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Q:
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. The most appropriate suggestion for the nurse to make to this mother would be:
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."
Q:
During a well-child exam, the parents of a four-year-old child 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. The best response from the nurse would be:
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 two 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."
Q:
A concerned parent calls the school nurse because of changes in his 15-year-old's behavior. Which behaviors would the nurse identify as most likely to be abnormal and indicate possible substance abuse in an adolescent?
1. Becoming very involved with friends and in activities related to the basketball team that she is on, never seeming to be home, and, when she is home, preferring to be in her room with the door shut
2. Becoming moody, crying, and weeping one minute and then cheerful and excited the next
3. Receiving numerous detentions lately from teachers for sleeping in class
4. Buying baggy, oversized clothing at thrift shops and dyeing her hair black
Q:
A premature infant is being tube fed. The physician ordered the feeding to total 120 kcal/kg/day. The infant weighs 1.86 kg. The formula contains 20 kcal per ounce. How many ounces of formula should the infant receive per day? Round your answer to the hundredth.
Standard Text:
Q:
A two-year-old child is admitted to the hospital for chronic diarrhea. After investigation, the child is diagnosed with celiac disease. The nurse teaches the family to avoid all glutens and to carefully read all labels. In evaluating the parents' understanding, the nurse allows the family to complete the child's menus. The nurse recognizes the family understands glutens when they choose which foods?
Standard Text: Select all that apply.
1. Milk
2. Mashed potatoes with gravy
3. Apple sauce
4. Corn in cream sauce
5. Rice cakes
Q:
A two-month-old infant is admitted to the hospital with a diagnosis of "failure to thrive" (FTT). The nurse recognizes that the infant will be evaluated for:
Standard Text: Select all that apply.
1. Over-dilution of formula concentrate.
2. Parental neglect.
3. Rumination.
4. Malabsorption syndromes.
5. Pica
Q:
A 14-year-old girl is being admitted to the eating disorders unit of the hospital. The girl has a two-year history of anorexia nervosa and recently has sustained additional weight loss and electrolyte imbalances. During hospitalization, the priority concern for the health care team will be:
1. Individual counseling.
2. Family therapy.
3. Regulation of antidepressant drugs.
4. Nutritional support.
Q:
The mother of a six-week-old infant tells the nurse that her baby has had colic for several days, crying for up to three hours and drawing his legs up on his abdomen. The mother says she is at "wits end" and wonders what she can do. The nurse learns that the infant is formula fed and gaining weight satisfactorily. The nurse would recommend:
Standard Text: Select all that apply.
1. Breastfeeding the infant.
2. Switching to a bottle that has a collapsible bag inside.
3. Putting the infant in a baby swing after feeding.
4. Burping the baby more frequently.
5. Giving the baby a suppository once each morning.
Q:
A six-year-old child has been newly diagnosed with cystic fibrosis. During discharge teaching, the nurse is instructing the parents on nutritional requirements specifically related to the child's decreased ability to absorb fats. The nurse teaches the family that the child will need supplementation with vitamins that are fat soluble, such as:
1. Vitamin K.
2. Riboflavin.
3. Vitamin B12.
4. Thiamin.
Q:
During a well-child physical, a 16-year-old girl 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 25th to 50th percentile for her age. Based on these findings, which disorder would the nurse suspect?
1. Anorexia nervosa
2. Bulimia nervosa
3. Marasmus
4. Kwashiorkor
Q:
A six-year-old recently diagnosed with asthma also has a peanut allergy. The nurse instructs the family not only to avoid peanuts, but also to check food label ingredients carefully 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. The nurse should reply that in comparison with other children, this child has a higher risk for:
1. Urticaria.
2. Anaphylaxis.
3. Diarrhea.
4. Headache.
Q:
The parents of a two-and-a-half-year-old are concerned about their child's finicky eating habits. While counseling the parents, which statements by the nurse would be accurate?
Standard Text: Select all that apply.
1. "Nutritious foods should be made available at all times of the day so that the child is able to 'graze' whenever he is hungry."
