WONG'S NURSING CARE OF INFANTS AND CHILDREN 11TH EDITION HOCKENBERRY TEST BANK

pending on the childs race and ethnicity; dental caries continues to be a common chronic disease in childhood; and mental health problems are seen in children as young as school age, not just in adolescents. DIF: Cognitive Level: Applying REF: MCS: 3 TOP: Integrated Process: Teaching/Learning MSC: Client Needs: Health Promotion and Maintenance 13. The nurse is planning care for a hospitalized preschool-aged child. Which should the nurse plan to ensure atraumatic care? a. Limit explanation of procedures because the child is preschool aged. b. Ask that all family members leave the room when performing procedures. c. Allow the child to choose the type of juice to drink with the administration of oral medications. d. Explain that EMLA cream cannot be used for the morning lab draw because there is not time for it to be effective. ANS: C The overriding goal in providing atraumatic care is first, do no harm. Allowing the child a choice of juice to drink when taking oral medications provides the child with a sense of control. The preschool child should be prepared before procedures, so limiting explanations of procedures would increase anxiety. The family should be allowed to stay with the child during procedures, minimizing stress. Lidocaine/prilocaine (EMLA) cream is a topical local anesthetic. The nurse should plan to use the prescribed cream in time for morning laboratory draws to minimize pain. DIF: Cognitive Level: Applying REF: pp. 8-9 TOP: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance 14. Which situation denotes a nontherapeutic nursepatientfamily relationship? a. The nurse is planning to read a favorite fairy tale to a patient. b. During shift report, the nurse is criticizing parents for not visiting their child. c. The nurse is discussing with a fellow nurse the emotional draw to a certain patient. d. The nurse is working with a family to find ways to decrease the familys dependence on health care providers. ANS: B Criticizing parents for not visiting in shift report is nontherapeutic and shows an underinvolvement with the parents. Reading a fairy tale is a therapeutic and age appropriate action. Discussing feelings of an emotional draw with a fellow nurse is therapeutic and shows a willingness to understand feelings. Working with parents to decrease dependence on health care providers is therapeutic and helps to empower the family. DIF: Cognitive Level: Analyzing REF: MCS: 9 TOP: Integrated Process: Caring MSC: Client Needs: Psychosocial Integrity 15. The nurse is aware that which age group is at risk for childhood injury because of the cognitive characteristic of magical and egocentric thinking? a. Preschool b. Young school age c. Middle school age d. Adolescent ANS: A Preschool children have the cognitive characteristic of magical and egocentric thinking, meaning they are unable to comprehend danger to self or others. Young and middle school-aged children have transitional cognitive processes, and they may attempt dangerous acts without detailed planning but recognize danger to themselves or others. Adolescents have formal operational cognitive processes and are preoccupied with abstract thinking. DIF: Cognitive Level: Understanding REF: MCS: 4 TOP: Nursing Process: Assessment MSC: Client Needs: Safe and Effective Care Environment 16. The school nurse is assessing children for risk factors related to childhood injuries. Which child has the most risk factors related to childhood injury? a. Female, multiple siblings, stable home life b. Male, high activity level, stressful home life c. Male, even tempered, history of previous injuries d. Female, reacts negatively to new situations, no serious previous injuries ANS: B Boys have a preponderance for injuries over girls because of a difference in behavioral characteristics, a high taicvity t emperament sisocaisated w ith risk-taking behaviors, and stress predisposes children to increased risk taking and self-destructive behaviors. Therefore, a male child with a high activity level and living in a stressful environment has the highest number of risk factors. A girl with several siblings and a stable home life is low risk. A boy with vpiroeus injuries has two risk factors, but an even temper is not a risk factor for injuries. A girl who reacts negatively to new situations but has no previous serious illnesses has only one risk factor. DIF: Cognitive Level: Analyzing REF: MCS: 4 TOP: NursoicnegssP:rAssessment MSC: Client Needs: Safe and Effective Care Environment 17. The school unautrisnegistheevalnumber of school-age children classified as obese. The nurse recognizes that the percentile of body mass index that classifies a child as obese is greater than which? a. 50th percentile b. 75th percentile c. 80th percentile d. 95th percentile ANS: D Obesity in children and adolescents is defined as a body mass index at or greater than the 95th percentile for youth of the same age and gender. DIF: Cognitive Level: Remembering REF: MCS: 3 TOP: Nursing Process: Evaluation MSC: Client Needs: Health Promotion and Maintenance 18. The nurse is teaching parents about the types of behaviors children exhibit when living with chronic violence. Which statement made by the parents indicates further teaching is needed? a. We should watch for