Q&A Hero

Q: The nurse is completing a physical examination of a four-year-old child. The best position in which to place the child for assessment of the genitalia would be: 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-leg position.

Q: A nurse working in the newborn nursery notes that an infant is having frequent episodes of apnea lasting 10 to15 seconds without any changes in color or decreases in heart rate. Which intervention would be the most appropriate? 1. Continue to observe the infant and call the physician if the apnea lasts longer than 20 seconds. 2. Suction the infant's mouth and nares. 3. Call the physician immediately. 4. Turn the infant on its right side.

Q: The nurse is taking a health history from the family of a three-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."

Q: During the newborn examination, the nurse assesses the infant for signs of developmental dysplasia of the hip. Which finding would strongly suggest this disorder? 1. Asymmetric thigh and gluteal folds 2. Positive Babinski's reflex 3. A negative Moro reflex 4. Flat soles with prominent fat pads

Q: A seven-year-old has just returned to the unit from the operating room after undergoing an appendectomy. When asked, the child states that his pain is a 1 on a scale of 0 to 10. Which finding makes the nurse question this response? 1. Lies rigid in bed, refusing to move 2. Eyes closed, flat effect 3. Turning away from the nurse, avoiding eye contact 4. Mother states that the child is in pain.

Q: Following a car accident, a four-year-old child was admitted to the pediatric intensive care unit. Both parents were injured in the accident and have been unable to visit. The child's condition has stabilized, and the child is transferred to the surgical unit for the remainder of her hospitalization. The child has not expressed any feelings during the hospitalization. Which interventions might help the child express her feelings? 1. Asking the hospital chaplain to talk with the child 2. Use play therapy including mother, father, and child dolls. 3. Use journaling to allow the child to express herself. 4. Using humor by telling knock-knock jokes

Q: The nurse is working with a 14-year-old adolescent with an intellectual disability. The adolescent's mental age is four. In explaining an X-ray to the adolescent, the nurse should explain: 1. To the adolescent in terms appropriate to a teenager. 2. To the parents and have them explain to their child. 3. As little as possible because the child will not understand anyway. 4. Using words that are in the vocabulary of a four-year-old without talking down to the adolescent.

Q: The nurse is attempting to take the blood pressure of a four-year-old child. The child is afraid of the sphygmomanometer. Which action by the nurse will help allay the child's feelings of anxiety? 1. Explain to the child: "I am just going to take your blood pressure." 2. Have the mother hold the child still while the nurse takes the blood pressure. 3. Allow the child to handle the equipment and then demonstrate how the equipment works. 4. Tell the child: "This won"t hurt. I"ve had it done a bunch of times."

Q: While the nurse is bathing a seven-year-old child, the child states, "I get so sad when my mom leaves." The response that ignores the importance of the child's feelings is: 1. "I am working tonight so I will be with you tonight while your mother is away." 2. "Could you explain to me what you mean by sad?" 3. "Your mother has to take care of your brothers and sisters, too. She will be back tomorrow." 4. "Can you tell me more about how it makes you feel when your mom leaves?"

Q: A non-Spanish-speaking nurse is working with a seven-year-old client who is able to speak English but whose family speaks only Spanish. The nurse needs to give discharge instructions regarding the client's oral antibiotics. There are no Spanish-speaking interpreters available presently, but one will be able to come in about one hour. The nurse's most appropriate intervention would be: 1. To give the discharge instructions to the parents, with the child acting as interpreter. 2. To give the discharge instructions to the child. 3. To obtain an English/Spanish translation book and use this to aid in giving discharge instructions to the parents. 4. To have the parents wait until an interpreter can be found to translate the discharge instructions.

Q: While assessing an eight-month-old infant, the best strategy for the nurse to use to promote communication with the infant would be to: 1. Use touch, patting, and cuddling the infant. 2. Speak to the infant in low-pitched, soft tones. 3. Place the infant out of the parents' view to decrease distraction. 4. Lean over the infant's face and talk with forceful tones.

Q: The nurse caring for a Chinese American child should be aware that acceptable nonverbal communication patterns to use when giving information to the child's father include: Standard Text: Select all that apply. 1. Handshakes between men only. 2. The father prefers not to be touched by strangers. 3. Avoiding direct eye contact when listening. 4. Distant personal space is preferred. 5. Touch is common with family members and close friends.