2. "The child is experiencing physiologic anorexia, which is normal for this age group."
3. "A general guideline for food quantity at a meal is one-quarter cup of each food per year of age."
4. "It is more appropriate to assess a toddler's nutritional demands over a one-week period rather than a 24-hour one."
5. "The toddler should drink sixteen to twenty-four ounces of milk daily."
Q:
During a four-month-old infant's well-child checkup, the nurse discusses introduction of solid foods into the infant's diet. Although the nurse recommends delaying the introduction of many foods into the diet, which food(s) will the nurse discuss delaying because they increase the risk for food allergy?
1. Honey
2. Carrots, beets, and spinach
3. Pork
4. Cow's milk, eggs, and peanuts
Q:
The nurse is presenting a program on healthy eating habits to the parents of children attending the clinic. In the discussion period of the program, parents make the following comments. Which parent needs more information about safe food preparation?
1. "We always wash our hands well before any food preparation."
2. "We use separate utensils for preparing raw meat and for preparing fruits, vegetables, and other foods."
3. "We take the meat out of the freezer and then allow it to thaw on the counter for two to three hours before cooking it thoroughly."
4. "If our baby doesn"t drink all the formula in his bottle, we throw the rest out."
Q:
An adolescent who is a vegetarian has been placed on iron supplementation secondary to a diagnosis of iron-deficiency anemia. To increase the absorption of iron, the nurse would instruct the teen to take the supplement with:
1. Orange juice.
2. Black or green tea.
3. Milk.
4. Tomato juice.
Q:
The nurse is teaching the parents of a four-month-old infant about good feeding habits. The nurse emphasizes the importance of holding the baby during feedings and not letting the infant go to sleep with the bottle, as this is most likely to increase the incidence of both dental caries and:
1. Aspiration.
2. Otitis media.
3. Malocclusion problems.
4. Sleeping disorders.
Q:
While teaching parents of a newborn about normal growth and development, the nurse informs them that their child's weight should:
1. Triple by nine months of age.
2. Double by five months of age.
3. Triple by six months of age.
4. Double by one year of age.
Q:
A nurse is talking to the mother of an exclusively breastfed, African American infant who is three months old and was born in late fall. The nurse would want to make sure that this child is receiving:
1. Iron
2. Vitamin D
3. Calcium
4. Fluoride
Q:
While teaching the parents of a newborn about infant care and feeding, the nurse instructs the parents to:
1. Delay supplemental foods until the infant is four to six months old.
2. Begin diluted fruit juice at two months of age, but wait three to five days before trying a new food.
3. Add rice cereal to the nighttime feeding if the infant is having difficulty sleeping after two months of age.
4. Delay supplemental foods until the infant reaches 15 pounds or greater.
Q:
The hospital unit is very busy and nursing is understaffed. The nurse recognizes that death is imminent in one of her assigned patients. Nursing behaviors to offer family support would include:
Standard Text: Select all that apply.
1. Using active listening techniques when in the child's hospital room.
2. Sitting in the room as time permits and looking the parents in the eye.
3. Avoiding tears in the child's room.
4. Offering to call and notify family.
5. Recognizing that these parents' needs are greater than the other patients and staying with the parents.
Q:
The nurse is performing post-mortem care for a child of the Hindu faith. In the process of removing medical equipment, intravenous lines, and urinary catheters, the nurse discovers a thread wrapped around the child's neck. The nurse should:
1. Report this finding to social services as a possible act of child abuse.
2. Assume the thread became wrapped around the neck during the unsuccessful resuscitation effort and remove it.
3. Remove the thread for safe keeping and return it to the family with the child's other possessions.
4. Leave the thread in place.
Q:
A child's understanding of death changes as the child matures. When describing the adolescent's understanding of death, which of the following concepts puts the adolescent at risk for driving under the influence (drunk driving) accidents?
