Nursing, 8e (Ball et al.)

Chapter 20 The Child with Alterations in Respiratory Function 1) The mother of a toddler-age client states, "My daughter seems to be at an increased risk for complications associated with respiratory infections." Which response by the nurse is accurate?

1. "You are incorrect in your assessment."

2. "The younger child's airways are smaller and more easily occluded."

3. "Air passages are more likely to become blocked with mucus because younger children make more mucus than older children."

4. "Toddlers do not breathe as deeply as do older children."

Answer: 2 Explanation: 1. The mother is correct in her statement.

2. Airways are smaller in the younger child and are more easily occluded when mucus is produced.

3. Blockage of air passages with mucus is not related to the age of the child but more to the etiology of mucus production and the continuation of the causative agent.

4. Depth of breathing is not age dependent.

Page Ref: 456 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 20.1 Describe unique characteristics of the pediatric respiratory system anatomy and physiology and apply that information to the care of children with respiratory conditions.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 2) Which problem should the nurse include in the plan of care for an infant with acute bronchiolitis due to respiratory syncytial virus (RSV)?

1. Intolerance of activity 2. Poor tissue perfusion 3. Pain 4. Reduced cardiac output Answer: 1 Explanation: 1. Intolerance of activity is a problem because of the imbalance between oxygen supply and demand.

2. Tissue perfusion is not affected by this respiratory disease process.

3. Pain is not usually associated with acute bronchiolitis.

4. Cardiac function is not compromised during an acute phase of bronchiolitis.

Page Ref: 470 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.4 Diagnose actual or potential health problems and needs. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Diagnosis Learning Outcome: 20.5 Distinguish between conditions of the lower respiratory tract that cause illness in children.

3) A toddler-age client presents to the emergency department with a sore throat and difficulty swallowing. The nurse suspects acute epiglottitis. Which nursing action is avoided based on the current assessment data?

1. Throat culture 2. Medical history 3. Vital signs 4. Auscultation of breath sounds Answer: 1 Explanation: 1. Throat cultures should never be done when a diagnosis of epiglottis is suspected.

Manipulation of the throat can stimulate the gag reflex in an already inflamed airway and can cause complete occlusion of the airway.

2. Medical history should be obtained, which assists in diagnosis.

3. Vital signs should always be taken when assessment is done.

4. Assessment of breath sounds is essential for diagnosis.

Page Ref: 466 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 20.6 Create a nursing care plan for a child with a common acute respiratory condition.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 4) Which nursing action is appropriate for the family of a 4-month-old infant who died due to sudden infant death syndrome (SIDS)?

1. Sheltering parents from the grief by not giving them any personal items of the infant, such as footprints 2. Reassure other children that it will not happen to them 3. Advising parents that an autopsy is not necessary 4. Interviewing parents to determine the cause of the incident Answer: 2 Explanation: 1. Parents will want any personal items available.

2. Older children may need reassurance that SIDS will not happen to them. They may also believe that bad thoughts or wishes about their baby brother or sister caused the death.

3. The death of an infant without a known medical condition is an indication for an autopsy.

4. The parents need to know that SIDS is not their fault.

Page Ref: 464 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 20.6 Create a nursing care plan for a child with a common acute respiratory condition.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 5) Which immunization should the nurse include in a teaching session for parents of a toddlerage client to decrease the risk for epiglottitis?

1. Hepatitis B 2. Polio 3. Measles, mumps, and rubella (MMR) 4. Haemophilus influenzae type B (HIB) Answer: 4 Explanation: 1. Hepatitis B, measles, mumps, rubella, and the poliovirus are not causative agents for epiglottitis.

2. Hepatitis B, measles, mumps, rubella, and the poliovirus are not causative agents for epiglottitis.

3. Hepatitis B, measles, mumps, rubella, and the poliovirus are not causative agents for epiglottitis.

4. The Haemophilus influenzae type B (HIB) immunization can assist in prevention of epiglottitis.

Page Ref: 466 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 20.2 Contrast different respiratory medical conditions that can cause respiratory distress in infants and children.

6) A 10 year-old child is diagnosed with tuberculosis. In which way should this client receive prescribed doses of rifampin?

1. At bedtime 2. With morning cereal 3. Before going to school 4. Twice a week by a healthcare provider Answer: 4 Explanation: 1. The medication does not need to be taken at bedtime.

2. The medication does not need to be taking with cereal.

3. There is no specific time for the medication to be taken.

4. Direct-observed drug therapy administered by a healthcare provider two times a week for the duration of treatment is recommended for children with active TB. Page Ref: 474 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 20.6 Create a nursing care plan for a child with a common acute respiratory condition.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 7) Which parental statement at the conclusion of a teaching session regarding environmental controls for childhood asthma indicates correct understanding of the information presented?

1. "We're glad the dog can continue to sleep in our child's room."

2. "We'll keep the plants in our child's room dusted."

3. "We'll be sure to use the fireplace often to keep the house warm in the winter."

4. "We will replace the carpet in our child's bedroom with tile."

Answer: 4 Explanation: 1. When possible, pets and plants should not be kept in the home.

2. When possible, pets and plants should not be kept in the home.

3. Smoke from fireplaces should be eliminated.

4. Control of dust in the child's bedroom is an important aspect of environmental control for asthma management.

Page Ref: 485 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 20.7 Develop a school-based nursing care plan for the child with asthma.

8) Which assessment data would cause the nurse to suspect that a newborn requires further testing for cystic fibrosis?

1. Rectal prolapse 2. Constipation 3. Steatorrheic stools 4. Meconium ileus Answer: 4 Explanation: 1. Rectal prolapse is a complication of the large, bulky fatty stools.

2. Constipation is not a symptom of cystic fibrosis.

3. Steatorrhea and rectal prolapse might be signs of cystic fibrosis seen in an older infant or child.

4. Newborns with cystic fibrosis might present in the first 48 hours with meconium ileus.

Page Ref: 487 Cognitive Level: Understanding Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 20.7 Develop a school-based nursing care plan for the child with asthma.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 9) Which parental statement indicates correct understanding regarding pancreatic enzyme administration in the treatment of cystic fibrosis?

1. "I will administer this medication 4 times each day."

2. "I will administer this medication twice each day."

3. "I will administer this medication with meals and snacks."

4. "I will administer this medication every 6 hours around the clock."

Answer: 3 Explanation: 1. A scheduled time would not be appropriate because the enzymes are used to assist in digestion of nutrients.

2. A scheduled time would not be appropriate because the enzymes are used to assist in digestion of nutrients.

3. Pancreatic enzymes are administered with meals and large snacks.

4. A scheduled time would not be appropriate because the enzymes are used to assist in digestion of nutrients.

Page Ref: 490 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 20.7 Develop a school-based nursing care plan for the child with asthma.

10) Which should the nurse include in a teaching session for the mother of a 3-year-old client who is concerned about her child choking?

1. Show the mother how to do cardiac compressions and rescue breathing.

2. Recommend the mother perform back blows and chest thrusts.

3. Teach the mother how to perform abdominal thrusts.

4. Tell the mother to do nothing until the child loses consciousness.

Answer: 3 Explanation: 1. The method of cardiac compressions and rescue breathing is not the first thing that the mother needs to know.

2. This is the treatment for a choking infant, not a child.

3. Giving abdominal thrusts is the correct intervention for a choking child.

4. The mother should respond to the choking child before the child loses consciousness.

Page Ref: 461 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 20.2 Contrast different respiratory medical conditions that can cause respiratory distress in infants and children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 11) Which positions are appropriate for the nurse to include in a plan of care for a child who is experiencing an acute asthma attack? Select all that apply.

1. Sitting 2. Semi-Fowler 3. Prone 4. With the head hyperextended 5. Supine Answer: 2, 5 Explanation: 1. A sitting position promotes the ease of respiratory effort.

2. The semi-Fowler position promotes the ease of respiratory effort.

3. Prone positioning will not promote respirations.

4. The head should not be hyperextended as that position does not open the airway.

5. The supine position will not promote respirations..

Page Ref: 482 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 20.6 Create a nursing care plan for a child with a common acute respiratory condition.

12) Which nursing action is appropriate when providing care to a newborn with a respiratory rate of 102 breaths per minute with lungs that are clear to auscultation?

1. Administering the bath to the neonate in the nursery 2. Transferring to the neonatal intensive care unit for further observation 3. Allowing the neonate to room-in to promote bonding 4. Providing the first feeding in the nursery Answer: 2 Explanation: 1. The newborn is tachypneic. Bathing will only add to the respiratory distress and should be avoided.

2. This newborn needs to remain under constant observation due to the respiratory rate.

3. The newborn needs to be monitored.

4. With a respiratory rate this high, aspiration is likely so feeding should be avoided.

Page Ref: 461 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 20.4 Assess the child's respiratory status and analyze the need for oxygen supplementation.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 13) Which independent nursing action is appropriate for a 2-month-old infant who is a direct admission to the pediatric unit with a diagnosis of brief resolved unexplained event (BRUE)?

1. Place the child on an apnea monitor.

2. Place the child on nasal cannula oxygen.

3. Draw blood for arterial blood gases.

4. Place the child on contact isolation.

Answer: 1 Explanation: 1. This is appropriate monitoring of the infant.

2. Oxygen is a dependent order except under emergency situations. There is no evidence the child needs oxygen.

3. Laboratory tests are not an independent action.

4. There is no indication of a respiratory infection. At this time, contact isolation is not indicated.

Page Ref: 463 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 20.4 Assess the child's respiratory status and analyze the need for oxygen supplementation.

14) Which is the priority nursing action for a premature neonate who is experiencing apnea?

1. Administering oxygen 2. Performing back blows and chest thrusts 3. Calling a code blue 4. Providing stimulation by stroking the back Answer: 4 Explanation: 1. If the infant is not breathing, oxygen will not help.

2. This is intervention for choking, not apnea.

3. A code is not the initial response. If the nurse is unable to restart breathing, then a code should be initiated.

4. Tactile stimulation is often sufficient to restart the infant's respirations.

Page Ref: 464 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 20.2 Contrast different respiratory medical conditions that can cause respiratory distress in infants and children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 15) Which statements should the nurse include in the discharge medication teaching for a child diagnosed with asthma who is prescribed cromolyn sodium (a mast cell stabilizer)? Select all that apply.

1. "The medication works to prevent exacerbations."

2. "The medication should be administered at the first symptom of an asthmatic attack."

3. "The medication should be taken on a daily basis."

4. "The medication should not be administered if the child has a cold."

5. "The medication desensitizes the child against specific allergens."

Answer: 1, 3 Explanation: 1. This statement is true. Cromolyn sodium is used to inhibit an asthmatic response to allergens.

2. This is incorrect. This medication does not improve the child's condition during an asthmatic attack.

3. This is a preventative medication so doses should not be missed.

4. The medication should be taken daily.

5. This medication does not desensitize the child against allergens.

Page Ref: 480 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 20.7 Develop a school-based nursing care plan for the child with asthma.

16) Which is the priority nursing action for a child who presents in the emergency department after a motor vehicle accident with a sucking wound of the chest?

1. Placing the child in a Trendelenburg position 2. Beginning rescue breathing for the child 3. Beginning cardiac resuscitation for the child 4. Covering the child's wound with an air occlusive dressing Answer: 4 Explanation: 1. This would not be the appropriate response to a sucking chest wound.

2. The child is conscious. Rescue breathing is not appropriate at this time.

3. There is no need for cardiac resuscitation at this time.

4. This prevents more air from entering the chest and is appropriate.

Page Ref: 494 Cognitive Level: Analyzing Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 20.9 Contrast the signs of different injuries to the respiratory system.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 17) Which data collected during the respiratory assessment would indicate the pediatric client is compromised? Select all that apply.

1. Lung sounds clear to auscultation 2. Stridor 3. Substernal retractions 4. Nasal flaring 5. Strong cry Answer: 2, 3, 4 Explanation: 1. Lung sounds that are clear to auscultation do not indicate respiratory compromise.

2. Stridor is an adventitious breath sound that may indicate respiratory compromise.

3. Substernal retractions may indicate respiratory compromise.

4. Nasal flaring may indicate respiratory compromise.

5. A weak, not strong, cry may indicate respiratory compromise.

Page Ref: 460 Cognitive Level: Understanding Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 20.3 Explain the visual and auditory observations made to assess a child's respiratory effort or work of breathing.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 18) Which should the nurse assess to determine oxygenation during the respiratory assessment for a pediatric client? Select all that apply.

1. Mucous membranes 2. Nail beds 3. Skin 4. Sclerae 5. Corneas Answer: 1, 2, 3 Explanation: 1. The nurse assesses the mucous membranes to determine oxygenation during the respiratory assessment for a pediatric client.

2. The nurse assesses the nail beds to determine oxygenation during the respiratory assessment for a pediatric client.

3. The nurse assesses the skin to determine oxygenation during the respiratory assessment for a pediatric client.

4. The sclerae are not assessed to determine oxygenation during the respiratory assessment for a pediatric client.

5. The corneas are not assessed to determine oxygenation during the respiratory assessment for a pediatric client.

Page Ref: 460 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 20.3 Explain the visual and auditory observations made to assess a child's respiratory effort or work of breathing.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 19) Which nursing actions are appropriate when providing care to a pediatric client who has sustained a smoke-inhalation injury? Select all that apply.

1. Assessing for respiratory distress 2. Auscultating the lungs for wheezing 3. Prescribing oxygen for low saturations 4. Administering prescribed prophylactic antibiotic therapy 5. Providing support to the family Answer: 1, 2, 5 Explanation: 1. A pediatric client who sustained a smoke-inhalation injury is at risk for respiratory distress; therefore, it is appropriate for the nurse to assess this patient for clinical manifestations associated with the phenomenon.

2. Crackles and wheezing are both complications associated with a smoke-inhalation injury. This nursing action is appropriate.

3. It is outside the scope of nursing practice to prescribe oxygen therapy for a pediatric client.

The nurse would, however, administer prescribed oxygen for this client.

4. Prophylactic antibiotic therapy is not included in the treatment plan for a pediatric client who sustained a smoke-inhalation injury.

5. The nurse should provide support to the family of a pediatric client who sustained a smokeinhalation injury.

Page Ref: 493 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 20.9 Contrast the signs of different injuries to the respiratory system.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 20) Which pediatric clients would require a nursing assessment for blunt chest trauma? Select all that apply.

1. A preschool-age client who is admitted after a house fire 2. A toddler-age client who is admitted for injuries sustained in a motor vehicle accident 3. A school-age client who is admitted for observation after a skateboarding accident 4. An adolescent client admitted for an asthma exacerbation 5. An infant admitted to rule out cystic fibrosis Answer: 2, 3 Explanation: 1. A preschool-age client admitted after a house fire would require assessment for smoke-inhalation injury not blunt chest trauma.

2. A toddler-age client admitted for injuries sustained in a motor vehicle accident would require assessment to determine blunt chest trauma.

3. A school-age client admitted for observation after a skateboarding accident would require assessment to determine blunt chest trauma.

4. An asthma exacerbation would not necessitate a nursing assessment for blunt chest trauma.

5. An infant admitted to rule out cystic fibrosis would not necessitate a nursing assessment for blunt chest trauma.

Page Ref: 493 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 20.9 Contrast the signs of different injuries to the respiratory system.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 21) Which nursing assessment data would indicate that a pediatric client sustained a large pulmonary contusion in a motor vehicle crash? Select all that apply.

1. Eupnea 2. Dyspnea 3. Hemoptysis 4. Fever 5. Crackles Answer: 2, 3, 4, 5 Explanation: 1. Eupnea, or a normal respiratory rate, is not assessment data the nurse expects for a pediatric client who sustained a large pulmonary contusion in a motor vehicle crash.

2. Dyspnea is a clinical manifestation associated with respiratory distress, which can occur for the pediatric client who sustained a large pulmonary contusion in a motor vehicle crash.

3. Hemoptysis is a clinical manifestation associated with a large pulmonary contusion.

4. Fever is a clinical manifestation associated with a large pulmonary contusion.

5. Crackles are a clinical manifestation associated with a large pulmonary contusion.

Page Ref: 493 Cognitive Level: Understanding Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 20.9 Contrast the signs of different injuries to the respiratory system.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 22) A preschool-age child with cystic fibrosis receives care from a grandparent during the day.

Which suggestion should the nurse make to ensure the child receives the needed chest physiotherapy until the parents return home from work? Select all that apply.

1. Use an oscillating vest.

2. Instruct on the huffing technique.

3. Place the child in the prone position.

4. Restrict fluids until the parents come home.

5. Use an oscillating positive expiration pressure device.

Answer: 1, 2, 5 Explanation: 1. An oscillating vest will help mobilize secretions.

2. The huffing technique will help mobilize secretions.

3. The prone position is not a recommendation to mobilize secretions.

4. Restricting fluids will thicken secretions, making them harder to expectorate.

5. An oscillating positive expiration pressure device will help mobilize secretions.

Page Ref: 492 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 20.8 Develop a home nursing care plan for the child with cystic fibrosis.

23) A school-age child with cystic fibrosis is playing baseball during physical education class in school. Which action should the school nurse take when the child is sitting between innings?

1. Provide a salty snack.

2. Count respiratory rate.

3. Measure peripheral pulse.

4. Provide chest physiotherapy.

Answer: 1 Explanation: 1. Children with CF lose more than normal amounts of salt in their sweat, especially during strenuous exercise. During periods of exercise and increased sweating, encourage the child to increase salt intake. Allow the child to eat salty snacks.

2. The child's respiratory rate does not need to be assessed.

3. The child's pulse does not need to be assessed.

4. Physiotherapy is not needed while exercise is in progress.

Page Ref: 492 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 20.8 Develop a home nursing care plan for the child with cystic fibrosis.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 Principles of Pediatric Nursing, 8e (Ball et al.)

Chapter 21 The Child with Alterations in Cardiovascular Function 1) Which assessment finding indicates adequate peripheral perfusion for a child after a cardiac catheterization?

1. Capillary refill is greater than 3 seconds.

2. Lower extremities are warm, with a capillary refill of less than 3 seconds.

3. Sensation is decreased with a weakened dorsalis pedis pulse.

4. Dorsalis pedis pulse is palpable but posterior tibial pulse is weak.

Answer: 2 Explanation: 1. If the capillary refill is over 3 seconds; if any of the pedal pulses are absent and/or weakened; or if the extremity is cool, cyanotic, or lacking sensation, circulation might not be adequate.

2. The nurse checks the extremity to determine adequacy of circulation following a cardiac catheterization. An extremity that is warm with capillary refill of less than 3 seconds has adequate circulation. Other indicators of adequate circulation include palpable pedal (dorsalis and posterior tibial) pulses, adequate sensation, and pinkness of skin color.

3. If the capillary refill is over 3 seconds; if any of the pedal pulses are absent and/or weakened; or if the extremity is cool, cyanotic, or lacking sensation, circulation might not be adequate.

4. If the capillary refill is over 3 seconds; if any of the pedal pulses are absent and/or weakened; or if the extremity is cool, cyanotic, or lacking sensation, circulation might not be adequate.

Page Ref: 503 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 21.2 Contrast the pathophysiology associated with congenital heart defects having increased pulmonary circulation, decreased pulmonary circulation, mixed defects, and obstructed systemic blood flow.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 2) Which initial laboratory data does the nurse anticipate for a child who is admitted to the hospital with a cyanotic heart defect?

1. A low platelet count 2. A high white blood cell count 3. A high hemoglobin 4. A low hematocrit Answer: 3 Explanation: 1. The platelets would be normal.

2. The white blood cell count would not be high unless an infection was present.

3. The child's bone marrow responds to chronic hypoxemia by producing more red blood cells to increase the amount of hemoglobin available to carry oxygen to the tissues. This occurs in cases of cyanotic heart defects.

4. The hematocrit would not be low.

Page Ref: 511 Cognitive Level: Understanding Client Need/Sub: Physiological Integrity / Reduction of Risk Potential Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 21.2 Contrast the pathophysiology associated with congenital heart defects having increased pulmonary circulation, decreased pulmonary circulation, mixed defects, and obstructed systemic blood flow.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 3) The nurse admits a child with a ventricular septal defect (VSD) to the pediatric unit. On which problem should the nurse focus for this child?

1. Hypothermia 2. Pain 3. Muscle dysfunction 4. Problems with gas exchange Answer: 4 Explanation: 1. Ventricular septal defects do not cause pain, fever, or deficient fluid volume.

2. Ventricular septal defects do not cause pain, fever, or deficient fluid volume.

3. Ventral septal defects do not cause problems with muscle function.

4. Because of the increased pulmonary congestion, problems with gas exchange would be the focus problem.

Page Ref: 507 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.4 Diagnose actual or potential health problems and needs. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Diagnosis Learning Outcome: 21.2 Contrast the pathophysiology associated with congenital heart defects having increased pulmonary circulation, decreased pulmonary circulation, mixed defects, and obstructed systemic blood flow.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 4) Which heart defect should the nurse suspect for an infant whose upper extremities have stronger pulses than the lower extremities, and blood pressure is higher in the arms than in the legs?

1. Transposition of the great vessels 2. Patent ductus arteriosus 3. Coarctation of the aorta 4. Atrial septal defect Answer: 3 Explanation: 1. These defects are not associated with blood pressures that are different in upper and lower extremities.

2. These defects are not associated with blood pressures that are different in upper and lower extremities.

3. Coarctation of the aorta can present with stronger pulses in the upper extremities than in the lower extremities and higher blood pressure readings in the arms than in the legs because of obstruction of circulation to the lower extremities.

4. These defects are not associated with blood pressures that are different in upper and lower extremities.

Page Ref: 519 Cognitive Level: Understanding Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 21.2 Contrast the pathophysiology associated with congenital heart defects having increased pulmonary circulation, decreased pulmonary circulation, mixed defects, and obstructed systemic blood flow.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 5) An infant with tetralogy of Fallot (TOF) is having a hypercyanotic episode ("tet" spell).

Which nursing interventions are appropriate? Select all that apply.

1. Administer oxygen.

2. Place the child in knee-chest position.

3. Administer morphine and propranolol intravenously as ordered.

4. Draw blood for serum hemoglobin.

5. Administer diphenhydramine (Benadryl) as ordered.

Answer: 1, 2, 3 Explanation: 1. When an infant with TOF has a hypercyanotic episode, interventions should be geared toward decreasing the pulmonary vascular resistance. Therefore, the nurse would place the infant in knee-chest position (to decrease venous blood return from the lower extremities), and administer oxygen, morphine, and propranolol (to decrease the pulmonary vascular resistance).

2. When an infant with TOF has a hypercyanotic episode, interventions should be geared toward decreasing the pulmonary vascular resistance. Therefore, the nurse would place the infant in knee-chest position (to decrease venous blood return from the lower extremities) and, administer oxygen, morphine, and propranolol (to decrease the pulmonary vascular resistance).

3. When an infant with TOF has a hypercyanotic episode, interventions should be geared toward decreasing the pulmonary vascular resistance. Therefore, the nurse would place the infant in kneechest position (to decrease venous blood return from the lower extremities) and, administer oxygen, morphine, and propranolol (to decrease the pulmonary vascular resistance).

4. The nurse would not draw blood until the episode had subsided because unpleasant procedures are postponed.

5. Benadryl is not appropriate for this child.

Page Ref: 513 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 21.2 Contrast the pathophysiology associated with congenital heart defects having increased pulmonary circulation, decreased pulmonary circulation, mixed defects, and obstructed systemic blood flow.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 6) An infant who is diagnosed with a mild heart defect will not have surgical correction for at least 2 years. Which information should the nurse include in the discharge teaching regarding management in the home environment?

1. "Your child will have a low-grade fever until the defect is repaired."

2. "It is important for your child to maintain normal activity."

3. "Your child is not at risk for congestive heart failure."

4. "It is important to avoid antipyretics for the treatment of fever."

Answer: 2 Explanation: 1. Low-grade fever is not a normal finding in a child with a mild cyanotic heart defect and could be a sign of infective endocarditis.

2. A child with a mild cyanotic heart defect should be treated as normally as possible without activity adjustment.

3. Any child with a heart defect could develop congestive heart failure.

4. Fevers are treated with antipyretics so that dehydration is avoided.

Page Ref: 518 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 21.3 Develop a nursing care plan for the infant with a congenital heart defect cared for at home prior to corrective surgery.

7) A 2-month-old infant with a congenital heart defect is admitted to the pediatric intensive care unit with congestive heart failure. Which intervention should the nurse include in the infant's plan of care?

1. Monitor respirations during active periods.

2. Give larger feedings less often to conserve energy.

3. Organize activities to allow for uninterrupted sleep.

4. Force fluids appropriate for age.

Answer: 3 Explanation: 1. Respirations are difficult to monitor during active periods, making this an unrealistic goal.

2. Feedings should be small-volume, high-calorie.

3. It is important to allow for uninterrupted sleep to decrease metabolic demands on the heart.

4. Fluids should be restricted to high-calorie and low-volume in order to avoid overloading the lungs with fluid.

Page Ref: 524 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 21.6 Develop a nursing care plan for a child with congestive heart failure.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 8) A toddler is prescribed digoxin (Lanoxin) for cardiac failure. Which should the nurse instruct the toddler's parents to monitor for as a manifestation associated with digoxin toxicity?

1. Bradycardia 2. Tinnitus 3. Ataxia 4. Hypotension Answer: 1 Explanation: 1. Early signs of digoxin (Lanoxin) toxicity are bradycardia and arrhythmias.

2. Digoxin (Lanoxin) toxicity does not cause tinnitus (ringing in the ears).

3. Digoxin (Lanoxin) toxicity does not cause ataxia (unsteady gait).

4. Digoxin (Lanoxin) toxicity does not cause hypotension (low blood pressure).

Page Ref: 525 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 21.3 Develop a nursing care plan for the infant with a congenital heart defect cared for at home prior to corrective surgery.

9) Which teaching point should the nurse include in the discharge instructions for a pediatric client who has undergone cardiac surgery?

1. Should not receive routine immunizations.

2. Should be restricted from most play activities.

3. Fever is expected for several weeks following the surgery.

4. Prophylactic antibiotics are required for any dental, oral, or upper respiratory tract procedures.

Answer: 4 Explanation: 1. Immunizations should be provided according to the schedule.

2. The child should live a normal and active life following repair of a cardiac defect.

3. Fever is not expected for a prolonged period after surgery, and any unexplained fever should be reported.

4. Parents should be taught that the child should receive prophylactic antibiotics to prevent endocarditis.

Page Ref: 529 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 21.4 Create a nursing care plan for the child undergoing open heart surgery.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 10) Which parental statement regarding the use of cyclosporin A after a heart transplant indicates correct understanding of the information presented by the nurse?

1. "This medication is used to treat hypertension."

2. "This medication is used to reduce serum cholesterol level."

3. "This medication is used to prevent rejection."

4. "This medication is used to treat infections."

Answer: 3 Explanation: 1. Calcium channel blockers may be used to treat hypertension.

2. Lovastatin is given to reduce serum cholesterol level.

3. Cyclosporin A is given to prevent rejection.

4. An antibiotic may be given to treat an infection.

Page Ref: 527 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 21.4 Create a nursing care plan for the child undergoing open heart surgery.

11) Which clinical manifestation does the nurse anticipate for a pediatric client who is admitted with congestive heart failure (CHF)?

1. Tachycardia 2. Weight loss 3. Hypertension 4. Bradycardia Answer: 1 Explanation: 1. Tachycardia is a sign of congestive heart failure because the heart attempts to improve cardiac output by beating faster.

2. The weight, instead of decreasing, increases, because of retention of fluids.

3. Blood pressure does not increase in CHF. 4. Bradycardia is a serious sign and can indicate impending cardiac arrest.

Page Ref: 522 Cognitive Level: Understanding Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 21.5 Recognize the signs and symptoms of congestive heart failure in an infant and child.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 12) Which is the rationale the nurse provides to the parents of an infant diagnosed with congestive heart failure (CHF) for the prescribed spironolactone?

1. Produces rapid diuresis.

2. Blocks reabsorption of sodium and water in renal tubules.

3. Spares potassium.

4. Promotes vascular relaxation.

Answer: 3 Explanation: 1. Furosemide (Lasix) produces rapid diuresis, and blocks reabsorption of sodium and water in renal tubules.

2. Furosemide (Lasix) produces rapid diuresis, and blocks reabsorption of sodium and water in renal tubules.

3. Spironolactone (Aldactone) is a maintenance diuretic that is potassium-sparing. Hypokalemia would increase the risk of Lanoxin toxicity.

4. Angiotensin-converting enzyme (ACE) inhibitors promote vascular relaxation.

Page Ref: 523 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 21.6 Develop a nursing care plan for a child with congestive heart failure.

13) Which laboratory test does the nurse anticipate for a child who is admitted to the hospital with suspected rheumatic fever?

1. Erythrocyte sedimentation rate 2. Throat culture 3. C-reactive protein 4. Antistreptolysin-O (ASO) titer Answer: 4 Explanation: 1. An erythrocyte sedimentation rate and a C-reactive protein can indicate inflammation.

2. A culture can indicate a current streptococcal infection.

3. An erythrocyte sedimentation rate and a C-reactive protein can indicate inflammation.

4. The laboratory test for antistreptococcal antibodies is an antistreptolysin-O (ASO) titer.

Page Ref: 530 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Reduction of Risk Potential Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 21.7 Differentiate among the heart diseases that are acquired or begin development during childhood.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 14) Which athletic activity should the nurse recommend for a school-age child who is diagnosed with pulmonary artery hypertension?

1. Golf 2. Basketball 3. Cross-country running 4. Soccer Answer: 1 Explanation: 1. A child with pulmonary artery hypertension should have exercise tailored to avoid dyspnea, such as golf.

2. Soccer, basketball, and cross-country running are all aerobic activities requiring heavy exertion.

3. Soccer, basketball, and cross-country running are all aerobic activities requiring heavy exertion.

4. Soccer, basketball, and cross-country running are all aerobic activities requiring heavy exertion.

Page Ref: 528 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 21.7 Differentiate among the heart diseases that are acquired or begin development during childhood.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 15) Which treatment options should the nurse anticipate for a 10-month-old infant admitted to the emergency department with supraventricular tachycardia? Select all that apply.

1. Administering intravenous adenosine (Adenocard) 2. Administering intravenous amiodarone (Cardarone) 3. Preparing for cardioversion 4. Applying ice to the face 5. Having the child perform a Valsalva maneuver Answer: 1, 2, 3, 4 Explanation: 1. Adenosine or amiodarone may be given when vagal maneuvers are unsuccessful. Cardioversion is used in an urgent situation.

2. Adenosine or amiodarone may be given when vagal maneuvers are unsuccessful.

Cardioversion is used in an urgent situation.

3. Adenosine or amiodarone may be given when vagal maneuvers are unsuccessful.

Cardioversion is used in an urgent situation.

4. Supraventricular tachycardia episodes are initially treated with vagal maneuvers to slow the heart rate including the application of ice or iced saline solution to the face to reduce the heart rate.

5. A 10-month-old child cannot be instructed to hold her breath and bear down as with a bowel movement.

Page Ref: 532 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 21.7 Differentiate among the heart diseases that are acquired or begin development during childhood.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 16) Which assessment data would cause the nurse to suspect that a pediatric client is experiencing hypovolemic shock? Select all that apply.

1. Dyspnea 2. Bradycardia 3. Tachycardia 4. Capillary refill time greater than 3 seconds 5. Blood pressure 72/42 mmHg Answer: 1, 3, 4 Explanation: 1. Increased work of breathing is an early sign of shock, indicating compensation for decreased cardiac output and volume.

2. Bradycardia is a late and ominous sign of shock indicating that the child is no longer able to compensate.

3. Tachycardia is an early compensatory mechanism for hypovolemia in a child.

4. Decreased capillary refill time would be an early indicator of decreased fluid volume and compensation.

5. Decreased blood pressure is a later finding and would not occur until other compensatory mechanisms were exhausted.

Page Ref: 535 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 21.10 Plan the nursing management of hypovolemic shock.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 17) Which is the priority nursing action when providing care to a pediatric client who is diagnosed with hypovolemic shock?

1. Assessing the cause of bleeding 2. Establishing an open airway and administering oxygen 3. Administering analgesics for pain control 4. Providing replacement of volume Answer: 2 Explanation: 1. Airway patency and replacement of volume are priorities before assessing the cause of the bleeding.

2. Airway patency and oxygen delivery (breathing) are always first in the treatment for a client with health concerns.

3. Pain would be a consideration but would not be attended to as a first priority.

4. Replacement of volume is vital but would follow establishing airway and breathing.

Page Ref: 535 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 21.10 Plan the nursing management of hypovolemic shock.

18) The nurse is teaching a pregnant client about fetal circulation. Which is the correct sequence of blood flow that indicates the pregnant client understands the information presented?

1. Ductus arteriosus 2. Ductus venosus 3. Foramen ovale Answer: 3, 1, 2 Explanation: 1.

The ductus arteriosus connects the pulmonary artery to the aorta and is the last structure that blood reaches.

2. The ductus venosus connects the umbilical vein to the inferior vena cava bypassing the liver.

It is the first structure that blood reaches.

3. The foramen ovale connects the right atrium to the left ventricle and bypasses the lungs. It is the second structure that blood reaches.

Page Ref: 500 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 21.1 Describe the anatomy and physiology of the cardiovascular system, focusing on the flow of blood and the action of heart valves.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 19) Which parental statement indicates correct understanding for the reason a cardiac catheterization is needed for a child who is diagnosed with a congenital heart defect?

1. "This procedure will keep the ductus arteriosus open and oxygenated and unoxygenated blood mixed."

2. "This procedure is used to close the ductus arteriosus to prevent mixing of arterial and venous blood."

3. "This procedure will redirect the blood so that blood bypasses the right ventricle."

4. "This procedure connects the ventricle to the atrium."

Answer: 1 Explanation: 1. This statement is accurate.