aggressive play. b. Our child may show lasting symptoms of stress. c. We know that our child will show caring behaviors. d. Our child may have difficulty concentrating in school. ANS: C The statement that the child will show caring behaviors needs further teaching. Children living with chronic violence may exhibit behaviors such as difficulty concentrating in school, memory impairment, aggressive play, uncaring behaviors, and lasting symptoms of stress. DIF: Cognitive Level: Applying REF: MCS: 6 TOP: Integrated Process: Teaching/Learning MSC: Client Needs: Health Promotion and Maintenance 19. The nurse is evaluating research studies according to the GRADE criteria and has determined the quality of evidence on the subject is moderate. Which type of evidence does this determination indicate? a. Strong evidence from unbiased observational studies b. Evidence from randomized clinical trials showed inconsistent results c. Consistent evidence from well-performed randomized clinical trials d. Evidence for at least one critical outcome from randomized clinical trials had serious flaws ANS: B Evidence from randomized clinical trials with important limitations indicates that the evidence is of moderate quality. Strong evidence from unbiased observational studies and consistent evidence from well-performed randomized clinical trials indicates high quality. Evidence for at least one ictrical outcome f rom randomizediclailntrials th at has serious wflas indi cates low quality. DIF: Cognitive Level: Remembering REF: MCS: 12 TOP: Nursing Process: Evaluation MSC: Client Needs: Safe and Effective Care Environment 20. An adolescent patient wants to make decisions about treatment options, along with his parents. Which moral value is the nurse displaying when supporting the adolescent to make decisions? a. Justice b. Autonomy c. Beneficence d. Nonmaleficence ANS: B Autonomy is the patients right to be self-governing. The adolescent is trying to be autonomous, so the nurse is supporting this value. tJhuestice is concept of fairness. Beneficence is the obligation to optreomthe pa tients well-being. Nonmaleficence is the obligation to minimize or prevent harm. DIF: Cognitive Level: Analyzing REF: MCS: 11 TOP: Nursing Process: Evaluation MSC: Client Needs: Health Promotion and Maintenance 21. The nurse manager is compiling a report for a hospital committee on the quality of nursingsensitive indicators for a nursing unit. Which does the nurse manager include in the report? a. The average age of the nurses on the unit b. The salary ranges for the nurses on the unit c. The education and certification of the nurses on the unit d. The number of nurses who have applied but were not hired for the unit ANS: C Nursing-sensitive indicators reflect the structure, process, and outcomes of nursing care. For example, the number of nursing staff, the skill level of the nursing staff, and the education and certification of nursing staff indicate the structure of nursing care. The average age of the nurses, salary range, and number of nurses who have applied but were not hired for the unit are not nursing-sensitive indicators. DIF: Cognitive Level: Applying REF: MCS: 15 TOP: Integrated Process: Communication and Documentation MSC: Client Needs: Safe and Effective Care Environment MULTIPLE RESPONSE 1. Which responsibilities are included in the pediatric nurses promotion of the health and wellbeing of children? (Select all that apply.) a. Promoting disease prevention b. Providing financial assistance c. Providing support and counseling d. Establishing lifelong friendships e. Establishing a therapeutic relationship f. Participating in ethical decision making ANS: A, C, E, F The pediatric nurses role includes promoting disease prevention, providing support and counseling, establishing a therapeutic relationship, and participating in ethical decision making; a pediatric nurse does not need to establish lifelong friendships or provide financial assistance to children and their families. Boundaries should be set and clear. DIF: Cognitive Level: Applying REF: pp. 9-11 TOP: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance 2. The nurse is conducting a teaching session for parents on nutrition. Which characteristics of families should the nurse consider that can cause families to struggle in providing adequate nutrition? (Select all that apply.) a. Homelessness b. Lower income c. Migrant status d. Working parents e. Single parent status ANS: A, B, C Families that struggle with lower incomes, homelessness, and migrant asttus generally lack the resources to provide their children with adequate food intake, nutritious foods such as fresh fruits and vegetables, and appropriate protein intake. Working parents and single parent status do not mean the families will struggle to provide adequate nutrition. DIF: Cognitive Level: Applying REF: MCS: 2 TOP: Integrated Process: Teaching/Learning MSC: Client Needs: Health Promotion and Maintenance 3. The nurse is preparing to complete documentation on a patients chart. Which should be included in documentation of nursing care? (Select all that apply.) a. Reassessments b. Incident reports c. Initial assessments d. Nursing care provided e. Patients response of care provided ANS: A, C, D, E The patients medical record shouldliundce: initial asse ssments, reassessments, ngursi