1. A sense of invincibility
2. The idea that death is universal
3. The understanding that death is permanent
4. An understanding that death has an effect on survivors
Q:
The nurse is leading a recovery group made up of parents who have lost a child. As the opening topic for the night's discussion, the nurse has again reviewed information about the grief process to the parents and talked about how different people grieve. During the discussion phase, several fathers speak. The nurse recognizes that the father who needs more time to understand the grief process is the father who says:
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 six 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."
Q:
The nurse is doing a follow-up home visit to a family who lost their three-month-old infant to SIDS eight 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." The nurse recognizes that the mother is demonstrating which stage of grief behavior?
1. Recovery
2. Yearning, pining
3. Hostile
4. Disorganization
Q:
The mother of a dying three-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." The nurse who has worked with the family recognizes that Michael's mother is in which stage of grieving according to Kubler-Ross?
1. Denial
2. Acceptance
3. Bargaining
4. Depression
Q:
A woman gives birth to a stillborn infant. It is the policy of the maternity unit to create a memory box for parents of a fetal demise. Without parental permission, the nurse should avoid which intervention?
1. Making a plaster cast of the infant's foot
2. Placing the blanket the baby was wrapped in into the memory box
3. Making hand- and footprints of the infant
4. Clipping a lock of hair to include in the memory box
Q:
The nurse is having difficulty coping with the impending death of a child. Which would most likely be the best resource for the nurse at this time?
1. Co-workers
2. Hospice nurses
3. Unit manager
4. Spouse
Q:
The nurse is speaking with a preschool-age child whose sibling recently died. The nurse understands that preschool-age siblings might feel that the death was due to:
1. The child's being bad, and the sibling is being punished.
2. The child's having a fight with their sibling.
3. The child's having thoughts about their sibling dying.
4. Their parents' not liking that sibling.
Q:
The nurse is counseling some parents on how they will feel after the death of a child. The nurse understands that the parents might feel which of the following?
Standard Text: Select all that apply.
1. Loneliness
2. Guilt
3. Anger
4. High energy
5. Depression
Q:
The nurse has been working with the parents of a dying child. The nurse has explained signs of imminent death. Which statement by the parents indicates that they understand the teaching?
1. "I understand that my child can see me until the very end."
2. "Dying children always lose consciousness a few hours before they pass."
3. "My child may become flushed as his heart slows down."
4. "My child may see visions that I cannot see."
Q:
The nurse is taking care of a child who is terminally ill. The nurse notices the child is having periods of shallow breathing followed by short periods of apnea. The nurse recognizes that this is:
1. Normal respiratory function of a young child.
2. Cheyne-Stokes respiration, which is a sign of imminent death. The child should be assessed for other signs of imminent death.
3. Dyspnea secondary to muscle relaxation.
4. A sign of air hunger.
Q:
The nurse is taking care of a child who is showing signs of imminent death. What changes should the nurse expect to see related to the cardiovascular system?
1. An increase in the volume of Korotkoff's sounds
2. Mottling, cool and clammy skin
3. Peripheral pulses will remain when the heart beat is not heard on auscultation.
4. Increase in cardiac output
Q:
A three-year-old child has a brain tumor and is now dying. The child has an Allow Natural Death order (AND order). Which of the following care and interventions are allowed for a child with an AND order?
Standard Text: Select all that apply.
1. Oxygen
2. Suctioning
3. Use of a ventilator if respiratory failure occurs
4. Pain control
5. Cardiac compressions
Q:
The nurse is caring for a child who is dying. The parent asks that the child not be told he is dying. The child asks the nurse if he is dying. Which of the following would be the most appropriate action by the nurse at this time?
1. Ignore the child's question and change the subject.
2. Offer to bring in the child life therapist.
3. Suggest the parents meet with the health care team.
4. Tell the child he is dying and offer to stay with him.
Q:
The nurse is working in a PICU with several children with life-threatening illnesses. The children come from a variety of cultural and religious groups. Because of their religious beliefs, the parents of which religious group should not be contacted regarding organ and tissue donation?