2. A stent maintains an opening; it does not close an opening.

3. A stent maintains the ductus as patent. It does not bypass the ventricle.

4. This is not the purpose of the stent.

Page Ref: 502 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Reduction of Risk Potential Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 21.2 Contrast the pathophysiology associated with congenital heart defects having increased pulmonary circulation, decreased pulmonary circulation, mixed defects, and obstructed systemic blood flow.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 20) Which feeding techniques should the nurse include in the teaching session for the parents of an infant who is being discharged in order to gain weight for the corrective surgery needed for a congenital heart defect? Select all that apply.

1. Breastfeed if possible.

2. Complete each feeding within 30 minutes.

3. Position the infant flat to promote swallowing.

4. Dilute the formula with extra water to ensure adequate fluid intake.

5. Burp the infant frequently.

Answer: 1, 2, 5 Explanation: 1. Breastfeeding is recommended because it provides antibodies to help protect the infant from infection.

2. Allowing the infant to nurse for more than 30 minutes will burn more calories than calories are gained.

3. The infant should be positioned at a 45-degree angle to reduce the workload of the heart.

4. The formula should not be diluted beyond the label recommendations, as it would lower the caloric count.

5. This is appropriate for the infant with a congenital heart defect as well as the normal infant.

Page Ref: 508 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Basic Care and Comfort Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 21.3 Develop a nursing care plan for the infant with a congenital heart defect cared for at home prior to corrective surgery.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 21) Which age-appropriate information should the nurse provide to an 8-year-old girl who is being emotionally prepared for open heart surgery?

1. The name of the surgeon who will be performing the procedure 2. What the surgical procedure will entail 3. The purpose of the heart-lung machine used during the procedure 4. What the environment will look and sound like when the child wakes up Answer: 4 Explanation: 1. The parents know the name of the surgeon. It will mean nothing to a 4-year-old child.

2. The child will be asleep during surgery and therefore does not need to know about the procedure.

3. This is beyond the understanding of a 4-year-old.

4. The child should be prepared in terms of what she will see, hear, smell, or feel.

Page Ref: 508 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 21.4 Create a nursing care plan for the child undergoing open heart surgery.

22) A child is admitted to the pediatric medical unit with a diagnosis of Kawasaki disease.

Which provider prescription should the nurse question?

1. Contact isolation 2. Oral aspirin every 8 hours 3. Echocardiogram 4. Vital signs every 4 hours Answer: 1 Explanation: 1. The child is not contagious so contact isolation is not appropriate.

2. Aspirin is used as an anti-inflammatory and is prescribed around the clock. This is appropriate.

3. This examination will be used as a baseline to compare against as the child recovers to assist in monitoring for cardiac lesions.

4. The child will need close monitoring during the early period of the disease.

Page Ref: 531 Cognitive Level: Analyzing Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 21.7 Differentiate among the heart diseases that are acquired or begin development during childhood.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 23) A school-age client is diagnosed with rheumatic fever. Which parental statement indicates the need for further education by the nurse?

1. "I understand rheumatic fever is a strep infection of the heart."

2. "My child will be on bed rest for several weeks."

3. "My child will be treated with aspirin and/or corticosteroids."

4. "Once my child has recovered, she will still need to be monitored for sequelae to the disease."

Answer: 1 Explanation: 1. Rheumatic fever is not a strep infection of the heart but an autoimmune connective tissue disease in response to a previous strep infection. This statement requires clarification.

2. This statement is correct. No further clarification is needed.

3. This statement is correct and needs no clarification.

4. Children who have had one episode of rheumatic fever are at greater risk for future episodes.

In addition, long-term valve damage may occur. This statement needs no further clarification.

Page Ref: 529 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 21.7 Differentiate among the heart diseases that are acquired or begin development during childhood.

24) Which is the priority action by the school nurse for an adolescent who drops to the ground and is unresponsive during a high school basketball game?

1. Initiating cardiopulmonary resuscitation (CPR) 2. Calling 911 3. Offering the parents comfort 4. Assessing for hemorrhage Answer: 1 Explanation: 1. This situation is an example of cardiac concussion. Survival chances improve if CPR is initiated immediately.

2. Other people can call 911. Cardiac resuscitation must be initiated immediately.

3. This is an appropriate action but not a priority.

4. This type of injury often has no external symptoms of injury.

Page Ref: 538 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 21.7 Differentiate among the heart diseases that are acquired or begin development during childhood.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 25) Which is an appropriate statement for the nurse to include in the discharge instructions to the parents of a child who is recovering from cardiac surgery?

1. "The child will have a fever for several weeks following the surgery."

2. "The child will be restricted from most play activities."

3. "The child will not receive routine immunizations."

4. "The child will receive prophylactic antibiotics prior to any dental procedures."

Answer: 4 Explanation: 1. Any unexplained fever should be reported.

2. The child should live a normal and active life following repair of a cardiac defect.

3. Immunizations should be provided according to the schedule.

4. Parents should be taught that the child should receive prophylactic antibiotics to prevent endocarditis, according to the American Heart Association.

Page Ref: 513 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 21.8 Develop a nursing care plan for a child with Kawasaki syndrome.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 26) Which cardiovascular manifestations should the nurse anticipate for a pediatric client diagnosed with early compensated hypovolemic shock? Select all that apply.

1. Tachycardia 2. Weak distal pulses 3. Thready distal pulses 4. Normal blood pressure 5. Decrease in systolic blood pressure Answer: 1, 2, 4 Explanation: 1. Tachycardia is a cardiovascular manifestation the nurse anticipates for the pediatric client who is diagnosed with early compensated hypovolemic shock.

2. Weak distal pulses are cardiovascular manifestations the nurse anticipates for the pediatric client who is diagnosed with early compensated hypovolemic shock.

3. Thready distal pulses are cardiovascular manifestations the nurse anticipates for the pediatric client who is diagnosed with moderate uncompensated hypovolemic shock.

4. Normal blood pressure for age is a cardiovascular manifestation the nurse anticipates for the pediatric client who is diagnosed with early compensated hypovolemic shock.

5. A decrease in systolic blood pressure is a cardiovascular manifestation the nurse anticipates for the pediatric client who is diagnosed with moderate uncompensated hypovolemic shock.

Page Ref: 538 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 21.10 Plan the nursing management of hypovolemic shock.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 27) Which cardiovascular manifestations should the nurse anticipate for a pediatric client diagnosed with moderate uncompensated hypovolemic shock? Select all that apply.

1. Tachycardia 2. Weak distal pulses 3. Thready distal pulses 4. Normal blood pressure 5. Decrease in systolic blood pressure Answer: 3, 5 Explanation: 1. Tachycardia is a cardiovascular manifestation the nurse anticipates for the pediatric client who is diagnosed with early compensated hypovolemic shock.

2. Weak distal pulses are cardiovascular manifestations the nurse anticipates for the pediatric client who is diagnosed with early compensated hypovolemic shock.

3. Thready distal pulses are cardiovascular manifestations the nurse anticipates for the pediatric client who is diagnosed with moderate uncompensated hypovolemic shock.

4. Normal blood pressure for age is a cardiovascular manifestation the nurse anticipates for the pediatric client who is diagnosed with early compensated hypovolemic shock.

5. A decrease in systolic blood pressure is a cardiovascular manifestation the nurse anticipates for the pediatric client who is diagnosed with moderate uncompensated hypovolemic shock.

Page Ref: 535 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 21.10 Plan the nursing management of hypovolemic shock.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 28) Which strategies should the nurse recommend for a school-age client who is at risk for developing hypertension as an adult? Select all that apply.

1. Using seasoning substitutes for salt 2. Providing a list of foods high in sodium 3. Decreasing television time 4. Increasing physical activity 5. Monitoring blood pressure daily Answer: 1, 2, 3, 4 Explanation: 1. Habits that are implemented during childhood will decrease the likelihood of developing hypertension as an adult. The nurse should recommend the use of seasoning substitutes to replace added salt.

2. Habits that are implemented during childhood will decrease the likelihood of developing hypertension as an adult. The nurse should provide a list of foods that are high in sodium.

3. Habits that are implemented during childhood will decrease the likelihood of developing hypertension as an adult. The nurse should recommend a decrease in television screen time.

4. Habits that are implemented during childhood will decrease the likelihood of developing hypertension as an adult. The nurse should recommend an increase in physical activity.

5. Monitoring blood pressure daily is not an activity that reduces the child's likelihood of developing hypertension as an adult.

Page Ref: 532 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 21.9 List strategies to reduce a child's risk of adult onset cardiovascular disease.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 29) Which clinical manifestations does the nurse anticipate for a pediatric client who is diagnosed with the subacute stage of Kawasaki disease? Select all that apply.

1. High fever 2. Diarrhea 3. Thrombocytosis 4. Joint pain 5. Beau lines Answer: 3, 4 Explanation: 1. High fever is a clinical manifestation anticipated for a pediatric client diagnosed with the acute stage of Kawasaki disease.

2. Diarrhea is a clinical manifestation anticipated for a pediatric client diagnosed with the acute stage of Kawasaki disease.

3. Thrombocytosis is a clinical manifestation anticipated for a pediatric client diagnosed with the subacute stage of Kawasaki disease.

4. Joint pain is a clinical manifestation anticipated for a pediatric client diagnosed with the subacute stage of Kawasaki disease.

5. Beau lines are a clinical manifestation anticipated for a pediatric client diagnosed with the convalescent stage of Kawasaki disease.

Page Ref: 530 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 21.8 Develop a nursing care plan for a child with Kawasaki syndrome.

Principles of Pediatric Nursing, 8e (Ball et al.)

Chapter 22 The Child with Alterations in Immune Function 1) A parent of a newborn asks the nurse why young children seem to become ill so often when compared with older children and adults. Which is the best response by the nurse?

1. "Newborns have lower numbers of natural killer cells."

2. "Newborns have high levels of IgA in their systems."

3. "Newborns are lacking lymphoid tissue."

4. "Newborns have an immature thymus gland."

Answer: 1 Explanation: 1. Newborns have lower numbers of natural killer cells than do older children and adults, decreasing their ability to respond to certain antigens.

2. IgA is not present at birth. Development of IgA begins at 2 weeks of age but does not reach adult levels until the age of 6.

3. Lymphoid tissue, such as the spleen and tonsils, is present at birth.

4. The thymus is large at birth and grows during childhood, decreasing by adulthood.

Page Ref: 543 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation 441 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 22.1 Describe the structure and function of the immune system and apply that knowledge to the care of children with immunologic disorders.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 2) A premature neonate is at greater risk for infection than a full-term newborn because of a reduced number of which immunoglobulin?

1. IgE 2. IgG 3. IgA 4. IgM Answer: 2 Explanation: 1. IgE does not cross the placenta and is not present at birth in either preterm or full-term infants.

2. Maternal IgG crosses the placenta. Newborns' levels are similar to their mothers'. Premature infants have lower levels of IgG obtained from their mothers and are at greater risk for infection.

3. IgA does not cross the placenta and is not present at birth in either preterm or full-term infants.

4. IgM does not cross the placenta. The levels are low at birth in both preterm and full-term infants.

Page Ref: 543 Cognitive Level: Understanding Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 22.1 Describe the structure and function of the immune system and apply that knowledge to the care of children with immunologic disorders.

3) The nurse is planning care for a child with acquired immune deficiency syndrome (AIDS).

Which vaccines should be avoided in the child with AIDS? 1. Inactivated polio vaccine 2. Tetanus toxoid vaccination 3. Varicella vaccine 4. Acellular pertussis vaccine Answer: 3 Explanation: 1. Killed virus vaccines are safe to administer to the child with AIDS as there is no risk of acquiring an infection.

2. A toxoid vaccination is made of a toxin that has been produced by the organism but does not include living organisms.

3. A child with an immune disorder should not be immunized with a live varicella vaccine because of the risk of contracting the disease.

4. Acellular pertussis vaccine contains a protein from pertussis rather than the whole cell.

Page Ref: 549 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 22.1 Describe the structure and function of the immune system and apply that knowledge to the care of children with immunologic disorders.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 4) An adolescent female client is diagnosed with systemic lupus erythematosus (SLE). Which action by the client indicates acceptance of the body changes that occur because of SLE? 1. Attends school but does not stay for after-school activities.

2. Discusses the body changes with healthcare providers only.

3. Discusses the body changes with her best friend.

4. Only attends small parties at friends' homes.

Answer: 3 Explanation: 1. Avoiding social activities does not show acceptance of body changes.

2. Discussing changes only with healthcare providers does not indicate the teen has adjusted to the body image changes.

3. Peer interaction is important to the teen. Being able to discuss the changes to her body with a peer indicates acceptance of the changes in her body image.

4. Avoiding social activities other than those involving immediate friends indicates the teen is still concerned with body image.

Page Ref: 555 Cognitive Level: Analyzing Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 22.4 Plan nursing care for the child with an autoimmune condition such as systemic lupus erythematosus or juvenile arthritis.

5) A school-age client diagnosed with rheumatoid arthritis (RA) wants to participate in the school sports programs. The client asks the nurse to recommend a sporting activity that is appropriate. Which activity would be the most appropriate for the nurse to recommend?

1. Baseball 2. Basketball 3. Football 4. Swimming Answer: 4 Explanation: 1. Baseball places stress on the knee joints.

2. Basketball involves running, which will stress the joints.

3. All positions in football will cause stress to the joints.

4. Swimming helps to exercise all the extremities without putting undue stress on joints.

Page Ref: 557 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 22.4 Plan nursing care for the child with an autoimmune condition such as systemic lupus erythematosus or juvenile arthritis.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 6) The nurse is caring for a child with rheumatoid arthritis. Which nonpharmacologic intervention should the nurse include in the plan of care for joint pain?

1. Elevation of the extremity 2. Immobilization 3. Massage 4. Application of moist heat Answer: 4 Explanation: 1. Elevation of the extremity would not have an effect on reducing pain in rheumatoid arthritis.

2. Immobilization can lead to contractures. Range of motion to the involved joint should be maintained.

3. Massage of extremities should be avoided because of potential risk for emboli.

4. Moist heat can promote relief of pain and decrease joint stiffness.

Page Ref: 558 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Basic Care and Comfort Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 22.4 Plan nursing care for the child with an autoimmune condition such as systemic lupus erythematosus or juvenile arthritis.

7) Which action should the nurse take if a hospitalized pediatric client has a history of an anaphylactic reaction to a medication?

1. Review actions for the client to take if the medication is taken.

2. Label the chart, the bed, and apply a red armband.

3. Instruct the mother to obtain a medical alert bracelet for the child.

4. Ask the healthcare provider to prescribe an epinephrine pen for the child.

Answer: 2 Explanation: 1. The child has an allergy to the medication and should never take it.

2. When the child is hospitalized, be sure to label the child's chart and bed, and apply a red armband to alert others to allergies.

3. The child may not need a medical alert bracelet if the medication is not one that is routinely used.

4. An epinephrine pen would not be applicable.

Page Ref: 560 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 22.6 Determine nursing interventions and prevention measures for the child experiencing hypersensitivity reactions.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 8) A child is prescribed oral corticosteroid for a rash caused by graft-versus-host disease. Which should the nurse monitor the child for after administering the drug?

1. Infection 2. Hepatic toxicity 3. Seizures 4. Renal toxicity Answer: 1 Explanation: 1. Corticosteroids suppress the immune system, and increase the risk of infections.

2. Hepatic toxicity is not a side effect associated with steroid therapy.

3. Seizures are not a side effect associated with steroid therapy.

4. Renal toxicity is not a side effect associated with steroid therapy.

Page Ref: 561 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 22.6 Determine nursing interventions and prevention measures for the child experiencing hypersensitivity reactions.

9) After a severe allergic reaction, an EpiPen is prescribed for the school-age child. Which instructions should the nurse provide to this child's parents based on the current data? Select all that apply.

1. "It is important that your child always has access to this medication."

2. "Your child is too young to self-administer this medication."

3. "If you are able to administer the medication, there is no need for follow-up care."

4. "It is important to check the expiration date on the medication and replace, if expired."

5. "Your child should wear a Medic Alert bracelet at all times."

Answer: 1, 4, 5 Explanation: 1. This is appropriate care.

2. Both the child and family members should be taught administration of the EpiPen. 3. The EpiPen effect is good for approximately 20 minutes. The child should be transported to the hospital immediately after administering the EpiPen. 4. An expired EpiPen may have less than desired effects.

5. If the child is unable to speak due to anaphylaxis, it is important that rescuers have information about the child's allergies.

Page Ref: 560 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 22.6 Determine nursing interventions and prevention measures for the child experiencing hypersensitivity reactions.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 10) An adolescent female client is diagnosed with systemic lupus erythematosus (SLE). Which should the nurse include in the teaching session regarding an activity that should be avoided?

1. Receiving a manicure and a pedicure 2. Washing the hair with shampoo daily 3. Using a tanning bed 4. Attending late night parties and dances Answer: 3 Explanation: 1. Manicures and pedicures do not place the teenager at any risk.

2. Although one symptom of SLE can be alopecia, gentle shampooing is not a cause of this symptom.

3. Individuals with SLE have photosensitivity, and tanning beds can lead to exacerbations as well as skin damage from sunburns.

4. Although adequate rest is important for the teenager with SLE, the teenager can "catch up" on her sleep the next day.

Page Ref: 556 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 22.4 Plan nursing care for the child with an autoimmune condition such as systemic lupus erythematosus or juvenile arthritis.

11) Which is the priority nursing action when providing care to a pediatric client who has documented allergies to cow's milk, peanuts, and latex?

1. Evaluating the hospital room for equipment containing latex 2. Ordering an EpiPen for the child 3. Notifying dietary of the milk and peanut allergy 4. Placing a sign on the door, which identifies all allergies Answer: 1 Explanation: 1. This is appropriate as latex allergies can be life threatening. Many pieces of medical equipment may contain latex.

2. Nurses do not prescribe or dispense medication, so this is inappropriate.

3. This action should be taken but is not the priority.

4. Depending on hospital policy, there may be some sign to indicate allergies, but this is not the priority.

Page Ref: 561 Cognitive Level: Analyzing Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: V.A.4. Delineate general categories of errors and hazards in care | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 22.5 Identify exposure prevention measures for the child with latex allergy.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 12) Which is the rationale for ensuring a pediatric client with severe combined immune deficiency (SCID) receives blood that has been irradiated?

1. Transfusion reaction from lymphocytes and platelets in the donor blood 2. Transfusion reaction and infection from lymphocytes in the donor blood 3. Infection and graft-versus-host disease from lymphocytes in the donor blood 4. Infection and graft-versus-host disease from erythrocytes in the donor blood Answer: 3 Explanation: 1. Lymphocytes in the donor blood are responsible for infection and graft-versushost disease.

2. Lymphocytes in the donor blood are responsible for infection and graft-versus-host disease.

3. Lymphocytes in the donor blood are responsible for infection and graft-versus-host disease.

4. Lymphocytes in the donor blood are responsible for infection and graft-versus-host disease.

Page Ref: 544 Cognitive Level: Understanding Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: V.A.4. Delineate general categories of errors and hazards in care | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 22.2 Summarize infection control measures needed for children with an immunodeficiency.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 13) A nurse is planning care for a child with human immunodeficiency virus (HIV). Which is the priority problem for this child?

1. Insufficient blood circulation 2. Fever 3. Lack of sufficient fluid volume 4. Potential for infection Answer: 4 Explanation: 1. A child with HIV is at risk for a myriad of bacterial, viral, fungal, and opportunistic infections because of the effect of the virus on the immune system. Insufficient blood circulation would not be a priority problem with this disease process.

2. A child with HIV is at risk for a myriad of bacterial, viral, fungal, and opportunistic infections because of the effect of the virus on the immune system. Fever would not be a priority problem with this disease process.

3. A child with HIV is at risk for a myriad of bacterial, viral, fungal, and opportunistic infections because of the effect of the virus on the immune system. Lack of sufficient fluid volume would not be a priority problem with this disease process.

4. A child with HIV is at risk for a myriad of bacterial, viral, fungal, and opportunistic infections because of the effect of the virus on the immune system.

Page Ref: 548 Cognitive Level: Analyzing Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.4 Diagnose actual or potential health problems and needs. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Diagnosis Learning Outcome: 22.3 Develop a nursing care plan in partnership with the family for a child with human immunodeficiency virus (HIV infection).

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 14) A child is receiving a nucleoside reverse transcriptase inhibitor for human immunodeficiency virus (HIV). Which mechanism of action should the nurse review with the child's parent?

1. Inhibits the action of an enzyme.

2. Blocks the virus from replicating.

3. Kills the virus.

4. Boosts the production of white blood cells.

Answer: 1 Explanation: 1. A nucleoside reverse transcriptase inhibitor inhibits the action of an enzyme in the conversion of RNA to DNA. 2. A nucleoside reverse transcriptase inhibitor does not block the virus from replicating.

3. A nucleoside reverse transcriptase inhibitor does not kill the virus.

4. A nucleoside transcriptase inhibitor does not boost the production of white blood cells.

Page Ref: 548 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Reduction of Risk Potential Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 22.3 Develop a nursing care plan in partnership with the family for a child with human immunodeficiency virus (HIV infection).

15) A child with human immunodeficiency virus (HIV) is diagnosed with oral candidiasis.

Which should the nurse include in the plan of care related to oral care based on this information?

1. Listerine 2. Normal saline 3. Viscous lidocaine 4. Scope Answer: 2 Explanation: 1. Listerine is a commercial mouth rinse that can have an alcohol base and cause drying of the membranes.

2. The mouth care should be with a nonalcohol base. Normal saline can keep the child's lips and mouth moist.

3. Viscous lidocaine causes numbing, and could depress the gag reflex in a younger child.

4. Scope is a commercial mouth rinse that can have an alcohol base and cause drying of the membranes.

Page Ref: 551 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Basic Care and Comfort Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 22.3 Develop a nursing care plan in partnership with the family for a child with human immunodeficiency virus (HIV infection).

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 16) The nurse is providing care for the family of a child who is diagnosed with acquired immunodeficiency syndrome (AIDS). Which problem should the nurse include in the plan of care?

1. Stress 2. Role conflict 3. Anger 4. Financial problems Answer: 1 Explanation: 1. Family support systems and coping mechanisms should be addressed because the stress of caring for a child with AIDS infection may overwhelm the parents.

2. There is no evidence of role conflict when caring for a child with AIDS. 3. There is no evidence of anger when caring for a child with AIDS. 4. There is no evidence of financial problems when caring for a child with AIDS. Page Ref: 548 Cognitive Level: Analyzing Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.4 Diagnose actual or potential health problems and needs. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Diagnosis Learning Outcome: 22.3 Develop a nursing care plan in partnership with the family for a child with human immunodeficiency virus (HIV infection).

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 17) The nurse is providing discharge instructions to the family of a child who experienced an anaphylactic reaction. Which parental statements indicate accurate understanding of the action that histamine plays during this type of reaction? Select all that apply.

1. "Histamine releases IgE antibodies, which help to stop the reaction."

2. "Histamine causes smooth muscle contraction, which causes the wheezing."

3. "Histamine causes increased capillary permeability, which is what causes difficulty breathing."

4. "Histamine causes vasoconstriction leading to respiratory issues."

5. "Histamine causes the destruction of red blood cells, which is why we administer the EpiPen." Answer: 2, 3 Explanation: 1. IgE antibodies cause the release of histamine, not the other way around.

2. Smooth muscle contraction causes the constriction of the bronchioles, which causes the wheezing and respiratory distress.

3. Increased capillary permeability causes the plasma to leak into surrounding tissues, including the lungs, leading to pulmonary edema.

4. Anaphylaxis causes vasodilation, not vasoconstriction.

5. Histamine does not cause red cell destruction.

Page Ref: 558 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 22.6 Determine nursing interventions and prevention measures for the child experiencing hypersensitivity reactions.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 18) When teaching a pregnant client about antibodies that are passed from mother to newborn, which antibody should the nurse include?

1. IgM 2. IgA 3. IgD 4. IgG Answer: 4 Explanation: 1. IgM is the first antibody produced with primary immune response. It does not cross the placenta.

2. IgA does not cross the placenta.

3. Although the function of IgD is not fully understood, it is not thought to cross the placenta.

4. IgG crosses the placenta, and provides the newborn with passive immunity.

Page Ref: 542 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 22.1 Describe the structure and function of the immune system and apply that knowledge to the care of children with immunologic disorders.

453 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 19) Which infection control measures should the nurse include in the discharge instructions for the family of a child who is immunodeficient? Select all that apply.

1. "It is important that your child does not share cups with other members of the family."

2. "You should avoid washing your child's utensils in the dishwasher."

3. "You should allow your child to eat fresh fruit with the skin intact."

4. "It is important that everyone practices hand hygiene before touching your child."

5. "You should use alcohol wipes to cleanse your child's diaper area."

Answer: 1, 4 Explanation: 1. Children who are immunodeficient should not share cups with other members of the family, as this increases the child's risk for developing an infection.

2. Utensils should be washed in warm water or placed in the dishwasher to ensure that contaminates are properly cleansed.

3. Fresh fruit should be washed and peeled prior to allowing the child who is immunocompromised to eat it.

4. Hand hygiene before handling the child, after changing diapers, and prior to feeding the child is essential to decrease the risk for infection.

5. The diaper area should be cleaned with mild soap and allowed to dry. The use of alcohol will increase the risk for skin breakdown and infection.

Page Ref: 544 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: V.A.4. Delineate general categories of errors and hazards in care | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 22.2 Summarize infection control measures needed for children with an immunodeficiency.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 20) Which interventions should the nurse include in the plan of care to address nutrition for a child who is diagnosed with acquired immunodeficiency syndrome (AIDS)? Select all that apply.

1. Encourage three large meals each day.

2. Eliminate unpleasant odors from the environment during meals.

3. Weigh the child each day, using the same scale.

4. Assess skin turgor every 4 hours.

5. Include favorite foods in the meal plan.

Answer: 2, 3, 5 Explanation: 1. Children diagnosed with AIDS who are experiencing impaired nutrition should be offered small frequent meals to meet nutritional needs.

2. Unpleasant stimuli and odors often decrease the desire for food.

3. Taking daily weights, using the same scale, is an appropriate intervention to monitor the child's nutritional status.

4. Skin turgor should be assessed each shift, not every 4 hours, in order to monitor hydration status.

5. Allowing children to eat their favorite foods encourages intake.

Page Ref: 549 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Basic Care and Comfort Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 22.3 Develop a nursing care plan in partnership with the family for a child with human immunodeficiency virus (HIV infection).

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 21) Which interventions should the nurse include in the plan of care for a hospitalized child who is diagnosed with rheumatoid arthritis (RA)? Select all that apply.

1. Performing passive range-of-motion (ROM) exercises with the child 2. Discouraging the child from completing activities of daily living (ADLs) 3. Encouraging periods of rest for the child 4. Placing cool compresses on the child's joints 5. Measure daily weights Answer: 1, 3, 5 Explanation: 1. Active and passive ROM is encouraged as this decreases joint stiffness and inflammation.

2. The child should be encouraged, not discouraged, to be as independent as possible with ADLs. 3. Exacerbations of RA often cause fatigue; therefore, it is appropriate for the nurse to encourage rest periods.

4. Warm, not cool, compresses should be placed on the joints.

5. Daily weights are needed, as it is not uncommon for the child with RA to experience reduced activity and metabolic needs yet maintain the same diet, which places the child at risk for overweight and obesity.

Page Ref: 557-558 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 22.4 Plan nursing care for the child with an autoimmune condition such as systemic lupus erythematosus or juvenile arthritis.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 22) The nurse is providing education to a family whose child experiences anaphylaxis when exposed to any amount of latex. Which items, often found in the home or school environment, should the nurse include in the teaching session? Select all that apply.

1. Art supplies 2. Toothpaste 3. Balloons 4. Perfumes 5. Chewing gum Answer: 1, 3, 5 Explanation: 1. Art supplies often contain latex; therefore, the nurse should include this item in the teaching session.

2. Toothbrushes, not toothpaste, are known to contain latex. The nurse should not include this item in the teaching session.

3. Balloons often contain latex; therefore, the nurse should include this item in the teaching session.

4. Perfumes are not known to contain latex. The nurse should not include this item in the teaching session.

5. Chewing gum often contains latex; therefore, the nurse should include this item in the teaching session.

Page Ref: 561 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: V.A.4. Delineate general categories of errors and hazards in care | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 22.5 Identify exposure prevention measures for the child with latex allergy.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 23) The nurse is providing care to a child who experienced an anaphylactic reaction to an unknown allergen. Which high-risk foods should the nurse question the family about regarding recent consumption?

1. Peanut butter 2. Shrimp 3. Eggs 4. Milk 5. Soda Answer: 1, 2, 3 Explanation: 1. Peanut products, such as peanut butter, are considered a high-risk food allergen.

The nurse should question the family about the consumption of this product.

2. Shellfish, such as shrimp, is considered a high-risk food allergen. The nurse should question the family about the consumption of this product.

3. Egg whites are considered a high-risk food allergen. The nurse should question the family about the consumption of this product.

4. While milk allergies are common, they rarely cause anaphylaxis.

5. Soda is not a high risk for the nurse to include in the assessment process.

Page Ref: 558 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 22.6 Determine nursing interventions and prevention measures for the child experiencing hypersensitivity reactions.

Principles of Pediatric Nursing, 8e (Ball et al.)

Chapter 23 The Child with Alterations in Hematologic Function 1) The nurse prepares to administer a vitamin K injection during the admission assessment for a newborn. The father asks, "Why does my baby need a shot?" Which rationale for administering this injection should the nurse include in the response?

1. Activates clotting factors.

2. Dissolves blood clots.

3. Promotes gas exchange.

4. Promotes the production of hemoglobin.

Answer: 1 Explanation: 1. Levels of clotting factors are lower in infants, so vitamin K is given prophylactically to activate essential clotting factors.

2. Vitamin K promotes clotting; it is not administered to dissolve blood clots.

3. Vitamin K does not promote gas exchange.

4. Vitamin K has no effect on the production of hemoglobin.

Page Ref: 567 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, 458 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 23.3 Explain similarities and differences in the major bleeding disorders affecting the pediatric population.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 2) Which parental statement indicates correct understanding of information presented regarding the treatment for infant anemia?

1. "We will add green leafy vegetables to our child's low-iron formula."

2. "We will discontinue the use of vitamin C supplements by 6 months of age."

3. "We will begin an iron-fortified infant cereal at 4 to 6 months of age."

4. "We will introduce cow's milk by 6 months of age."

Answer: 3 Explanation: 1. The infant's maternal iron stores are depleted by 6 months. Infants who are not breastfed should get iron-fortified formula. Green leafy vegetables, while iron fortified, are not appropriate for the infant.

2. Vitamin C should be started at 6 to 9 months of age and continued because foods rich in vitamin C improve iron absorption.

3. Starting iron-fortified infant cereal at 4 to 6 months of age is recommended for prevention of iron deficiency in children.

4. Cow's milk should not be introduced until 12 months of age.

Page Ref: 568 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 23.2 Discuss the pathophysiology and clinical manifestations of the major disorders of red blood cells affecting the pediatric population.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 3) The parents of an infant diagnosed with sickle-cell disease ask, "How did our child get this disease? Neither one of us has it." Which should the nurse consider when responding to the parents?

1. The father is not the biologic father of the infant.

2. The mother of the child has the trait, but the father does not.

3. The father of the child has the trait, but the mother does not.

4. The mother and the father of the child have the sickle-cell trait.

Answer: 4 Explanation: 1. There is no indication that the father is not the actual parent. Both parents could be carriers of the disorder but unaware of their status.

2. Both parents must have the trait for the child to have a 25% chance of having this disease.

3. Both parents must have the trait for the child to have a 25% chance of having this disease.

4. Sickle-cell disease is an autosomal recessive disorder; both parents must have the trait in order for a child to have a 25% chance of having this disease.

Page Ref: 569 Cognitive Level: Understanding Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 23.2 Discuss the pathophysiology and clinical manifestations of the major disorders of red blood cells affecting the pediatric population.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 4) Which parental statements regarding precipitating factors for sickle-cell disease indicate correct understanding of the discharge information presented by the nurse? Select all that apply.

1. "My child should avoid regular exercise."

2. "We should provide acetaminophen or ibuprofen to treat fever."

3. "Our child needs to drink lots of fluid to avoid dehydration when playing sports."

4. "High altitudes can cause exacerbation and should be avoided."

5. "Fluid restriction is necessary to avoid exacerbations from occurring."

Answer: 2, 3, 4 Explanation: 1. Regular exercise and increased fluid intake are recommended activities for a child with sickle-cell disease and will not contribute to a sickle-cell crisis.

2. Fever, dehydration, and altitude are all precipitating factors contributing to a sickle-cell crisis.

3. Fever, dehydration, and altitude are all precipitating factors contributing to a sickle-cell crisis.

4. Fever, dehydration, and altitude are all precipitating factors contributing to a sickle-cell crisis.

5. Regular exercise and increased fluid intake are recommended activities for a child with sicklecell disease and will not contribute to a sickle-cell crisis.

Page Ref: 569, 571 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 23.2 Discuss the pathophysiology and clinical manifestations of the major disorders of red blood cells affecting the pediatric population.

5) The nurse is administering packed red blood cells to a child with sickle-cell disease (SCD).

When should the nurse monitor the child closely due to the risk of reaction?

1. Six hours after the transfusion is given.

2. At the end of the administration of the transfusion.

3. The first 20 mL of blood administered.

4. Never; children with SCD do not have reactions.

Answer: 3 Explanation: 1. Transfusion reaction does not occur this long after the transfusion.

2. Reactions generally occur at the onset or during the first 20 minutes of transfusion.

3. Blood reactions can occur as soon as the blood transfusion begins. The nurse should administer the first 20 mL of blood slowly, and monitor for a reaction during this time frame.

4. Anyone can have a transfusion reaction during any transfusion.

Page Ref: 575 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 23.2 Discuss the pathophysiology and clinical manifestations of the major disorders of red blood cells affecting the pediatric population.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 6) A child who has beta-thalassemia is receiving numerous blood transfusions and deferoxamine (Desferal) therapy. The parents ask how the deferoxamine will help their child. Which response by the nurse is accurate?