Q: A nurse is working with a child who is a pediatric trauma victim. The nurse is planning nursing interventions to facilitate rapport and effective communication with this child and family. The nurse will utilize which interventions? Standard Text: Select all that apply. 1. Closing the door to the room when speaking to the family or child 2. Avoiding the use of medical jargon 3. Inviting the family out to a movie to decrease their anxiety 4. Introducing self to the child and family 5. Sitting in a chair facing the family and child

Q: A nurse working with Japanese American adolescents should be aware of nonverbal communication patterns in their culture. While working with these clients, the nurse should: 1. Touch them often during the communication to reassure them. 2. Stand very close to them while talking with them. 3. Shake their hands upon greeting them. 4. Look directly at them while talking with them.

Q: The nurse caring for a nine-year-old child with extensive burns needs to prepare the child for going to whirlpool therapy for the first time. The most effective response to promote communication with this child would be: 1. "Have you been to the playroom yet? Maybe when you get back from whirlpool we can check it out together." 2. "Before you leave for whirlpool, I will give you a shot that will relax you, and you probably won't even remember going downstairs at all." 3. "I am going to be taking you downstairs to whirlpool. Do you have any questions?" 4. "Some of the children I have worked with have told me that they worried about the whirlpool hurting them."

Q: In order to prepare a six-year-old client for an intravenous catheter insertion, the nurse's best response would be: 1. "If I were you, I would hold very still so that it will only take one stick." 2. "It is okay to cry. I know that this hurts." 3. "Why are you crying? I thought that you were a tough kid." 4. "Don't worry a bit; this is just like a little mosquito bite."

Q: While caring for an adolescent with cystic fibrosis, the nurse would best demonstrate friendliness and interest by engaging in which nonverbal behavior? 1. Sitting at eye level and leaning forward while speaking with the client. 2. Crossing the legs and leaning back slightly in the chair while talking with the client. 3. Making eye contact with the client only when necessary. 4. Standing over the client's bed while talking with him.

Q: A nurse notices a client sitting at the edge of the chair, tapping her fingers, fidgeting, and blinking her eyes frequently. In planning this client's care, the nurse should take into account that this client is most likely displaying nonverbal cues of: 1. Shyness. 2. Anxiety. 3. Anger. 4. Interest.

Q: While the nurse is admitting a pediatric patient, the mother blurts out, "I think this hospital is the most disorganized, inefficient place I have ever been in!" The most therapeutic response for the nurse to make would be: 1. "This hospital and its staff are extremely competent, and you are receiving the best possible care." 2. "Does your child have any allergies or take any medication routinely?" 3. "It happens to be very busy right now, and there are children much sicker than your child who need to be cared for first." 4. "It sounds like you are upset with the care your child has received. Is that correct?"

Q: A 10-year-old child 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. Have his mother compliment him when he completes his homework. 3. Encourage the child to participate in boy scouts and earn badges. 4. Suggest to the mother that she allow the child to babysit his younger siblings.

Q: As children grow and develop, their style of play changes. Place the following descriptions of play styles in order from infancy to school-age. Standard Text: Click and drag the options below to move them up or down. Choice 1. Plays beside but not with other children Choice 2. Plays games with other children and is able to follow the rules of the game Choice 3. Plays alone with play directed by others Choice 4. Plays with others in loose groups

Q: 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. The argument the nurse will use in to advocate for more than one group session would be based on: 1. Freud's theory of psychosexual development, which states that the six-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 six-year-old learns by concrete examples while the 15-year-old can think abstractly. 4. Kohlberg's theory, which says the young child is conventional in his thinking and will want to learn to please others while the older child can internalize values and will learn for his own principles.

Q: The home health nurse is visiting a family at home when the toddler has an "accident" and has a bowel movement in his diaper. The mother becomes angry with the child and calls him a baby for messing himself. The nurse considers Erikson's theory and recognizes that the mother's behavior may have an effect on the child's: 1. Cognitive development. 2. Sense of independence. 3. Conscience. 4. Development of superego.

Q: A 14-year-old with cystic fibrosis suddenly becomes noncompliant with the medication regimen. The intervention by the nurse that would most likely improve compliance would be to: 1. Give the child a computer-animated game that presents information on the management of cystic fibrosis. 2. Set up a meeting with some older teens who have cystic fibrosis and have been managing their disease effectively. 3. Arrange for the physician to sit down and talk to the child about the risks related to noncompliance with medications. 4. Discuss with the child's parents that privileges, such as a cell phone, can be taken away if compliance fails to improve.