1. Jehovah's Witness
2. Islam
3. Hinduism
4. Buddhism
Q:
The nurse is providing postmortem care to a child. Along with following the facility's guidelines, what else should the nurse consider?
1. Identifying the family's wishes for postmortem care before performing care
2. Avoiding delay in moving the body to the morgue
3. Removing all articles from patient's body
4. Leaving all equipment in the room during postmortem care
Q:
The nurse is caring for a child with a terminal illness. Physical care for the dying child would include which interventions?
Standard Text: Select all that apply.
1. Providing oral care to moisten a dry mouth
2. Administering ordered laxatives to counter the effects of opioids
3. Encouraging a favorite food
4. Keeping the child pain-free
5. Taking vital signs and blood pressure every two hours
Q:
The nurse working on a pediatric unit is speaking to a child who is terminally ill. The child is describing her illness in terms of mutilation to her body. The nurse understands this to be representative of the development of which age group?
1. Adolescents
2. Preschoolers
3. School-age children
4. Infants
Q:
An adolescent with a gunshot wound presents to the emergency department with his distraught parents. He states that he saw a classmate shoot his teacher and several other students. As a result of the shooting incident, the nurse expects this adolescent to be at risk for which disorder?
1. Conduct disorder
2. Depression
3. Post-traumatic stress disorder
4. School phobia
Q:
A child has been comatose in the PICU for three days. The parents have been at the child's bedside or in the waiting room the entire time. Which statement by the nurse would be most helpful in promoting the parents to take a break?
1. "You"ve been here three days. It is time for you to go home and take a shower."
2. "Your child isn"t aware you are here anyway, so why don"t you take a break?"
3. "I"ll be with your child, so go home and get a good nap."
4. "I know you are concerned and afraid to leave. If you"d like to take a short walk, you can leave me your cell phone number and I"ll call you if there are any changes."
Q:
The hospital recently changed its policy and now allows families members to be present during resuscitation of their child. The benefits expected from this policy change include:
Standard Text: Select all that apply.
1. Positive patient outcomes increase due to the patient hearing family voices during the resuscitation.
2. Parents are reassured that everything possible is being done.
3. Professional behavior by the healthcare team improves.
4. Parental feelings of helplessness decrease.
5. Grieving and closure are facilitated.
Q:
Complementary activities that may reduce stress for the child and parents in the Pediatric Intensive Care Unit include:
Standard Text: Select all that apply.
1. Prayer.
2. Maintaining silence in the PICU.
3. Maintaining a sterile-appearing hospital room.
4. Music playing softly.
5. Encouraging the parents to read age-appropriate books to the child.
Q:
A young child is admitted to the hospital following a serious injury while on a field trip with his school class. When the parents arrive at the emergency room, the nurse recognizes that the parents have only limited English. The nurse will:
1. Speak slowly and clearly so the parents can understand.
2. Have a translator/interpreter present when the nurse and physician describe the child's condition to the parents.
3. Have a family member who speaks English translate for the family
4. Give the parents a pamphlet written in their primary language that describes the hospital routine.
Q:
A baby is born at 32 weeks' gestation and is admitted to the NICU. After 4 difficult weeks, the child's condition has improved and survival seems guaranteed. The mother comes every day to feed the infant. Between feedings, the mother sits alone in the waiting room. The mother tells the nurse that she feels her life is in a holding pattern, not yet being a parent but no longer anticipating the excitement of the planned delivery. The nurse recognizes that the mother's reaction could be defined as:
1. Shock and disbelief.
2. Anticipatory waiting.
3. Readjustment.
4. Mourning.
Q:
Following a tornado destroying the family home and injuring all family members, the four-year-old child is admitted to the Pediatric Intensive Care Unit. All other family members are hospitalized at a different hospital. The nursing staff can provide the four-year-old with a sense of security by:
1. Providing new toys for the child.
2. Asking a hospital volunteer to visit the child daily and stay as long as possible.
3. Explaining to the child that mom and dad also are sick and cannot come to visit.
4. Keeping the child's security blanket with the child at all times.
Q:
Twenty-four hours after being transferred from the pediatric intensive care unit to the regular pediatrics floor, the seven-year-old child is asked about his experience in the PICU. The child says he was not in the PICU but came directly to the floor from the ambulance ride. The nurse recognizes this is a coping behavior for the child known as:
1. Repression.
2. Regression.
3. Amnesia.
4. Developmental delay.
Q:
A premature infant is admitted to the Neonatal Intensive Care Unit. The infant is in critical condition, and the outcome is questionable. Nursing behaviors that will promote visitation include:
1. Explaining to the parents that everything possible is being done for their infant.
2. Smiling at the parents and making them welcome when they come to visit.
3. Allowing alone time with their infant when they visit.
4. Introducing the parents to the other parents visiting their babies.
Q:
A new pediatric hospital is under development. A suggestion that has been shown to improve the psychological comfort of children in the Pediatric Intensive Care Unit would be:
1. Limiting the number of visitors to allow the child to rest.
2. Allowing the parents to visit every two hours for 10 to 15 minutes.
3. Planning all rooms to be two-patient rooms so each child will have another child for comfort and support.
4. Providing a bed for a parent to stay with the child in the PICU.
Q:
In which settings is the nurse most likely to work with parents experiencing shock and disbelief related to the sudden onset of a life-threatening illness for their child?
Standard Text: Select all that apply.
1. Emergency departments
2. Pediatric Intensive Care Unit
3. Operating room
4. Neonatal Intensive Care Unit
5. Pediatric cancer clinics
Q:
A newborn is admitted to the neonatal intensive care unit (NICU). The parents are concerned because they cannot stay for long hours to visit. Which statement made by the nurse is most appropriate?
1. "Why can't you visit after work every day?"
2. "One of you could take a leave of absence to be here more."
3. "Perhaps the grandparents can make the visits for you."
4. "Parents often feel this way; you can call any time to see how your baby is doing."
Q:
A child is admitted to the PICU following an accident. The parents ask the nurse about bringing the siblings to visit. The nurse will meet with the siblings and the parents and:
Standard Text: Select all that apply.
1. Describe the sights, sounds, and smells of the pediatric intensive care unit.
2. Provide a simple explanation of the other children being cared for in the PICU.
3. Explain the child's injuries in ways that are appropriate to the ages of the siblings.
4. Describe how the child looks.
5. Explain why the siblings will not be able to visit until the child has stabilized and is progressing.
Q:
In caring for a child with a life-threatening illness, the nurse should anticipate the parent's reaction to the child illness. Which response should the nurse anticipate the parent will experience?
Standard Text: Select all that apply.
1. Anticipatory waiting
2. Post-traumatic stress disorder
3. Deprivation and loss
4. Anger and guilt
5. Readjustment and mourning
Q:
A six-year-old child is in the pediatric intensive care unit (PICU) with a fractured femur and head trauma. The child was not wearing a helmet while riding his new bicycle on the highway, and he collided with a car. The parents appear lost and unable to take in the medical discussion. Which nursing diagnosis is most appropriate for the parents of this child?
1. Parental role conflict related to child's wellness vs. illness
2. Guilt related to buying a bicycle for the child
3. Family coping: compromised, related to the critical injury of the child
4. Knowledge deficit home care of fractured femur
Q:
A 16-year-old boy has a stiff neck, a headache, a fever of 103 Fahrenheit, and purpuric lesions on his legs. He is admitted to the hospital for treatment of suspected meningococcemia. Although the adolescent's physical needs take priority at the present time, the nurse can expect which of the following to be the most significant psychological stressor for this adolescent?
1. Fear of getting behind in schoolwork
2. Fear of painful procedures and bodily mutilation
3. Separation from friends and permanent changes in appearance
4. Separation from parents and home
Q:
An adolescent with cystic fibrosis is intubated with an endotracheal tube. Which is the most appropriate nursing diagnosis for the adolescent?