1. "It stimulates red blood cell production."

2. "It prevents iron overload."

3. "It provides vitamin supplementation."

4. "It decreases the risk of transfusion reactions."

Answer: 2 Explanation: 1. Desferal does not stimulate red blood cell production.

2. Iron overload can be a side effect of a hypertransfusion therapy. Desferal is an iron-chelating drug that binds excess iron so it can be excreted by the kidneys. It does not prevent blood transfusion reactions, stimulate red blood cell production, or provide vitamin supplementation.

3. Desferal does not provide vitamin supplementation.

4. Desferal does not prevent blood transfusion reactions.

Page Ref: 577 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 23.2 Discuss the pathophysiology and clinical manifestations of the major disorders of red blood cells affecting the pediatric population.

7) A child diagnosed with aplastic anemia is admitted to the hospital. The parents ask the nurse what aplastic anemia is. Which response by the nurse is accurate?

1. "Aplastic anemia causes a proliferation of white blood cells."

2. "Aplastic anemia is characterized by abnormally shaped red blood cells."

3. "Aplastic anemia is caused the bone marrow producing inadequate cells."

4. "Aplastic anemia is a disorder that occurs after a viral illness."

Answer: 3 Explanation: 1. All blood cells, not just white blood cells, are affected by aplastic anemia.

2. Aplastic anemia does not cause abnormally shaped red blood cells; this is a description of sickle-cell disease.

3. In aplastic anemia, the bone marrow does not produce sufficient numbers of circulating blood cells.

4. There is no known association between aplastic anemia and viral illness.

Page Ref: 577 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 23.2 Discuss the pathophysiology and clinical manifestations of the major disorders of red blood cells affecting the pediatric population.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 8) Which symptoms should the nurse include in the teaching plan for the family of a recently child diagnosed with aplastic anemia?

1. Fatigue and fever 2. Runny nose and cough 3. Nausea and vomiting 4. Cyanosis and bradycardia Answer: 1 Explanation: 1. Fatigue secondary to anemia and fever related to infection secondary to neutropenia are common symptoms.

2. Aplastic anemia is not associated with upper respiratory infections.

3. Nausea and vomiting are not symptoms of aplastic anemia.

4. The child would exhibit tachycardia rather than bradycardia, and there is no reason for cyanosis.

Page Ref: 578 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 23.4 Plan the nursing management and collaborative care of a child with a hematologic disorder.

9) A child diagnosed with hemophilia presents to the emergency department (ED) with multiple injuries following a motor vehicle crash. Which injury is the priority when conducting the nursing assessment?

1. Occipital hematoma 2. Radial fracture 3. Dislocated shoulder 4. Abdominal abrasions Answer: 1 Explanation: 1. A potential intracranial bleed would receive highest priority because of the danger of increased intracranial pressure and potential neurologic damage.

2. Although at risk for bleeding, this would not take priority over a head injury.

3. A dislocation is not at high risk for bleeding or tissue ischemia.

4. Although at risk for bleeding, this would not take priority over a head injury.

Page Ref: 579 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 23.4 Plan the nursing management and collaborative care of a child with a hematologic disorder.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 10) Which nursing action is appropriate when treating a school-age child, diagnosed with hemophilia, for a superficial wound above the knee?

1. Applying pressure to the area 2. Applying a warm, moist pack to the area 3. Performing some passive range-of-motion to the affected leg 4. Keeping the affected extremity in a dependent position Answer: 1 Explanation: 1. If a child with hemophilia experiences a bleeding episode, superficial bleeding should be controlled by applying pressure to the wound.

2. Heat would increase the bleeding by dilating the superficial blood vessels. A cool compress should be applied.

3. The extremity should be immobilized to prevent further bleeding; passive range-of-motion could cause further bleeding at the site.

4. The extremity should be elevated, if possible, to prevent swelling at the site.

Page Ref: 579 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 23.4 Plan the nursing management and collaborative care of a child with a hematologic disorder.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 11) The nurse is providing care to a child diagnosed with hemophilia who states, "I am going to join a bike club at school." Which recommendation should the nurse give to the child?

1. Wear kneepads, elbow pads, and a helmet while bicycling.

2. Consider a swim club instead of the bicycling club.

3. Do not join the club.

4. Participate only in the social activities of the club.

Answer: 1 Explanation: 1. Children with hemophilia should be encouraged to participate in noncontact sports activities. Bicycling is an excellent option, and is recommended, along with swimming.

However, the child should always use kneepads, elbow pads, and a helmet when participating in any physical sport.

2. Biking is an acceptable sport as long as protective equipment is worn, and the child should be encouraged to make choices when possible.

3. Discouraging a child from joining a club would not foster growth and development.

4. Participating only in the social aspects of the club would not encourage physical activity.

Page Ref: 579 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 23.4 Plan the nursing management and collaborative care of a child with a hematologic disorder.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 12) Which is the priority nursing intervention when providing care to a pediatric client who is experiencing disseminated intravascular coagulation (DIC)?

1. Preparing the child for radiographic procedures 2. Implementing the prescribed fluid restriction for the child 3. Encouraging the child to frequently ambulate 4. Monitoring the child's oxygen saturation and vital signs Answer: 4 Explanation: 1. DIC is not diagnosed with a radiographic examination but by serum laboratory studies.

2. Fluids need to be monitored but will not be restricted.

3. Ambulation places stress on joints and can promote bleeding. The child with DIC should be placed on bed rest.

4. In a child who has a bleeding and clotting disorder, the priority nursing intervention would be monitoring for life-threatening complications.

Page Ref: 580 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 23.4 Plan the nursing management and collaborative care of a child with a hematologic disorder.

13) Which is the priority problem for the child diagnosed with idiopathic thrombocytopenic purpura (ITP)?

1. Pain 2. Anxiety 3. Increased fluid 4. Risk for bleeding Answer: 4 Explanation: 1. Pain is not a major problem with ITP. 2. Anxiety is not a problem with ITP. 3. Excess fluid is not a problem with ITP. 4. ITP is a common bleeding disorder in children, which increases the risk for bleeding.

Page Ref: 581 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.4 Diagnose actual or potential health problems and needs. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Diagnosis Learning Outcome: 23.3 Explain similarities and differences in the major bleeding disorders affecting the pediatric population.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 14) Which is the priority teaching point for the nurse to include in the discharge instructions for the parents of a child who was admitted in a sickle-cell crisis?

1. Rapid weaning of pain medications 2. A diet high in protein 3. Adequate hydration 4. Restriction of activities Answer: 3 Explanation: 1. Rapid weaning is not necessary; reduction of pain medication should proceed at a rate dictated by the child's pain.

2. A high-protein diet is not necessary; a well-balanced diet should be promoted.

3. Adequate hydration will help prevent further sequestration and crisis.

4. Normal activities are not restricted.

Page Ref: 572 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 23.4 Plan the nursing management and collaborative care of a child with a hematologic disorder.

15) Which teaching topic should the nurse include in the discharge instructions for the family of child diagnoses with sickle-cell disease to prevent crisis?

1. Respiratory infection and dehydration 2. Midrange altitudes 3. Weight loss without dehydration 4. Overhydration Answer: 1 Explanation: 1. The child with sickle-cell disease is at risk for infection, and dehydration can precipitate crisis.

2. High altitudes with lower oxygen concentrations pose a risk; mid-altitude is not a risk factor.

3. Weight loss is acceptable as long as hydration is maintained.

4. Hydration should be encouraged; risk of overhydration is minimal.

Page Ref: 574 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 23.4 Plan the nursing management and collaborative care of a child with a hematologic disorder.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 16) Which risks should the nurse closely assess a pediatric client for during the posttransplant phase of hematopoietic stem cell transplantation (HSCT)?

1. Hemorrhage 2. Thrombosis 3. Pancytopenia 4. Infection 5. Fluid volume overload Answer: 1, 3, 4 Explanation: 1. Suppression of platelets increases the risk for bleeding.

2. There is no increased risk for thrombosis.

3. It takes 2 to 4 weeks for the bone marrow to begin producing cells; the client will show evidence of suppression until that time.

4. Suppression of white blood cells increases the client's risk for infection.

5. There is no increased risk of excess fluid; the client is at greater risk for dehydration.

Page Ref: 581 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 23.4 Plan the nursing management and collaborative care of a child with a hematologic disorder.

17) During a natural disaster, a child diagnosed with hemophilia is injured and bleeding internally. Which blood product should the nurse plan to administer if the appropriate factor is not available?

1. Platelets 2. Whole blood 3. Packed cells 4. Fresh or fresh frozen plasma Answer: 4 Explanation: 1. The child has adequate platelets, and administration of platelets will not promote clotting.

2. Whole blood will increase the blood volume without promoting clotting.

3. A unit of packed cells will provide red blood cells (RBCs) but not the factor needed to clot.

4. Factors are located in the plasma. Fresh or fresh frozen plasma will provide the best source of factor available.

Page Ref: 578 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 23.3 Explain similarities and differences in the major bleeding disorders affecting the pediatric population.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 18) A school-age child diagnosed with classic hemophilia is admitted to the hospital for hemorrhage into the knee joint. Which problem should the nurse use to plan care for this child?

1. Anxiety 2. Reduced self-esteem 3. Reduced hemoglobin level 4. Possible impaired physical mobility Answer: 4 Explanation: 1. A bleed into the joint will not cause a high amount of anxiety.

2. Although the knee will be swollen, self-esteem is not the priority diagnosis at this time.

3. The bleeding into the joint will not most likely affect total circulating hemoglobin level.

4. A bleed into the joint can lead to permanent contracture of the joint. Bone changes can result from the immobility associated with the bleed.

Page Ref: 579 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.4 Diagnose actual or potential health problems and needs. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Diagnosis Learning Outcome: 23.4 Plan the nursing management and collaborative care of a child with a hematologic disorder.

19) Which rationale should the nurse include in the teaching session, related to infant iron deficiency anemia, when a parent asks why it is inappropriate to switch from formula to cow's milk prior to 1 year of age? Select all that apply.

1. Cow's milk is a poor source of iron.

2. The child may be exposed to an antibiotic in processed milk.

3. Cow's milk has a high fat content.

4. In young children, cow's milk can lead to bleeding from the gastrointestinal tract.

5. Cow's milk contains no vitamin C, which is necessary for iron absorption.

Answer: 1, 4 Explanation: 1. This information is correct.

2. This would not be a reason for delaying the entry of milk into the diet.

3. Because there are low-fat varieties of cow's milk, this would not be a reason to delay introducing it.

4. This information is correct.

5. While the amount of vitamin C in milk is limited, this is not the reason for delaying introducing cow's milk into the child's diet.

Page Ref: 568 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 23.2 Discuss the pathophysiology and clinical manifestations of the major disorders of red blood cells affecting the pediatric population.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 20) The nurse is preparing to administer a blood transfusion to a child with a severe anemia.

Which type of transfusion reaction can be avoided by the nurse's assessment?

1. Allergic 2. Hemolytic 3. Febrile 4. Septic Answer: 2 Explanation: 1. Allergic reactions are due to a protein in the donated blood to which the child reacts. The nurse cannot prevent this type of reaction.

2. A hemolytic reaction results from mismatched blood, a preventable error. This error is most likely to occur at the bedside if the nurse does not carefully identify the unit of blood and the patient.

3. A febrile reaction is related to contamination of blood. The nurse has no control over this type of reaction.

4. Septic is another name for a febrile reaction and is not preventable by the nurse.

Page Ref: 575 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 23.2 Discuss the pathophysiology and clinical manifestations of the major disorders of red blood cells affecting the pediatric population.

21) The healthcare provider prescribes a unit of packed red blood cells for a pediatric client.

Which intravenous fluid should the nurse infuse during the blood transfusion?

1. D5W 2. D5LR 3. D5 1/4NS 4. NS Answer: 4 Explanation: 1. Dextrose should not be used, as it will cause packed cells to clot.

2. D5 lactated Ringer solution also contains dextrose and should not be used with packed cells.

3. Dextrose is inappropriate no matter what is the other component of the intravenous fluids.

4. Normal saline is appropriate to use prior to initiating blood.

Page Ref: 575 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 23.4 Plan the nursing management and collaborative care of a child with a hematologic disorder.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 22) A school-age child is admitted to the hospital in a sickle-cell crisis. Which actions should the nurse include in the plan of care to address the child's pain?

1. Administering opioid analgesics, per order 2. Administering nonsteroidal anti-inflammatory drugs (NSAIDs), per order 3. Applying cold packs to affected joints, prn 4. Encouraging oral fluid intake 5. Maintaining bed rest Answer: 1, 2, 4, 5 Explanation: 1. Narcotics, such as morphine, are used to control the pain and reduce sickling.

2. NSAIDs may be used in combination with narcotics to control the pain.

3. Cold application is inappropriate in this situation as it would increase the sickling.

4. Oral fluids will help "thin" the blood and reduce sickling.

5. Bed rest will reduce the oxygen requirements of the body and prevent further sickling.

Page Ref: 571-572 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 23.2 Discuss the pathophysiology and clinical manifestations of the major disorders of red blood cells affecting the pediatric population.

23) The healthcare provider orders laboratory tests following the initiation of treatment for a child diagnosed with iron deficiency anemia. Which laboratory result should the nurse share with the child's family as an indication of improvement?

1. Low hemoglobin 2. Normal platelet count 3. High reticulocyte count 4. Low hematocrit Answer: 3 Explanation: 1. Low hemoglobin is a typical finding in iron deficiency anemia.

2. Platelet count is unrelated to iron deficiency anemia.

3. Reticulocytes are immature red blood cells, and indicate new cells are being produced.

4. This would be a typical finding in iron deficiency anemia.

Page Ref: 568 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Reduction of Risk Potential Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 23.2 Discuss the pathophysiology and clinical manifestations of the major disorders of red blood cells affecting the pediatric population.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 24) Which topic should the nurse include in the discharge instructions for the family of a child who has undergone hematopoietic stem cell transplantation (HSCT)?

1. Avoiding influenza vaccination 2. Returning to school within 6 weeks 3. Maintaining a low-calcium diet 4. Practicing diligent hand hygiene Answer: 4 Explanation: 1. The child and the family should be encouraged to get yearly influenza vaccinations.

2. The child cannot return to school for 6 to 12 months after an HSCT. In-hospital or in-home schooling is required.

3. The child should be placed on calcium supplements to reduce the risk of osteopenia.

4. Handwashing is essential to prevent the spread of infection.

Page Ref: 581 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 23.5 Prioritize nursing interventions for a child receiving hematopoietic stem cell transplantation (HSCT).

25) Which functions of red blood cells (RBCs) should the nurse include in a teaching session for the family of a pediatric client who is diagnosed with anemia? Select all that apply.

1. Carry oxygen from the lungs to the tissues.

2. Return carbon dioxide from the tissues to the lungs.

3. Assist the body to fight infection.

4. Assist the body to fight allergens.

5. Form hemostatic plugs to stop bleeding.

Answer: 1, 2 Explanation: 1. A function of RBCs is to carry oxygen from the lungs to the tissues.

2. A function of RBCs is to return carbon dioxide from the tissues to the lungs.

3. A function of the white blood cells, not the RBCs, is to fight infection.

4. A function of the white blood cells, not the RBCs, is to fight allergens.

5. A function of platelets, not RBCs, is to form hemostatic plugs to stop bleeding.

Page Ref: 567 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Reduction of Risk Potential Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 23.1 Describe the function of red blood cells, white blood cells, and platelets.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 26) Which functions of white blood cells (WBCs) should the nurse include in a teaching session for the family of a pediatric client who is diagnosed with human immunodeficiency virus (HIV)?

Select all that apply.

1. Carry oxygen from the lungs to the tissues.

2. Return carbon dioxide from the tissues to the lungs.

3. Assist the body to fight infection.

4. Assist the body to fight allergens.

5. Form hemostatic plugs to stop bleeding.

Answer: 3, 4 Explanation: 1. A function of red blood cells, not WBCs, is to carry oxygen from the lungs to the tissues.

2. A function of red blood cells, not WBCs, is to return carbon dioxide from the tissues to the lungs.

3. A function of the WBCs is to fight infection.

4. A function of the WBCs is to fight allergens.

5. A function of platelets, not WBCs, is to form hemostatic plugs to stop bleeding.

Page Ref: 567 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Reduction of Risk Potential Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 23.1 Describe the function of red blood cells, white blood cells, and platelets.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 27) The nurse is providing care to a pediatric client who is diagnosed with leukopenia. Which disorders should the nurse suspect based on this information? Select all that apply.

1. Cardiovascular 2. Immune 3. Bone marrow 4. Respiratory 5. Neurologic Answer: 2, 3 Explanation: 1. Cardiovascular disorders are not associated with leukopenia.

2. Immune disorders are associated with leukopenia.

3. Bone marrow disorders are associated with leukopenia.

4. Respiratory disorders are not associated with leukopenia.

5. Neurologic disorders are not associated with leukopenia.

Page Ref: 567 Cognitive Level: Understanding Client Need/Sub: Physiological Integrity / Reduction of Risk Potential Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Assessment Learning Outcome: 23.3 Explain similarities and differences in the major bleeding disorders affecting the pediatric population.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 28) Which injury prevention topics should the nurse include in the plan of care for a pediatric client who has received hematopoietic stem cell transplantation (HSCT)? Select all that apply.

1. Medication storage strategies 2. Needle and syringe disposal 3. Immunization schedule 4. Yearly influenza vaccination 5. Routine dental appointments Answer: 1, 2 Explanation: 1. Medication storage strategies is a topic the nurse should include in the plan of care related to injury prevention strategies.

2. Needle and syringe disposal is an area the nurse should include in the plan of care related to injury prevention strategies.

3. An altered immunization schedule is a topic related to infection, not injury, prevention.

4. Yearly influenza vaccination is a topic related to infection, not injury, prevention.

5. Routine dental appointments are an important topic to include regarding oral health, not injury prevention.

Page Ref: 581 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 23.5 Prioritize nursing interventions for a child receiving hematopoietic stem cell transplantation (HSCT).

Principles of Pediatric Nursing, 8e (Ball et al.)

Chapter 24 The Child with Cancer 1) The nurse is providing care for a pediatric client who is diagnosed with a Wilms tumor. Which laboratory test result should the nurse monitor prior to administering the prescribed chemotherapy dose?

1. Hemoglobin 2. Red blood cell count 3. Platelets 4. Absolute neutrophil count (ANC) Answer: 4 Explanation: 1. Hemoglobin indicates oxygen-carrying capacity, not immune response.

2. Red blood cell count has no correlation with immune function.

3. Platelets are associated with clotting, not immune function.

4. The absolute neutrophil count uses both the segmented (mature) and bands (immature) neutrophils as a measure of the body's infection-fighting capability.

Page Ref: 589 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Reduction of Risk Potential Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate 477 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 24.2 Synthesize information about diagnostic tests and clinical therapy for cancer to plan comprehensive care for children undergoing these procedures.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 2) Which general manifestations should the nurse monitor for when conducting a physical assessment for a pediatric client who is diagnosed with cancer? Select all that apply.

1. Infection 2. Polycythemia 3. Petechiae 4. Pain 5. Cachexia Answer: 1, 3, 4, 5 Explanation: 1. Infection is often a general manifestation associated with cancer caused by altered immune function.

2. Anemia, not polycythemia, is a general manifestation associated with cancer.

3. Hemorrhagic spots, or petechiae, are general manifestations associated with cancer.

4. Pain is often a general manifestation of cancer resulting from neoplasms directly or indirectly affecting nerve receptors.

5. Cachexia is a state that is often associated with cancer. Specific symptoms include anorexia, nausea, and vomiting.

Page Ref: 588 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 24.1 Describe the incidence, known etiologies, and common clinical manifestations of cancer.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 3) Which is a therapeutic nursing response when the mother of a pediatric client diagnosed with cancer states, "I regret not seeking medical attention earlier for my child"?

1. "You may feel guilty, but you should not blame yourself."

2. "Most cancers can be treated easily."

3. "Many types of cancer are difficult to diagnose and might not show early symptoms."

4. "Early diagnosis is not significant in the diagnosis and management of cancer."

Answer: 3 Explanation: 1. This is not a therapeutic response. It is not appropriate for the nurse to tell the family how they should feel.

2. This answer is not accurate, as cancer is generally prolonged and difficult for both the child and family.

3. Many cancers do not present significant findings until late and can progress rapidly. Giving such information is a communication tool.

4. Outcomes for many cancers are improved with early diagnosis.

Page Ref: 606 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 24.1 Describe the incidence, known etiologies, and common clinical manifestations of cancer.

4) A child diagnosed with cancer is prescribed chemotherapy. Recent laboratory data show a low white blood cell (WBC) count. Which prescription should the nurse anticipate based on the current data?

1. Epoetin alfa (Epogen) 2. Ondansetron (Zofran) 3. Oprelvekin (Neumega) 4. Filgrastim (Neupogen) Answer: 4 Explanation: 1. Epoetin alfa (human recombinant erythropoietin) stimulates red blood cell (RBC) production.

2. Ondansetron (Zofran) is an antiemetic.

3. Oprelvekin (Neumega) increases platelets.

4. Filgrastim (Neupogen) increases production of neutrophils, a specific WBC, by the bone marrow.

Page Ref: 594 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 24.2 Synthesize information about diagnostic tests and clinical therapy for cancer to plan comprehensive care for children undergoing these procedures.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 5) Which urine specific gravity, and corresponding pH, should the nurse include in a goal statement for a pediatric client receiving chemotherapy in the treatment of cancer?

1. Specific gravity 1.030 and pH 7.5 2. Specific gravity 1.005 and pH 6 3. Specific gravity 1.030 and pH 6 4. Specific gravity 1.005 and pH 7.5 Answer: 4 Explanation: 1. A specific gravity higher than 1.010 can mean fluid intake is not high enough.

2. A pH of less than 7 means acidosis.

3. A specific gravity higher than 1.010 can mean fluid intake is not high enough, and a pH of less than 7 means acidosis.

4. Because the breakdown of malignant cells releases intracellular components into the blood and electrolyte imbalance causes metabolic acidosis, the patient should remain well hydrated, with the urine specific gravity at less than 1.010 and the pH at 7.0 to 7.5.

Page Ref: 596 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Reduction of Risk Potential Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 24.2 Synthesize information about diagnostic tests and clinical therapy for cancer to plan comprehensive care for children undergoing these procedures.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 6) The nurse is preparing to administer a prescribed, as needed, antiemetic drug for a child who is diagnosed with cancer. Which action by the nurse is most appropriate?

1. Administering the drug only if the child is nauseated 2. Administering the drug prophylactically prior to the next dose of chemotherapy 3. Administering the drug after the next dose of chemotherapy 4. Administering the drug only if the child is experiencing diarrhea Answer: 2 Explanation: 1. Administering the prn dose of the antiemetic drug only if the child is nausea is not the best use of this medication.

2. The antiemetic should be administered before chemotherapy and every 4 hours during the administration of chemotherapy, as a prophylactic measure.

3. Administering the prn dose of the antiemetic drug after the next dose of chemotherapy may not provide adequate coverage for nausea.

4. Antiemetic drugs are not administered to treat diarrhea. They are administered to treat nausea and vomiting.

Page Ref: 604 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 24.2 Synthesize information about diagnostic tests and clinical therapy for cancer to plan comprehensive care for children undergoing these procedures.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 7) Which nursing intervention is contraindicated for a pediatric client who is experiencing thrombocytopenia secondary to chemotherapy treatments?

1. Administering intramuscular injections 2. Monitoring intake and output 3. Palpating during the assessment 4. Providing oral hygiene Answer: 1 Explanation: 1. When the child is thrombocytopenic (decreased platelets) from chemotherapy, the nurse should not administer intramuscular injections because of the risk of bleeding.

2. Monitoring intake and output is not contraindicated for a pediatric client who is experiencing thrombocytopenia as a result of chemotherapy treatments.

3. Palpation during the assessment is not contraindicated due to thrombocytopenia. This action is contraindicated for a child who is diagnosed with Wilms tumor.

4. Providing oral hygiene is not contraindicated for a pediatric client who is experiencing thrombocytopenia as a result of chemotherapy treatments.

Page Ref: 604 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Reduction of Risk Potential Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 24.3 Integrate information about oncologic emergencies into plans for monitoring all children with cancer.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 8) The child is receiving chemotherapy for acute lymphocytic leukemia (ALL). Which assessment data should the nurse immediately report to the healthcare provider due to a metabolic emergency?

1. Thrombocytopenia 2. Leukocytosis 3. Oliguria 4. Edema Answer: 3 Explanation: 1. Thrombocytopenia is a clinical manifestation associated with a hematologic, not metabolic, emergency.

2. Leukocytosis is a clinical manifestation associated with a hematologic, not metabolic, emergency.

3. Tumor lysis causes a metabolic emergency caused by an electrolyte imbalance. Clinical manifestations associated with this include altered renal function and altered levels of consciousness.

4. Edema is not indicative of a metabolic emergency.

Page Ref: 596 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 24.3 Integrate information about oncologic emergencies into plans for monitoring all children with cancer.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 9) The adolescent client is receiving methotrexate chemotherapy after undergoing limb-salvage surgery for osteogenic sarcoma. The healthcare provider also prescribes leucovorin therapy.

Which adolescent statement indicates correct understanding for the administration schedule for this newly prescribed drug?

1. "I do not have any pain, so I will not need to take the leucovorin this time."

2. "I do not have any nausea, so I will not need the leucovorin."

3. "I am glad I only need one dose of the leucovorin."

4. "It is important that I receive my leucovorin on time, as it protects my body from the methotrexate."

Answer: 4 Explanation: 1. Leucovorin is not administered for pain.

2. Leucovorin is administered for nausea.

3. One dose is not the recommended therapy.

4. Leucovorin (citrovorum factor) is a form of folic acid that helps to protect normal cells from the destructive action of methotrexate. It is started within 24 hours of methotrexate administration and is given along with hydration therapy. Usual administration is every 6 hours times 72 hours or until serum methotrexate is at the desired level.

Page Ref: 604 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 24.4 Recognize the most common solid tumors in children, describe their treatment, and plan comprehensive nursing care.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 10) The sibling of a pediatric client diagnosed with leukemia expresses feelings of anger and guilt to the nurse. Which explanation should the nurse provide to the client's parents regarding the reaction of the sibling?

1. Abnormal; the sibling should be referred to a psychologist.

2. Unexpected; the cancer is easily treated.

3. Unusual; the illness does not affect the sibling.

4. Normal; the sibling is affected, too, and anger and guilt are expected feelings.

Answer: 4 Explanation: 1. Siblings are generally affected to some degree, but this is a normal reaction.

2. Cancer is not easily treated, and will affect the entire family.

3. A diagnosis of cancer affects the entire family; siblings will be affected to some degree.

4. A diagnosis of cancer affects the whole family, and initial feelings experienced by the sibling might be anger and guilt.

Page Ref: 606 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 24.5 Plan care for children and adolescents of all ages who have a diagnosis of leukemia.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 11) The nurse is providing care to a pediatric client who is receiving chemotherapy to treat acute lymphocytic leukemia (ALL). For which potential problems should the nurse plan care for this client? Select all that apply.

1. Potential injury 2. Change in skin status 3. Electrolyte imbalances 4. Potential for an infection 5. Change in sleep pattern Answer: 1, 2, 3, 4 Explanation: 1. A pediatric client can sustain an injury due to the potential hemorrhagic cystitis, a common side effect for chemotherapy.

2. A pediatric client is at risk to a change in skin status due to mouth sores, a common early side effect of chemotherapy.

3. The client could experience nausea and vomiting, which would affect the balance of electrolytes.

4. The chemotherapy can suppress the bone marrow, which increases the client's risk for an infection.

5. There is no expected change in sleep pattern for this client.

Page Ref: 600 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.4 Diagnose actual or potential health problems and needs. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Diagnosis Learning Outcome: 24.5 Plan care for children and adolescents of all ages who have a diagnosis of leukemia.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 12) Which is the priority nursing intervention for a pediatric client, diagnosed with leukemia, who has a granulocyte count of 250/mm3 and a platelet count of 150,000/mm3?

1. Fluid restriction 2. Mouth care 3. Neutropenic precautions 4. Hand hygiene Answer: 4 Explanation: 1. A fluid restriction is not a priority nursing intervention based on the current data.

Fluids should continue to be encouraged.

2. Platelet count is normal; mouth care should include brushing with a soft toothbrush and frequent rinsing.

3. The child should be isolated from anyone infectious, but neutropenic isolation is not necessary.

4. Hand hygiene is vital for preventing the spread of infection.

Page Ref: 601 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Reduction of Risk Potential Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 24.5 Plan care for children and adolescents of all ages who have a diagnosis of leukemia.

13) A child with rhabdomyosarcoma is prescribed radiation therapy after surgical removal of the tumor. Which intervention should the nurse include in the child's plan of care?

1. Apply lotion to the area before radiation therapy.

2. Apply sunscreen to the area when the child is exposed to sunlight.

3. Remove any markings left after each radiation treatment.

4. Vigorously scrub the area when bathing the child.

Answer: 2 Explanation: 1. Lotion can increase the chance of a radiation burn when applied before the treatment.

2. Radiation therapy causes the skin in that area to be sensitive. Sunscreen should be applied so that sunburns are avoided.

3. Radiation markings are to guide the radiologist and should not be removed.

4. Vigorous scrubbing is not recommended.

Page Ref: 597 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 24.6 Prioritize elements of comprehensive care planning for children with soft-tissue tumors.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 14) The child is admitted to the hospital unit newly diagnosed with retinoblastoma. Which clinical manifestation does the nurse anticipate upon assessment?

1. A white reflection 2. Blue-tinged sclerae 3. A red reflex 4. Yellow-tinged sclerae Answer: 1 Explanation: 1. The first sign of retinoblastoma is a white pupil. The red reflex is absent. This is known as leukocoria, or "cat's eye" reflex.

2. Blue-tinged sclerae are a sign of osteogenesis imperfecta, not retinoblastoma.

3. Red reflex is absent in retinoblastoma.

4. Yellow sclerae are a sign of jaundice, not retinoblastoma.

Page Ref: 621 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 24.6 Prioritize elements of comprehensive care planning for children with soft-tissue tumors.

15) A preschool-age child is being seen in the oncology clinic. Which reaction should the nurse anticipate based on the child's stage of development?

1. Unawareness of the illness and its severity 2. Acceptance, especially if able to discuss the disease with children their own age 3. Understanding of what cancer is, and how it is treated 4. Thoughts that they caused their illness, and are being punished Answer: 4 Explanation: 1. Infants and toddlers are unaware of the severity of the disease.

2. Immediate acceptance will not occur with children of any age. Adolescents find contact with others who have gone through their experience helpful.

3. School-age children can understand a diagnosis of cancer.

4. Preschool-age children are egocentric and have magical thinking, and thus, they might believe they caused their own illness.

Page Ref: 597 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 24.7 Analyze the impact of cancer survival on children and use this information to plan for ongoing physiologic and psychosocial care in the children's futures.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 16) A pediatric client diagnosed with cancer is to receive 2 months of chemotherapy that is separated by a 6-week period. The mother asks why the child cannot receive the medication for 2 months straight. Which rationale should the nurse include when responding to the client's mother?

1. Prevention of nausea and vomiting from the drugs 2. Schedule requirement of the infusion center 3. Decrease incidence of heart failure 4. Allows normal cells to repair themselves while the cancer cells die Answer: 4 Explanation: 1. The 6-week break will not decrease the side effects of nausea and vomiting.

2. Necessary treatment should never be delayed for the convenience of the medical personnel.

3. The 6-week break is not to decrease the incidence of heart failure, as this is not an adverse effect to chemotherapy.

4. Cancer cells have lost the ability to repair themselves, so medications allow the normal cells to repair while the cancer cells die.

Page Ref: 590 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 24.2 Synthesize information about diagnostic tests and clinical therapy for cancer to plan comprehensive care for children undergoing these procedures.

17) The parent of a child diagnosed with Ewing sarcoma asks why multiple drugs are needed to treat this cancer. Which rationale should the nurse use when responding to the client's mother?

1. The prescribed drug protocol is needed due to the aggressive nature of the cancer.

2. The prescribed drug protocol decreases side effects.

3. The prescribed drug protocol is used in specifically in children.

4. The prescribed drug protocol involves a group of drugs that work in different modes.

Answer: 4 Explanation: 1. A multiple drug protocol is not prescribed due to aggressive nature of Ewing sarcoma.

2. A multiple drug protocol is not prescribed to decrease side effects.

3. A multiple drug protocol is used in both children and adults.

4. A multiple drug protocol is used to attack the cancer cells from all angles.

Page Ref: 604 Cognitive Level: Understanding Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 24.4 Recognize the most common solid tumors in children, describe their treatment, and plan comprehensive nursing care.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 18) An adolescent female client, diagnosed with osteosarcoma, has a below-the-knee amputation as part of the treatment regimen. Which behavior, assessed by the nurse, indicates the client is beginning to accept the amputation?

1. Complaints of pain in the missing leg.

2. Insists that a prosthetic be applied prior to participating in physical therapy.

3. Insists on covering the lower portion of the body prior to peer visitation.

4. Watches the dressing change.

Answer: 4 Explanation: 1. Phantom pain is an expected finding after an amputation; however, this does not indicate acceptance.

2. This indicates she wants to return to mobility but has not yet accepted the stump.

3. Being in a wheelchair with a blanket cover indicates she doesn't want her friends to be aware of her amputation.

4. This indicates the girl is willing to look at the stump, which is a step toward acceptance.

Page Ref: 616 Cognitive Level: Analyzing Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 24.6 Prioritize elements of comprehensive care planning for children with soft-tissue tumors.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 19) A school-age child, diagnosed with rhabdomyosarcoma, is experiencing nausea and vomiting related to the prescribed chemotherapy in spite of the use of antiemetics. The mother is pushing the child to eat the food. Which statement by the nurse is appropriate to address this situation?