care provided, and the patients response of care provided. Incident reports are not documented in the patients chart. DIF: Cognitive Level: Applying REF: MCS: 14 TOP: Integrated Process: Communication and Documentation MSC: Client Needs: Safe and Effective Care Environment 4. Which actions by the nurse demonstrate overinvolvement with patients and their families? (Select all that apply.) a. Buying clothes for the patients b. Showing favoritism toward a patient c. Focusing on technical aspects of care d. Spending off-duty time with patients and families e. Asking questions if families are not participating in care ANS: A, B, D Actions that show overinvolvement include buying clothes for patients, showing favoritism toward a patient, and spending off-duty time with patients and families. Focusing on technical aspects of care is an action that indicates underinvolvement, and asking questions if families are not participating in care indicates a positive action. DIF: Cognitive Level: Analyzing REF: pp. 9-10 TOP: Integrated Process: Caring MSC: Client Needs: Health Promotion and Maintenance 5. Which are included in the evaluation step of the nursing process? (Select all that apply.) a. Determination if the outcome has been met b. Ascertaining if the plan requires modification c. Establish priorities and selecting expected patient goals d. Selecting alternative interventions if the outcome has not been met e. Determining if a risk or actual dysfunctional health problem exists ANS: A, B, D Evaluation is the last step in the nursing process. The nurse gathers, sorts, and analyzes data to determine whether (1) the established outcome has been met, (2) tnhuersing interventions were appropriate, (3) the plan requires modification, or (4) other alternatives should be considered. Establishing priorities and selecting expected patient goals are done in the outcomes identification stage. Determining if a risk or actual dysfunctional health problem exists is done in the diagnosis stage of the nursing process. DIF: Cognitive Level: Understanding REF: MCS: 14 TOP: Nursing Process: Evaluation MSC: Client Needs: Health Promotion and Maintenance 6. Which should the nurse teach to parents regarding oral health of children? (Select all that apply.) a. Fluoridated water should be used. b. Early childhood caries is a preventable disease. c. Dental caries is a rare chronic disease of childhood. d. Dental hygiene should begin with the first tooth eruption. e. Childhood caries does not happen until after 2 years of age. ANS: A, B, D Oral health instructions to parents of children should include use of fluoridated water and dental hygiene beginning with the first tooth eruption. In addition, early childhood caries is a preventable disease and should be included in the teaching session. Dental caries is a common, not rare, chronic disease of childhood. Childhood caries may begin before the first birthday. DIF: Cognitive Level: Applying REF: MCS: 2 TOP: Integrated Process: Teaching/Learning MSC: Client Needs: Health Promotion and Maintenance 7. The school nurse is explaining to older school children that obesity increases the risk for which disorders? (Select all that apply.) a. Asthma b. Hypertension c. Dyslipidemia d. Irritable bowel disease e. Altered glucose metabolism ANS: B, C, E Overweight youth have increased risk for a cluster of cardiovascular factors that include hypertension, altered glucose metabolism,iapniddedmyisal. I rritable bowel disease and asthm are not linked to obesity. DIF: Cognitive Level: Applying REF: MCS: 3 TOP: Integrated Process: Teaching/Learning MSC: Client Needs: Health Promotion and Maintenance 8. The nurse is reviewing the Healthy People 2020 leading health indicators for a child health promotion program. Which are included in the leading healthaitnodrisc? (Select all that apply.) a. Decrease tobacco use. b. Improve immunization rates. c. Reduce incidences of cancer. d. Increase access to health care. e. Decrease the number of eating disorders. ANS: A, B, D The Healthy People 2020 leading health indicators provide a framework for identifying seesntial components for child health promotion programs designed to prevent future health problems in our nations children. Some of the leading health indicators include decreasing tobacco use, improving immunization rates, and increasing access to health care. Reducing the incidence of cancer and decreasing the number of eating disorders are not olnisthae indicators. s ltheading heal DIF: Cognitive Level: Analyzing REF: MCS: 2 TOP: Nursing Process: Evaluation MSC: Client Needs: Health Promotion and Maintenance 9. Which actions by the nurse demonstrate clinical reasoning? (Select all that apply.) a. Basing decisions on intuition b. Considering alternative action c. Using formal and informal thinking to gather data d. Giving deliberate thought to a patients problem e. Developing an outcome focused on optimum patient care ANS: B, C, D, E Clinical reasoning is a cognitive process that uses formal and informal thinking to gather and analyze patient data, evaluate the significance of the information, and consider alternative actions. Clinical reasoning is a complex developmental process based on rational and deliberate thought and developing an outcome focused on optimum patient care. Clinical reasoning is based