1. Impaired social interaction related to hospitalization and separation from peers
2. Delayed growth and development related to prolonged hospitalization and life-threatening condition
3. Powerlessness (moderate) related to inability to speak to or communicate
4. Potential for imbalanced nutrition, more than body requirements related to inactivity
Q:
The nurse is preparing a seriously ill child for a procedure. Which age group of children benefits most from being talked to, soothed, and touched during and after the procedure?
1. Preschoolers
2. School-age children
3. Adolescents
4. Toddlers
Q:
The nurse is taking care of a school-age child with 50% burns to the head and upper part of the body. The nurse recognizes that the most significant stressors for school-age children with life-threatening illness are:
Standard Text: Select all that apply.
1. Painful and invasive procedures.
2. Fear of the medical team.
3. Disfigurement.
4. Separation from family.
5. Loss of self-control.
Q:
The nurse is caring for an eight-year-old child who has been in a car accident, has a head injury, and is in the ICU. The nurse sees the child pulling on the IV line. What action should the nurse take?
1. Sedate the child as needed.
2. Place soft wrist restraints on the child.
3. Ask the parents to watch the child closely at all times.
4. Tell the child not to pull on the IV line.
Q:
Following an automobile accident in which the child received a traumatic head injury, the child has been hospitalized for two weeks. The parents have just been informed that their four-month-old child will have long-term consequences due to the injury, including intellectual disability and cerebral palsy. The parents express anger at the diagnosis and project that anger on the nursing staff. The response by the nursing staff should include:
Standard Text: 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.
Q:
Shortly after birth, all newborns are tested for phenylketonuria. The test results are not available before mother and baby are discharged from the hospital. When the diagnosis of PKU is made, the most appropriate means of informing the parents would be:
1. Immediately in a phone call requesting a follow-up office visit
2. In a certified letter explaining the diagnosis and requesting the parents make a pediatric office appointment.
3. In a group meeting of all parents whose children tested positive for phenylketonuria during the last two months.
4. In person with the physician and both parents present.
Q:
The three-year-old child with cystic fibrosis has just been discharged from the hospital following a two-week stay due to a respiratory infection. The child has a post-discharge office visit the next day. During the office visit, the mother mentions that the child was toilet trained before hospitalization but now is having accidents. Which response by the nurse would be 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 physician 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."
Q:
The mother of a 16-year-old child 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 would be an appropriate nursing diagnosis for this mother?
1. Caregiver role strain related to providing 24-hour care for a child with medical and developmental issues
2. Risk for injury (maternal) related to overwhelming demands of the medically fragile child
3. Knowledge deficit (maternal) nursing care of the child
4. Health seeking behaviors (maternal) related to interest in learning to care for her child
Q:
The nurse recommends to the family of a child with severe cerebral palsy that they enroll their child in hippotherapy. The nurse would explain that hippotherapy includes:
1. Water exercises to increase muscular strength.
2. Use of braces and walkers to support walking.
3. Dietary therapy to maintain a normal weight.
4. Horseback riding, or hippotherapy, improves posture and balance and allows the child to participate in a physical activity.
Q:
The school nurse is reviewing the records of all incoming kindergarten students. The nurse recognizes that an individualized education plan (IEP) will be required for which children?
Standard Text: Select all that apply.
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
5. The child with an IQ of 60
Q:
The nurse works in a clinic for medically fragile children who require constant home care. The nurse has noticed that a high percentage of the families wind up divorcing. In an attempt to reduce the divorce rate among the parents, the nurse creates an educational session for parents of medically fragile children that focuses on the need for:
1. Communication.
2. Financial stability.
3. Meeting the child's physical needs.
4. The state laws that have relevance to the medically fragile child.
Q:
After the infant is diagnosed as a child with a chronic health condition, the family is assigned a nurse working as a case manager. The nurse would explain that as a case manager, the nurse's role will include:
Standard Text: Select all that apply.