Q: Prior to giving an intramuscular injection to a two-and-a-half-year-old child, the most appropriate statement by the nurse would be: 1. "It is all right to cry. I know that this hurts. 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. "This is medicine that will make you better. First we will hold your leg, then I will wipe it off with this magic cloth that kills the germs on your leg right here. Then I will hold the needle like this and say 'one, two, three, go' and give you your shot. After the shot is over with, I will hold the cotton ball until it stops bleeding and then put the Band-Aid on. Are you ready?" 4. "This is a magic sword that will give you your medicine and make you all better."

Q: The mother of a six-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. The nurse caring for the child should assure the mother that this is a normal response for a child who has undergone surgery and that it is a coping mechanism that children sometimes use called: 1. Repression. 2. Rationalization. 3. Fantasy. 4. Regression.

Q: While trying to inform a five-year-old girl 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. The nurse's best response would be: 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. "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 child's responses and continue discussing the procedure.

Q: A neonatal nurse who encourages parents to hold their baby and provides opportunities for kangaroo care most likely is demonstrating concern for which aspect of the infant's psychosocial development? 1. Attachment 2. Assimilation 3. Resilience 4. Centration

Q: Two three-year-olds are playing in a hospital playroom together. One is working on a puzzle, while the other is stacking blocks. The mother of one of the children scolds them for not sharing their toys. The nurse counsels this mother that this is normal developmental behavior for this age, and the term for it is: 1. Cooperative play. 2. Solitary play. 3. Parallel play. 4. Associative play.

Q: A nurse is assessing language development in all the infants presenting at the physician's office for well-child visits. The nurse would want to evaluate the child further who is not able to verbalize the words "dada" and "mama" by the age of: 1. 18 months. 2. 8 months. 3. 5 months. 4. 12 months.

Q: While assessing the development of a nine-month-old infant, the nurse asks the mother if the child actively looks for toys when they are placed out of sight. The nurse is trying to determine whether the infant has developed: 1. Transductive reasoning 2. Conservation 3. Centration 4. Object permanence

Q: While in the pediatrician's office for their child's 12-month well-child exam, the parents ask the nurse for advice on age-appropriate toys for their child. Based on the child's developmental level, the nurse should suggest which types of toys? Standard Text: Select all that apply. 1. Soft toys that can be manipulated and 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

Q: The parents of a one-month-old infant are concerned that their baby seems different from their other child, and they ask the nurse if this is normal. The nurse informs them that it is normal for babies to have different temperaments and that according to the "temperament theory" of Chess and Thomas, one of the characteristics of the "slow-to-warm-up" child is that he: 1. Initially reacts to new situations by withdrawing. 2. Commonly has intense reactions to the environment. 3. Displays a predominately negative mood. 4. Shows a regularity in patterns of eating.

Q: Utilizing Bronfenbrenner's ecologic theory of development, the nurse caring for a child would discuss the parents' work environment as part of an assessment of that child's: 1. Chronosystem. 2. Mesosystem. 3. Macrosystem. 4. Exosystem.

Q: While being comforted in the emergency department, the six-year-old 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!" The nurse, realizing that the child is experiencing magical thinking, should respond by: 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. Calmly discussing the catheters, tubes, and equipment that the patient requires, and explaining to the sibling why the patient needs them.

Q: A couple has been referred for genetic counseling. Prior to making the appointment, the couple should understand that: 1. The cost of genetic counseling will be covered by their health insurance. 2. Genetic counseling and testing is voluntary. They have a right to decide not to seek the information. 3. Once genetic counseling has been completed, the physician may require sterilization of the man or woman. 4. Their extended family will benefit from the knowledge the couple gains.

Q: The nurse is discussing autosomal recessive inheritance with a patient. The nurse will include which statements in the discussion? Standard Text: Select all that apply. 1. "The disorder may appear to skip generations." 2. "Boys and girls are affected in equal numbers." 3. "The disorder passes from mother to son but not from father to daughter." 4. "Daughters that are affected will be more severely involved than sons." 5. "Both parents must be carriers for the disorder."