1. "Since your child is receiving IV fluids, it is not important to push oral intake of food."

2. "A food aversion may occur if you continue to force your child to eat."

3. "Emesis that is caused by your child being force-fed can damage the stomach."

4. "A psychological conflict could occur between you and your child if you continue to push eating."

Answer: 2 Explanation: 1. Intravenous fluids do not replace normal food intake.

2. If the child is forced to eat and then vomits, the child can develop a food aversion in which the child associates that food with vomiting.

3. Vomiting is unpleasant but does not usually lead to stomach damage.

4. This is not a correct statement. Parents and children often disagree, but the child will still relate to the parent.

Page Ref: 604 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Basic Care and Comfort Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 24.6 Prioritize elements of comprehensive care planning for children with soft-tissue tumors.

20) The school-age child, diagnosed with a medulloblastoma, will receive intrathecal chemotherapy injections after surgery. Which rationale for this type of chemotherapy administration should the nurse include in the medication teaching?

1. It reduces side effects.

2. It does not require the child being "stuck."

3. Many chemotherapy drugs do not cross the blood-brain barrier.

4. Intrathecal administration is less expensive than intravenous administration.

Answer: 3 Explanation: 1. Intrathecal administration does not reduce side effects.

2. Intrathecal administration is through a spinal tap, so the child will be "stuck" for administration.

3. This is correct for the selection of intrathecal administration of chemotherapy.

4. This is not accurate and would not be a reason to change administration modes.

Page Ref: 610 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 24.2 Synthesize information about diagnostic tests and clinical therapy for cancer to plan comprehensive care for children undergoing these procedures.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 21) The school-age child is admitted to the pediatric neurologic unit with a suspected craniopharyngioma. Which assessment data collected by the nurse supports the suspected diagnosis? Select all that apply.

1. Evening nausea 2. Excessive urination 3. Nystagmus 4. Headaches 5. Orbital ecchymosis Answer: 2, 3, 4 Explanation: 1. Nausea is a common symptom of a brain tumor due to effect on the vomiting center of the brain. However, it occurs primarily in the morning on arising.

2. Diabetes insipidus is common in tumors involving the pituitary gland, such as craniopharyngioma.

3. Nystagmus is a symptom of pressure on the optic nerve chiasm.

4. The headaches may be due to the increased bulk in the cranium and/or the ventricular blockage leading to hydrocephalus.

5. Orbital ecchymosis is seen in neuroblastoma secondary to metastasis to the bone.

Page Ref: 609 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 24.6 Prioritize elements of comprehensive care planning for children with soft-tissue tumors.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 22) Which nursing actions will decrease the risk of extravasation when administering chemotherapy to a pediatric client through a peripheral line? Select all that apply.

1. Ensuring that the intravenous line is a free flowing line 2. Administering the medication by infusion pump 3. Checking for blood return before and during chemotherapy administration 4. Diluting the medication with normal saline 5. Administering the vesicant drug last Answer: 1, 3 Explanation: 1. This is critical, as extravasation is leaking into the tissues.

2. An infusion pump does not ensure that the line is free flowing; this is inappropriate.

3. This checks for intravenous administration and is appropriate.

4. Not all medications can be mixed with normal saline, and this does not protect against extravasation.

5. The vesicant drug should be administered first.

Page Ref: 592 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 24.3 Integrate information about oncologic emergencies into plans for monitoring all children with cancer.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 23) The nurse is preparing to assist with a lumbar puncture for a pediatric client who is diagnosed with cancer. Which statements should the nurse include in the teaching session for the client and family? Select all that apply.

1. "This procedure assesses the bone marrow."

2. "This procedure assesses cerebrospinal fluid."

3. "This procedure confirms the diagnosis of acute lymphoblastic leukemia."

4. "This procedure determines if malignant cells are affecting the nervous system."

5. "This procedure assesses cellular components of the blood."

Answer: 2, 4 Explanation: 1. A bone marrow aspiration, not a lumbar puncture, is used to assess bone marrow.

2. A lumbar puncture is used to assess cerebrospinal fluid.

3. A bone marrow aspiration, not a lumbar puncture, is used to confirm the diagnosis of acute lymphoblastic leukemia.

4. A lumbar puncture is used to assess if malignant cells are affecting the central nervous system.

5. A complete blood count with differential, not a lumbar puncture, is used to assess the cellular components of the blood.

Page Ref: 609 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Reduction of Risk Potential Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 24.2 Synthesize information about diagnostic tests and clinical therapy for cancer to plan comprehensive care for children undergoing these procedures.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 24) Which assessment findings, indicative of a hematologic emergency, should the nurse report to the healthcare provider due to the need for immediate intervention? Select all that apply.

1. Anemia 2. Thrombocytopenia 3. Disseminated intravascular coagulation 4. Cardiac arrhythmias 5. Tetany Answer: 1, 2, 3 Explanation: 1. Anemia is a clinical manifestation associated with a hematologic emergency necessitating the need for immediate intervention.

2. Thrombocytopenia is a clinical manifestation associated with a hematologic emergency necessitating the need for immediate intervention.

3. Disseminated intravascular coagulation is a clinical manifestation associated with a hematologic emergency necessitating the need for immediate intervention.

4. Cardiac arrhythmias are associated with metabolic, not hematologic, emergencies.

5. Tetany is associated with metabolic, not hematologic, emergencies.

Page Ref: 595 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 24.3 Integrate information about oncologic emergencies into plans for monitoring all children with cancer.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 25) Which pediatric cancer diagnoses necessitate priority assessment by the nurses for clinical manifestations associated with emergencies related to space-occupying lesions? Select all that apply.

1. Hodgkin disease 2. Leukemia 3. Neuroblastoma 4. Melanoma 5. Lymphoma Answer: 1, 3, 5 Explanation: 1. A pediatric client diagnosed with Hodgkin disease is at risk for emergencies related to space-occupying lesions.

2. Leukemia is not a pediatric cancer associated with emergencies related to space-occupying lesions.

3. A pediatric client diagnosed with neuroblastoma is at risk for emergencies related to spaceoccupying lesions.

4. Melanoma is not a pediatric cancer associated with emergencies related to space-occupying lesions.

5. A pediatric client diagnosed with lymphoma is at risk for emergencies related to spaceoccupying lesions.

Page Ref: 596 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 24.3 Integrate information about oncologic emergencies into plans for monitoring all children with cancer.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 26) The nurse is providing care to a pediatric client who will require surgery as a portion of the treatment regimen. Which topics should the nurse include in the teaching session related to longterm ramifications associated with this treatment option?

1. Scoliosis 2. Adhesions 3. Hypothyroidism 4. Visual impairment 5. Cardiotoxicity Answer: 2, 4 Explanation: 1. Scoliosis is a long-term ramification associated with radiation, not surgical, intervention for cancer.

2. Adhesions are a long-term ramification associated with surgical intervention for cancer.

3. Hypothyroidism is a long-term ramification associated with radiation, not surgical, intervention for cancer.

4. Visual impairment is a long-term ramification associated with surgical intervention for cancer.

5. Cardiotoxicity is a long-term ramification associated with radiation, not surgical, intervention for cancer.

Page Ref: 599 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 24.7 Analyze the impact of cancer survival on children and use this information to plan for ongoing physiologic and psychosocial care in the children's futures.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 27) The nurse is providing care to a pediatric client who will require radiation as a portion of the treatment regimen. Which topics should the nurse include in the teaching session related to longterm ramifications associated with this treatment option?

1. Scoliosis 2. Adhesions 3. Hypothyroidism 4. Visual impairment 5. Cardiotoxicity Answer: 1, 3, 5 Explanation: 1. Scoliosis is a long-term ramification associated with radiation treatment for cancer.

2. Adhesions are a long-term ramification associated with surgical intervention, not radiation treatment, for cancer.

3. Hypothyroidism is a long-term ramification associated with radiation treatment for cancer.

4. Visual impairment is a long-term ramification associated with surgical intervention, not radiation treatment, for cancer.

5. Cardiotoxicity is a long-term ramification associated with radiation treatment for cancer.

Page Ref: 500 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 24.7 Analyze the impact of cancer survival on children and use this information to plan for ongoing physiologic and psychosocial care in the children's futures.

Principles of Pediatric Nursing, 8e (Ball et al.)

Chapter 25 The Child with Alterations in Gastrointestinal Function 1) The nurse is planning postoperative care for an infant after a cleft-lip repair. Which nursing intervention is most appropriate for this infant?

1. Prone positioning 2. Suctioning with a Yankauer device 3. Supine or side-lying positioning 4. Avoidance of soft elbow restraints Answer: 3 Explanation: 1. Integrity of the suture line is essential for postoperative care of cleft-lip repair.

The infant should be placed in a supine or side-lying position to avoid rubbing the suture line on the bedding. The prone position should be avoided. A Yankauer suction device is made of hard plastic and, if used, could cause trauma to the suture line. Suctioning should be done with a small, soft suction catheter. Soft elbow restraints may be used to prevent the infant from touching the incisional area.

2. Integrity of the suture line is essential for postoperative care of cleft-lip repair. The infant should be placed in a supine or side-lying position to avoid rubbing the suture line on the bedding. The prone position should be avoided. A Yankauer suction device is made of hard plastic and, if used, could cause trauma to the suture line. Suctioning should be done with a 499 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 small, soft suction catheter. Soft elbow restraints may be used to prevent the infant from touching the incisional area.

3. Integrity of the suture line is essential for postoperative care of cleft-lip repair. The infant should be placed in a supine or side-lying position to avoid rubbing the suture line on the bedding. The prone position should be avoided. A Yankauer suction device is made of hard plastic and, if used, could cause trauma to the suture line. Suctioning should be done with a small, soft suction catheter. Soft elbow restraints may be used to prevent the infant from touching the incisional area.

4. Integrity of the suture line is essential for postoperative care of cleft-lip repair. The infant should be placed in a supine or side-lying position to avoid rubbing the suture line on the bedding. The prone position should be avoided. A Yankauer suction device is made of hard plastic and, if used, could cause trauma to the suture line. Suctioning should be done with a small, soft suction catheter. Soft elbow restraints may be used to prevent the infant from touching the incisional area.

Page Ref: 664 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Planning/Coordination of care Learning Outcome: 25.5 Analyze developmentally appropriate approaches for nursing management of gastrointestinal disorders in the pediatric population.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 2) An infant is born with an esophageal atresia and tracheoesophageal fistula. Which preoperative nursing diagnosis is the priority for this infant?

1. Risk for Aspiration Related to Regurgitation 2. Acute Pain Related to Esophageal Defect 3. Ineffective Infant Feeding Pattern Related to Uncoordinated Suck and Swallow 4. Ineffective Tissue Perfusion: Gastrointestinal, Related to Decreased Circulation Answer: 1 Explanation: 1. With the most common type of esophageal atresia and tracheoesophageal fistula, the upper segment of the esophagus ends in a blind pouch and a fistula connects the lower segment to the trachea. Preoperatively, there is a risk of aspiration of gastric secretions from the stomach into the trachea because of the fistula that connects the lower segment of the esophagus to the trachea. Pain is not usually experienced preoperatively with this condition. The infant is always kept NPO (nothing by mouth) preoperatively, so ineffective feeding pattern would not apply. Tissue perfusion is not a problem with this condition.

2. With the most common type of esophageal atresia and tracheoesophageal fistula, the upper segment of the esophagus ends in a blind pouch and a fistula connects the lower segment to the trachea. Preoperatively, there is a risk of aspiration of gastric secretions from the stomach into the trachea because of the fistula that connects the lower segment of the esophagus to the trachea. Pain is not usually experienced preoperatively with this condition. The infant is always kept NPO (nothing by mouth) preoperatively, so ineffective feeding pattern would not apply.

Tissue perfusion is not a problem with this condition.

3. With the most common type of esophageal atresia and tracheoesophageal fistula, the upper segment of the esophagus ends in a blind pouch and a fistula connects the lower segment to the trachea. Preoperatively, there is a risk of aspiration of gastric secretions from the stomach into the trachea because of the fistula that connects the lower segment of the esophagus to the trachea. Pain is not usually experienced preoperatively with this condition. The infant is always kept NPO (nothing by mouth) preoperatively, so ineffective feeding pattern would not apply.

Tissue perfusion is not a problem with this condition.

4. With the most common type of esophageal atresia and tracheoesophageal fistula, the upper segment of the esophagus ends in a blind pouch and a fistula connects the lower segment to the trachea. Preoperatively, there is a risk of aspiration of gastric secretions from the stomach into the trachea because of the fistula that connects the lower segment of the esophagus to the trachea. Pain is not usually experienced preoperatively with this condition. The infant is always kept NPO (nothing by mouth) preoperatively, so ineffective feeding pattern would not apply.

Tissue perfusion is not a problem with this condition.

Page Ref: 666 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Basic Care and Comfort Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Diagnosis/Coordination of care Learning Outcome: 25.2 Discuss the pathophysiologic processes associated with specific gastrointestinal disorders in the pediatric population.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 3) The nurse is evaluating an infant's tolerance of feedings after a pyloromyotomy. Which finding indicates that the infant is not tolerating the feeding?

1. Need for frequent burping 2. Irritability during feeding 3. The passing of gas 4. Emesis after two feedings Answer: 4 Explanation: 1. An infant is not tolerating feedings after a pyloromyotomy if emesis is present.

Frequent burping, irritability, and the passing of gas would be expected findings following a pyloromyotomy and would indicate tolerance of the feeding.

2. An infant is not tolerating feedings after a pyloromyotomy if emesis is present. Frequent burping, irritability, and the passing of gas would be expected findings following a pyloromyotomy and would indicate tolerance of the feeding.

3. An infant is not tolerating feedings after a pyloromyotomy if emesis is present. Frequent burping, irritability, and the passing of gas would be expected findings following a pyloromyotomy and would indicate tolerance of the feeding.

4. An infant is not tolerating feedings after a pyloromyotomy if emesis is present. Frequent burping, irritability, and the passing of gas would be expected findings following a pyloromyotomy and would indicate tolerance of the feeding.

Page Ref: 668 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Evaluation/Coordination of care Learning Outcome: 25.4 Contrast nursing management and plan care for disorders of the gastrointestinal system for the child needing abdominal surgery versus the child needing nonoperative management.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 4) An infant born with an omphalocele defect is admitted to the intensive-care nursery. Which instruction from the nurse manager to the unlicensed assistive personnel is most appropriate?

1. Prepare a warmer.

2. Prepare a crib.

3. Prepare a feeding of formula.

4. Prepare the bilirubin light.

Answer: 1 Explanation: 1. Omphalocele is a congenital malformation in which intra-abdominal contents herniate through the umbilical cord. The infant many lose heat through the viscera; a warmer is indicated to prevent hypothermia. The crib would not provide adequate maintenance of temperature control. The infant is NPO (nothing by mouth) preoperatively and may or may not need a bilirubin light before surgery.

2. Omphalocele is a congenital malformation in which intra-abdominal contents herniate through the umbilical cord. The infant many lose heat through the viscera; a warmer is indicated to prevent hypothermia. The crib would not provide adequate maintenance of temperature control.

The infant is NPO (nothing by mouth) preoperatively and may or may not need a bilirubin light before surgery.

3. Omphalocele is a congenital malformation in which intra-abdominal contents herniate through the umbilical cord. The infant many lose heat through the viscera; a warmer is indicated to prevent hypothermia. The crib would not provide adequate maintenance of temperature control.

The infant is NPO (nothing by mouth) preoperatively and may or may not need a bilirubin light before surgery.

4. Omphalocele is a congenital malformation in which intra-abdominal contents herniate through the umbilical cord. The infant many lose heat through the viscera; a warmer is indicated to prevent hypothermia. The crib would not provide adequate maintenance of temperature control.

The infant is NPO (nothing by mouth) preoperatively and may or may not need a bilirubin light before surgery.

Page Ref: 671 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Coordination of care Learning Outcome: 25.4 Contrast nursing management and plan care for disorders of the gastrointestinal system for the child needing abdominal surgery versus the child needing nonoperative management.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 5) The nurse is providing instruction to the parents of an infant with a colostomy. Which statement by the parents indicates appropriate understanding of the teaching session?

1. "We will change the colostomy bag with each wet diaper."

2. "We will use adhesive enhancers when we change the bag."

3. "We will watch for skin irritation around the stoma."

4. "We will expect a moderate amount of bleeding after cleansing the area around the stoma."

Answer: 3 Explanation: 1. Skin irritation around the stoma should be assessed; it may indicate leakage.

Physical or chemical skin irritation may occur if the appliance is changed too frequently or with each wet diaper. Adhesive enhancers should be avoided on the skin of newborns. Their skin layers are thin, and removal of the appliance can strip off the skin. Also, adhesive contains latex, and its constant use is not advised due to risk of latex allergy development. Bleeding is usually attributable to excessive cleaning.

2. Skin irritation around the stoma should be assessed; it may indicate leakage. Physical or chemical skin irritation may occur if the appliance is changed too frequently or with each wet diaper. Adhesive enhancers should be avoided on the skin of newborns. Their skin layers are thin, and removal of the appliance can strip off the skin. Also, adhesive contains latex, and its constant use is not advised due to risk of latex allergy development. Bleeding is usually attributable to excessive cleaning.

3. Skin irritation around the stoma should be assessed; it may indicate leakage. Physical or chemical skin irritation may occur if the appliance is changed too frequently or with each wet diaper. Adhesive enhancers should be avoided on the skin of newborns. Their skin layers are thin, and removal of the appliance can strip off the skin. Also, adhesive contains latex, and its constant use is not advised due to risk of latex allergy development. Bleeding is usually attributable to excessive cleaning.

4. Skin irritation around the stoma should be assessed; it may indicate leakage. Physical or chemical skin irritation may occur if the appliance is changed too frequently or with each wet diaper. Adhesive enhancers should be avoided on the skin of newborns. Their skin layers are thin, and removal of the appliance can strip off the skin. Also, adhesive contains latex, and its constant use is not advised due to risk of latex allergy development. Bleeding is usually attributable to excessive cleaning.

Page Ref: 673 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Evaluation/Health teaching and health promotion Learning Outcome: 25.4 Contrast nursing management and plan care for disorders of the gastrointestinal system for the child needing abdominal surgery versus the child needing nonoperative management.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 6) A nurse is preparing for the delivery of a newborn with a known diaphragmatic hernia defect.

Which equipment does the nurse ensure is prepared at the bedside?

1. Intubation setup 2. Appropriate bag and mask 3. Sterile gauze and saline 4. Soft arm restraints Answer: 1 Explanation: 1. A diaphragmatic hernia (protrusion of abdominal contents into the chest cavity through a defect in the diaphragm) is a life-threatening condition. Intubation is required immediately so the newborn's respiratory status can be stabilized. A bag and mask will not be adequate to ventilate a newborn with this condition. The defect is not external, so sterile gauze and saline are not needed. Soft arm restraints are not immediately necessary.

2. A diaphragmatic hernia (protrusion of abdominal contents into the chest cavity through a defect in the diaphragm) is a life-threatening condition. Intubation is required immediately so the newborn's respiratory status can be stabilized. A bag and mask will not be adequate to ventilate a newborn with this condition. The defect is not external, so sterile gauze and saline are not needed. Soft arm restraints are not immediately necessary.

3. A diaphragmatic hernia (protrusion of abdominal contents into the chest cavity through a defect in the diaphragm) is a life-threatening condition. Intubation is required immediately so the newborn's respiratory status can be stabilized. A bag and mask will not be adequate to ventilate a newborn with this condition. The defect is not external, so sterile gauze and saline are not needed. Soft arm restraints are not immediately necessary.

4. A diaphragmatic hernia (protrusion of abdominal contents into the chest cavity through a defect in the diaphragm) is a life-threatening condition. Intubation is required immediately so the newborn's respiratory status can be stabilized. A bag and mask will not be adequate to ventilate a newborn with this condition. The defect is not external, so sterile gauze and saline are not needed. Soft arm restraints are not immediately necessary.

Page Ref: 675 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Reduction of Risk Potential Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Implementation/Coordination of care Learning Outcome: 25.4 Contrast nursing management and plan care for disorders of the gastrointestinal system for the child needing abdominal surgery versus the child needing nonoperative management.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 7) The nurse is administering several medications to an infant with neurologic impairment and delay. Which medication is a proton pump inhibitor that is administered for gastroesophageal reflux?

1. Omeprazole 2. Ranitidine 3. Phenytoin 4. Glycopyrrolate Answer: 1 Explanation: 1. Omeprazole is the proton pump inhibitor that blocks the action of acidproducing cells and is used to treat gastroesophageal reflux. Ranitidine causes the stomach to produce less acid and may be used to treat gastroesophageal reflux, but it is a histamine-2 receptor blocker. Phenytoin is an anticonvulsant used to treat seizures, and glycopyrrolate is an anticholinergic agent used to inhibit excessive salivation.

2. Omeprazole is the proton pump inhibitor that blocks the action of acid-producing cells and is used to treat gastroesophageal reflux. Ranitidine causes the stomach to produce less acid and may be used to treat gastroesophageal reflux, but it is a histamine-2 receptor blocker. Phenytoin is an anticonvulsant used to treat seizures, and glycopyrrolate is an anticholinergic agent used to inhibit excessive salivation.

3. Omeprazole is the proton pump inhibitor that blocks the action of acid-producing cells and is used to treat gastroesophageal reflux. Ranitidine causes the stomach to produce less acid and may be used to treat gastroesophageal reflux, but it is a histamine-2 receptor blocker. Phenytoin is an anticonvulsant used to treat seizures, and glycopyrrolate is an anticholinergic agent used to inhibit excessive salivation.

4. Omeprazole is the proton pump inhibitor that blocks the action of acid-producing cells and is used to treat gastroesophageal reflux. Ranitidine causes the stomach to produce less acid and may be used to treat gastroesophageal reflux, but it is a histamine-2 receptor blocker. Phenytoin is an anticonvulsant used to treat seizures, and glycopyrrolate is an anticholinergic agent used to inhibit excessive salivation.

Page Ref: 670 Cognitive Level: Understanding Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Implementation/Coordination of care Learning Outcome: 25.2 Discuss the pathophysiologic processes associated with specific gastrointestinal disorders in the pediatric population.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 8) A newborn is diagnosed with Hirschsprung disease. Which clinical manifestations found on assessment support this newborn's diagnosis?

1. Acute diarrhea; dehydration 2. Delayed passage of meconium; abdominal distension 3. Currant jelly; gelatinous stools; pain 4. Projectile vomiting; altered electrolytes Answer: 2 Explanation: 1. Hirschsprung disease is the absence of autonomic parasympathetic ganglion cells in the colon that prevent peristalsis at that portion of the intestine. In newborns, the symptoms include delayed passage of meconium and abdominal distension. Acute diarrhea and dehydration are symptoms characteristic of gastroenteritis. Currant jelly, gelatinous stools, and pain are symptoms of intussusception, and projectile vomiting and altered electrolytes are symptoms of pyloric stenosis.

2. Hirschsprung disease is the absence of autonomic parasympathetic ganglion cells in the colon that prevent peristalsis at that portion of the intestine. In newborns, the symptoms include delayed passage of meconium and abdominal distension. Acute diarrhea and dehydration are symptoms characteristic of gastroenteritis. Currant jelly, gelatinous stools, and pain are symptoms of intussusception, and projectile vomiting and altered electrolytes are symptoms of pyloric stenosis.

3. Hirschsprung disease is the absence of autonomic parasympathetic ganglion cells in the colon that prevent peristalsis at that portion of the intestine. In newborns, the symptoms include delayed passage of meconium and abdominal distension. Acute diarrhea and dehydration are symptoms characteristic of gastroenteritis. Currant jelly, gelatinous stools, and pain are symptoms of intussusception, and projectile vomiting and altered electrolytes are symptoms of pyloric stenosis.

4. Hirschsprung disease is the absence of autonomic parasympathetic ganglion cells in the colon that prevent peristalsis at that portion of the intestine. In newborns, the symptoms include delayed passage of meconium and abdominal distension. Acute diarrhea and dehydration are symptoms characteristic of gastroenteritis. Currant jelly, gelatinous stools, and pain are symptoms of intussusception, and projectile vomiting and altered electrolytes are symptoms of pyloric stenosis.

Page Ref: 673 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care Learning Outcome: 25.3 Identify signs and symptoms that may indicate a disorder of the gastrointestinal system.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 9) A child with severe gastroenteritis is admitted to a semiprivate room on the pediatric unit. The charge nurse should place this client with which roommate?

1. An infant with meningitis 2. A child with fever and neutropenia 3. Another child with gastroenteritis 4. A child recovering from an appendectomy Answer: 3 Explanation: 1. Gastroenteritis may be viral or bacterial and can be infectious. It is best to cohort children with this infectious process. Good handwashing is essential to prevent the spread. An infant with meningitis, a child with fever and neutropenia, and a child recovering from an appendectomy should not be placed with another child with an infectious process.

2. Gastroenteritis may be viral or bacterial and can be infectious. It is best to cohort children with this infectious process. Good handwashing is essential to prevent the spread. An infant with meningitis, a child with fever and neutropenia, and a child recovering from an appendectomy should not be placed with another child with an infectious process.

3. Gastroenteritis may be viral or bacterial and can be infectious. It is best to cohort children with this infectious process. Good handwashing is essential to prevent the spread. An infant with meningitis, a child with fever and neutropenia, and a child recovering from an appendectomy should not be placed with another child with an infectious process.

4. Gastroenteritis may be viral or bacterial and can be infectious. It is best to cohort children with this infectious process. Good handwashing is essential to prevent the spread. An infant with meningitis, a child with fever and neutropenia, and a child recovering from an appendectomy should not be placed with another child with an infectious process.

Page Ref: 684 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Coordination of care Learning Outcome: 25.2 Discuss the pathophysiologic processes associated with specific gastrointestinal disorders in the pediatric population.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 10) The nurse is preparing to ambulate a school-age client who had an appendectomy. In addition to pharmacological pain management, the nurse can use which nonpharmacological pain-management strategy for this client?

1. A heating pad 2. A warm, moist pack 3. A pillow on the abdomen 4. An ice pack Answer: 3 Explanation: 1. A pillow placed on the abdomen can be a nonpharmacological strategy to decrease discomfort after an appendectomy. Heat and ice are not used on the incisional area as they can impair the healing process of the wound.

2. A pillow placed on the abdomen can be a nonpharmacological strategy to decrease discomfort after an appendectomy. Heat and ice are not used on the incisional area as they can impair the healing process of the wound.

3. A pillow placed on the abdomen can be a nonpharmacological strategy to decrease discomfort after an appendectomy. Heat and ice are not used on the incisional area as they can impair the healing process of the wound.

4. A pillow placed on the abdomen can be a nonpharmacological strategy to decrease discomfort after an appendectomy. Heat and ice are not used on the incisional area as they can impair the healing process of the wound.

Page Ref: 679 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Basic Care and Comfort Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Implementation/Coordination of care Learning Outcome: 25.4 Contrast nursing management and plan care for disorders of the gastrointestinal system for the child needing abdominal surgery versus the child needing nonoperative management.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 11) A neonate is fed 20 mL of formula every three hours by orogastric lavage. At the beginning of this feeding, the nurse aspirates 15 mL of gastric residual. Which action by the nurse is the most appropriate?

1. Withhold the feeding and notify the healthcare provider.

2. Replace the residual and continue with the full feeding.

3. Replace the residual but only give 5 mL of the feeding.

4. Withhold the feeding and check the residual in three hours.

Answer: 1 Explanation: 1. Residual of more than half the amount of feeding indicates a feeding intolerance and could be a sign of necrotizing enterocolitis. Early detection of enterocolitis is essential, and aggressive management is required. Therefore, the healthcare provider should be notified of this finding. The amount of residual is too much to replace and continue with the feeding, and waiting for 3 hours to recheck the residual could delay treatment of a serious condition.

2. Residual of more than half the amount of feeding indicates a feeding intolerance and could be a sign of necrotizing enterocolitis. Early detection of enterocolitis is essential, and aggressive management is required. Therefore, the healthcare provider should be notified of this finding.

The amount of residual is too much to replace and continue with the feeding, and waiting for 3 hours to recheck the residual could delay treatment of a serious condition.

3. Residual of more than half the amount of feeding indicates a feeding intolerance and could be a sign of necrotizing enterocolitis. Early detection of enterocolitis is essential, and aggressive management is required. Therefore, the healthcare provider should be notified of this finding.

The amount of residual is too much to replace and continue with the feeding, and waiting for 3 hours to recheck the residual could delay treatment of a serious condition.

4. Residual of more than half the amount of feeding indicates a feeding intolerance and could be a sign of necrotizing enterocolitis. Early detection of enterocolitis is essential, and aggressive management is required. Therefore, the healthcare provider should be notified of this finding.

The amount of residual is too much to replace and continue with the feeding, and waiting for 3 hours to recheck the residual could delay treatment of a serious condition.

Page Ref: 688 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: Teamwork and collaboration | AACN Essential Competencies: Essential VI: Interprofessional communication and collaboration for improving patient health outcomes. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Collaboration Learning Outcome: 25.3 Identify signs and symptoms that may indicate a disorder of the gastrointestinal system.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 12) A child with inflammatory bowel disease is prescribed prednisone daily. At which time is it most appropriate for the family to administer the prednisone?

1. Between meals 2. One hour before meals 3. At bedtime 4. With meals Answer: 4 Explanation: 1. Prednisone, a corticosteroid, can cause gastric irritation. It should be administered with meals to reduce the gastric irritation.

2. Prednisone, a corticosteroid, can cause gastric irritation. It should be administered with meals to reduce the gastric irritation.

3. Prednisone, a corticosteroid, can cause gastric irritation. It should be administered with meals to reduce the gastric irritation.

4. Prednisone, a corticosteroid, can cause gastric irritation. It should be administered with meals to reduce the gastric irritation.

Page Ref: 682 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Coordination of care Learning Outcome: 25.5 Analyze developmentally appropriate approaches for nursing management of gastrointestinal disorders in the pediatric population.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 13) The nurse is caring for a school-age client who had an appendectomy after a ruptured appendix. Which orders does the nurse anticipate for this client? Select all that apply.

1. Antibiotics 2. A clear liquid diet 3. NG tube 4. Vital signs every 4 hours 5. Frequent monitoring of bowel sounds Answer: 1, 3, 4, 5 Explanation: 1. Antibiotics, an NG tube, vital signs every 4 hours, and frequent monitoring of bowel sounds are appropriate interventions following a ruptured appendix. The client is NPO until bowel sounds return.

2. Antibiotics, an NG tube, vital signs every 4 hours, and frequent monitoring of bowel sounds are appropriate interventions following a ruptured appendix. The client is NPO until bowel sounds return.

3. Antibiotics, an NG tube, vital signs every 4 hours, and frequent monitoring of bowel sounds are appropriate interventions following a ruptured appendix. The client is NPO until bowel sounds return.

4. Antibiotics, an NG tube, vital signs every 4 hours, and frequent monitoring of bowel sounds are appropriate interventions following a ruptured appendix. The client is NPO until bowel sounds return.

5. Antibiotics, an NG tube, vital signs every 4 hours, and frequent monitoring of bowel sounds are appropriate interventions following a ruptured appendix. The client is NPO until bowel sounds return.

Page Ref: 678-679 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Basic Care and Comfort Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Coordination of care Learning Outcome: 25.4 Contrast nursing management and plan care for disorders of the gastrointestinal system for the child needing abdominal surgery versus the child needing nonoperative management.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 14) A 3-day-old preterm infant is diagnosed with necrotizing enterocolitis. The nurse plans care around the frequent radiographs. How frequently should the nurse anticipate that the radiology staff will bring the portable machine to the nursery?

1. Every 6 hours 2. Every 12 hours 3. Every 24 hours 4. Every 48 hours Answer: 1 Explanation: 1. Radiographs are done every 6 hours to evaluate for perforation.

2. Radiographs are done every 6 hours to evaluate for perforation.

3. Radiographs are done every 6 hours to evaluate for perforation.

4. Radiographs are done every 6 hours to evaluate for perforation.

Page Ref: 680 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Basic Care and Comfort Standards: QSEN Competencies: Teamwork and collaboration | AACN Essential Competencies: Essential VI: Interprofessional communication and collaboration for improving patient health outcomes. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Implementation/Collaboration Learning Outcome: 25.4 Contrast nursing management and plan care for disorders of the gastrointestinal system for the child needing abdominal surgery versus the child needing nonoperative management.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 15) A school-age client is recovering after abdominal surgery. The nurse is planning care for the return of bowel function. Which intervention should be included in the client's plan of care?

1. Fowler's position 3 times per day for 30 minutes each time 2. Assist the child in choosing a low-fat diet.

3. Commode at bedside 4. Ambulate 3 to 4 times a day.

Answer: 4 Explanation: 1. The best data that indicate return of bowel sounds are flatus and passage of stool. Ambulation is the primary intervention to assist with both. A Fowler's position, bedside commode, and a low-fat diet will not assist with bowel function.

2. The best data that indicate return of bowel sounds are flatus and passage of stool. Ambulation is the primary intervention to assist with both. A Fowler's position, bedside commode, and a lowfat diet will not assist with bowel function.

3. The best data that indicate return of bowel sounds are flatus and passage of stool. Ambulation is the primary intervention to assist with both. A Fowler's position, bedside commode, and a lowfat diet will not assist with bowel function.

4. The best data that indicate return of bowel sounds are flatus and passage of stool. Ambulation is the primary intervention to assist with both. A Fowler's position, bedside commode, and a lowfat diet will not assist with bowel function.

Page Ref: 679 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Coordination of care Learning Outcome: 25.4 Contrast nursing management and plan care for disorders of the gastrointestinal system for the child needing abdominal surgery versus the child needing nonoperative management.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 16) A child experienced a lacerated spleen in a motor vehicle accident. Which is the highestpriority nursing intervention on admission to the pediatric intensive care unit (PICU) following surgery?