1. Limiting the number of visits to the health care 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.
Q:
A family actively participates in school functions with all their children, one of whom is paraplegic and requires a wheelchair for mobility. The nurse evaluates this family to be working on the process of:
1. Stagnation.
2. Isolation.
3. Normalization.
4. Interaction.
Q:
The nurse is working with a 20-year-old who is medically fragile. It is the policy of the clinic to only see patients from birth to 21 years of age. The nurse is responsible for assisting the individual and family to transition to adult health care. The nurse recognizes that the individual may face difficulties related to:
Standard Text: Select all that apply.
1. No longer qualifying for the state's child health insurance program and becoming uninsured.
2. Wanting to start fresh with the new healthcare provider and refusing to allow transfer of their records to the new agency.
3. Adult clinics being unwilling to accept this chronically ill individual into their practice.
4. The parents choosing an adult clinic that is not the one the individual would like to attend.
5. Being unwilling to transition to the adult clinic due to the relationships they have with the pediatric clinic.
Q:
An adolescent has recently been diagnosed with type 1 diabetes mellitus and is on dietary restrictions and daily insulin. The nurse is teaching the adolescent's family members about the disease and treatment. The nurse will warn the family that the adolescent, upon returning to school, may:
1. Recognize that there is no difference between her and her classmates.
2. Not experience social stigma.
3. Acknowledge her condition to her classmates.
4. Not adhere to dietary recommendations.
Q:
The nurse is conducting an educational program for parents of children with chronic conditions. Which statement by a parent requires additional nursing interventions?
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."
Q:
The nurse is conducting a nursing assessment of the parent and child with severe cerebral palsy during a routine clinic visit. Which of the following is important for the nurse to include on this assessment?
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
Q:
The nurse is working with a child with a chronic condition. The nurse observes that over time, the parents have experienced a pattern of periodic grieving alternating with denial. The nurse would recognize this pattern as:
1. Pathologic grieving.
2. Compassion fatigue.
3. Chronic sorrow.
4. Dysfunctional parenting.
Q:
In working with parents of children with chronic diseases, the nurse is concerned with helping the parents to protect themselves from compassion fatigue. The nurse would encourage which activities?
Standard Text: 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
Q:
The nurse is working with the parents of a child with a chronic condition. The nurse concludes that the parents' caregiver burden might become overwhelming when the mother states which of the following?
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."
Q:
The nurse is working in an adolescent medical clinic. When comparing adolescents in the clinic who have chronic conditions with their peers, the nurse would expect chronically ill adolescents to have:
1. More concern for their parents.
2. A decreased concern about their appearance.
3. An altered body image.
4. Higher self-esteem.
Q:
The nurse can instruct parents to expect children in which age group to begin to assume more independent responsibility for their own management of a chronic condition, such as blood glucose monitoring, insulin administration, intermittent self-catheterization, and appropriate inhaler use?
1. Preschoolers
2. School-age children
3. Adolescents
4. Toddlers
Q:
The nurse is partnering with the family of a hospitalized premature infant who suffered an intraventricular brain hemorrhage. After three 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?
Standard Text: 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
Q:
The school nurse completes an assessment of a six-year-old child to determine the services this child will need in the classroom. The child needs respiratory support with oxygen. The child requires enteral tube feedings and intravenous medications during the school day. With these needs, the school nurse evaluates the child to be:
1. Medically fragile.
2. Developmentally delayed.
3. Mentally retarded.
4. Socially withdrawn.
Q:
All of the following children are inpatients on the pediatric unit. Which child is likely to be left with a developmental disability?
1. An 18-month-old admitted with a diagnosis of near drowning
2. A school-age child newly diagnosed with type 1 diabetes mellitus
3. A toddler with sepsis
4. A two-year-old child with a fractured femur
Q:
The nurse in the long-term care clinic is reviewing the charts of a group of children being seen for follow-up visits in the pediatric clinic. The nurse recognizes that chronic limitations might result from which diagnosis?
1. Pneumonia from Haemophilus influenzae virus
2. Respiratory syncytial virus
3. Streptococcus pneumoniae, a gram-positive diplococcus
4. Congenital heart defect