Q: A child has been diagnosed as having a genetic disorder based on a mosaic trisomy. The nurse recognizes that the mother understands the significance of this diagnosis when she states: 1. "Because my child has a mosaic trisomy, he will have some normal cells in his body, which means his disorder may not be as severe as in other children." 2. "Children born with mosaic trisomy do not pass the disorder on to their children." 3. "Mosaic trisomies are inherited from the father's side of the family." 4. "Mosaic trisomies occur in an ovum from an older woman."

Q: As medical care has evolved, it has become more common for children with genetic disorders to live longer. What impact does this have on health care delivery for the nurse providing care for these children? 1. Health care delivery is becoming more complex, despite these children requiring less care as they age. 2. Nurses should not spend much time at the bedside, as these children will eventually die of these disorders. 3. Nurses must be familiar with increasing numbers of genetic disorders and the care these children require. 4. Health care delivery will become more and more expensive until children with genetic disorders will have to do without.

Q: Advances in genetic screening provide information with high levels of certainty about genetic disorders a fetus might have. Which is an ethical implication of these advances? 1. The nurse must participate in actions that are completely contradictory to his personal ethics. 2. The nurse must be aware of his own personal feelings about the actions taken after the screening tests are completed. 3. The nurse must be aware of parent feelings regarding the information available to them. 4. The parents must be aware of the nurse's feelings regarding the information available about the fetus.

Q: Parents of a baby who died shortly after birth from a genetic disorder have been referred to a genetics clinic. The physician has explained to the parents why the referral was made. Which statement by the parents indicates that they understand the reason for the referral? 1. "I think going to the genetics clinic will help us get over the loss of our baby." 2. "I'm afraid the genetics clinic will tell us we cannot have another baby." 3. "The genetics clinic will prevent this from happening to us again." 4. "The genetics clinic will give us the information we need to decide whether we want to try again."

Q: Following carrier testing, it is determined that both the husband and wife have sickle-cell trait. Which statement by the wife indicates correct understanding of autosomal recessive inheritance? 1. "Because both my husband and I carry the trait but do not have the disease, I don"t need to have prenatal testing because my baby will also be a carrier." 2. "Because both my husband and I are both carriers, I don"t need to have prenatal testing because all of our children will have the disease. 3. "When I become pregnant, I need to have an amniocentesis or other prenatal test to determine whether my baby is affected with sickle-cell disease." 4. "There is no use undergoing prenatal testing as sickle-cell anemia cannot be diagnosed prenatally."

Q: During genetic testing, one parent is found to have a chromosomal abnormality without any physical or mental disability; however, the offspring has inherited physical and/or mental disability. During patient education, the nurse explains that the type of individual who can have a chromosomal abnormality without any disability but can cause his offspring to receive chromosomal alterations and disability is the parent with: 1. Dominant-gene structural chromosomal inversions. 2. Mosaicism. 3. Dominant-gene structural chromosomal balanced translocations. 4. Dominant-gene structural chromosomal deletions.

Q: The nurse in the genetics clinic is working with families undergoing testing for genetic disease. If the initial testing is positive, more extensive testing is required to confirm: 1. Prenatal diagnostic testing. 2. Carrier screening. 3. Newborn screening. 4. Pre-implantation genetic diagnosis.

Q: A nurse is reviewing the charts of children in the pediatric units to determine which parents would benefit from referral to the genetics clinic. The nurse recognizes that the parents of children with genetic and chromosomal disorders would benefit most from this referral. Therefore, the nurse refers the parents of the: Standard Text: Select all that apply. 1. Neonate born at 28 weeks with respiratory distress syndrome. 2. Two-year-old child who is terminally ill with a brain tumor. 3. Child diagnosed at age six with cystic fibrosis. 4. Four-year-old child with nephrotic syndrome. 5. Child with Duchenne muscular dystrophy being treated for respiratory symptoms.

Q: The nurse is discussing genetic referral with the parents of children being seen in the pediatric clinic. The child who would benefit from a genetic referral is the child whose family has a history of: 1. Prominent epicanthal folds, resonant lungs, or absent tinnitus in Asian families. 2. Broad face, lower-extremity lichenification, or spider angiomas. 3. Normocephalic head, euthyroid, or five digits per extremity. 4. Cleft lip and/or cleft palate, diaphragmatic hernia, or cataract.