1. Observing for signs of hypovolemic shock 2. Maintaining IV fluids 3. Implementing strict bedrest 4. Administering blood products as ordered Answer: 1 Explanation: 1. The priority nursing intervention is observing for signs of hypovolemic shock due to bleeding from the lacerated spleen. The other interventions are appropriate but not the highest priority.

2. The priority nursing intervention is observing for signs of hypovolemic shock due to bleeding from the lacerated spleen. The other interventions are appropriate but not the highest priority.

3. The priority nursing intervention is observing for signs of hypovolemic shock due to bleeding from the lacerated spleen. The other interventions are appropriate but not the highest priority.

4. The priority nursing intervention is observing for signs of hypovolemic shock due to bleeding from the lacerated spleen. The other interventions are appropriate but not the highest priority.

Page Ref: 696-697 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Evaluation/Coordination of care Learning Outcome: 25.6 Plan nursing care for the child with an injury to the gastrointestinal system.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 17) The nurse educator is preparing an in-service on the basic functions of the gastrointestinal (GI) system. Which statements will the nurse educator include in the in-service?

Select all that apply.

1. "The GI system is responsible for the ingestion of fluids and nutrients."

2. "The GI system is responsible for the excretion of fluids and nutrients."

3. "The GI system is responsible for the metabolism of nutrients."

4. "As infants grow, their stomach capacity increases, decreasing the frequency with which they need to be fed."

5. "By the second year of life, digestive processes are still developing."

Answer: 1, 3, 4 Explanation: 1. The GI system is responsible for the ingestion of fluids and nutrients as well as the metabolism of nutrients. As infants grow, their stomach capacity increases, which does decrease the frequency with which they need to be fed. The GI system is responsible for the excretion of waste products. By the second year of life, digestive processes are fairly complete.

2. The GI system is responsible for the ingestion of fluids and nutrients as well as the metabolism of nutrients. As infants grow, their stomach capacity increases, which does decrease the frequency with which they need to be fed. The GI system is responsible for the excretion of waste products. By the second year of life, digestive processes are fairly complete.

3. The GI system is responsible for the ingestion of fluids and nutrients as well as the metabolism of nutrients. As infants grow, their stomach capacity increases, which does decrease the frequency with which they need to be fed. The GI system is responsible for the excretion of waste products. By the second year of life, digestive processes are fairly complete.

4. The GI system is responsible for the ingestion of fluids and nutrients as well as the metabolism of nutrients. As infants grow, their stomach capacity increases, which does decrease the frequency with which they need to be fed. The GI system is responsible for the excretion of waste products. By the second year of life, digestive processes are fairly complete.

5. The GI system is responsible for the ingestion of fluids and nutrients as well as the metabolism of nutrients. As infants grow, their stomach capacity increases, which does decrease the frequency with which they need to be fed. The GI system is responsible for the excretion of waste products. By the second year of life, digestive processes are fairly complete.

Page Ref: 657-659 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 25.1 Describe the general function of the gastrointestinal system.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 18) The nurse is caring for a 5-month-old with biliary atresia. The mother asks why the healthcare provider wants her child to take the medication, cholestyramine. What would the nurse's response be?

1. Decrease itching 2. Increase WBCs 3. Decrease use of antibiotics 4. Increase appetite Answer: 1 Explanation: 1. Cholestyramine is taken to decrease itching.

2. Cholestyramine is taken to decrease itching.

3. Cholestyramine is taken to decrease itching.

4. Cholestyramine is taken to decrease itching.

Page Ref: 693 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care Learning Outcome: 25.3 Identify signs and symptoms that may indicate a disorder of the gastrointestinal system.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 19) The nurse is caring for the newborn with hyperbilirubinemia. What nursing diagnoses would the nurse address? Select all that apply.

1. Activity intolerance 2. Deficient fluid volume 3. Risk for impaired attachment 4. Ineffective breathing pattern 5. Risk for imbalanced body temperature Answer: 2, 3, 5 Explanation: 1. Nursing diagnoses that may apply to the newborn with hyperbilirubinemia are deficient fluid volume, risk for impaired attachment, risk for imbalanced body temperature, and risk for injury.

2. Nursing diagnoses that may apply to the newborn with hyperbilirubinemia are deficient fluid volume, risk for impaired attachment, risk for imbalanced body temperature, and risk for injury.

3. Nursing diagnoses that may apply to the newborn with hyperbilirubinemia are deficient fluid volume, risk for impaired attachment, risk for imbalanced body temperature, and risk for injury.

4. Nursing diagnoses that may apply to the newborn with hyperbilirubinemia are deficient fluid volume, risk for impaired attachment, risk for imbalanced body temperature, and risk for injury.

5. Nursing diagnoses that may apply to the newborn with hyperbilirubinemia are deficient fluid volume, risk for impaired attachment, risk for imbalanced body temperature, and risk for injury.

Page Ref: 691-692 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Diagnosis/Coordination of care Learning Outcome: 25.6 Plan nursing care for the child with an injury to the gastrointestinal system.

20) A pediatric nurse is educating the parents of a child diagnosed with a GI disturbance. The nurse states these types of disturbances can be caused by many factors. Which is not a recognized cause of GI issues in infants? Select the best answer.

1. Congenital defect 2. Nutritional deficiencies 3. Infection 4. Injury Answer: 2 Explanation: 1. Congenital defects can cause GI disorders.

2. Nutritional deficiencies may be caused by a GI disorder but usually not the other way around.

3. Both infection and injury can cause the development of a GI disturbance or defect.

4. Both infection and injury can cause the development of a GI disturbance or defect.

Page Ref: 627 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Coordination of care Learning Outcome: 25.1 Describe the general function of the gastrointestinal system.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 Principles of Pediatric Nursing, 8e (Ball et al.)

Chapter 26 The Child with Alterations in Genitourinary Function 1) The nurse is providing care to a male infant who is diagnosed with hypospadias. Which clinical manifestation does the nurse anticipate when assessing this infant?

1. A urethral meatus that is located on the ventral surface of the penis 2. The presence of foreskin 3. A small opening or a fissure that extends the entire length of the penis 4. An opening on the dorsal surface of the penis Answer: 1 Explanation: 1. For an infant diagnosed with hypospadias, the nurse would anticipate a urethral meatus that is located on the ventral surface of the penis. Infants diagnosed with hypospadias may also have a partial absence of the foreskin. A small opening or a fissure that extends the entire length of the penis or an opening on the dorsal side of the penis would be expected for an infant diagnosed with epispadias.

2. For an infant diagnosed with hypospadias, the nurse would anticipate a urethral meatus that is located on the ventral surface of the penis. Infants diagnosed with hypospadias may also have a partial absence of the foreskin. A small opening or a fissure that extends the entire length of the penis or an opening on the dorsal side of the penis would be expected for an infant diagnosed with epispadias.

3. For an infant diagnosed with hypospadias, the nurse would anticipate a urethral meatus that is located on the ventral surface of the penis. Infants diagnosed with hypospadias may also have a partial absence of the foreskin. A small opening or a fissure that extends the entire length of the penis or an opening on the dorsal side of the penis would be expected for an infant diagnosed with epispadias.

4. For an infant diagnosed with hypospadias, the nurse would anticipate a urethral meatus that is located on the ventral surface of the penis. Infants diagnosed with hypospadias may also have a partial absence of the foreskin. A small opening or a fissure that extends the entire length of the penis or an opening on the dorsal side of the penis would be expected for an infant diagnosed with epispadias.

Page Ref: 708-709 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care Learning Outcome: 26.3 Discuss the nursing management of a child with a structural defect of the genitourinary system.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 2) A nurse is preparing to admit a child with possible obstructive uropathy. Which laboratory test should the nurse expect to draw on this child?

1. Platelet count 2. Blood urea nitrogen (BUN) and creatinine 3. Partial thromboplastin time (PTT) 4. Blood culture Answer: 2 Explanation: 1. The blood urea nitrogen (BUN) and creatinine are serum lab tests for kidney function. Obstructive uropathy is a structural or functional abnormality of the urinary system that interferes with urine flow and results in urine backflow into the kidneys; therefore, the BUN and creatinine will be elevated. Platelet count and partial thromboplastin time (PTT) are drawn when a bleeding disorder is suspected. A blood culture is done when an infectious process is suspected.

2. The blood urea nitrogen (BUN) and creatinine are serum lab tests for kidney function.

Obstructive uropathy is a structural or functional abnormality of the urinary system that interferes with urine flow and results in urine backflow into the kidneys; therefore, the BUN and creatinine will be elevated. Platelet count and partial thromboplastin time (PTT) are drawn when a bleeding disorder is suspected. A blood culture is done when an infectious process is suspected.

3. The blood urea nitrogen (BUN) and creatinine are serum lab tests for kidney function.

Obstructive uropathy is a structural or functional abnormality of the urinary system that interferes with urine flow and results in urine backflow into the kidneys; therefore, the BUN and creatinine will be elevated. Platelet count and partial thromboplastin time (PTT) are drawn when a bleeding disorder is suspected. A blood culture is done when an infectious process is suspected.

4. The blood urea nitrogen (BUN) and creatinine are serum lab tests for kidney function.

Obstructive uropathy is a structural or functional abnormality of the urinary system that interferes with urine flow and results in urine backflow into the kidneys; therefore, the BUN and creatinine will be elevated. Platelet count and partial thromboplastin time (PTT) are drawn when a bleeding disorder is suspected. A blood culture is done when an infectious process is suspected.

Page Ref: 670 Table 26.2 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Reduction of Risk Potential Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Planning/Coordination of care Learning Outcome: 26.3 Discuss the nursing management of a child with a structural defect of the genitourinary system.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 3) The nurse is preparing to discharge a toddler-age client who just had an orchiopexy. Which discharge instruction is appropriate for this client?

1. Information to the parents about the child's resuming normal vigorous activities 2. Discussion with the parents about the low incidence of testicular malignancy and no further need for any follow-up 3. Explanation to the parents about the need for loose, nonrestrictive clothing 4. Reassurance to the parents that infertility is not a future risk Answer: 3 Explanation: 1. Orchiopexy is the surgical correction of cryptorchidism (failure of the testes to descend into the scrotal sac). Discharge instructions should include information about the need for loose, nonrestrictive clothing to avoid pressure on the postoperative site. The risk of testicular cancer is 35 to 50 times greater in men with a history of cryptorchidism. Long-term planning includes teaching the child to perform monthly testicular examinations once puberty has been reached. Vigorous activities such as straddling toys, riding bicycles, or rough play should be avoided for up to two weeks following surgery to promote healing and prevent injury. A discussion of fertility and the possible need for fertility testing is important, since cryptorchidism increases the risk of infertility.

2. Orchiopexy is the surgical correction of cryptorchidism (failure of the testes to descend into the scrotal sac). Discharge instructions should include information about the need for loose, nonrestrictive clothing to avoid pressure on the postoperative site. The risk of testicular cancer is 35 to 50 times greater in men with a history of cryptorchidism. Long-term planning includes teaching the child to perform monthly testicular examinations once puberty has been reached.

Vigorous activities such as straddling toys, riding bicycles, or rough play should be avoided for up to two weeks following surgery to promote healing and prevent injury. A discussion of fertility and the possible need for fertility testing is important, since cryptorchidism increases the risk of infertility.

3. Orchiopexy is the surgical correction of cryptorchidism (failure of the testes to descend into the scrotal sac). Discharge instructions should include information about the need for loose, nonrestrictive clothing to avoid pressure on the postoperative site. The risk of testicular cancer is 35 to 50 times greater in men with a history of cryptorchidism. Long-term planning includes teaching the child to perform monthly testicular examinations once puberty has been reached.

Vigorous activities such as straddling toys, riding bicycles, or rough play should be avoided for up to two weeks following surgery to promote healing and prevent injury. A discussion of fertility and the possible need for fertility testing is important, since cryptorchidism increases the risk of infertility.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 4. Orchiopexy is the surgical correction of cryptorchidism (failure of the testes to descend into the scrotal sac). Discharge instructions should include information about the need for loose, nonrestrictive clothing to avoid pressure on the postoperative site. The risk of testicular cancer is 35 to 50 times greater in men with a history of cryptorchidism. Long-term planning includes teaching the child to perform monthly testicular examinations once puberty has been reached.

Vigorous activities such as straddling toys, riding bicycles, or rough play should be avoided for up to two weeks following surgery to promote healing and prevent injury. A discussion of fertility and the possible need for fertility testing is important, since cryptorchidism increases the risk of infertility.

Page Ref: 732 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Planning/Health teaching and health promotion Learning Outcome: 26.3 Discuss the nursing management of a child with a structural defect of the genitourinary system.

4) Which symptoms are characteristic of a preschool-age client who is diagnosed with a urinary tract infection?

1. Foul-smelling urine, elevated blood pressure, and hematuria 2. Severe flank pain, nausea, headache 3. Headache, hematuria, vertigo 4. Urgency, dysuria, fever Answer: 4 Explanation: 1. Clinical manifestations of a urinary tract infection (UTI) in a preschool-age client include fever, urgency, and dysuria. While hematuria may be present, there is no elevated blood pressure, headache, or vertigo.

2. Clinical manifestations of a urinary tract infection (UTI) in a preschool-age client include fever, urgency, and dysuria. While hematuria may be present, there is no elevated blood pressure, headache, or vertigo.

3. Clinical manifestations of a urinary tract infection (UTI) in a preschool-age client include fever, urgency, and dysuria. While hematuria may be present, there is no elevated blood pressure, headache, or vertigo.

4. Clinical manifestations of a urinary tract infection (UTI) in a preschool-age client include fever, urgency, and dysuria. While hematuria may be present, there is no elevated blood pressure, headache, or vertigo.

Page Ref: 706 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care Learning Outcome: 26.2 Develop a nursing care plan for the child with a urinary tract infection.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 5) A child is admitted to the hospital unit with a diagnosis of minimal-change nephrotic syndrome (MCNS). Which clinical manifestations does the nurse anticipate when conducting the admission assessment?

1. Hematuria, bacteriuria, weight gain 2. Gross hematuria, albuminuria, fever 3. Massive proteinuria, hypoalbuminemia, edema 4. Hypertension, weight loss, proteinuria Answer: 3 Explanation: 1. Nephrotic syndrome is an alteration in kidney function secondary to increased glomerular basement membrane permeability to plasma protein. It is characterized by massive proteinuria, hypoalbuminemia, and edema. While hematuria and hypertension may be present, they are not pronounced. Gross hematuria and hypertension are associated with glomerulonephritis. Bacteriuria and fever are associated with a urinary tract infection. Because of the edema, a weight gain, not a weight loss, would be seen.

2. Nephrotic syndrome is an alteration in kidney function secondary to increased glomerular basement membrane permeability to plasma protein. It is characterized by massive proteinuria, hypoalbuminemia, and edema. While hematuria and hypertension may be present, they are not pronounced. Gross hematuria and hypertension are associated with glomerulonephritis.

Bacteriuria and fever are associated with a urinary tract infection. Because of the edema, a weight gain, not a weight loss, would be seen.

3. Nephrotic syndrome is an alteration in kidney function secondary to increased glomerular basement membrane permeability to plasma protein. It is characterized by massive proteinuria, hypoalbuminemia, and edema. While hematuria and hypertension may be present, they are not pronounced. Gross hematuria and hypertension are associated with glomerulonephritis.

Bacteriuria and fever are associated with a urinary tract infection. Because of the edema, a weight gain, not a weight loss, would be seen.

4. Nephrotic syndrome is an alteration in kidney function secondary to increased glomerular basement membrane permeability to plasma protein. It is characterized by massive proteinuria, hypoalbuminemia, and edema. While hematuria and hypertension may be present, they are not pronounced. Gross hematuria and hypertension are associated with glomerulonephritis.

Bacteriuria and fever are associated with a urinary tract infection. Because of the edema, a weight gain, not a weight loss, would be seen.

Page Ref: 713-715 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care Learning Outcome: 26.4 Outline a plan to meet the fluid and dietary restrictions for the child with a renal disorder.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 6) A school-age client diagnosed with nephrotic syndrome is severely edematous. The primary healthcare provider has placed the child on bed rest. Which nursing intervention is a priority for this client?

1. Reposition the child every 2 hours.

2. Monitor BP every 30 minutes.

3. Encourage fluids.

4. Limit visitors.

Answer: 1 Explanation: 1. A child with severe edema, on bed rest, is at risk for altered skin integrity. To prevent skin breakdown, the child should be repositioned every 2 hours. Vital signs are taken every 4 hours, fluids need to be monitored and should not be encouraged, and the child needs social interaction, so visitors should not be limited.

2. A child with severe edema, on bed rest, is at risk for altered skin integrity. To prevent skin breakdown, the child should be repositioned every 2 hours. Vital signs are taken every 4 hours, fluids need to be monitored and should not be encouraged, and the child needs social interaction, so visitors should not be limited.

3. A child with severe edema, on bed rest, is at risk for altered skin integrity. To prevent skin breakdown, the child should be repositioned every 2 hours. Vital signs are taken every 4 hours, fluids need to be monitored and should not be encouraged, and the child needs social interaction, so visitors should not be limited.

4. A child with severe edema, on bed rest, is at risk for altered skin integrity. To prevent skin breakdown, the child should be repositioned every 2 hours. Vital signs are taken every 4 hours, fluids need to be monitored and should not be encouraged, and the child needs social interaction, so visitors should not be limited.

Page Ref: 715-716 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Reduction of Risk Potential Standards: QSEN Competencies: Teamwork and collaboration | AACN Essential Competencies: Essential VI: Interprofessional communication and collaboration for improving patient health outcomes. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Planning/Collaboration Learning Outcome: 26.6 Plan nursing care for the child with acute kidney injury and chronic kidney disease.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 7) A preschool-age client diagnosed with nephrotic syndrome is placed on prednisone for several weeks. Which teaching point is appropriate for the nurse to include in the teaching plan for this client?

1. Never stop the medication suddenly.

2. This drug is taken once a week on Sunday.

3. The child should always take the medication at night before bed.

4. This drug should be taken with meals.

Answer: 1 Explanation: 1. Prednisone, a corticosteroid with anti-inflammatory action, is frequently used to treat nephrotic syndrome. It should never be stopped suddenly. The drug is taken more than once a week and can be taken any time during the day, but should remain on a constant schedule.

Taking with food is always appropriate for most medications, but it does not have to be with a meal.

2. Prednisone, a corticosteroid with anti-inflammatory action, is frequently used to treat nephrotic syndrome. It should never be stopped suddenly. The drug is taken more than once a week and can be taken any time during the day, but should remain on a constant schedule.

Taking with food is always appropriate for most medications, but it does not have to be with a meal.

3. Prednisone, a corticosteroid with anti-inflammatory action, is frequently used to treat nephrotic syndrome. It should never be stopped suddenly. The drug is taken more than once a week and can be taken any time during the day, but should remain on a constant schedule.

Taking with food is always appropriate for most medications, but it does not have to be with a meal.

4. Prednisone, a corticosteroid with anti-inflammatory action, is frequently used to treat nephrotic syndrome. It should never be stopped suddenly. The drug is taken more than once a week and can be taken any time during the day, but should remain on a constant schedule.

Taking with food is always appropriate for most medications, but it does not have to be with a meal.

Page Ref: 715-716 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 26.6 Plan nursing care for the child with acute kidney injury and chronic kidney disease.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 8) A preschool-age client is diagnosed with acute glomerulonephritis and is admitted to the hospital. Which nursing diagnosis is most appropriate for this client?

1. Risk for Injury Related to Loss of Blood in Urine 2. Fluid-Volume Excess Related to Decreased Plasma Filtration 3. Risk for Infection Related to Hypertension 4. Altered Growth and Development Related to a Chronic Disease Answer: 2 Explanation: 1. The fluid is excessive, and fluid and electrolyte balance should be monitored.

There is no risk for injury because the blood loss in the urine is not such that it causes anemia.

While a risk for infection may be present, it is not related to the hypertension. Growth and development is not normally affected because this is an acute process, not a chronic one.

2. The fluid is excessive, and fluid and electrolyte balance should be monitored. There is no risk for injury because the blood loss in the urine is not such that it causes anemia. While a risk for infection may be present, it is not related to the hypertension. Growth and development is not normally affected because this is an acute process, not a chronic one.

3. The fluid is excessive, and fluid and electrolyte balance should be monitored. There is no risk for injury because the blood loss in the urine is not such that it causes anemia. While a risk for infection may be present, it is not related to the hypertension. Growth and development is not normally affected because this is an acute process, not a chronic one.

4. The fluid is excessive, and fluid and electrolyte balance should be monitored. There is no risk for injury because the blood loss in the urine is not such that it causes anemia. While a risk for infection may be present, it is not related to the hypertension. Growth and development is not normally affected because this is an acute process, not a chronic one.

Page Ref: 718 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Reduction of Risk Potential Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Diagnosis/Coordination of care Learning Outcome: 26.4 Outline a plan to meet the fluid and dietary restrictions for the child with a renal disorder.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 9) A child diagnosed with acute glomerulonephritis is in the playroom and experiences blurred vision and headache. Which action by the nurse is the most appropriate?

1. Check the urine to see if hematuria has increased.

2. Obtain a blood pressure on the child; notify the healthcare provider.

3. Reassure the child, and encourage bed rest until the headache improves.

4. Obtain serum electrolytes, and send a urinalysis to the lab.

Answer: 2 Explanation: 1. Blurred vision and headache may be signs of encephalopathy, a complication of acute glomerulonephritis. A blood pressure (BP) should be obtained and the healthcare provider notified. The healthcare provider may decide to order an antihypertensive to bring down the BP. This is a serious complication, and delay in treatment could mean lethargy and seizures.

Therefore, the other options (checking urine for hematuria, encouraging bed rest, and obtaining serum electrolytes) do not directly address the potential problem of encephalopathy.

2. Blurred vision and headache may be signs of encephalopathy, a complication of acute glomerulonephritis. A blood pressure (BP) should be obtained and the healthcare provider notified. The healthcare provider may decide to order an antihypertensive to bring down the BP. This is a serious complication, and delay in treatment could mean lethargy and seizures.

Therefore, the other options (checking urine for hematuria, encouraging bed rest, and obtaining serum electrolytes) do not directly address the potential problem of encephalopathy.

3. Blurred vision and headache may be signs of encephalopathy, a complication of acute glomerulonephritis. A blood pressure (BP) should be obtained and the healthcare provider notified. The healthcare provider may decide to order an antihypertensive to bring down the BP. This is a serious complication, and delay in treatment could mean lethargy and seizures.

Therefore, the other options (checking urine for hematuria, encouraging bed rest, and obtaining serum electrolytes) do not directly address the potential problem of encephalopathy.

4. Blurred vision and headache may be signs of encephalopathy, a complication of acute glomerulonephritis. A blood pressure (BP) should be obtained and the healthcare provider notified. The healthcare provider may decide to order an antihypertensive to bring down the BP. This is a serious complication, and delay in treatment could mean lethargy and seizures.

Therefore, the other options (checking urine for hematuria, encouraging bed rest, and obtaining serum electrolytes) do not directly address the potential problem of encephalopathy.

Page Ref: 718 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: Teamwork and collaboration | AACN Essential Competencies: Essential VI: Interprofessional communication and collaboration for improving patient health outcomes. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Collaboration Learning Outcome: 26.4 Outline a plan to meet the fluid and dietary restrictions for the child with a renal disorder.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 10) A child, in renal failure, is diagnosed with hyperkalemia. Which food choices will the nurse teach the parents and child to avoid?

1. Carrots and green, leafy vegetables 2. Chips, cold cuts, and canned foods 3. Spaghetti and meat sauce, breadsticks 4. Hamburger on a bun, cherry gelatin Answer: 1 Explanation: 1. Carrots and green, leafy vegetables are high in potassium. Chips, cold cuts, and canned foods are high in sodium but not necessarily potassium. Spaghetti and meat sauce with breadsticks and a hamburger on a bun with cherry gelatin would be acceptable choices for a lowpotassium diet.

2. Carrots and green, leafy vegetables are high in potassium. Chips, cold cuts, and canned foods are high in sodium but not necessarily potassium. Spaghetti and meat sauce with breadsticks and a hamburger on a bun with cherry gelatin would be acceptable choices for a low-potassium diet.

3. Carrots and green, leafy vegetables are high in potassium. Chips, cold cuts, and canned foods are high in sodium but not necessarily potassium. Spaghetti and meat sauce with breadsticks and a hamburger on a bun with cherry gelatin would be acceptable choices for a low-potassium diet.

4. Carrots and green, leafy vegetables are high in potassium. Chips, cold cuts, and canned foods are high in sodium but not necessarily potassium. Spaghetti and meat sauce with breadsticks and a hamburger on a bun with cherry gelatin would be acceptable choices for a low-potassium diet.

Page Ref: 720-722 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Planning/Health teaching and health promotion Learning Outcome: 26.6 Plan nursing care for the child with acute kidney injury and chronic kidney disease.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 11) A child recently had a kidney transplant and is prescribed cyclosporine. The parents ask the nurse about the reason for the cyclosporine. Which reason will the nurse include in the response for why this medication is prescribed?

1. To boost immunity 2. To suppress rejection 3. To decrease pain 4. To improve circulation Answer: 2 Explanation: 1. Cyclosporine is given to suppress rejection. It doesn't boost immunity, decrease pain, or improve circulation.

2. Cyclosporine is given to suppress rejection. It doesn't boost immunity, decrease pain, or improve circulation.

3. Cyclosporine is given to suppress rejection. It doesn't boost immunity, decrease pain, or improve circulation.

4. Cyclosporine is given to suppress rejection. It doesn't boost immunity, decrease pain, or improve circulation.

Page Ref: 730 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Planning/Health teaching and health promotion Learning Outcome: 26.7 Summarize psychosocial issues for the child requiring surgery on the genitourinary system.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 12) A child is prescribed hemodialysis for the treatment of kidney failure. When providing care for this child, what will the nurse monitor for during the assessment? Select all that apply.

1. Shock 2. Hypotension 3. Infections 4. Migraines 5. Fluid overload Answer: 1, 2, 3 Explanation: 1. Rapid changes in fluid and electrolyte balance during hemodialysis may lead to shock and hypotension. Other complications to watch for are thromboses and infection.

Migraines and fluid overload are not clinical manifestations associated with hemodialysis.

2. Rapid changes in fluid and electrolyte balance during hemodialysis may lead to shock and hypotension. Other complications to watch for are thromboses and infection. Migraines and fluid overload are not clinical manifestations associated with hemodialysis.

3. Rapid changes in fluid and electrolyte balance during hemodialysis may lead to shock and hypotension. Other complications to watch for are thromboses and infection. Migraines and fluid overload are not clinical manifestations associated with hemodialysis.

4. Rapid changes in fluid and electrolyte balance during hemodialysis may lead to shock and hypotension. Other complications to watch for are thromboses and infection. Migraines and fluid overload are not clinical manifestations associated with hemodialysis.

5. Rapid changes in fluid and electrolyte balance during hemodialysis may lead to shock and hypotension. Other complications to watch for are thromboses and infection. Migraines and fluid overload are not clinical manifestations associated with hemodialysis.

Page Ref: 728-730 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care Learning Outcome: 26.4 Outline a plan to meet the fluid and dietary restrictions for the child with a renal disorder.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 13) A child is scheduled for a kidney transplant. The nurse completes the preoperative teaching to prepare the child and parents for the surgery and postoperative considerations. Which statement by the parents indicates understanding of the teaching session?

1. "We know it's important to see that our child takes prescribed medications after the transplant."

2. "We'll be glad we won't have to bring our child in to see the doctor again."

3. "We're happy our child won't have to take any more medicine after the transplant."

4. "We understand our child won't be at risk anymore for catching colds from other children at school."

Answer: 1 Explanation: 1. It is important that the nurse emphasize compliance with treatments that will need to be followed after the transplant. Follow-up appointments will be necessary, as well as medications and general health promotion.

2. It is important that the nurse emphasize compliance with treatments that will need to be followed after the transplant. Follow-up appointments will be necessary, as well as medications and general health promotion.

3. It is important that the nurse emphasize compliance with treatments that will need to be followed after the transplant. Follow-up appointments will be necessary, as well as medications and general health promotion.

4. It is important that the nurse emphasize compliance with treatments that will need to be followed after the transplant. Follow-up appointments will be necessary, as well as medications and general health promotion.

Page Ref: 730 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Evaluation/Health teaching and health promotion Learning Outcome: 26.5 Identify growth and developmental issues for the child with chronic kidney disease.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 14) The nurse teaches parents that the anticholinergic drug oxybutynin is used to treat enuresis.

The parents ask the nurse why the medication is being prescribed. Which response by the nurse is the most appropriate?

1. "It's an antidepressant that is used to help the child relax."

2. "It will help decrease the spasms sometimes associated with enuresis."

3. "It has an antidiuretic effect, so your child can attend sleepovers."

4. "It will slow the production of urine, so your child does not have to urinate as frequently."

Answer: 2 Explanation: 1. Oxybutynin (Ditropan) is an anticholinergic that relaxes the smooth muscle of the bladder and decreases spasms. Oxybutynin is not an antidepressant or an antidiuretic, and does not slow urine production.

2. Oxybutynin (Ditropan) is an anticholinergic that relaxes the smooth muscle of the bladder and decreases spasms. Oxybutynin is not an antidepressant or an antidiuretic, and does not slow urine production.

3. Oxybutynin (Ditropan) is an anticholinergic that relaxes the smooth muscle of the bladder and decreases spasms. Oxybutynin is not an antidepressant or an antidiuretic, and does not slow urine production.

4. Oxybutynin (Ditropan) is an anticholinergic that relaxes the smooth muscle of the bladder and decreases spasms. Oxybutynin is not an antidepressant or an antidiuretic, and does not slow urine production.

Page Ref: 712-713 Cognitive Level: Applying Client Need/Sub: Physiological Integrity Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion Learning Outcome: 26.4 Outline a plan to meet the fluid and dietary restrictions for the child with a renal disorder.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 15) The nurse educator is teaching a group of nursing students the pathophysiologic reasons related to genitourinary (GU) disorders in the pediatric population. Which statements are appropriate for the nurse educator to include in the teaching session? Select all that apply.

1. "Incomplete organ development during fetal development is the cause of many GU disorders."

2. "Improper placement of the urethra in vagina is one cause of GU disorders."

3. "GU disorders in the pediatric population can be caused by hydronephrosis."

4. "GU disorders in the pediatric population are not caused by infections."

5. "Anatomic obstruction or incomplete nerve innervation can cause GU disorders."

Answer: 1, 3, 5 Explanation: 1. Pathophysiologic causes of GU disorders in the pediatric population include incomplete organ development during fetal development; hydronephrosis; and anatomic obstruction or incomplete nerve innervations. Improper placement of the urethra in the penis, not the vagina, is another pathophysiologic cause of GU disorders. GU disorders can also be caused by infection.

2. Pathophysiologic causes of GU disorders in the pediatric population include incomplete organ development during fetal development; hydronephrosis; and anatomic obstruction or incomplete nerve innervations. Improper placement of the urethra in the penis, not the vagina, is another pathophysiologic cause of GU disorders. GU disorders can also be caused by infection.

3. Pathophysiologic causes of GU disorders in the pediatric population include incomplete organ development during fetal development; hydronephrosis; and anatomic obstruction or incomplete nerve innervations. Improper placement of the urethra in the penis, not the vagina, is another pathophysiologic cause of GU disorders. GU disorders can also be caused by infection.

4. Pathophysiologic causes of GU disorders in the pediatric population include incomplete organ development during fetal development; hydronephrosis; and anatomic obstruction or incomplete nerve innervations. Improper placement of the urethra in the penis, not the vagina, is another pathophysiologic cause of GU disorders. GU disorders can also be caused by infection.

5. Pathophysiologic causes of GU disorders in the pediatric population include incomplete organ development during fetal development; hydronephrosis; and anatomic obstruction or incomplete nerve innervations. Improper placement of the urethra in the penis, not the vagina, is another pathophysiologic cause of GU disorders. GU disorders can also be caused by infection.

Page Ref: 710-711 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Assessment/Health teaching and health promotion Learning Outcome: 26.1 Describe the pathophysiologic processes associated with genitourinary disorders in the pediatric population.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 16) A 10-year-old diagnosed with chronic kidney disease is seen at the dialysis center for dialysis treatment three times a week. The child weighs 35 pounds after dialysis.

Physician's order: Epogen 50 U/kg three times weekly after dialysis.

Medication on hand: Epogen 2000 U/mL Calculate how many ml of Epogen the child should receive three times a week.

Answer: 0.38 mL Explanation: 0.38 mL Page Ref: 723 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Planning/Coordination of care Learning Outcome: 26.6 Plan nursing care for the child with acute kidney injury and chronic kidney disease.

17) The child is diagnosed with an upper urinary tract infection (UTI). The family asks the nurse what is the difference in the symptoms of an upper versus a lower urinary tract infection? Match each symptom (1-8 below) with the appropriate infection.

Infection A. Lower UTI B. Upper UTI Symptom 1. High fever 2. Diarrhea 3. Chills 4. Hematuria 5. Costovertebral angle tenderness 6. Cloudy urine 7. Suprapubic or flank pain 8. Moderate/severe dehydration Answer: 1/B, 2/A, 3/B, 4/A, 5/B, 6/A, 7/A, 8/B Explanation: Lower UTI: Fever, diarrhea, vomiting, irritability, lethargy, foul smelling and cloudy urine, dehydration, abdominal pain, enuresis, suprapubic or flank pain, and urgency.

Upper UTI: high fever, chills abdominal pain, nausea, vomiting, flak pain, costo-vertebral angle tenderness, moderate to severe dehydration.

Page Ref: 706 Cognitive Level: Analyzing Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Diagnosis/Coordination of care Learning Outcome: 26.1 Describe the pathophysiologic processes associated with genitourinary disorders in the pediatric population.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 18) Parents of a 2-year-old bring their child into the ED for an unexplained fever and are confused why the child is being tested for UTI. Which would be the best explanation for the nurse to provide the parents? Select the best answer.