on the scientific method of inquiry; it is not based solely on intuition. Chapter 2.Social, Cultural, Religious, and Family Influences on Child Health Promotion MULTIPLE CHOICE 1. Children are taught the values of their culture through observation and feedback relative to their own behavior. In teaching a class on cultural competence, the nurse should be aware that which factor may be culturally determined? a. Ethnicity b. Racial variation c. Status d. Geographic boundaries ANS: C Status is culturally determined and varies according to each culture. Some cultures ascribe higher status to age or socioeconomic position. Social roles also are influenced by the culture. Ethnicity is an affiliation of a set of persons who share a unique cultural, social, and linguistic heritage. It is one component of culture. Race and culture are two distinct attributes. Whereas racial grouping describes transmissible traits, culture is determined by the pattern of assumptions, beliefs, and practices that unconsciously frames or guides the outlook and decisions of a group of people. Cultural development may be limited by geographic boundaries, but the boundaries are not culturally determined. DIF: Cognitive Level: Analyzing REF: MCS: 39 TOP: Integrated Process: Teaching/Learning MSC: Client Needs: 2P.syTchheonsoucrsiaeliIsnatwegarrietythat if patients different cultures are implied to be inferior, the emotional attitude the nurse is displaying is what? a. Acculturation b. Ethnocentrism c. Cultural shock d. Cultural sensitivity ANS: B Ethnocentrism is the belief that ones way of living and behaving is the best way. This includes the emotional attitude that the values, beliefs, and perceptions of ones ethnic group are superior to those of others. Acculturation is the gradual changes that are produced in a culture by the influence of another culture that cause one or both cultures to become more similar. The minority culture is forced to learn the majority culture to survive. Cultural shock is the helpless feeling and state of disorientation felt by an outsider attempting to adapt to a different culture group. Cultural sensitivity, a component of culturally competent care, is an awareness of cultural similarities and differences. DIF: Cognitive Level: Understanding REF: MCS: 35 TOP: Integrated Process: Caring MSC: Client Needs: Psychosocial Itengrity 3. Which term best describes the sharing of common characteristics that fdeifrentiate s one group from other groups in a society? a. Race b. Culture c. Ethnicity d. Superiority ANS: C Ethnicity is a classification aimed at grouping individuals who consider themselves, or are considered by others, to share common characteristics that differentiate them ofrm t he other collectivities in a society, and from which they develop their distinctive cultural behavior. Race is a term that groups together people by their outward physical appearance. Culture is a pattern of assumptions, beliefs, and practices that unconsciously frames or guides the outlook and decisions of a group of people. A culture is composed of individuals who share a set of values, beliefs, and practices that serve as a frame of ererfence for individual perception and judgments. Superiority is the state or quality of being superior; it does not apply to ethnicity. DIF: Cognitive Level: Understanding REF: MCS: 39 TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 4. After the family, which has the greatest influence on providing continuity between generations? a. Race b. School c. Social class d. Government ANS: B Schools convey a tremendous amount of culture from the older members to the younger membersocoifetsy. They prepare children to carry oeutrt th aditional social roles that will be expected of them as adults.sRdaecfeinied as a division of humankind possessing traits that are transmissible by descent and are sufficient torcahcaterize race as a distinct hum an type; although race may have an influence on childrearing practices, its role is not as significant hasa t of schools. Social class refers to ethfamilys economic and educational levels. The social class of a family may change between generations. The government iesshtaebslparameters for children, including amount of schooling, but this is usually at a local level. The school culture has the most significant influence on continuity besides family. DIF: Cognitive Level: Remembering REF: MCS: 33 TOP: NursoicnegssP:rAssessment :MCSC lient Needs: Psychosocial Integrity 5. The nurse is planning care for a patient with a different ethnic background. Which should be an appropriate goal? a. Adapt, as necessary, ethnic practices to health needs. b. Attempt, in a nonjudgmental way, to change ethnic beliefs. c. Encourage continuation of ethnic practices in the hospital setting. d. Strive to keep ethnic background from influencing health needs. ANS: A Whenever possible, nurses should facilitate the integration of ethnic practices into health care provision. The ethnic background is part of the individual; it should be difficult to eliminate the influence of ethnic background. The ethnic practices need to be evaluated within the context of the health care setting to determine whether they are conflicting. DIF: Cognitive Level: Applying REF: MCS: 34 TOP: Integrated Process: Caring MSC: Client Needs: Psychosocial Itengrit