Q: When a parent reports multiple male miscarriages, the nurse should confer with the health care provider about a possible genetics referral for which type of conditions? 1. Anticipation autosomal dominant conditions 2. X-linked recessive conditions 3. X-linked dominant conditions 4. Autosomal recessive conditions

Q: During a sports physical, a client is found to have myopia, long digits, tall stature, an arm span greater than his height, scoliosis, and a hollow chest. The nurse should suspect: 1. Phenylketonuria. 2. Turner's syndrome. 3. Huntington's chorea. 4. Marfan's syndrome.

Q: All five of the children in a family were born with a genetic disorder. The disorder is inherited as autosomal dominant. If this is not a statistical rarity, the likelihood would be that: 1. One parent has both chromosomes with the affected gene. 2. Both parents are carriers. 3. One parent is a carrier and the other parent is unaffected. 4. One parent has one chromosome affected and the other parent has none.

Q: A couple is evaluated in the genetics clinic, and the male is found to be a carrier of an X-linked dominant disorder. The couple asks the nurse what this means in regard to their future children. The nurse's response will include the information that: 1. All girls born to the family will be affected. 2. About 25% of the boys born to the family will be affected. 3. About 25% of the girls born to the family will be affected. 4. All boys born to the family will be affected.

Q: Which parent statement shows understanding of the cause of the child's genetic condition in such a way that the nurse can document that no further teaching about the cause is needed? 1. "I was angry on the day he was conceived; that is why he got this sickness." 2. "My nephews had chickenpox in my seventh month of pregnancy with my son, so that is how he got this way." 3. "My child has this disease because the code in the genes just changed, and it is no one's fault." 4. "Our child is like this because I sunbathed too much during the pregnancy when I carried him."

Q: The nurse teaches children with genetic disorders ways to maintain health and avoid complications. The nurse will teach children with which genetic disorder to follow medical guidelines and maintain penicillin prophylaxis? 1. Sickle-cell disease 2. Hereditary idiopathic scoliosis 3. Klinefelter's syndrome 4. Recklinghausen's disease

Q: After reading a magazine article on complementary medicine methods, a teenager diagnosed with cancer asks the nurse about the possibility of adding CAM to the medical treatment plan. The nurse would explain to the child that prior to deciding on a CAM method, the adolescent must discuss: 1. The cost of the CAM with her parents. 2. The availability of CAM leaders with the hospital social worker. 3. The safety of the chosen CAM modality with her primary physician. 4. Alternative CAM methods with the nurse.

Q: A child has been admitted to the hospital for treatment of otitis media. When explaining to the mother that the child will be treated for an ear infection, the mother states: "Oh, it is important that my child receives hot foods to help my child." Recognizing that this is a cultural preference and that ear infections are "cold conditions," the nurse will include which of the following in the child's diet? 1. Cheese and eggs 2. Chicken and fish 3. Fresh fruits and vegetables 4. Goat meat and raisins

Q: A new nurse takes a job in a clinic that works with immigrants from many different cultures. The nurse recognizes that to be culturally sensitive, the nurse will need to: Standard Text: Select all that apply. 1. Determine means to indoctrinate the patients in the American culture. 2. Gain knowledge about the cultural groups attending the clinic. 3. Avoid the use of interpreters to reduce the impression of a bias. 4. Honor the cultural variations of the patients at the clinic. 5. Acquire information and educational media, such as pamphlets and teaching videos, that use languages spoken by the cultural groups attending the clinic.

Q: Access to health care often is less accessible to many groups of children and parents. Which factors can contribute to reducing access to health care? Standard Text: Select all that apply. 1. Transportation problems 2. Lack of community healthcare facilities 3. Lack of health insurance among low-income families 4. Overload of clients resulting in inability to be seen in a timely fashion 5. Communication difficulties if the family is unable to speak or read English

Q: The nurse is working with a child whose religious beliefs differ from those of the general population. The best nursing intervention to use to meet the specific spiritual needs of this child and family is to: 1. Ask, "What do you think caused the child's illness?" 2. Show respect while allowing time and privacy for religious rituals. 3. Identify health care practices forbidden by religious or spiritual beliefs. 4. Ask, "How do the child and family's religious and spiritual beliefs impact their practices for health and illness?"