1. Since preschoolers don't tend to exhibit classic lower UTI symptoms, any unexplained fever warrants a UTI screening.

2. Children with UTI tend to have a decreased urge to urinate and can lead to a fever.

3. Antibiotics are routinely started on all children with an unexplained fever.

4. UTIs in children 2 years and below are at high risk for renal damage.

Answer: 1 Explanation: 1. Preschool age children with UTI are often asymptomatic or only have a vague fever.

2. Children with UTI tend to experience urgency but also painful urination leading to retention.

3. Antibiotics are based on urine culture results, the child's age, and symptoms.

4. UTI in children less than 1 year old increases risks of renal damage.

Page Ref: 670 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Planning/Coordination of care Learning Outcome: 26.2 Develop a nursing care plan for the child with a urinary tract infection.

19) A nurse educator is conducting an in-service on chronic kidney disease in pediatric clients.

Which is an accurate statement about the developmental issues that may occur with CKD? Select the best answer.

1. Electrolyte disturbances in CKD may cause growth retardation.

2. CKD is mostly asymptomatic until end stage disease.

3. Children with CKD tend to be hyperactive and have decreased cognitive abilities.

4. Children diagnosed with CKD tend to be low activity and drowsy due to hypotension.

Answer: 1 Explanation: 1. The disturbances in metabolism of key minerals and vitamins can lead to growth retardation and delayed maturity.

2. CKD is often asymptomatic initially but progresses to nausea, headaches, and pale skin.

3. Children with CKD tend to demonstrate decreased alertness, fatigue, and inability to concentrate.

4. These children are lower in activity, but they suffer from hypertension, not hypotension.

Page Ref: 685-686 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice. | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Planning/Health teaching and health promotion Learning Outcome: 26.5 Identify growth and developmental issues for the child with chronic kidney disease.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 20) Children who must have surgery due to GU defects may experience psychosocial disturbances. Which issues may exacerbate these disturbances and should be addressed by the nurse? Select all that apply.

1. Fears of altered body image 2. Concerns that the original condition will reoccur or worsen 3. Depression regarding long-term complications such as infertility 4. Risk of postoperative infections Answer: 1, 2, 3 Explanation: 1. Depending on the type of defect, surgery may require removal of anatomy that can have a negative effect on body image, especially in older children and teens. Expression of these concerns should be encouraged.

2. Fear of recurrence is a common concern for both parents and patients. The nurse can help manage this by providing emotional support and education.

3. Some GU defects result in delays in maturation of several body systems. These delays may have long term consequences for the child as they age. Honest communication between the child, family, and nurse regarding these conditions can help with acceptance.

4. Postoperative infections are always a risk after any surgery, and this could cause any of the other issues discussed but on its own, this should not result in a psychosocial disorder.

Page Ref: 675-676, 679.

Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Reduction of Risk Potential Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health. | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Planning/Coordination of care Learning Outcome: 26.7 Summarize psychosocial issues for the child requiring surgery on the genitourinary system.

Principles of Pediatric Nursing, 8e (Ball et al.)

Chapter 27 The Child with Alterations in Endocrine Function 1) The home health nurse is visiting a 3-month-old infant who is diagnosed with congenital hypothyroidism and is prescribed daily levothyroxine. Which should the nurse include in the infant's continued plan of care?

1. Stopping the medication as long as the child continues to grow 2. Preventing hypothermia with appropriate clothing 3. Changing formula because it is contraindicated with prescribed medication 4. Monitoring growth and development without any other prescribed interventions Answer: 2 Explanation: 1. The medication should not be stopped without discussing with the healthcare provider.

2. The parents should be cautioned to dress the child appropriately to prevent hypothermia.

3. The healthcare provider should be contacted about the choice of formula.

4. The child may have additional health problems because of the condition and may need additional prescribed interventions.

Page Ref: 710 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation 536 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 27.4 Prioritize nursing care for each type of acquired metabolic disorder.

537 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 2) The nurse is providing information to an adolescent newly diagnosed with diabetes. Which clinical manifestations of diabetic ketoacidosis (DKA) should the nurse include in the teaching session? Select all that apply.

1. Change in mental status 2. Tachycardia 3. Fruity breath odor 4. Rapid, shallow respirations 5. Abdominal pain Answer: 1, 2, 3, 4, 5 Explanation: 1. A change in mental state can be associated with DKA. 2. Tachycardia is associated with DKA 3. A fruity breath odor is common when the client is in a state of ketoacidosis.

4. Kussmaul respirations is a deep, rapid breathing pattern is commonly seen in DKA. 5. Abdominal pain is commonly seen with DKA. Page Ref: 723 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 27.6 Distinguish between the nursing care of the child with type 1 and type 2 diabetes.

3) A child weighing 18.2 kg with a history of diabetes insipidus (DI) has been admitted to the hospital. Which healthcare provider prescription should the nurse question?

1. Stat electrolytes 2. Urine specific gravity with each void 3. DDAVP (desmopressin) PO 4. Restrict oral fluids to 500 mL every 24 hours Answer: 4 Explanation: 1. Stat electrolytes should be obtained upon admission.

2. Urine specific gravity should be checked to determine hydration status.

3. DDAVP should be administered per provider order.

4. Fluid replacement, not fluid restriction, is necessary for child with DI. Page Ref: 707 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 27.4 Prioritize nursing care for each type of acquired metabolic disorder.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 4) A 5-year-old child with a history of hypopituitarism presents with complaints of right hip and leg pain. Which prescribed medication for the diagnosis should the nurse identify as the cause for the current symptoms?

1. Daily growth hormone 2. Insulin before meals and bedtime 3. DDAVP (desmopressin) at bedtime 4. Cortisone injections Answer: 1 Explanation: 1. Growth hormone injections and hypopituitarism have been associated with slipped capital femoral epiphysis, which manifests with complaints of hip or knee pain.

2. Hip or leg pain is not a common side effect of insulin.

3. Hip or leg pain is not a common side effect of DDAVP 4. Hip or leg pain is not a common side effect of cortisone injections.

Page Ref: 706 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 27.2 Summarize signs and symptoms that may indicate a disorder of the endocrine system.

5) Which clinical manifestations should the nurse anticipate when providing care to an adolescent client who presents with untreated Graves disease?

1. Hyperglycemia, ketonuria, and glucosuria 2. Weight gain, hirsutism, and muscle weakness 3. Tachycardia, fatigue, and heat intolerance 4. Dehydration, metabolic acidosis, and hypertension Answer: 3 Explanation: 1. Hyperglycemia, ketonuria, and glucosuria are not all symptoms of untreated Graves disease.

2. Weight gain, hirsutism, and muscle weakness are not all symptoms of untreated Graves disease.

3. Clinical manifestations of Graves disease are tachycardia, fatigue, and heat intolerance, seen with hyperthyroidism.

4. Dehydration, metabolic acidosis, and hypertension are not all symptoms of untreated Graves disease.

Page Ref: 710 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 27.2 Summarize signs and symptoms that may indicate a disorder of the endocrine system.

539 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 6) A hospitalized child has been diagnosed with SIADH (syndrome of inappropriate antidiuretic hormone), a complication of his meningitis. Which laboratory data should the nurse anticipate for this child?

1. Hyponatremia 2. Hypocalcemia 3. Hyperglycemia 4. Hypernatremia Answer: 1 Explanation: 1. SIADH is associated with increased permeability in distal renal tubes, leading to water intoxication and low sodium.

2. Laboratory findings for a child diagnosed with SIADH include low serum osmolality, low serum sodium, high urine sodium, and decreased blood urea nitrogen not hypocalcemia.

3. Laboratory findings for a child diagnosed with SIADH include low serum osmolality, low serum 4. sodium, high urine sodium, and decreased blood urea nitrogen, not hyperglycemia.

4. Laboratory findings for a child diagnosed with SIADH include low serum osmolality, low serum sodium, high urine sodium, and decreased blood urea nitrogen, not hypernatremia.

Page Ref: 708 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Reduction of Risk Potential Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 27.2 Summarize signs and symptoms that may indicate a disorder of the endocrine system.

540 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 7) The nurse is giving discharge instructions to the parents of a child whose adrenal glands have been removed due to a tumor. Which parental statement indicates the need for further education?

1. "I will call the doctor if my child has restlessness and confusion."

2. "If my child has any gastric irritation, I will give him antacids."

3. "If my child has vomiting and diarrhea, I will hold his hydrocortisone."

4. "I will give my child his hydrocortisone in the morning."

Answer: 3 Explanation: 1. Restlessness and confusion are common symptoms for a child whose adrenal gland has been removed.

2. The oral preparations of cortisone have a bitter taste and can cause gastric irritation. Antacids can help reduce these side effects.

3. If the child is ill and cannot take hydrocortisone by mouth, the child would need to have an injection. Failure to give hydrocortisone could lead to severe illness and cardiovascular collapse.

The mother needs additional instruction.

4. Giving the dose of hydrocortisone at mealtimes and using antacids between meals help reduce side effects.

Page Ref: 713 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 27.5 Develop a family education plan for the child who needs lifelong cortisol replacement.

8) The nurse is caring for a child just admitted with diabetic ketoacidosis (DKA). Which healthcare provider prescription should the nurse question?

1. Neurologic checks hourly 2. Insert urinary catheter, and measure output hourly 3. NPH insulin IV at 0.1 unit/kg per hour 4. Stat serum electrolytes Answer: 3 Explanation: 1. Neurologic status can indicate a change in the patients status that requires intervention.

2. Accurate intake and output is needed for these patients.

3. NPH insulin is never administered IV. A short-acting insulin needs to be ordered.

4. Electrolytes are ordered to determine if any replacement is needed.

Page Ref: 725 Cognitive Level: Analyzing Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 27.6 Distinguish between the nursing care of the child with type 1 and type 2 diabetes.

541 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 9) An adolescent presents in the emergency department (ED) with confusion. The healthcare provider suspects diabetic ketoacidosis (DKA). A stat serum glucose is done, and the result is 7l5 mg/dL. Which clinical manifestations does the nurse anticipate upon assessment for this client?

1. Tachycardia, dehydration, and abdominal pain 2. Sweating, photophobia, and tremors 3. Dry mucous membranes, blurred vision, and weakness 4. Dry skin, shallow rapid breathing, and dehydration Answer: 1, 3 Explanation: 1. All 3 of these symptoms can be DKA. 2. Sweating and tremors are clinical manifestations of hypoglycemia.

3. Dry mucous membranes, blurred vision, and weakness are seen with hyperglycemia.

4. Deep, rapid breathing is a clinical manifestation of DKA. Page Ref: 726 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 27.6 Distinguish between the nursing care of the child with type 1 and type 2 diabetes.

10) Which teaching point should the nurse include when providing education to an adolescent client, who participates in soccer, regarding the plan of care for diabetes mellitus?

1. Decreased food intake 2. Increased doses of insulin 3. Increased food intake 4. Decreased doses of insulin Answer: 3 Explanation: 1. Encourage regular physical activity, and educate the child to increase not decrease food intake for extra physical activity periods.

2. The insulin dose should be based on the blood sugar.

3. An increase in physical activity requires an increase in caloric intake to prevent hypoglycemia.

4. The insulin dose should be based on the blood sugar.

Page Ref: 727 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 27.6 Distinguish between the nursing care of the child with type 1 and type 2 diabetes.

542 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 11) Which action related to insulin administration should the nurse include in the teaching plan for an adolescent client who has been newly diagnosed with diabetes mellitus to avoid the development of lipoatrophy?

1. Rotating injection sites 2. Checking blood sugars at mealtime and bedtime 3. Using a sliding scale for additional coverage 4. Administration of insulin via insulin pump Answer: 1 Explanation: 1. Lipoatrophy is caused by using the same insulin injection site.

2. Checking blood sugars at mealtime and bedtime is necessary for care of this client and will not cause lipoatrophy if done correctly.

3. A sliding scale will keep the client's blood sugars more controlled but does not cause lipoatrophy.

4. An insulin pump will decrease the risk of lipoatrophy as it decreases the number of injection sites.

Page Ref: 721 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 27.6 Distinguish between the nursing care of the child with type 1 and type 2 diabetes.

543 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 12) The nurse is teaching the caregiver of a child who is newly diagnosed with type 1 diabetes mellitus how to minimize pain with insulin injections. Which interventions should the nurse include in the teaching session? Select all that apply.

1. Do not reuse needles.

2. Remove all bubbles from the syringe before injecting.

3. Have the child flex the muscle during injection.

4. Inject insulin when it is cold.

5. Do not change the direction of the needle during insertion or withdrawal.

Answer: 1, 2, 5 Explanation: 1. Reusing needles leads to more pain on injection.

2. Removing bubbles from the syringe minimizes pain.

3. The child should relax their muscles during injection.

4. Insulin at room temperature will hurt less.

5. Keeping the direction of the syringe constant will minimize pain.

Page Ref: 725 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 27.6 Distinguish between the nursing care of the child with type 1 and type 2 diabetes.

13) Which food should the nurse remove from the food tray for a toddler-age client who is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH)?

1. Oatmeal 2. Yogurt 3. Biscuit 4. Watermelon Answer: 4 Explanation: 1. Oatmeal is an appropriate food for this client to eat.

2. Yogurt is an appropriate food for this client to eat.

3. A biscuit is an appropriate food for this client to eat.

4. A child with SIADH is on a fluid restriction. Watermelon contains significant fluid volume, so it would not be a good food for this child to consume.

Page Ref: 708 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Basic Care and Comfort Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 27.4 Prioritize nursing care for each type of acquired metabolic disorder.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 14) Which sequela should the nurse include in the teaching session for a parent who does not believe in medication for the treatment of the newborn's hypothyroidism?

1. Heart disease 2. Intellectual disability 3. Renal failure 4. Thyroid storm Answer: 2 Explanation: 1. Developmental delay, alterations in growth, and poor body image are the main problems with a client who is not treated for hypothyroidism.

2. Untreated hypothyroidism will lead to intellectual disability.

3. Developmental delay, alterations in growth, and poor body image are the main problems with a client who is not treated for hypothyroidism.

4. Developmental delay, alterations in growth, and poor body image are the main problems with a client who is not treated for hypothyroidism.

Page Ref: 709 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 27.7 Plan care for the child with an inherited metabolic disorder.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 15) Which changes should the school nurse implement to decrease the risk for the development of type 2 diabetes mellitus for a population who is identified as being at risk? Select all that apply.

1. Increase the amount of daily physical activity.

2. Meet with all parents, and explain the risk that is associated with obesity.

3. Test each child's urine monthly.

4. Teach the parents to avoid administering aspirin to their children.

5. Work with the cafeteria to decrease the amount of fat in the foods served.

Answer: 1, 2, 5 Explanation: 1. Increased physical activity will decrease a child's risk of developing type 2 diabetes.

2. Obese children have an increased risk of type 2 diabetes. Working with the parents, the nurse can reduce the obesity in the school.

3. Blood glucose levels are a better indication of diabetes than urine checks.

4. There is no indication that administering aspirin will decrease the risk of these children developing type 2 diabetes mellitus.

5. A diet high in fat is associated with type 2 diabetes.

Page Ref: 728 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 27.6 Distinguish between the nursing care of the child with type 1 and type 2 diabetes.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 16) Which assessment finding would cause the nurse to question whether a preschool-age boy, diagnosed with phenylketonuria shortly after birth, is following the prescribed dietary restrictions?

1. The child's body has a musty odor.

2. This child is a blue-eyed blonde.

3. The child appears sleepy and uninterested in the surroundings.

4. The child has sunburn over his entire body.

Answer: 1 Explanation: 1. The odor is caused by the excretion of phenylketone by-products through the skin and would indicate noncompliance with the dietary restrictions.

2. Eye and hair color are not an indication of whether or not the child is following prescribed dietary restrictions.

3. Symptoms of phenylketonuria are irritability, vomiting, hyperactivity, hypertonia, hyperreflexive deep tendon reflexes, seizures, and an eczema-like rash.

4. Sunburn is not an indication of whether or not the child is following prescribed dietary restrictions.

Page Ref: 730 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 27.2 Summarize signs and symptoms that may indicate a disorder of the endocrine system.

547 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 17) The nurse is providing care to a newborn who is suspected of having Turner syndrome.

Which should the nurse assess the newborn for based on the current diagnosis?

1. Club foot (talipes equinovarus) 2. Congenital heart anomalies 3. Hyperbilirubinemia due to liver abnormalities 4. Diaphragmatic hernia Answer: 2 Explanation: 1. Club foot is not a usual finding for a newborn suspected of having Turner syndrome.

2. Congenital heart anomalies, including coarctation of the aorta, frequently are associated with Turner syndrome.

3. Hyperbilirubinemia is not a usual finding for a newborn suspected of having Turner syndrome.

4. A diaphragmatic hernia is not a usual finding for a newborn suspected of having Turner syndrome.

Page Ref: 729 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 27.2 Summarize signs and symptoms that may indicate a disorder of the endocrine system.

18) Which prescription regarding an oral hydrocortisone for a toddler-age client diagnosed with congenital adrenal insufficiency should the nurse anticipate when the client is admitted to the hospital with pneumonia?

1. It will be discontinued.

2. It will be reduced.

3. It will be continued as previously prescribed.

4. It will be increased.

Answer: 4 Explanation: 1. The medication should not be completely stopped.

2. The medication should be increased during illness, not decreased.

3. If the client is sick, the medication should be increased.

4. During periods of stress including illness and surgery, the dose of steroids needs to be increased.

Page Ref: 713 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 27.5 Develop a family education plan for the child who needs lifelong cortisol replacement.

548 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 19) Which type of nutrition should the nurse include when planning care for a newborn who is diagnosed with galactosemia?

1. Goat's milk formula 2. Breast milk 3. Cow's milk-based formula 4. Lactose-free formula Answer: 4 Explanation: 1. The infant should be placed on a lactose- or galactose-free formula which does not include goat's milk.

2. The infant should be placed on a lactose- or galactose-free formula which does not include breast milk.

3. The infant should be placed on a lactose- or galactose-free formula which does not include cow's milk-based formula.

4. A lactose-free formula is the type of nutrition the nurse should include in the teaching plan for this newborn.

Page Ref: 731 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Basic Care and Comfort Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 27.7 Plan care for the child with an inherited metabolic disorder.

549 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 20) The nurse is providing care to a newborn female who is born with ambiguous genitalia. The follow-up investigation discovers adrenogenital syndrome (also called congenital adrenal hyperplasia [CAH]). The parents question why the baby's genitalia looks more male than female.

Which response by the nurse is accurate?

1. "The disorder caused your baby to be a hermaphrodite with both male and female sex organs."

2. "The changes in the genitalia are due to increased androgens secondary to deficient cortisol."

3. "The excessive cortisol caused the enlargement of the female tissue, creating a male appearance."

4. "Your baby has only one sex chromosome resulting in an XO configuration."

Answer: 2 Explanation: 1. Adrenogenital syndrome does not mean the newborn is a hermaphrodite and only has female sex organs.

2. Deficient cortisol causes the amount of adrenocorticotropic hormone (ACTH) to be high, overstimulating the adrenal production of androgens, which causes the pseudomasculinization.

3. The serum cortisol level is inappropriately low in comparison to ACTH. 4. Children with CAH have insufficient production of aldosterone and cortisol and an overproduction of androgen Page Ref: 713 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 27.2 Summarize signs and symptoms that may indicate a disorder of the endocrine system.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 21) Which pediatric client diagnoses would cause the nurse to include information related to short stature? Select all that apply.

1. Hypothyroidism 2. Turner syndrome 3. Chronic renal failure 4. Cushing syndrome 5. Diabetes mellitus Answer: 1, 2, 3, 4 Explanation: 1. Hypothyroidism is a pediatric client diagnosis that would cause the nurse to include information related to short stature.

2. Turner syndrome is a pediatric client diagnosis that would cause the nurse to include information related to short stature.

3. Chronic renal failure is a pediatric client diagnosis that would cause the nurse to include information related to short stature.

4. Cushing syndrome is a pediatric client diagnosis that would cause the nurse to include information related to short stature.

5. Diabetes mellitus is not a diagnosis that includes short stature as a clinical manifestation.

Page Ref: 704 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 27.3 Identify all conditions for which short stature is a sign.

22) Which functions of the adrenal hormone aldosterone should the nurse include in a teaching session for a pediatric client diagnosed with alterations in adrenal function? Select all that apply.

1. Stimulates bone development.

2. Increases sodium ion reabsorption.

3. Stimulates secondary sexual characteristics.

4. Increases potassium excretion by the kidneys.

5. Activates the sympathetic nervous system.

Answer: 2, 4 Explanation: 1. This is not a function of aldosterone.

2. This is a function of aldosterone.

3. This is not a function of aldosterone.

4. This is a function of aldosterone.

5. This is not a function of aldosterone.

Page Ref: 713 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 27.1 Identify the function of important hormones of the endocrine system.

551 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 23) Which functions of the adrenal androgens should the nurse include in a teaching session for a pediatric client diagnosed with alterations in adrenal function? Select all that apply.

1. Stimulates bone development.

2. Increases sodium ion reabsorption.

3. Stimulates secondary sexual characteristics.

4. Increases potassium excretion by the kidneys.

5. Activates the sympathetic nervous system.

Answer: 1, 3 Explanation: 1. This is a function of androgens.

2. This is not a function of adrenal androgens.

3. This is a function of androgens.

4. This is not a function of adrenal androgens.

5. This is not a function of adrenal androgens.

Page Ref: 703 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 27.1 Identify the function of important hormones of the endocrine system.

24) Which diagnostic tests should the nurse include in the plan of care for a pediatric client who is at risk for short stature? Select all that apply.

1. Thyroid function studies 2. Adrenocorticotropic hormone (ACTH) and cortisol levels 3. Complete blood count 4. Blood culture 5. Urine creatinine Answer: 1, 2, 3, 5 Explanation: 1. Thyroid function tests are often included in the plan of care for a pediatric client at risk for short stature.

2. ACTH and cortisol levels are often included in the plan of care for a pediatric client at risk for short stature.

3. A complete blood count often included in the plan of care for a pediatric client at risk for short stature.

4. A blood culture is not indicated for a client at risk for short stature.

5. A urine creatinine is often included in the plan of care for a pediatric client at risk for short stature.

Page Ref: 705 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Reduction of Risk Potential Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 27.3 Identify all conditions for which short stature is a sign.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 25) Which assessment data for a pediatric client supports the diagnosis of familial or idiopathic central diabetes insipidus (DI)? Select all that apply.

1. Polyuria 2. Polydipsia 3. Nocturia 4. Enuresis 5. Constipation Answer: 3, 4, 5 Explanation: 1. Polyuria is not a clinical manifestation of central diabetes insipidus (DI) 2. Polydipsia is not a clinical manifestation of central diabetes insipidus (DI) 3. Nocturia is a clinical manifestation associated with familial or idiopathic central DI. 4. Enuresis a clinical manifestation associated with familial or idiopathic central DI. 5. Constipation a clinical manifestation associated with familial or idiopathic central DI. Page Ref: 707 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 27.2 Summarize signs and symptoms that may indicate a disorder of the endocrine system.

Principles of Pediatric Nursing, 8e (Ball et al.)

Chapter 28 The Child with Alterations in Neurological Function 1) Which assessment finding for a 4-month-old infant would require further action by the nurse?

1. The anterior fontanel is bulging.

2. The infant has good head control when held upright.

3. The infant is able to roll only from abdomen to back.

4. The anterior fontanel is open and soft.

Answer: 1 Explanation: 1. A bulging anterior fontanel is a characteristic of hydrocephalus.

2. Good head control is expected at 4 months of age.

3. Rolling from abdomen to back is a skill the 4-month-old infant should be learning.

4. An open anterior fontanel, which is soft, is a normal finding at 4 months.

Page Ref: 739 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 28.1 Describe the pediatric differences associated with the anatomy and physiology of the neurologic system.

2) The nurse is providing care for a pediatric client in the emergency department (ED) with a 553 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 diagnosis of decreased level of consciousness (LOC) secondary to increased intracranial pressure (ICP). Which healthcare provider order should the nurse question?

1. Passive range-of-motion exercises to promote hip flexion 2. Oxygen at 2 L nasal cannula to keep saturation above 95% 3. Hourly vital signs and neurologic checks 4. Elevate head of bed 30 degrees Answer: 1 Explanation: 1. Range-of-motion exercises, especially hip flexion, would not be done. It is imperative to keep the child with increased intracranial pressure quiet, with as little stimulation as possible.

2. Oxygen should be ordered to keep the child's O2 saturation above 95%.

3. Hourly vital signs and neurologic checks are appropriate to watch for changes in this child's condition.

4. The head is elevated 30 degrees to help decrease increased intracranial pressure.

Page Ref: 772 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 28.2 Choose the appropriate assessment guidelines and tools to examine infants and children with altered levels of consciousness and other neurologic conditions.

3) A 4-year-old client with intractable seizures has been on a ketogenic diet for the last 6 months, with a decrease in seizure activity. This child is now admitted to the pediatric unit with left-sided pain. Which possible complication to this diet does the nurse suspect?

1. Appendicitis 2. Bowel obstruction 3. Urinary tract infection 4. Kidney stones Answer: 4 Explanation: 1. Appendicitis does not occur as a result of the ketogenic diet.

2. The ketogenic diet does not cause a bowel obstruction.

3. Urinary tract infections are not a result of a ketogenic diet.

4. Kidney stones are seen in 5% of children on a ketogenic diet.

Page Ref: 748 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Basic Care and Comfort Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 28.3 Differentiate between the signs of a seizure and status epilepticus in infants and children, and describe appropriate nursing management for each condition.

4) A child with a history of seizures arrives in the emergency department (ED) in status epilepticus. Which is the priority nursing action?

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 1. Take vital signs.

2. Establish an intravenous line.

3. Perform rapid neurologic assessment.

4. Maintain patent airway.

Answer: 4 Explanation: 1. Taking vital signs is important, but airway always comes first.

2. Once the airway is secure, securing an IV is vital.

3. A rapid neurologic assessment is appropriate once the airway is secure.

4. Airway is always the priority of care.

Page Ref: 745 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 28.3 Differentiate between the signs of a seizure and status epilepticus in infants and children, and describe appropriate nursing management for each condition.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 5) The nurse is teaching a mother of a young child with a newly diagnosed seizure disorder. The child is prescribed valproic acid (Depakote) for control of seizures. Which parental statement indicates the need for further education?

1. "I will not use carbonated beverages to dilute his medication."

2. "I will give his medicine on an empty stomach so he will absorb it better."

3. "I will not let him chew his tablet."

4. "I will bring him to the physician's office for regular blood work to check bleeding times."

Answer: 2 Explanation: 1. Carbonated beverages should never be used to dilute valproic acid.

2. Valproic acid (Depakote) should be given with foods to decrease gastrointestinal irritation.

3. This child should not be allowed to chew a valproic acid tablet.

4. It is appropriate to have periodic blood studies to check bleeding times and platelet count.

Page Ref: 746 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 28.3 Differentiate between the signs of a seizure and status epilepticus in infants and children, and describe appropriate nursing management for each condition.

6) A young child admitted to the pediatric unit has fever, irritability, and vomiting with suspected bacterial meningitis. For which reason should a lumbar puncture be completed?

1. Evaluate for white blood cells.

2. Reduce intracranial pressure.

3. Rule out a cerebral bleed.

4. Inject antibiotic medication.

Answer: 4 Explanation: 1. In meningitis, a lumbar puncture is performed to culture the cerebrospinal fluid, and evaluate it for white blood cells.

2. A lumber puncture is not done to reduce intracranial pressure.

3. A lumbar puncture is not done to rule out a cerebral bleed.

4. A lumbar puncture is not done to inject antibiotic medication.

Page Ref: 751 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Reduction of Risk Potential Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 28.4 Differentiate between signs of bacterial meningitis, viral meningitis, encephalitis, and Guillain-Barré syndrome in infants and children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 7) Which is the priority problem when planning care for a pediatric client who is diagnosed with bacterial meningitis?

1. Insufficient oxygenation 2. Infection 3. Parental anxiety 4. Pain Answer: 1 Explanation: 1. The child is at risk for insufficient oxygenation if the airway is impeded.

2. The child already has an infection.

3. The parents will be anxious about the outcome for their child, but this is not the priority problem.

4. Pain management is important but is not the priority.

Page Ref: 753 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.4 Diagnose actual or potential health problems and needs. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Diagnosis Learning Outcome: 28.4 Differentiate between signs of bacterial meningitis, viral meningitis, encephalitis, and Guillain-Barré syndrome in infants and children.

8) The nurse is caring for a 9-month-old infant who just returned from the postanesthesia care unit (PACU) after a shunt placement for hydrocephalus. Which healthcare provider prescription should the nurse question?

1. Vital signs and neurologic checks hourly 2. Small, frequent formula feedings 3. Elevate head of bed 4. Daily head circumference Answer: 3 Explanation: 1. Frequent vital signs and neurologic checks are needed postoperatively.

2. Small, frequent feedings are appropriate to decrease the chance of vomiting.

3. The 9-month-old should be placed in a flat position so that cerebrospinal fluid drainage is not too rapid.

4. Daily head circumferences are needed to help evaluate shunt functioning.

Page Ref: 761 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 28.6 Develop a nursing care plan for the infant with hydrocephalus and spina bifida.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 9) A neonate with a meningomyelocele is to have surgery in the morning. Which nursing action is appropriate for this neonate?

1. Applying a diaper to prevent contamination of sac 2. Positioning the newborn in a side-lying position 3. Encouraging the mother to hold the newborn because she will not be able to pick him up after surgery 4. Positioning the newborn in a prone position Answer: 4 Explanation: 1. A diaper is not used because it also puts pressure on the sac.

2. A side-lying position would be contraindicated because it would place pressure on the sac.

3. The mother should not hold the baby because that would put too much pressure on the sac.

4. The newborn should be placed in a prone position to keep pressure off the sac.

Page Ref: 763 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 28.6 Develop a nursing care plan for the infant with hydrocephalus and spina bifida.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 10) Which should the nurse include in the plan of care for a hospitalized school-age child with myelodysplasia? Select all that apply.

1. Implementing interventions for a client of normal intelligence 2. Using latex precautions when providing client care 3. Allowing the client to self-catheterize 4. Ensuring that the client has a low-fiber diet 5. Encouraging the client to shift positions hourly when in the wheelchair Answer: 1, 2, 3, 5 Explanation: 1. Many children with myelodysplasia have normal intellect. They should be treated according to their intellectual level rather than their motor development.

2. Children with myelodysplasia are at great risk for latex allergy. It is important to use latex-free products.

3. Self-catheterization fosters independence in this child. It is important to maintain the same schedule as much as possible when this child is hospitalized.

4. Children with myelodysplasia need a high-fiber diet to maintain adequate stool and bowel function.

5. Due to decreased sensation in the buttocks and lower extremities, it is very important for the child to shift positions while in the wheelchair, to prevent pressure sores.

Page Ref: 753 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 28.6 Develop a nursing care plan for the infant with hydrocephalus and spina bifida.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 11) Which side effect should the nurse include in the parent teaching for a child who is prescribed a baclofen pump for cerebral palsy?

1. Diarrhea 2. Hypertonia 3. Hypotonia 4. Restlessness Answer: 3 Explanation: 1. Continuous baclofen infusion does not cause diarrhea.

2. Hypertonia is not seen as a side effect of baclofen infusion.

3. Hypotonia is possible if the child is getting too much baclofen.

4. Restlessness is not seen with baclofen; rather, these children can be drowsy and sleepy.

Page Ref: 768 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 28.7 Plan family-centered nursing care for the child with cerebral palsy in a community setting.

12) A 9-month-old infant who is not sitting independently has been diagnosed with ataxic cerebral palsy (CP). Which clinical manifestations would the nurse expect to see in the baby?

1. Hypotonia and muscle instability 2. Hypertonia and persistence primitive reflexes 3. Tremors and exaggerated posturing 4. Hemiplegia and hypertonia Answer: 1 Explanation: 1. Hypotonia in infancy and muscle instability are seen in ataxic CP. 2. Hypertonia and persistent primitive reflexes are seen in spastic CP. 3. Tremors and exaggerated posturing are seen in dyskinetic CP. 4. Hemiplegia and hypertonia are seen in spastic CP. Page Ref: 767 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 28.7 Plan family-centered nursing care for the child with cerebral palsy in a community setting.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 13) A pediatric client is admitted to the emergency department with a traumatic brain injury (TBI) that caused a loss of consciousness. The last set of vital signs showed heart rate 48, blood pressure (BP) 148/74 mmHg, and respiratory rate 28 and irregular. Which does the nurse suspect based on these data?

1. Spinal cord injury 2. Increased intracranial pressure.

3. Typical for sleep 4. Improvement Answer: 2 Explanation: 1. If the child suffered a spinal cord injury, and neurogenic shock were suspected, the child would be hypotensive.

2. These vital signs show increased BP, with a wide pulse pressure, slow heart rate, and respirations that are irregular, all indicating possible significant increased intracranial pressure.

3. Normal sleeping pulse at this age is 60 to 90 bpm.

4. Without previous vital signs, there is no way to determine if the current changes in the vital signs indicate improvement.

Page Ref: 740 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 28.8 Contrast the appropriate initial nursing management for mild versus severe traumatic brain injury.

14) Which clinical manifestation should the nurse monitor for when assessing a pediatric client who is diagnosed with a basilar skull fracture?

1. Periorbital ecchymosis 2. Subdural hematoma 3. Protruding bone 4. Epidural hematoma Answer: 1 Explanation: 1. Periorbital ecchymosis, also called raccoon eyes, is seen with a basilar fracture.

2. Subdural hematoma might be seen with a linear fracture.

3. Protruding bone might be seen with a compound fracture.

4. Epidural hematoma is seen with linear fracture.

Page Ref: 775 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 28.8 Contrast the appropriate initial nursing management for mild versus severe traumatic brain injury.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 15) A teacher states to the school nurse, "I have a student who will often just stare at me for 15 seconds after asking a question; then, the student blinks and asks me to repeat the question.

