Wong's Nursing Care of Infants and Children | 12th
Edition| Chapters 1-34 Complete | A+ Graded |
Solutions with Rationale
Marilyn J. Hockenberry PhD RN PPCNP-BC FAAN
Elizabeth A. Duffy DNP RN CPNP
Karen Gibbs MSN/MPH RN PHNA-BC CPN
,SECTION I Children. Their Families, and the Nurse
Chapter 1: Perspectives of Pediatric Nursing
1. A 6-year-old child with newly diagnosed type 1 diabetes is hospitalized for stabilization.
The parents insist on performing all blood glucose checks and insulin administration,
stating they do not trust the child to participate. Which nursing action best reflects
family-centered care?
A. Allow the parents to perform all care to reduce their anxiety
B. Encourage the child to participate in simple tasks such as selecting the finger for testing
C. Explain that hospital policy requires nurses to perform all procedures
D. Tell the parents that the child must independently manage diabetes before discharge
ANS: B
Rationale: Family-centered care supports collaboration while promoting developmentally
appropriate autonomy. A 6-year-old is in the initiative versus guilt stage and benefits from
participation in simple health tasks. Encouraging involvement fosters competence and coping.
Allowing parents full control limits developmental growth. Hospital policy does not override
therapeutic partnership. Requiring independence before discharge is unrealistic and
developmentally inappropriate.
2. A nurse is caring for a hospitalized toddler who cries whenever staff enter the room. The
mother reports the child recently began attending daycare. Which explanation best
describes the toddler’s behavior?
A. The child is demonstrating egocentrism
B. The child is experiencing separation anxiety
C. The child has developed mistrust of healthcare workers
D. The child is exhibiting regression due to hospitalization
ANS: B
Rationale: Separation anxiety peaks between 12 and 30 months. Hospitalization intensifies fear
of separation from primary caregivers. Crying when unfamiliar staff enter is developmentally
expected. Egocentrism is a cognitive feature of the preoperational stage but does not
specifically explain this distress. Mistrust is unlikely in the presence of a caregiver. Regression
may occur but persistent distress toward staff is most consistent with separation anxiety.
3. A school-age child requires a lumbar puncture. Which nursing intervention best
supports atraumatic care?
,A. Perform the procedure without parental presence to reduce contamination
B. Provide developmentally appropriate explanation using concrete terms
C. Delay all discussion until immediately before the procedure
D. Use physical restraint without preparation to minimize procedure time
ANS: B
Rationale: Atraumatic care minimizes physical and psychological distress. School-age children
are in the concrete operational stage and benefit from clear, literal explanations and
opportunity to ask questions. Parental presence is encouraged unless contraindicated.
Withholding information increases anxiety. Unprepared restraint increases trauma and fear.
4. A nurse notes that a 4-year-old hospitalized child resumes thumb-sucking and
bedwetting. Which is the best interpretation?
A. The child has a new developmental disorder
B. The behavior indicates poor parental discipline
C. The child is demonstrating regression as a coping mechanism
D. The child has a urinary tract infection
ANS: C
Rationale: Regression is a common stress response in preschoolers during hospitalization. It
reflects temporary return to earlier behaviors for comfort. There is no evidence of
developmental disorder or infection unless additional symptoms exist. Discipline is unrelated to
stress-induced regression.
5. Which statement by a pediatric nurse demonstrates understanding of the difference
between adult and pediatric care?
A. Children should be treated as small adults
B. Growth and development influence all aspects of care
C. Children rarely require family involvement in treatment
D. Pediatric medication dosing is standardized regardless of weight
ANS: B
Rationale: Pediatric nursing integrates growth and developmental stage into assessment,
communication, and intervention. Children are not small adults due to physiologic, cognitive,
and emotional differences. Family involvement is central. Medication dosing is weight-based or
body surface area based.
6. A nurse is planning discharge teaching for an adolescent with asthma. Which approach
is most appropriate?
, A. Direct all teaching to the parents
B. Provide written materials only
C. Involve the adolescent in decision-making and self-management planning
D. Limit information to avoid overwhelming the adolescent
ANS: C
Rationale: Adolescents are in the formal operational stage and seek autonomy. Shared
decision-making enhances adherence and self-efficacy. Teaching only parents undermines
independence. Written materials alone are insufficient. Withholding information decreases
engagement.
7. During a home visit, a nurse observes unsafe sleeping conditions for an infant. Which
principle guides the nurse’s response?
A. Nonmaleficence
B. Justice
C. Autonomy
D. Fidelity
ANS: A
Rationale: Nonmaleficence requires prevention of harm. Addressing unsafe sleep reduces risk
of sudden infant death. While respecting autonomy is important, safety takes priority in
pediatric advocacy. Justice refers to fairness. Fidelity refers to keeping promises.
8. A hospitalized child asks the nurse if a procedure will hurt. Which response reflects
therapeutic communication?
A. No, it will not hurt at all
B. It may feel like a quick pinch, and I will stay with you
C. Do not worry about it
D. If you cry, we will have to stop
ANS: B
Rationale: Honest, developmentally appropriate information builds trust. Minimizing or denying
pain damages credibility. Dismissing concern invalidates feelings. Threatening statements
increase fear.