Q: The nurse working in a multicultural clinic recognizes that when the purpose of teaching is to promote the health of individual children, this effort should be directed to the authority responsible for the health care decisions. In certain cultural groups, health care decisions typically are made by the father. Therefore, the nurse should direct teaching efforts to the fathers in which cultures? 1. European American 2. African American 3. Native American 4. Appalachian

Q: The oncology nurse is working with patients from many cultural backgrounds. When assessing pain, the nurse should recall that members of which cultural group are more likely to remain quiet when experiencing severe pain? 1. Hispanic 2. Asian 3. Italian 4. Jewish

Q: During the assessment, the nurse notices that a Black baby has a darker, slightly bluish-hued patch about 5 7 cm on the buttocks and lower back. What is the nurse's next action? 1. Ask the mother about the cause of the bruise. 2. Call the Department of Social Services (DSS) to report this as a sign of abuse. 3. Confer with the physician the possibility of a bleeding tendency. 4. Chart the presence of a Mongolian spot.

Q: The nurse is working in the respiratory clinic. In assessing children for cystic fibrosis, the nurse recognizes that children from which genetic and biologic racial background are more likely to have assessment findings characteristic of cystic fibrosis? 1. Asian 2. White 3. Hispanic 4. Black

Q: The nurse is reviewing the charts from a multicultural health clinic. The nurse needs to know that for three cultures, the listed first name is actually the family name, while the individual's given name is placed last. The three cultures with this variation are: 1. French, German, and Irish. 2. Cambodian, Filipino, and Korean. 3. Canadian, Egyptian, and Haitian. 4. Brazilian, English, and Jewish.

Q: The nurse is working with a family who has recently immigrated to this country. The nurse has recently studied Purnell's Model for Cultural Competence (2002) and wants to respond to the family in a culturally acceptable manner. The most appropriate assessment question(s) would be: 1. "In what places have you lived?" and "What do you miss about your native land?" 2. "When I discuss your child's problem with you, how close to you should I stand?" 3. "What is the school system like in your native land?" 4. "What does eye contact indicate?" and "When do you want me to make eye contact?"

Q: The nurse is beginning to obtain information about the present illness and medical history from the child's family. The "zone" of space that the nurse should plan to use include the: 1. Public zone. 2. Personal zone. 3. Intimate zone. 4. Social zone.

Q: The charge nurse is reviewing the care plans written by the unit's staff nurses. The charge nurse recognizes that the NANDA nursing diagnosis most likely to be construed as culturally biased and possibly offensive is: 1. Interrupted family processes related to shift in family roles secondary to demands of illness. 2. Fear related to separation from support system during hospitalization. 3. Noncompliance related to impaired verbal communication secondary to recent immigration from a non-English-speaking area. 4. Spiritual distress related to discrepancy between beliefs and prescribed treatment.

Q: Unhappy with the treatment progress for their child with cancer, the parents choose to add dietary supplements, including megavitamins, as complementary medicine to the treatment plan. What would be the priority nursing diagnosis for this child? 1. Impaired gas exchange 2. Risk for injury 3. Altered family processes 4. Altered parenting

Q: The nurse in a multicultural health clinic recognizes that many cultures use non-Western means in combination with Western health care prescriptions to treat illness. The nurse needs to recognize that the individuals most likely to combine curanderismo with Western health care prescriptions are: 1. African Americans 2. Native Americans 3. Asian Americans 4. Mexican Americans

Q: The nurse is working with a child newly enrolled in an English as a Second Language class. The nurse wants to teach the child about the importance of hand washing before meals and to not eat food dropped on the exam room floor. The best way to evaluate the child's understanding of hygienic nutrition is to: 1. Have the child repeat his interpretation of the information that was taught. 2. Schedule a medical interpreter to accompany the patient to his next visit. 3. Provide written materials in English about hygiene and diet for the client to take home. 4. Have the nurse model proper hand washing before examining the child, and throw out the dropped cookie.