Should I be concerned?" Which should the nurse include in the response to the teacher?

1. The child has a crush on the teacher.

2. The child has increased intracranial pressure.

3. The child may have had a head injury.

4. The child is experiencing absence seizures.

Answer: 4 Explanation: 1. There are no data to suspect a childhood crush is creating the situation.

2. There is no indication of increased intracranial pressure.

3. There is no indication of a head injury.

4. Absence seizures may cause staring and blinking; they are more common in girls in this age group and often are first noticed by the classroom teacher.

Page Ref: 744 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 28.3 Differentiate between the signs of a seizure and status epilepticus in infants and children, and describe appropriate nursing management for each condition.

16) The nurse is providing care to a child who was treated with aspirin during a viral infection.

Which clinical manifestations should cause the nurse concern?

1. Nausea, vomiting, and confusion 2. Headache, vomiting, and seizures 3. Sore throat, moist respirations, and cough 4. Fever, rash, and photophobia Answer: 1 Explanation: 1. These are the early symptoms of Reye syndrome.

2. These symptoms are associated with a malfunctioning shunt and not the early symptoms of Reye syndrome.

3. These symptoms are more likely to indicate pneumonia, not Reye syndrome.

4. These are not the early symptoms of Reye syndrome.

Page Ref: 755 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 28.2 Choose the appropriate assessment guidelines and tools to examine infants and children with altered levels of consciousness and other neurologic conditions.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 17) Which preventative strategies should the nurse include in a teaching session for a mother whose infant is at risk for febrile seizures? Select all that apply.

1. Increasing oral intake of fluids 2. Administering dose-appropriate aspirin 3. Providing a sponge bath with cold water 4. Decreasing oral fluid intake 5. Using complementary methods to reduce the fever Answer: 1, 5 Explanation: 1. Fluid intake will help heat loss.

2. Aspirin should be avoided due to the risk for Reye syndrome.

3. Cold water may cause shivering, which will increase the body temperature.

4. Decreasing fluid intake would increase the retention of heat.

5. Complementary methods should be used to reduce the fever.

Page Ref: 745 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 28.3 Differentiate between the signs of a seizure and status epilepticus in infants and children, and describe appropriate nursing management for each condition.

18) When the home health nurse visits the home of a 10-month-old child, she observes the environment for risks for injury to the child. Which observation will the nurse discuss with the mother?

1. The mother leaves the filled mop bucket on the floor while in another room.

2. The mother turns all panhandles to the back of the stove.

3. The mother fills the bathtub before bringing the baby into the bathroom.

4. When riding in a car, the child is in a car seat in the middle of the back seat.

Answer: 1 Explanation: 1. Toddlers can drown in a minimum amount of water. The child may look in the bucket and fall in headfirst. Because of mobility limitations, the child may not be able to get out of the bucket without help.

2. This is appropriate to reduce the risk of injury.

3. This allows the mother to adjust the temperature of the bath water and reduces the risk of burns.

4. This is the safest place for the child.

Page Ref: 778 Cognitive Level: Analyzing Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 28.9 Discuss initiatives to prevent drowning in children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 19) Which problems should the nurse include in the plan of care for a pediatric client who experiences a traumatic brain injury (TBI)? Select all that apply.

1. Reduced blood flow to the brain 2. Potential for aspirating 3. Insufficient body fluids 4. Problems with family functioning 5. Pain Answer: 1, 2, 3, 4 Explanation: 1. This is an appropriate problem for the nurse to include in the plan of care for the client.

2. This is an appropriate problem for the nurse to include in the plan of care for the client.

3. This is an appropriate problem for the nurse to include in the plan of care for the client.

4. This is an appropriate problem for the nurse to include in the plan of care for the client.

5. This nursing diagnosis is problem for a client diagnosed with cerebral palsy, not a TBI. Page Ref: 773 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Diagnosis Learning Outcome: 28.5 Develop a plan of nursing care for the child hospitalized with an acute neurologic condition.

20) Which problems should the nurse include in the plan of care for a pediatric client diagnosed with cerebral palsy? Select all that apply.

1. Constipation 2. Risk for skin breakdown 3. Problems with communication 4. Pain 5. Delays in development Answer: 1, 2, 3, 5 Explanation: 1. This is an appropriate problem for a pediatric client diagnosed with cerebral palsy.

2. This is an appropriate problem for a pediatric client diagnosed with cerebral palsy.

3. This is an appropriate problem for a pediatric client diagnosed with cerebral palsy.

4. Chronic, not acute, pain is a problem for a pediatric client diagnosed with cerebral palsy.

5. This is an appropriate problem for a pediatric client diagnosed with cerebral palsy.

Page Ref: 768-769 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 28.5 Develop a plan of nursing care for the child hospitalized with an acute neurologic condition.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 21) Which problem should the nurse include in the plan of care for a pediatric client diagnosed with hydrocephalus? Select all that apply.

1. Potential for infection 2. Problems with mobility 3. Caregiver burden 4. Potential for injury 5. Constipation Answer: 1, 2, 3, 4 Explanation: 1. This is an appropriate problem for a pediatric client diagnosed with hydrocephalus.

2. This is an appropriate problem for a pediatric client diagnosed with hydrocephalus.

3. This is an appropriate problem for a pediatric client diagnosed with hydrocephalus.

4. This is an appropriate problem for a pediatric client diagnosed with hydrocephalus.

5. Risk for constipation is not an appropriate problem for a pediatric client diagnosed with hydrocephalus.

Page Ref: 761 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 28.5 Develop a plan of nursing care for the child hospitalized with an acute neurologic condition.

22) Which clinical manifestations support the diagnosis of viral meningitis? Select all that apply.

1. Abrupt onset of fever 2. Headache 3. Myalgia 4. Hemorrhagic rash 5. Purpura Answer: 1, 2, 3 Explanation: 1. Abrupt onset of fever is a clinical manifestation associated with viral meningitis.

2. Headache is a clinical manifestation associated with viral meningitis.

3. Myalgia is a clinical manifestation associated with viral meningitis.

4. Hemorrhagic rash is a clinical manifestation associated with bacterial, not viral, meningitis.

5. Purpura is a clinical manifestation associated with bacterial, not viral, meningitis.

Page Ref: 755 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 28.4 Differentiate between signs of bacterial meningitis, viral meningitis, encephalitis, and Guillain-Barré syndrome in infants and children.

23) The nurse is planning a teaching session for the parents of a child who is diagnosed with 565 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 simple partial seizures. Which causes should the nurse include when teaching the parents? Select all that apply.

1. Lesions 2. Cysts 3. Tumor 4. Brain abscesses 5. Brain trauma Answer: 1, 2, 3, 4 Explanation: 1. Lesions are a cause of simple partial seizures.

2. Cysts are a cause of simple partial seizures.

3. Tumors are a cause of simple partial seizures.

4. Brain abscesses are a cause of simple partial seizures.

5. Brain trauma a cause of complex partial seizures.

Page Ref: 744 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Implementation Learning Outcome: 28.3 Differentiate between the signs of a seizure and status epilepticus in infants and children, and describe appropriate nursing management for each condition.

Principles of Pediatric Nursing, 8e (Ball et al.)

Chapter 29 The Child with Alterations in Mental Health and Cognitive Function 1) The nurse is assessing a 4-year-old child with a possible alteration in mental health. Which findings indicate a need for further investigation? Select all that apply.

1. Fails to make eye contact.

2. Flinches when touched on the arm.

3. History of limited prenatal care and precipitate delivery 4. Head circumference has not changed in over 1 year.

5. Flat facial expressions Answer: 1, 2, 3, 5 Explanation: 1. Making eye contact with the nurse and caregiver is part of the child's overall affect and social skills. A child who fails to make eye contact may have an alteration in mental health.

2. Flinching may indicate a desire to avoid contact; this can indicate a mental health issue and should be further evaluated.

3. History of prenatal care and delivery can help determine potential alterations in mental health in a child.

4. Head circumference is not measured in a 4-year-old.

5. Affect can be determined by facial expression and response to the nurse, helping to determine mental health.

Page Ref: 787 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity 566 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 29.1 Define mental health and describe major mental health alterations in childhood.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 2) Which factor, noted by the nurse during the pediatric health history portion of the assessment process, would indicate the child is at risk for attention deficit/hyperactivity disorder (ADHD)?

1. Measles, mumps, and rubella vaccine 2. Advanced parental age 3. Prenatal exposure to smoke 4. Immune response Answer: 3 Explanation: 1. Measles, mumps, and rubella vaccine has been thought to be associated with autism spectrum disorder, though a relationship has never been established through research.

2. Advanced parental age has been associated with autism spectrum disorders.

3. Research shows that a mother's use of cigarettes during pregnancy can increase the risk for ADHD. 4. Immune response can be associated with autism spectrum disorders.

Page Ref: 791 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 29.2 Discuss the clinical manifestations of the major mental health alterations of childhood and adolescence.

3) Which data, noted by the nurse during the physical assessment, would indicate the need to refer an adolescent client for further treatment due to possible depression? Select all that apply.

1. Agoraphobia 2. Somatic complaints 3. Focus on violence 4. Poor self-care 5. Poor school performance Answer: 3, 4, 5 Explanation: 1. Agoraphobia, which is a fear of being in places or situations from which escape might be difficult or embarrassing, is seen in children with a panic disorder, not with depression.

2. Somatic complaints are more commonly associated with depression in the younger school-age child.

3. Focus on violence can be associated with depression in the adolescent.

4. Poor self-care can be associated with depression in an adolescent.

5. Poor school performance is associated with depression in the adolescent with depression.

Page Ref: 794 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 29.2 Discuss the clinical manifestations of the major mental health alterations of childhood and adolescence.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 4) Which statement from the parent of a child diagnosed with attention deficit/hyperactivity disorder (ADHD) indicates the need for further education by the nurse?

1. "I will develop a reward system for desired behaviors."

2. "I will take my child to the physician every 3 months for a weight and height check."

3. "I will let him do his homework while he is watching his favorite television show."

4. "I will stick to the same routine each day after school."

Answer: 3 Explanation: 1. A reward system is a part of behavior modification and is appropriate to help the child behave appropriately.

2. Children with ADHD should be screened regularly for height and weight to monitor growth, which can be affected by medication.

3. This child should do homework in a quiet environment, away from distractions.

4. Maintaining the same daily routine helps the child know expectations, and a nighttime routine helps counteract insomnia.

Page Ref: 792 Cognitive Level: Analyzing Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 29.2 Discuss the clinical manifestations of the major mental health alterations of childhood and adolescence.

5) A child diagnosed with autism spectrum disorder (ASD) is admitted to the hospital with dehydration. Which should the nurse include in the plan of care for this child?

1. Discourage the parents from bringing favorite toys from home that might be lost.

2. Take the child on a tour of the pediatric unit.

3. Assign the child to a single-bed hospital room.

4. Take the child to the playroom for arts and crafts.

Answer: 3 Explanation: 1. Children with autism often carry a special toy. This should be kept with the child.

2. Taking a child with autism on a tour of the pediatric unit would be too much stimulation for this child. A quiet, controlled environment is best for a child with autism.

3. A single room is the best place for an autistic child if the child must be hospitalized.

4. Arts and crafts might be appropriate for an autistic child if they are done in the child's room.

Going to the playroom would be too much stimulation for this child.

Page Ref: 790 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 29.3 Plan for the nursing management of children and adolescents with mental health alterations in the hospital and community settings.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 6) A school-age child is diagnosed with a learning disorder that is characterized by problems with manual dexterity and coordination. Which term should the nurse use when documenting this child's disorder in the medical record?

1. Dysgraphia 2. Dyscalculia 3. Dyspraxia 4. Dyslexia Answer: 3 Explanation: 1. Children with dysgraphia have difficulty with writing, spelling, and composition.

2. Children with dyscalculia have problems with mathematics and computation problems.

3. Children with dyspraxia have problems with manual dexterity and coordination.

4. Children with dyslexia have difficulty with writing, reading, and spelling.

Page Ref: 804 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment / Management of Care Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Implementation/Communication and Documentation Learning Outcome: 29.4 Describe characteristics of common cognitive alterations of childhood.

7) The nurse is assessing a child with Down syndrome. Which illness should the nurse monitor for due to the increased risk for children with Down syndrome?

1. Rheumatic heart disease 2. Glomerulonephritis 3. Leukemia 4. Hepatitis Answer: 3 Explanation: 1. Heart defects might be seen with Down syndrome, but not rheumatic heart disease, which is associated with group A beta-hemolytic streptococcus infection.

2. Glomerulonephritis is not seen in association with Down syndrome.

3. Children with Down syndrome have a significantly higher than average risk of developing leukemia.

4. Hepatitis is not associated with Down syndrome.

Page Ref: 804 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 29.4 Describe characteristics of common cognitive alterations of childhood.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 8) Which children should the nurse identify as exhibiting a delay in meeting developmental milestones? Select all that apply.

1. An 18-month-old toddler who is unable to speak in sentences 2. A 2-year-old child who is unable to cut with scissors 3. A 2-year-old child who cannot recite her phone number 4. A 6-year-old child who is unable to sit still for a short story 5. A 5-year-old child who is unable to button his shirt Answer: 4, 5 Explanation: 1. An 18-month-old toddler is not usually able to speak in sentences. This is a skill to be accomplished by the age of 2.5 years.

2. A child who cannot cut with scissors by kindergarten age is considered abnormal.

3. A 2-year-old child is not expected to be able to recite a phone number.

4. A 6-year-old child should be able to sit still for a short story. A 3- to 5-year-old child should be able to sit still through a short story.

5. A 5-year-old child should be able to button his shirt.

Page Ref: 792, 804 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 29.4 Describe characteristics of common cognitive alterations of childhood.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 9) The nurse is planning care for a school-age child diagnosed with separation anxiety disorder.

Which aspects of cognitive-behavior therapy (CBT) should the nurse include in the teaching plan for the child's family? Select all that apply.

1. Self-talking 2. Relaxation 3. Hypnosis 4. Antidepressant medications 5. Recognition of feelings Answer: 1, 2, 5 Explanation: 1. Self-talking helps a child to focus the inner thoughts on the desired behavior.

2. Teaching self-relaxation skills can help the child to reduce anxiety.

3. Hypnosis is not a component of cognitive-behavioral therapy.

4. Although medications may be a part of the treatment plan, it is not a component of cognitivebehavioral therapy.

5. Recognition and acceptance of feelings helps the child to move forward toward a desired behavior.

Page Ref: 798 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 29.3 Plan for the nursing management of children and adolescents with mental health alterations in the hospital and community settings.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 10) Which information should the nurse include in the teaching plan for the parents of a child who is diagnosed with autism spectrum disorder (ASD) as methods to increase the child's socialization?

1. Create a reward system when the child interacts with a person.

2. Punish the child when the child's social behaviors are inappropriate.

3. Use dolls to demonstrate appropriate social interactions to the child.

4. Enroll the child in a day care facility to encourage interaction with other children.

Answer: 1 Explanation: 1. This is appropriate treatment involving behavior modification.

2. Behavior modification uses positive, not negative, reinforcement to encourage the desired behavior.

3. This activity would be a component of play therapy.

4. Enrolling the child in a day care facility may help with interactions, but this is not a description of behavior modification.

Page Ref: 790 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 29.6 Establish and evaluate expected outcomes of care for the child with a cognitive alteration.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 11) Which child should the nurse refer for further assessment due to a probable diagnosis for autism spectrum disorder (ASD)?

1. A 4-year-old girl who doesn't make eye contact with mother, and resists the mother's touch 2. A 3-year-old boy who joins one group of children, then moves to another group of children without joining their activities 3. An 18-month-old child who walks around the area using the furniture to provide balance 4. A 6-year-old boy who chatters constantly to anyone who will listen Answer: 1 Explanation: 1. Although boys are affected more often than girls, lack of eye contact and resistance to physical touch are common symptoms of autism.

2. Although this child is not interacting with other children, it is obvious that the child is aware of other children and interested in their activities, actions that are not indicative of autism.

3. This child may be developmentally delayed, as this behavior is typical of a 10- to 12-monthold child.

4. Children with autism often have language delays and impairment. This child does not have any obvious language issues.

Page Ref: 789 Cognitive Level: Analyzing Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 29.4 Describe characteristics of common cognitive alterations of childhood.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 12) Which activities should the nurse include in the plan of care for a child diagnosed with attention deficit/hyperactivity disorder (ADHD) to improve behavior and learning? Select all that apply.

1. Asking the mother to seek a prescription for methylphenidate (Ritalin) for the child 2. Placing the child's desk at the back of the room to reduce distractions 3. Developing a consistent routine for the classroom 4. Limiting the decorations in the classroom 5. Determining areas where the child performs well and using these areas to promote self-esteem Answer: 3, 4, 5 Explanation: 1. It is not the nurse's or teacher's place to suggest medications for this child.

2. The child's desk should be placed at the front of the room to promote attention.

3. Consistency is important for the child with ADD/ADHD, and reduces impulsive behavior.

4. Decorations are distracting and should be limited.

5. This is appropriate and will help reduce "acting out" behaviors.

Page Ref: 792 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 29.5 Use evidence-based practice to plan nursing management for children with cognitive alterations.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 13) A school-age client presents to the pediatric clinic with a history of abdominal pain 3 to 4 mornings per week over the last 2 months. The mother states the child usually complains on school days and always seems to be better by afternoon. Which mental health disorder does the nurse suspect?

1. Separation anxiety 2. Depression 3. School phobia 4. Bipolar disorder Answer: 3 Explanation: 1. Separation anxiety is most common in girls between the ages of 7 and 9 and may be accompanied by depression when separated. The child was able to successfully separate for a nonschool activity.

2. Depression is often manifested by sleep issues, avoidance of social interactions, and low energy.

3. The child is using somatic complaints to avoid attending school.

4. Bipolar disorder involves periods of hyperactivity alternating with periods of lethargy.

Page Ref: 799 Cognitive Level: Understanding Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 29.2 Discuss the clinical manifestations of the major mental health alterations of childhood and adolescence.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 14) Which nursing action assists in the diagnosis of mental health and cognitive disorders that occur during childhood?

1. Monitoring vital signs 2. Administering prescribed medications 3. Conducting a developmental assessment 4. Documenting an accurate history and physical Answer: 3 Explanation: 1. Monitoring vital signs is not a nursing action that assists in the diagnosis of mental health and cognitive disorders in pediatric clients.

2. Administering prescribed medications is not a nursing action that assists in the diagnosis of mental health and cognitive disorders in pediatric clients.

3. Conducting a developmental assessment is a nursing action that assists in the diagnosis of mental health and cognitive disorders in pediatric clients.

4. Documenting an accurate history and physical is not a nursing action that assists in the diagnosis of mental health and cognitive disorders in pediatric clients.

Page Ref: 807 Cognitive Level: Understanding Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 29.2 Discuss the clinical manifestations of the major mental health alterations of childhood and adolescence.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 15) The mother of a 22-month-old child states, "My child does not seem to be developing like my sister's daughter, who is the same age." Which diagnostic test should the nurse expect to be prescribed?

1. Magnetic resonance imaging (MRI) of the head 2. An electroencephalogram (EEG) 3. Developmental screening tests 4. Chromosomal study Answer: 3 Explanation: 1. The MRI is a diagnostic test, not a screening test, and it is not performed by the nurse.

2. An electroencephalogram evaluates brains wave activity of the brain. It does not evaluate the child's behavior.

3. Several screening tests are available for use in health maintenance visits. Once these are completed, additional testing may be performed to rule out other causes for the delay in development.

4. A chromosomal test is not used to determine developmental delay.

Page Ref: 790 Cognitive Level: Analyzing Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 29.5 Use evidence-based practice to plan nursing management for children with cognitive alterations.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 16) Which statements should the nurse include in the definition of mental health during a health maintenance fair for pediatric clients? Select all that apply.

1. Mental health is the change in thought that occurs during childhood.

2. Mental health is foundational to a sense of personal well-being.

3. Mental health does not impact physical health.

4. Mental health involves successful engagement in activities.

5. Mental health changes over time.

Answer: 2, 4 Explanation: 1. Cognition, not mental health, is the change in thought that occurs during childhood; therefore, the nurse should not include this information.

2. Mental health is foundational to a sense of personal well-being; therefore, the nurse should include this information in the presentation.

3. Mental health does impact physical health; therefore, the nurse should not include this information.

4. Mental health does involve successful engagement in activities; therefore, the nurse should include this information in the presentation.

5. Cognition, not mental health, changes over time; therefore, the nurse should not include this information.

Page Ref: 784 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Implementation/Teaching and Learning Learning Outcome: 29.1 Define mental health and describe major mental health alterations in childhood.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 17) Which clinical manifestations should the nurse expect when conducting an assessment for a child who is diagnosed with autism spectrum disorder (ASD)? Select all that apply.

1. Arm flapping 2. Language delays 3. Ritualistic behavior 4. Impulsive behavior 5. Sleep disturbances Answer: 1, 2, 3 Explanation: 1. Arm flapping is a clinical manifestation associated with ASD. 2. Language delay is a clinical manifestation associated with ASD. 3. Ritualistic behavior is a clinical manifestation associated with ASD. 4. Impulsive behavior is a clinical manifestation associated with attention deficit hyperactivity disorder, not ASD. 5. Sleep disturbance is a clinical manifestation associated with attention deficit hyperactivity disorder, not ASD. Page Ref: 789 Cognitive Level: Analyzing Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 29.2 Discuss the clinical manifestations of the major mental health alterations of childhood and adolescence.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 18) Which clinical manifestations should the nurse expect when conducting an assessment for a child who is diagnosed with attention deficit/ hyperactivity disorder (ADHD)? Select all that apply.

1. Arm flapping 2. Language delays 3. Ritualistic behavior 4. Impulsive behavior 5. Sleep disturbances Answer: 4, 5 Explanation: 1. Arm flapping is a clinical manifestation associated with autism spectrum disorder, not ADHD. 2. Language delay is a clinical manifestation associated with autism spectrum disorder, not ADHD. 3. Ritualistic behavior is a clinical manifestation associated with autism spectrum disorder, not ADHD. 4. Impulsive behavior is a clinical manifestation associated with ADHD. 5. Sleep disturbance is a clinical manifestation associated with ADHD. Page Ref: 792 Cognitive Level: Analyzing Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 29.2 Discuss the clinical manifestations of the major mental health alterations of childhood and adolescence.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 19) Which interventions should the nurse include in the plan of care for a child who is diagnosed with an intellectual disability? Select all that apply.

1. Providing emotional support to the family 2. Maintaining a safe environment for the client 3. Educating the family that maintenance of activities of daily living (ADL) is impossible to achieve 4. Participating in the individualized education program (IEP) process 5. Recommending permanent institutionalization Answer: 1, 2, 4 Explanation: 1. The nurse should include interventions in the plan of care for a child diagnosed with an intellectual disability that support the family.

2. The nurse should include interventions in the plan of care for a child diagnosed with an intellectual disability that maintain a safe environment.

3. Maintenance of ADL will be determined by the severity of the intellectual disability.

4. The nurse should participate in the IEP process for a child who is diagnosed with an intellectual disability.

5. Permanent institutionalization is no longer recommended for children diagnosed with an intellectual disability.

Page Ref: 807-808 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 29.5 Use evidence-based practice to plan nursing management for children with cognitive alterations.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 20) Which items noted in a pediatric client's medical record indicate the child may be experiencing a learning disability? Select all that apply.

1. Dyslexia 2. Dysphagia 3. Dyspraxia 4. Scoliosis 5. Hypotonia Answer: 1, 3 Explanation: 1. Dyslexia is the medical term indicating problems with reading, writing, and spelling. This indicates the child may be experiencing a learning disability.

2. Dysphagia is a medical term indicating problems with swallowing. This would not indicate the child is experiencing a learning disability.

3. Dyspraxia is the medical term indicating problems with manual dexterity and coordination.

This indicates the child may be experiencing a learning disability.

4. Scoliosis is curvature of the spine. This does not indicate the child may be experiencing a learning disability; however, this is often associated with Down syndrome.

5. Hypotonia is decreased muscle tone. This does not indicate the child may be experiencing a learning disability; however, this is often associated with Fragile X syndrome.

Page Ref: 804 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 29.4 Describe characteristics of common cognitive alterations of childhood.

Principles of Pediatric Nursing, 8e (Ball et al.)

Chapter 30 The Child with Alterations in Musculoskeletal Function 1) Which finding, noted during the newborn admission assessment, would lead the nurse to suspect developmental dysplasia of the hip (DDH)?

1. Lordosis 2. Trendelenburg sign 3. Asymmetry of the gluteal and thigh fat folds 4. Telescoping of the affected limb Answer: 3 Explanation: 1. Lordosis does not occur with DDH. 2. Trendelenburg sign and telescoping of the affected limb are signs that present in an older child with DDH. 3. A sign of developmental dysplasia of the hip in the infant would be asymmetry of the gluteal and thigh fat folds.

4. Trendelenburg sign and telescoping of the affected limb are signs that present in an older child with DDH. Page Ref: 820 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation 583 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 30.1 Describe pediatric variations in the musculoskeletal system.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 2) Which clinical manifestations should the nurse monitor for when conducting a scoliosis screening for a school-age child? Select all that apply.

1. Lordosis 2. Prominent scapula 3. Pain 4. A one-sided rib hump 5. Uneven shoulders and hips Answer: 2, 4, 5 Explanation: 1. Lordosis is not present with scoliosis.

2. The classic signs of scoliosis include uneven shoulders and hips, a one-sided rib hump, and prominent scapula.

3. Pain generally is not present with scoliosis unless it is severe.

4. The classic signs of scoliosis include uneven shoulders and hips, a one-sided rib hump, and prominent scapula.

5. The classic signs of scoliosis include uneven shoulders and hips, a one-sided rib hump, and prominent scapula.

Page Ref: 827 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 30.1 Describe pediatric variations in the musculoskeletal system.

3) Which parental statement would cause the nurse to include further education related to the care required for a child who is diagnosed with congenital clubfoot?

1. "We're getting a special car seat to accommodate the casts."

2. "We'll watch for any swelling of the feet while the casts are on."

3. "We'll keep the casts dry."

4. "We're happy this is the only cast our baby will need."

Answer: 4 Explanation: 1. Using a car seat is the law. Special car seats to accommodate the casts are available and should be utilized.

2. Parents should be watching for swelling while the casts are on.

3. Keeping the casts dry is important to prevent complications.

4. Serial casting is the treatment of choice for congenital clubfoot. The cast is changed every 1 to 2 weeks until the corrected foot position is achieved.

Page Ref: 818 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 30.2 Plan nursing care for children with structural deformities of the foot, leg, hip, and spine.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 4) Which is the priority problem for nurse to use when planning care for a school-age child who must wear a brace for correction of scoliosis?

1. Problems breathing 2. Developmental delays 3. Potential for skin breakdown 4. Difficulty with mobility Answer: 3 Explanation: 1. Problem with breathing is a late effect of scoliosis and would not be the priority.

If the client is compliant with wearing the brace, the risk should be minimized.

2. Developmental delays would not be the priority and should be corrected by the wearing of the brace.

3. The skin should be monitored for breakdown in any area where the brace might rub against the skin.

4. Difficulty with mobility would not be the priority and should be corrected if the client is compliant with wearing the brace.

Page Ref: 828 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 30.2 Plan nursing care for children with structural deformities of the foot, leg, hip, and spine.

5) Which assessment finding would require an immediate nursing action when providing care to an adolescent who is postoperative for spinal fusion surgery?

1. Sleeps when not bothered but arouses easily with stimuli 2. Impaired color, sensitivity, and movement to lower extremities 3. Nausea relieved by antiemetics 4. Pain relieved by analgesics Answer: 2 Explanation: 1. This is a normal response postanesthesia.

2. When the spinal column is manipulated, there is a risk for impaired color, sensitivity, and movement to lower extremities.

3. Nausea in the postoperative period is not uncommon, but it is not the priority at this time.

4. Pain is a common finding in the postoperative period and should be addressed, but impaired color, sensitivity, and movement of the lower extremities constitute the priority at this time.

Page Ref: 829 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 30.4 Partner with families to plan care for children with musculoskeletal conditions that are chronic or require long-term care.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 6) The nurse is providing care to a child who is diagnosed with Legg-Calvé-Perthes disease.

Which parental statement regarding the child's care required further teaching from the nurse?

1. "We're glad this will only take about 6 weeks to correct."

2. "We understand abduction of the affected leg is important."

3. "We know to watch for areas on the skin that the brace might rub."

4. "We understand swimming is a good sport for Legg-Calvé-Perthes."

Answer: 1 Explanation: 1. The treatment for Legg-Calvé-Perthes disease takes approximately 2 years.

2. The leg should be kept in the abducted position to prevent damage to the head of the femur due to Legg-Calvé-Perthes disease.

3. A brace is a component of the treatment of Legg-Calvé-Perthes disease and is worn to prevent damage to the head of the femur, so skin irritation should be monitored.

4. Swimming is a good activity to increase mobility in a child with Legg-Calvé-Perthes disease.

Page Ref: 823 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 30.4 Partner with families to plan care for children with musculoskeletal conditions that are chronic or require long-term care.

7) Which teaching topic is the priority for the nurse who is teaching the family of an infant diagnosed with osteogenesis imperfecta?

1. Cast care 2. Trunk and extremity support during everyday care 3. Postoperative spinal surgery care 4. Traction care Answer: 2 Explanation: 1. Traction, casts, and spinal surgery are not routinely done for osteogenesis imperfecta.

2. With osteogenesis imperfecta, nursing care focuses on preventing fractures. Because the bones are fragile, the entire body must be supported when the child is moved.

3. Traction, casts, and spinal surgery are not routinely done for osteogenesis imperfecta.

4. Traction, casts, and spinal surgery are not routinely done for osteogenesis imperfecta.

Page Ref: 831 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 30.4 Partner with families to plan care for children with musculoskeletal conditions that are chronic or require long-term care.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 8) An infant returns to the unit following surgical correction of bilateral congenital clubfeet. The infant has bilateral long-leg casts. The nurse notes that the toes on both feet are edematous, but there is color, sensitivity, and movement to them. Which action by the nurse is the priority?

1. Apply a warm, moist pack to the feet.

2. Elevate the legs on pillows.

3. Encourage movement of the toes.

4. Call the surgical provider to report the edema.

Answer: 2 Explanation: 1. Warm, moist heat will increase swelling and the moisture may cause the cast to disintegrate.

2. The infant's legs should be elevated on a pillow for 24 hours to promote healing and help with venous return. This is the priority action.

3. An infant would not be able to follow directions to move the toes, and in this case, it would not be as effective as would elevating the legs on pillows.

4. Some amount of swelling can be expected, so it would not be appropriate to notify the physician, especially if the color, sensitivity, and movement to the toes remained normal.

Page Ref: 818 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 30.5 Prioritize nursing interventions to promote safety and developmental progression in children who require braces, casts, traction, and surgery.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 9) Which should the nurse include in a teaching session for the parents of an infant who will be placed in a Pavlik harness for the treatment of congenital developmental dysplasia?

1. Apply lotion or powder to minimize skin irritation.

2. Check at least 2 or 3 times a day for red areas under the straps.

3. Put clothing over the harness for maximum effectiveness of the device.

4. Place a diaper over the harness, preferably using a thin, superabsorbent, disposable diaper.

Answer: 2 Explanation: 1. Lotion or powder can contribute to skin breakdown and should not be used.

2. The skin underneath the straps of the brace should be checked 2 or 3 times a day for red areas, which might indicate skin breakdown.

3. A light layer of clothing should be worn under the brace to assist in preventing skin breakdown, not over the brace.

4. The diaper should be placed under the brace, along with a light layer of clothing.

Page Ref: 822 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 30.5 Prioritize nursing interventions to promote safety and developmental progression in children who require braces, casts, traction, and surgery.

10) Which action by the nurse is appropriate for a child who presents in the emergency department with an ankle injury?

1. Avoid compressing the area to allow tissue swelling as necessary.

2. Perform passive range-of-motion to the extremity.

3. Lower the extremity below the level of the heart.

4. Apply ice to the extremity.

Answer: 4 Explanation: 1. For the first 24 hours for a sprain, rest, ice, compression, and elevation (RICE) should be followed. Therefore, the nurse should apply a compression bandage to the extremity.

2. For the first 24 hours for a sprain, rest, ice, compression, and elevation (RICE) should be followed. Therefore, the nurse should rest the extremity rather than perform range-of-motion.

3. For the first 24 hours for a sprain, rest, ice, compression, and elevation (RICE) should be followed. Therefore, the nurse should elevate the extremity.

4. For the first 24 hours for a sprain, rest, ice, compression, and elevation (RICE) should be followed. Therefore, the nurse should apply ice to the extremity.

Page Ref: 840 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 30.5 Prioritize nursing interventions to promote safety and developmental progression in children who require braces, casts, traction, and surgery.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 11) Which clinical data noted by the nurse during the shift assessment indicate the pediatric client may be experiencing compartment syndrome? Select all that apply.

1. Pink, warm extremity 2. Dorsalis pedis pulse present 3. Prolonged capillary refill time 4. Pain not relieved by pain medication 5. Paresthesia of the leg Answer: 3, 4, 5 Explanation: 1. Pink, warm extremity is a normal finding post fracture reduction.

2. A present dorsalis pedis pulse would be a normal finding post fracture reduction.

3. A prolonged capillary refill time is a sign of compartment syndrome.

4. A prolonged capillary refill time with loss of paresthesia and pain not relieved by medication are signs of compartment syndrome.

5. Paresthesia is tingling and numbness of the affected extremity and is a sign of compartment syndrome.

Page Ref: 843 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 30.6 Develop a nursing care plan for fractures, including teaching for injury prevention and nursing implementations for the child who has sustained a fracture.

12) The father of a school-age child who requires hospital admission for intravenous antibiotics to treat osteomyelitis states, "I don't understand why normal antibiotics can't be used." Which should the nurse include in the response to the father?