9. Which is the primary goal of atraumatic care?
A. Eliminate all procedures
B. Reduce physical and psychological distress
C. Shorten hospital stays
D. Increase parental responsibility
Edition| Chapters 1-34 Complete | A+ Graded |
Solutions with Rationale
Marilyn J. Hockenberry PhD RN PPCNP-BC FAAN
Elizabeth A. Duffy DNP RN CPNP
Karen Gibbs MSN/MPH RN PHNA-BC CPN
,SECTION I Children. Their Families, and the Nurse
Chapter 1: Perspectives of Pediatric Nursing
1. A 6-year-old child with newly diagnosed type 1 diabetes is hospitalized for stabilization.
The parents insist on performing all blood glucose checks and insulin administration,
stating they do not trust the child to participate. Which nursing action best reflects
family-centered care?
A. Allow the parents to perform all care to reduce their anxiety
B. Encourage the child to participate in simple tasks such as selecting the finger for testing
C. Explain that hospital policy requires nurses to perform all procedures
D. Tell the parents that the child must independently manage diabetes before discharge
ANS: B
Rationale: Family-centered care supports collaboration while promoting developmentally
appropriate autonomy. A 6-year-old is in the initiative versus guilt stage and benefits from
participation in simple health tasks. Encouraging involvement fosters competence and coping.
Allowing parents full control limits developmental growth. Hospital policy does not override
therapeutic partnership. Requiring independence before discharge is unrealistic and
developmentally inappropriate.
2. A nurse is caring for a hospitalized toddler who cries whenever staff enter the room. The
mother reports the child recently began attending daycare. Which explanation best
describes the toddler’s behavior?
A. The child is demonstrating egocentrism
B. The child is experiencing separation anxiety
C. The child has developed mistrust of healthcare workers
D. The child is exhibiting regression due to hospitalization
ANS: B
Rationale: Separation anxiety peaks between 12 and 30 months. Hospitalization intensifies fear
of separation from primary caregivers. Crying when unfamiliar staff enter is developmentally
expected. Egocentrism is a cognitive feature of the preoperational stage but does not
specifically explain this distress. Mistrust is unlikely in the presence of a caregiver. Regression
may occur but persistent distress toward staff is most consistent with separation anxiety.
3. A school-age child requires a lumbar puncture. Which nursing intervention best
supports atraumatic care?
,A. Perform the procedure without parental presence to reduce contamination
B. Provide developmentally appropriate explanation using concrete terms
C. Delay all discussion until immediately before the procedure
D. Use physical restraint without preparation to minimize procedure time
ANS: B
Rationale: Atraumatic care minimizes physical and psychological distress. School-age children
are in the concrete operational stage and benefit from clear, literal explanations and
opportunity to ask questions. Parental presence is encouraged unless contraindicated.
Withholding information increases anxiety. Unprepared restraint increases trauma and fear.
4. A nurse notes that a 4-year-old hospitalized child resumes thumb-sucking and
bedwetting. Which is the best interpretation?
A. The child has a new developmental disorder
B. The behavior indicates poor parental discipline
C. The child is demonstrating regression as a coping mechanism
D. The child has a urinary tract infection
ANS: C
Rationale: Regression is a common stress response in preschoolers during hospitalization. It
reflects temporary return to earlier behaviors for comfort. There is no evidence of
developmental disorder or infection unless additional symptoms exist. Discipline is unrelated to
stress-induced regression.
5. Which statement by a pediatric nurse demonstrates understanding of the difference
between adult and pediatric care?
A. Children should be treated as small adults
B. Growth and development influence all aspects of care
C. Children rarely require family involvement in treatment
D. Pediatric medication dosing is standardized regardless of weight
ANS: B
Rationale: Pediatric nursing integrates growth and developmental stage into assessment,
communication, and intervention. Children are not small adults due to physiologic, cognitive,
and emotional differences. Family involvement is central. Medication dosing is weight-based or
body surface area based.
6. A nurse is planning discharge teaching for an adolescent with asthma. Which approach
is most appropriate?
, A. Direct all teaching to the parents
B. Provide written materials only
C. Involve the adolescent in decision-making and self-management planning
D. Limit information to avoid overwhelming the adolescent
ANS: C
Rationale: Adolescents are in the formal operational stage and seek autonomy. Shared
decision-making enhances adherence and self-efficacy. Teaching only parents undermines
independence. Written materials alone are insufficient. Withholding information decreases
engagement.
7. During a home visit, a nurse observes unsafe sleeping conditions for an infant. Which
principle guides the nurse’s response?
A. Nonmaleficence
B. Justice
C. Autonomy
D. Fidelity
ANS: A
Rationale: Nonmaleficence requires prevention of harm. Addressing unsafe sleep reduces risk
of sudden infant death. While respecting autonomy is important, safety takes priority in
pediatric advocacy. Justice refers to fairness. Fidelity refers to keeping promises.
8. A hospitalized child asks the nurse if a procedure will hurt. Which response reflects
therapeutic communication?
A. No, it will not hurt at all
B. It may feel like a quick pinch, and I will stay with you
C. Do not worry about it
D. If you cry, we will have to stop
ANS: B
Rationale: Honest, developmentally appropriate information builds trust. Minimizing or denying
pain damages credibility. Dismissing concern invalidates feelings. Threatening statements
increase fear.
9. Which is the primary goal of atraumatic care?
A. Eliminate all procedures
B. Reduce physical and psychological distress
C. Shorten hospital stays
D. Increase parental responsibility