Q: A Southern, nominally Pentecostal, African American pediatric client is being assessed during admission. He has braided, black, kinky hair, and he celebrates Kwanzaa. The nurse should document his ethnicity and race on the nursing admission form as: 1. Ethnicity African American, race Black 2. Ethnicity Black, race African American 3. Ethnicity Pentecostal, race African American 4. Ethnicity Southern, race Black

Q: A nurse is working with a pediatric client who is overweight. Which diseases are associated with pediatric obesity? Standard Text: Select all that apply. 1. Cardiovascular disease 2. Asthma 3. Infant mortality 4. Diabetes

Q: As a component of the family assessment, the family assists the nurse in developing an ecomap. Prior to beginning the ecomap, the nurse explains that the ecomap: 1. Provides information about the family structure including family life events, health, and illness. 2. Illustrates family relationships and interactions with community activities including school, parental jobs, and children's activities. 3. Is a short questionnaire of five questions that measures family growth, affection, and resolve. 4. Is a family assessment that consists of three categories of information about the family's strengths and problems.

Q: While performing a family assessment, the nurse identifies which symptoms associated with dysfunctional family coping strategies? Standard Text: Select all that apply. 1. Father acknowledges an addiction to alcohol. 2. The mother is a stay-at-home mother, and the father works two jobs to make ends meet. 3. The family has deep religious beliefs. 4. The father makes all of the decisions for the family, and the mother is compliant with the father's decisions. 5. Direct, open communication among family members is observed.

Q: A pediatric clinic serves several children who were adopted. The clinic nurse recognizes that the adopted child who is most likely to blame himself for being "given away" by the biologic parents is the: 1. Adopted child entering high school. 2. Child under three who was adopted as an infant. 3. Preschooler whose skin color is different from the adopted parents. 4. Child entering kindergarten.

Q: The nurse working in a family-centered hospital sees families at all stages of the family life cycle. Place each of the following families along the continuum of the family life cycle, beginning with the earliest stage and proceeding to the last stage. Standard Text: Click and drag the options below to move them up or down. Choice 1. The husband who retired from his job four years ago. He has been widowed six months. Choice 2. Newlyweds Choice 3. Family with three children, ages 17, 13, and 9 Choice 4. Family taking their first child home from the birth hospital Choice 5. Family with grown children. Both parents hold full time jobs. Choice 6. Family whose oldest child will start kindergarten next year and whose third child will be born shortly

Q: A nurse is working with the family of a pediatric client. The nurse is planning to obtain an accurate family assessment. The initial step would be to: 1. Select the most relevant family assessment tool. 2. Establish a trusting relationship with the family. 3. Focus primarily on the mother, learning her greatest concern. 4. Observe the family in the home setting, since this step always proves indispensable.

Q: A new pediatric hospital will open soon. While planning nursing care, the hospital administration is considering two models of providing health care: family-focused care and family-centered care. The best example of a nursing action in the family-centered care approach would be when the nurse: 1. Assumes the role of an expert professional to direct the health care. 2. Encourages the parents to stay with and comfort the child during an invasive procedure. 3. Assumes the role of a healthcare authority and intervenes for the child and family as a unit. 4. Tells the family what must be done for the family's health.

Q: The camp nurse is assessing a group of children attending summer camp. Which child will be most likely to have problems perceiving a sense of belonging? 1. The child whose parents divorced recently 2. The child recently placed into foster care 3. The child whose mother remarried and who gained a stepparent recently 4. The child adopted as an infant

Q: Several children arrived at the emergency department accompanied only by their fathers. The nurse knows that the father who legally may sign emergency medical consent for treatment is: 1. The non-biologic one from the heterosexual cohabitating family. 2. The divorced one from the binuclear family. 3. The divorced one when the single-parent mother has custody. 4. The stepfather from the blended or reconstituted family.

Q: The nurse is assigned to a child in a spica cast for a fractured femur suffered in an automobile accident. The child's teenage brother was driving the car, which was totaled. The nurse learns that the father lost his job three weeks ago and that the mother has just accepted a temporary waitress job. An appropriate diagnosis for this family is: 1. Interrupted Family Processes related to a child with significant disability requiring alteration in family functioning. 2. Risk for Caregiver Role Strain related to a child with a newly acquired disability and the associated financial burden. 3. Impaired Social Interaction (parent and child) related to the lack of family or respite support. 4. Compromised Family Coping related to multiple simultaneous stressors.

Q: The nurse is working with a mother of three children on parenting skills. The nurse demonstrates a strategy that uses reward to increase positive behavior. This strategy is called: 1. Time-out. 2. Experiencing consequences of misbehavior. 3. Reasoning. 4. Behavior modification.