1. The antibiotic of choice is not available in oral form.

2. Blood flow to bones is limited, and parenteral administration is necessary to get appropriate blood levels.

3. Because the child is older now, it is harder to get the child to cooperate with oral antibiotics.

4. Because 2 weeks of therapy is necessary, the intravenous route will produce fewer side effects.

Answer: 2 Explanation: 1. Most antibiotics are available in multiple forms.

2. This is accurate information.

3. The older child can understand the reason for antibiotics and cooperate.

4. Both oral and intravenous antibiotics may have side effects.

Page Ref: 833 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 30.3 Recognize signs and symptoms of infectious musculoskeletal disorders and refer for appropriate care.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 13) Which assessment finding for a toddler-age child in balanced Bryant traction for a fractured right femur would require immediate action by the nurse?

1. The child keeps trying to turn and lie on his belly.

2. The ropes are unequal in length.

3. The child's buttocks are resting on the bed.

4. The Ace bandage wrapping the legs is wrinkled.

Answer: 3 Explanation: 1. This child needs a jacket restraint to maintain appropriate positioning if someone cannot stay with him. It does not require notifying the surgeon.

2. In balanced traction, the ropes and pulleys determine the traction and the length of the rope is unimportant.

3. In order to provide adequate counter-traction, the buttocks should be slightly elevated off the bed. The surgeon should be notified.

4. This is not a significant finding.

Page Ref: 844 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 30.5 Prioritize nursing interventions to promote safety and developmental progression in children who require braces, casts, traction, and surgery.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 14) Which interventions should the nurse include in the plan of care for an adolescent client who is on complete bed rest after spinal fusion surgery secondary to scoliosis to prevent complications associated with immobility? Select all that apply.

1. Encouraging use of the spirometer every 2 hours while the child is awake 2. Log-rolling the client every 2 hours while awake 3. Increasing intake of milk to maintain bone calcium 4. Increasing fruit and grains in the diet 5. Limiting fluid intake to reduce the need to void Answer: 1, 2, 4 Explanation: 1. Respiratory complications are a common complication of immobility.

2. Turning the client frequently will reduce pressure on bony prominences.

3. Calcium will be pulled from the bones due to immobility. Adding additional calcium in the form of milk will increase the risk of kidney stones.

4. Fruit and grains will provide extra fiber to reduce the risk of complication.

5. Fluid intake should be increased to "flush" the kidneys.

Page Ref: 822, 828-829 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 30.5 Prioritize nursing interventions to promote safety and developmental progression in children who require braces, casts, traction, and surgery.

15) A school nurse suspects that a child who fell at recess has a fractured arm. Which should the nurse consider when applying a splint to transport the child to the hospital?

1. The splint is applied firmly enough to prevent swelling.

2. The arm is fully extended in the splint.

3. The splint is fully padded to prevent skin damage.

4. The joints above and below the suspected fracture are immobilized by the splint.

Answer: 4 Explanation: 1. The purpose of the splint is not to prevent swelling.

2. The nurse will not want to manipulate the arm, so the nurse will splint the arm in the position it is found.

3. The splint does not need to be padded.

4. This is the important concept in splinting–immobilizing the joint above and below the fracture to prevent movement of the bones.

Page Ref: 843 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 30.6 Develop a nursing care plan for fractures, including teaching for injury prevention and nursing implementations for the child who has sustained a fracture.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 16) Which assessment data obtained by the nurse during the health history portion of the assessment process support the current diagnosis of Duchenne muscular dystrophy (MD) for an 18-month-old child?

1. Infant was postmature by almost 2 weeks.

2. The child seems very muscular.

3. The child walked early and without support at 10 months.

4. The child's older sister developed scoliosis in the fourth grade.

Answer: 2 Explanation: 1. Postmaturity is not related to Duchenne MD. 2. Duchenne MD is also called pseudohypertrophic due to the enlarged appearance of the muscle. The pathophysiology is infiltration of the muscle fibers with fatty tissue.

3. This finding is not indicative of Duchenne MD. 4. The older sister's scoliosis is not related to MD. Duchenne MD is sex-linked recessive and affects only boys.

Page Ref: 836 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 30.3 Recognize signs and symptoms of infectious musculoskeletal disorders and refer for appropriate care.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 17) Which should the nurse include in the neurovascular assessment for an infant following casting of the leg for talipes equinovarus?

1. Warmth 2. Capillary refill 3. Pedal pulse 4. Sensation 5. Movement of the toes Answer: 1, 2, 4, 5 Explanation: 1. The temperature of the foot of the casted leg should be compared to the temperature of the other foot.

2. This indicates blood return to the tissues and is an important finding.

3. The pedal pulse cannot be reached in the casted foot.

4. Nerve function is evaluated by touching the toes and noting the child's response.

5. The child is encouraged to wiggle the toes. If the client is an infant, tickling will cause the child to respond with movement.

Page Ref: 843 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 30.5 Prioritize nursing interventions to promote safety and developmental progression in children who require braces, casts, traction, and surgery.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 18) Which clinical manifestations should the nurse expect when assessing a pediatric client who is diagnosed with developmental dysplasia of the hip (DDH)? Select all that apply.

1. Limited adduction of the affected hip 2. Asymmetry of thigh fat folds 3. Telescoping of the thigh 4. Muscle weakness 5. Atrophy of the muscles Answer: 2, 3 Explanation: 1. The nurse would anticipate limited abduction, not adduction, of the affected hip for a child diagnosed with DDH. 2. Asymmetry of the thigh fat folds is a clinical manifestation associated with DDH. 3. Telescoping of the thigh is a clinical manifestation associated with DDH. 4. Muscle weakness is not an expected clinical manifestation associated with DDH. 5. Atrophy of the muscles is not an expected clinical manifestation associated with DDH. Page Ref: 821 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 30.3 Recognize signs and symptoms of infectious musculoskeletal disorders and refer for appropriate care.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 19) Which clinical manifestations should the nurse expect when assessing a pediatric client who is diagnosed with Legg-Calvé-Perthes disease? Select all that apply.

1. Limited abduction of the affected hip 2. Asymmetry of thigh fat folds 3. Telescoping of the thigh 4. Muscle weakness 5. Atrophy of the muscles Answer: 4, 5 Explanation: 1. Limited abduction of the affected hip is a clinical manifestation associated with clinical hip dysplasia, not Legg-Calvé-Perthes disease.

2. Asymmetry of the thigh fat folds is a clinical manifestation associated with clinical hip dysplasia, not Legg-Calvé-Perthes disease.

3. Telescoping of the thigh is a clinical manifestation associated with clinical hip dysplasia, not Legg-Calvé-Perthes disease.

4. Muscle weakness is an expected clinical manifestation associated with Legg-Calvé-Perthes disease.

5. Atrophy of the muscles is not an expected clinical manifestation associated with Legg-CalvéPerthes disease.

Page Ref: 824 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 30.3 Recognize signs and symptoms of infectious musculoskeletal disorders and refer for appropriate care.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 20) Which are appropriate interventions for the nurse to include in the plan of care for a child who is receiving traction? Select all that apply.

1. Monitoring breath sounds 2. Assessing neurovascular status every 2 hours 3. Repositioning every 2 to 3 hours 4. Using moleskin to protect the skin from rough edges 5. Encouraging the parents cuddle with their child Answer: 1, 2, 5 Explanation: 1. Children who are receiving traction are at risk for atelectasis and pneumonia; therefore, the nurse should monitor breath sounds frequently.

2. Children who are receiving traction are at risk for circulatory compromise; therefore, the nurse should perform neurovascular checks every 2 hours.

3. Repositioning every 2 to 3 hours is more appropriate for a child who is casted.

4. Using moleskin to protect the skin from rough edges is more appropriate for a child who is casted.

5. Children who are receiving traction should be allowed up to 1 hour per day without the traction device, at which time the child can eat and cuddle with parents.

Page Ref: 844 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 30.5 Prioritize nursing interventions to promote safety and developmental progression in children who require braces, casts, traction, and surgery.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 21) Which are appropriate interventions for the nurse to include in the plan of care for a child who is casted? Select all that apply.

1. Monitoring breath sounds 2. Assessing neurovascular status every 4 hours 3. Repositioning every 2 to 3 hours 4. Using moleskin to protect the skin from rough edges 5. Encouraging the parents cuddle with their child Answer: 1, 3, 4, 5 Explanation: 1. Children who are casted are at risk for atelectasis and pneumonia; therefore, the nurse should monitor breath sounds frequently.

2. Children who are casted are at risk for circulatory compromise; therefore, the nurse should perform neurovascular checks every 2, not 4, hours.

3. Repositioning every 2 to 3 hours is appropriate for a child who is casted.

4. Using moleskin to protect the skin from rough edges is appropriate for a child who is casted.

5. Children who are casted should be allowed to cuddle with parents to promote developmentally appropriate care.

Page Ref: 817 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 30.5 Prioritize nursing interventions to promote safety and developmental progression in children who require braces, casts, traction, and surgery.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 22) Which injury prevention strategies should the nurse include in the plan of care for a pediatric client who is diagnosed with muscular dystrophy?

1. Develop a home fire evacuation plan.

2. Provide information regarding oxygen safety.

3. Recommend the use of portable generator.

4. Teach safe transfer methods.

5. Perform neurovascular checks every 2 hours.

Answer: 1, 2, 3, 4 Explanation: 1. Helping the family to develop a home fire evacuation plan is an injury prevention strategy the nurse should include in the plan of care.

2. Providing information regarding oxygen safety is an injury prevention strategy the nurse should include in the plan of care.

3. Recommending the use of a portable generator is an injury prevention strategy the nurse should include in the plan of care.

4. Teaching safe transfer methods is an injury prevention strategy the nurse should include in the plan of care.

5. Performing neurovascular checks is appropriate to include in the plan of care for a client who is receiving traction or casting, not for a client diagnosed with muscular dystrophy.

Page Ref: 837-838 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 30.4 Partner with families to plan care for children with musculoskeletal conditions that are chronic or require long-term care.

Principles of Pediatric Nursing, 8e (Ball et al.)

Chapter 31 The Child with Alterations in Skin Integrity 1) Which is the most likely cause for a bright red perianal inflammation with scaly plaques and small papules noted by the nurse during the assessment of a 12-month-old infant?

1. Candida albicans (yeast) 2. Impetigo (staphylococcus) 3. Infrequent diapering 4. Urine and feces Answer: 1 Explanation: 1. Candida albicans is frequently the underlying cause of severe diaper rash. When a primary or secondary infection with C. albicans occurs, the rash has bright red, scaly plaques with sharp margins. Small papules and pustules might be seen, along with satellite lesions.

2. Even though diaper dermatitis can be caused by impetigo, urine, feces, and infrequent diapering, the lesions and persistent characteristics are common for Candida infection.

3. Infrequent diapering, along with urine and feces, can cause diaper dermatitis, but the persistence and characteristics of the lesions are common for Candida infection.

4. Urine and feces can cause diaper dermatitis, but the persistence and characteristics of the lesions are common for Candida infection.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 Page Ref: 855 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 31.1 Classify characteristics of skin lesions caused by irritants, drug reactions, mites, infection, and injury.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 2) Which finding noted by the school nurse while conducting pediculosis capitis (head lice) checks would indicate the need for treatment?

1. White, flaky particles throughout the entire scalp region 2. Lesions on the scalp that extend to the hairline or neck 3. Maculopapular lesions behind the ears 4. Silver/white sacs attached to the hair shafts in the occipital area Answer: 4 Explanation: 1. Lice and nits must be distinguished from dandruff, which appears as white, flaky particles.

2. Lesions might be present from itching, but the positive sign of head lice is evidence of nits.

3. Lesions might be present from itching, but the positive sign of head lice is evidence of nits.

4. Evidence of pediculosis capitis includes silver/white sacs (nits) that are attached to the hair shafts, frequently in the occiput area.

Page Ref: 869 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 31.1 Classify characteristics of skin lesions caused by irritants, drug reactions, mites, infection, and injury.

3) The 10-year-old child is admitted to the hospital following an accident at school that resulted in a puncture wound of the abdomen. Two days after the injury, the child continues in the inflammation phase of healing. Which finding would the nurse expect to see while changing the child's dressing and assessing the wound?

1. The wound is contracting, and the edges are growing together.

2. A blood clot has formed, sealing the wound.

3. Epithelial cells are growing into the wound.

4. The wound is pale and weepy.

Answer: 2 Explanation: 1. Wound contraction and inward movement of the wound edge occur during the reconstruction phase of wound healing.

2. Clot formation to seal the wound with fibrin and trapped cells and platelets occurs during the inflammation phase of wound healing, in the first 3 to 5 days.

3. Epithelial cells growing into the wound occurs in the reconstruction phase of wound healing.

4. During the initial phase of healing, there is increased blood flow, giving the area an "inflamed" appearance.

Page Ref: 822 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 31.2 Differentiate stages of wound healing.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 4) A child had an appendectomy and was discharged home at 48 hours postoperative. A week later, the child is readmitted for delayed wound healing. Which causes of delayed wound healing will the nurse review prior to assessing the child? Select all that apply.

1. Infection 2. Predisposing chronic condition, such as diabetes 3. Hypervolemia 4. Inadequate nutrition 5. Hypoxemia Answer: 1, 2, 4, 5 Explanation: 1. Infection can affect healing and cause excessive scarring.

2. Conditions such as diabetes affect circulating blood volume and are known to affect healing.

3. Hypovolemia, not hypervolemia, would inhibit inflammation due to low circulating blood volume.

4. Poor nutrition without proper protein and calorie intake will affect healing.

5. Hypoxemia makes tissues susceptible to infection due to insufficient oxygenation.

Page Ref: 854 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 31.2 Differentiate stages of wound healing.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 5) Which is the priority intervention when planning care for an infant who is diagnosed with eczema?

1. Applying antibiotics to lesions 2. Keeping the baby content 3. Maintaining adequate nutrition 4. Preventing infection of lesions Answer: 4 Explanation: 1. Antibiotics are not routinely applied to the lesions, since the lesions are not related to infection. However, impaired skin barrier function and cutaneous immunity place the infant at greater risk for the development of skin infection.

2. Keeping the infant content is not as high a priority as is prevention of infection. An infant with eczema is at a greater risk for the development of skin infection.

3. Maintaining adequate nutrition is important, but it is not as high a priority. Due to impaired skin barrier function and cutaneous immunity, an infant with eczema is at greater risk for the development of skin infection.

4. Nursing care should focus on preventing infection of lesions. Due to impaired skin barrier function and cutaneous immunity, an infant with eczema is at greater risk for the development of skin infections by organisms.

Page Ref: 863 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 31.3 Compare skin conditions that have a hereditary cause or predisposition.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 6) Which is the priority problem when planning care for an infant who is diagnosed with a severe case of oral thrush (Candida albicans)?

1. Problem with feeding 2. Problem with breathing 3. Difficulty moving 4. Excess mucous production Answer: 1 Explanation: 1. An infant with oral thrush might refuse to nurse or feed because of discomfort and pain. Prompt treatment is necessary so the infant can resume a normal feeding pattern.

2. Problem with breathing is not usually associated with oral thrush. An infant with oral thrush might refuse to nurse or feed because of discomfort and pain. Prompt recognition and treatment are necessary so that a normal feeding pattern can be resumed.

3. Difficulty moving is not usually associated with oral thrush. An infant with oral thrush might refuse to nurse or feed because of discomfort and pain. Prompt recognition and treatment are necessary so that a normal feeding pattern can be resumed.

4. Excess mucous production is not usually associated with oral thrush. An infant with oral thrush might refuse to nurse or feed because of discomfort and pain. Prompt recognition and treatment are necessary so that a normal feeding pattern can be resumed.

Page Ref: 859 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.4 Diagnose actual or potential health problems and needs. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Diagnosis Learning Outcome: 31.4 Plan the nursing care for the child with alterations in skin integrity, including dermatitis, infectious disorders, and infestations.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 7) Which parental statement indicates to the nurse accurate understanding regarding the care of their child with tinea capitis (ringworm of the scalp)?

1. "We will give the griseofulvin with milk or peanut butter."

2. "We're glad ringworm isn't transmitted from person to person."

3. "Once the lesion is gone, we can stop the griseofulvin."

4. "Well, at least we don't have to worry about the family cat getting the ringworm."

Answer: 1 Explanation: 1. Parents are advised to give oral griseofulvin with fatty foods such as milk or peanut butter to enhance absorption.

2. All members of the family and household pets should be assessed for fungal lesions because person-to-person and animal-to-person transmission can occur.

3. The medication must be used for the entire prescribed period, even if the lesions are gone.

4. Dogs and cats can develop the fungal lesions and be sources of spread of the organism.

Page Ref: 859 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 31.4 Plan the nursing care for the child with alterations in skin integrity, including dermatitis, infectious disorders, and infestations.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 8) Which nursing action is accurate when applying a 5% permethrin lotion to a toddler with scabies?

1. Applying the lotion to the scalp, forehead, and everywhere below the chin 2. Applying the lotion only on the areas with evidence of activity 3. Applying the lotion only to the hands 4. Applying the lotion only to the scalp Answer: 1 Explanation: 1. Treatment of scabies involves application of a scabicide, such as 5% permethrin lotion, over the entire body from the chin down. The scabicide is also applied to the scalp and forehead of younger children, avoiding the rest of the face.

2. Treatment of scabies involves application of a scabicide, such as 5% permethrin lotion, over the entire body from the chin down, as well as the scalp and forehead.

3. Treatment of scabies involves application of a scabicide, such as 5% permethrin lotion, over the entire body from the chin down, including the scalp and forehead.

4. Treatment of scabies involves application of a scabicide, such as 5% permethrin lotion, over the entire body from the chin down, as well as the scalp and forehead.

Page Ref: 870 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 31.4 Plan the nursing care for the child with alterations in skin integrity, including dermatitis, infectious disorders, and infestations.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 9) Which should the nurse include in the plan of care for a child with a minor burn to enhance nutrition and healing?

1. Protein 2. Minerals 3. Carbohydrates 4. Fats Answer: 1 Explanation: 1. Parents should be taught that management of a minor burn requires a highcalorie, high-protein diet. This is necessary to meet the increased nutritional requirements of healing.

2. A high-calorie, high-protein diet is required to meet the increased nutritional requirements for healing.

3. The family should be taught that a high-calorie, high-protein diet is best to meet the increased nutritional requirements for healing.

4. A high-calorie, high-protein diet is best to meet the increased nutritional requirements for healing.

Page Ref: 879 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Basic Care and Comfort Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 31.6 Summarize the process to measure the extent of burns and burn severity in children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 10) Which is the priority problem during the acute phase of a third-degree circumferential burn of the right arm for a pediatric client?

1. Change in tissue integrity 2. Development of infection 3. Difficulty moving 4. Change in oral intake Answer: 1 Explanation: 1. Circumferential burns can restrict blood flow due to edema, resulting in tissue hypoxia. Change in tissue integrity to the extremity is the greatest risk and therefore the priority diagnosis.

2. When the burn is circumferential, blood flow can become restricted due to edema and can result in tissue hypoxia. Development of infection would be a secondary priority in this case.

3. Difficulty moving is a secondary priority for the child with a circumferential burn.

4. There is no evidence that the client is having a change in oral intake; however, the burn will increase metabolism.

Page Ref: 873 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.4 Diagnose actual or potential health problems and needs. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Diagnosis Learning Outcome: 31.6 Summarize the process to measure the extent of burns and burn severity in children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 11) A toddler pulled a pot of boiling water off the stove and suffered partial- and full-thickness burns to the chest. The child is now in the recovery-management phase of burn treatment. Which common complication should the nurse assess this client for based on the current data?

1. Asphyxia 2. Metabolic acidosis 3. Shock 4. Wound infection Answer: 4 Explanation: 1. Asphyxia is not a common complication during the recovery-management phase of burn treatment. Infection of the burned area is a frequent complication.

2. Metabolic acidosis is not common in the recovery-management phase of burn treatment.

Infection of the burned area is a frequent complication.

3. Shock is not the most common complication during the recovery-management phase of burn treatment. Infection of the burned area is a frequent complication.

4. Infection of the burned area is a frequent complication in the recovery-management phase. A goal of burn-wound care is protection from infection.

Page Ref: 875 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 31.6 Summarize the process to measure the extent of burns and burn severity in children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 12) The nurse explains to the parents of a child with a severe burn that wearing an elastic pressure garment (Jobst stocking) during the rehabilitative stage can help prevent which complication?

1. Pain 2. Hypertrophic scarring 3. Poor circulation 4. Formation of thrombus in the burn area Answer: 2 Explanation: 1. The Jobst stockings, or pressure garments, do not prevent pain. They are used to prevent development of hypertrophic scarring and contractures.

2. During the rehabilitation stage, Jobst stockings, or pressure garments, are used to reduce development of hypertrophic scarring and contractures.

3. The Jobst pressure garments are used to prevent or minimize the development of hypertrophic scarring and contractures.

4. The elastic pressure garments are used to prevent development of hypertrophic scarring and contractures. They do not prevent the formation of thrombus in the burn area.

Page Ref: 876 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Implementation/Teaching and Learning Learning Outcome: 31.6 Summarize the process to measure the extent of burns and burn severity in children.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 13) Which is the priority nursing action when providing care to a child who is bitten by a snake?

1. Measuring the circumference of the extremity twice per hour 2. Monitoring respiratory status 3. Assessing vital signs 4. Evaluating response to pain medication Answer: 2 Explanation: 1. In order to track progression in swelling and response to treatment, the extremity with the bite is measured every 20 to 30 minutes. However, this does not take priority over airway, breathing, and circulation.

2. Emergency intervention for airway, breathing, and circulation takes priority and has a high probability of occurrence.

3. Vital signs and neurovascular status of the distal extremities should be monitored but do not take priority over airway, breathing, and circulation.

4. Pain medication will need to be given and the response to the treatment monitored; however, this should not take priority over airway, breathing, and circulation.

Page Ref: 884 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 31.8 Evaluate preventive strategies to reduce the risk of injury from burns, hypothermia, bites, and stings.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 14) Which parental statement regarding preventative strategies for insect bites and stings indicate the need for further education?

1. "If my child wears bright colors and floral prints when outdoors, she will blend in with the surroundings, and the stinging insects will not sting her."

2. "We should remove any items with standing water from our yard and surrounding area to prevent mosquito reproduction."

3. "My child can use insect repellent containing DEET of 10% or less."

4. "My child should avoid heavy colognes, perfumes, and soaps so that insects are not attracted to them."

Answer: 1 Explanation: 1. Bright-colored clothing and floral prints attract the insects. White- and lightcolored clothing should be worn. This statement requires clarification.

2. Standing water is a breeding ground for mosquitoes. Rid yards of all birdbaths, stagnant pools, and any standing water that mosquitoes could use for breeding. No clarification is needed.

3. DEET is an appropriate insect repellent and can be used in children. A concentration of 10% or less is recommended due to neurotoxic effects at greater concentrations. No clarification is needed.

4. Heavy colognes, perfumes, soaps, and detergents resemble flowers and plants and will attract the stinging insects. This statement is correct.

Page Ref: 884 Cognitive Level: Analyzing Client Need/Sub: Safe and Effective Care Environment / Safety and Infection Control Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 31.8 Evaluate preventive strategies to reduce the risk of injury from burns, hypothermia, bites, and stings.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 15) Which discharge instruction is appropriate for an adolescent client who is a paraplegic due to a motor vehicle accident, in order to prevent decubitus ulcer formation on the buttock?

1. Contract the muscles five times every 2 hours.

2. Increase fat in the diet to provide a protective coating over the bony prominences.

3. Do wheelchair push-ups every 15 to 30 minutes.

4. Avoid use of sheepskin, as it prevents air from reaching the area.

Answer: 3 Explanation: 1. The child is a paraplegic and therefore unable to contract the buttock muscles.

2. Extra weight will add to pressure on the bony prominences and should be avoided.

3. Lifting the buttocks with the arms can help with blood flow to the buttocks and reduce the risk of breakdown.

4. Sheepskin can reduce pressure on the buttocks; it is one of many pressure reducing materials available.

Page Ref: 873 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 31.2 Differentiate stages of wound healing.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 16) Which skin conditions should the nurse identify as having a genetic or inherited component during a presentation to the staff nurses who work in the integument clinic? Select all that apply.

1. Atopic dermatitis 2. Seborrheic dermatitis 3. Epidermolysis bullosa 4. Molluscum contagiosum 5. Psoriasis Answer: 1, 3, 5 Explanation: 1. Atopic dermatitis is an allergic skin disorder. Allergies have an inherited component.

2. Seborrheic dermatitis is thought to be an overgrowth of yeast and is influenced by hormones.

It is not inherited.

3. Epidermolysis bullosa is inherited either as autosomal dominant or autosomal recessive depending on type.

4. Molluscum is caused by a poxvirus and is transmitted person to person.

5. Psoriasis is usually seen in clients with a family history. A multifactorial inheritance is suspected.

Page Ref: 861, 866, 868 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Implementation/Teaching and Learning Learning Outcome: 31.3 Compare skin conditions that have a hereditary cause or predisposition.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 17) Which adolescent statement regarding skin care and acne prevention would indicate the need for further education by the nurse?

1. "I shouldn't squeeze my blackheads or pimples."

2. "I need to cut out all chocolates."

3. "I should avoid applying drying materials, such as astringents, to my face" 4. "I should wash my hands frequently and avoid touching my face."

Answer: 2 Explanation: 1. This practice can introduce organisms into the lesions and should be avoided.

This statement needs no clarification.

2. New evidence is revealing that some foods, such as a high glycemic index diet, skim milk, and whey protein are associated with acne. However, chocolate does not have to be excluded.

3. This statement is accurate and needs no clarification.

4. This is an important means of reducing facial irritation.

Page Ref: 866 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 31.5 Prepare an education plan for adolescents with acne to promote selfcare.

18) Which clinical therapy should the nurse anticipate when planning care for a toddler-age client who is admitted to the hospital unit with cellulitis of the neck?

1. Topical antibiotics 2. Intravenous antibiotics 3. Incision and drainage 4. Oral corticosteroids Answer: 2 Explanation: 1. This is an infection of the deeper tissues including the dermis and supporting connective tissues. Topical antibiotics will not reach the infection.

2. This infection usually requires parenteral antibiotics.

3. The infection is not consolidated into an abscess, so an incision and drainage would not be performed.

4. Corticosteroids are anti-inflammatories and would not be used to treat this infection.

Page Ref: 857 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Pharmacological and Parenteral Therapies Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 31.4 Plan the nursing care for the child with alterations in skin integrity, including dermatitis, infectious disorders, and infestations.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 19) Which preventative strategies for tinea pedis, a fungal infection, also known as athlete's foot, should the nurse include in a teaching session for an adolescent client? Select all that apply.

1. Wear 100% white cotton socks, changed twice a day.

2. Use talc on feet daily.

3. Use an over-the-counter corticosteroid cream to treat the area.

4. Wear foot covers such as flip- flops in the locker room and shower.

5. Apply heat to the area twice a day.

Answer: 1, 2, 4 Explanation: 1. The socks will wick moisture away from the feet to promote healing.

2. This process will help keep the feet dry.

3. Corticosteroids will not destroy the organism. An antifungal medication is required.

4. This will reduce the spread of the organism among team members.

5. Heat will not treat the problem. Antifungal medications are required.

Page Ref: 860 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 31.4 Plan the nursing care for the child with alterations in skin integrity, including dermatitis, infectious disorders, and infestations.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 20) Which is the priority nursing intervention for a 4-year-old client brought to the emergency department (ED) for treatment of frostbite?

1. Administer analgesics.

2. Immerse the hands in extremely warm water (120°F).

3. Do not remove clothing.

4. Place the extremity in a dependent position.

Answer: 1 Explanation: 1. Nursing interventions for frostbite include removing wet clothing, using mildly warm water (at 100 to 104°F) to warm the extremity, administering analgesics to decrease pain of the rewarming process, and raising the affected extremity to improve venous return.

2. Nursing interventions for frostbite include removing wet clothing, using mildly warm water (at 100 to 104°F) to warm the extremity, administering analgesics to decrease pain of the rewarming process, and raising the affected extremity to improve venous return.

3. Nursing interventions for frostbite include removing wet clothing, using mildly warm water (at 100 to 104°F) to warm the extremity, administering analgesics to decrease pain of the rewarming process, and raising the affected extremity to improve venous return.

4. Nursing interventions for frostbite include removing wet clothing, using mildly warm water (at 100 to 104°F) to warm the extremity, administering analgesics to decrease pain of the rewarming process, and raising the affected extremity to improve venous return.

Page Ref: 883 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 31.8 Evaluate preventive strategies to reduce the risk of injury from burns, hypothermia, bites, and stings.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 21) Which adolescent statements indicate the need for further education related to the prevention and treatment of acne? Select all that apply.

1. "I should wash my face each day with an approved cleanser."

2. "I should wash my hands frequently, and avoid touching my face."

3. "I should stay away from greasy foods, such as pizza."

4. "I should shampoo my hair only once per week."

5. "I should use my topical medication only when acne is present."

Answer: 3, 4, 5 Explanation: 1. Washing the face with an approved cleanser each day indicates appropriate understanding of prevention and treatment for acne.

2. Performing frequent hand hygiene and not touching the face indicates appropriate understanding of prevention and treatment for acne.

3. There is no evidence to suggest that greasy foods, such as pizza, cause acne. This statement indicates the need for further education.

4. Hair should be shampooed frequently, as the oil hair can cause acne. This statement indicates the need for further education.

5. Prescribed topical medication should be used daily and spread over the entire face. This statement indicates the need for further education.

Page Ref: 866 Cognitive Level: Analyzing Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 31.5 Prepare an education plan for adolescents with acne to promote selfcare.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 22) Which pain interventions should the nurse include in the plan of care for a pediatric client who suffered a full-thickness burn injury? Select all that apply.

1. Using an age-appropriate assessment scale 2. Covering the affected skin as much as possible 3. Providing analgesics prior to wound care 4. Keeping the skin as clean and dry as possible 5. Clipping hair around the wound Answer: 1, 2, 3 Explanation: 1. Pain assessment with an age-appropriate scale is an appropriate intervention for the nurse to include in the plan of care for a client with a full-thickness burn injury.

2. Covering the affected area to prevent temperature changes and air movement is an appropriate intervention for the nurse to include in the plan of care for a client with a full-thickness burn injury.

3. Analgesics administration prior to wound care is an appropriate intervention for the nurse to include in the plan of care for a client with a full-thickness burn injury.

4. Keeping the skin as clean and dry as possible is an appropriate intervention to decrease infection, not pain.

5. Clipping hair around the wound is an appropriate intervention to decrease infection, not pain.

Page Ref: 878-879 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Basic Care and Comfort Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 31.7 Develop a nursing care plan for the child with a full-thickness burn injury.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 23) Which interventions should the nurse include in the plan of care for a pediatric client who suffered a full-thickness burn injury to decrease the risk for infection? Select all that apply.

1. Using an age-appropriate assessment scale 2. Covering the affected skin as much as possible 3. Providing analgesics prior to wound care 4. Keeping the skin as clean and dry as possible 5. Clipping hair around the wound Answer: 4, 5 Explanation: 1. Pain assessment with an age-appropriate scale is an appropriate intervention to address pain, not infection.

2. Covering the affected area to prevent temperature changes and air movement is an appropriate intervention to address pain, not infection.

3. Analgesics administration prior to wound care is an appropriate intervention to address pain, not infection.

4. Keeping the skin as clean and dry as possible is an appropriate intervention to decrease infection.

5. Clipping hair around the wound is an appropriate intervention to decrease infection.

Page Ref: 876 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity / Basic Care and Comfort Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 31.7 Develop a nursing care plan for the child with a full-thickness burn injury.

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Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 24) Which topics should be included in a teaching session with parents of school-age children to prevent sunburn? Select all that apply.

1. Playing in the shade 2. Wearing a hat while outdoors 3. Restricting outside activities between 10 a.m. and 2 p.m.

4. Using sunscreen with an SPF of 30 or higher 5. Avoiding sunglasses Answer: 1, 2, 4 Explanation: 1. The nurse should recommend that school-age children play in the shade while outdoors to decrease the risk for sunburn.

2. The nurse should recommend that school-age children wear a hat while outdoors to decrease the risk for sunburn.

3. Outdoor activities should be restricted between 10 a.m. and 4 p.m. to decrease the risk for sunburn.

4. The nurse should recommend that school-age children use sunscreen with an SPF of 30 or higher to decrease the risk for sunburn.

5. Sunglasses should be encouraged, not discouraged, to decrease the risk for sunburn around the eyes.

Page Ref: 882 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Basic Care and Comfort Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 31.8 Evaluate preventive strategies to reduce the risk of injury from burns, hypothermia, bites, and stings.

621 Copyright © 2023 Pearson Education, Inc.

Complete Test Bank For Principles Of Pediatric Nursing 8th Edition By Jane W Ball, Ruth C Bindler, And Kay Cowen 2023 25) Which topics should be included in a teaching session with parents of school-age children to prevent frostbite? Select all that apply.

1. Dressing in layers 2. Having extra clothing available 3. Removing wet gloves immediately 4. Applying sunscreen twice per day 5. Wearing sunglasses while outside Answer: 1, 2, 3 Explanation: 1. Dressing in layers is a topic the nurse should include in the teaching session with parents of school-age children to prevent frostbite.

2. Having extra clothing available is a topic the nurse should include in the teaching session with parents of school-age children to prevent frostbite.

3. Removing wet gloves immediately is a topic the nurse should include in the teaching session with parents of school-age children to prevent frostbite.

4. Application of sunscreen is an appropriate topic to prevent sunburn, not frostbite.

5. Wearing sunglasses while outside is an appropriate topic to prevent sunburn, not frostbite.

Page Ref: 883 Cognitive Level: Applying Client Need/Sub: Physiological Integrity / Physiological Adaptation Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN 2021 Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 31.8 Evaluate preventive strategies to reduce the risk of injury from burns, hypothermia, bites, and stings.

622 Copyright © 2023 Pearson Education, Inc.