WONG’S Essentials of Pediatric Nursing|10th ed chapter 20 questions
and anwers on Pediatric variations of Nursing Interventions
Hockenberry
Chapter 20: Pediatric Variations of Nursing Interventions
Hockenberry: Wong’s Essentials of Pediatric Nursing, 10th Edition
MULTIPLE CHOICE
1. Which should the nurse consider when having consent forms signed for
surgery and procedures on children?
a. Only a parent or legal guardian can give
consent.
b. The person giving consent must be at least
18 years old.
c. The risks and benefits of a procedure are
part of the consent process.
d. A mental age of 7 years or older is
required for a consent to be considered
“informed.”
ANS: C
The informed consent must include the nature of the procedure, benefits and risks, and
alternatives to the procedure. In special circumstances, such as emancipated minors, the
consent can be given by someone younger than 18 years without the parent or legal
guardian. A mental age of 7 years is too young for consent to be informed.
DIF: Cognitive Level: Understand REF: p. 575
TOP: Integrated Process: Nursing Process: Planning
MSC: Area of Client Needs: Safe and Effective Care Environment: Management of Care
2. The nurse is planning to prepare a 4-year-old child for some diagnostic
procedures. Guidelines for preparing this preschooler should include which action?
a. Plan for a short teaching session of about
30 minutes.
b. Tell the child that procedures are never a
form of punishment.
c. Keep equipment out of the child’s view.
d. Use correct scientific and medical
terminology in explanations.
ANS: B
Illness and hospitalization may be viewed as punishment in preschoolers. Always state
directly that procedures are never a form of punishment. Teaching sessions for this age
group should be 10 to 15 minutes in length. Demonstrate the use of equipment, and allow
the child to play with miniature or actual equipment. Explain procedure in simple terms
and how it affects the child.
DIF: Cognitive Level: Apply REF: p. 575
TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Health Promotion and Maintenance
WONG’S Essentials of Pediatric Nursing|10th ed chapter 20 questions
and anwers on Pediatric variations of Nursing Interventions
Hockenberry
,WONG’S Essentials of Pediatric Nursing|10th ed chapter 20 questions
and anwers on Pediatric variations of Nursing Interventions
Hockenberry
3. Katie, 4 years old, is admitted to outpatient surgery for removal of a cyst
on her foot. Her mother puts the hospital gown on her, but Katie is crying because she
wants to leave on her underpants. What is the most appropriate nursing action?
a. Allow her to wear her underpants
b. Discuss with her mother why this is
important to Katie
c. Ask her mother to explain to her why she
cannot wear them
d. Explain in a kind, matter-of-fact manner
that this is hospital policy
ANS: A
It is appropriate for the child to leave her underpants on. This allows her some measure of
control in this procedure, foot surgery. Further discussions may make the child more
upset. Katie is too young to understand what hospital policy means.
DIF: Cognitive Level: Apply REF: p. 578
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Health Promotion and Maintenance
4. Using knowledge of child development, which is the best approach when
preparing a toddler for a procedure?
a. Avoid asking the child to make choices.
b. Demonstrate the procedure on a doll.
c. Plan for the teaching session to last about
20 minutes.
d. Show necessary equipment without
allowing the child to handle it.
ANS: B
Prepare toddlers for procedures by using play. Demonstrate on a doll, but avoid the
child’s favorite doll because the toddler may think the doll is really “feeling” the
procedure. In preparing a toddler for a procedure, allow the child to participate in care
and help whenever possible. Teaching sessions for toddlers should be about 5 to 10
minutes. Use a small replica of the equipment, and allow the child to handle it.
DIF: Cognitive Level: Apply REF: p. 578
TOP: Integrated Process: Nursing Process: Planning
MSC: Area of Client Needs: Health Promotion and Maintenance
5. The nurse is preparing a 12-year-old girl for a bone marrow aspiration.
The girl tells the nurse she wants her mother with her “like before.” What is the most
appropriate nursing action?
a. Grant her request
b. Explain why this is not possible
WONG’S Essentials of Pediatric Nursing|10th ed chapter 20 questions
and anwers on Pediatric variations of Nursing Interventions
Hockenberry
, WONG’S Essentials of Pediatric Nursing|10th ed chapter 20 questions
and anwers on Pediatric variations of Nursing Interventions
Hockenberry
c. Identify an appropriate substitute for her
mother
d. Offer to provide support to her during the
procedure
ANS: A
The parent’s preferences for assisting, observing, or waiting outside the room should be
assessed, along with the child’s preference for parental presence. The child’s choice
should be respected. If the mother and child are agreeable, then the mother is welcome to
stay. An appropriate substitute for the mother is necessary only if the mother does not
wish to stay. Support is offered to the child regardless of parental presence.
DIF: Cognitive Level: Apply REF: p. 596
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Health Promotion and Maintenance
6. The emergency department nurse is cleaning multiple facial abrasions on a
9-year-old child whose mother is present. The child is crying and screaming loudly. What
is the best nursing action?
a. Ask the child to be quieter
b. Have the child’s mother give instructions
about relaxation
c. Tell the child it is okay to cry and scream
d. Remove the mother from the room
ANS: C
The child should be allowed to express feelings of anger, anxiety, fear, frustration, or any
other emotion. The child needs to know it is all right to cry. There is no reason for the
child to be quieter and feelings need to be able to be expressed. The mother should stay in
the room to provide comfort to the child.
DIF: Cognitive Level: Apply REF: p. 577
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Health Promotion and Maintenance
7. In some genetically susceptible children, anesthetic agents can trigger
malignant hyperthermia. The nurse should be alert in observing that, in addition to an
increased temperature, what is an early sign of this disorder?
a. Apnea
b. Bradycardia
c. Muscle rigidity
d. Decreased blood pressure
ANS: C
Early signs of malignant hyperthermia include tachycardia, increasing blood pressure,
tachypnea, mottled skin, and muscle rigidity. Apnea is not a sign of malignant
hyperthermia. Tachycardia, not bradycardia, is an early sign of malignant hyperthermia.
Increased blood pressure, not decreased blood pressure, is characteristic of malignant
WONG’S Essentials of Pediatric Nursing|10th ed chapter 20 questions
and anwers on Pediatric variations of Nursing Interventions
Hockenberry
and anwers on Pediatric variations of Nursing Interventions
Hockenberry
Chapter 20: Pediatric Variations of Nursing Interventions
Hockenberry: Wong’s Essentials of Pediatric Nursing, 10th Edition
MULTIPLE CHOICE
1. Which should the nurse consider when having consent forms signed for
surgery and procedures on children?
a. Only a parent or legal guardian can give
consent.
b. The person giving consent must be at least
18 years old.
c. The risks and benefits of a procedure are
part of the consent process.
d. A mental age of 7 years or older is
required for a consent to be considered
“informed.”
ANS: C
The informed consent must include the nature of the procedure, benefits and risks, and
alternatives to the procedure. In special circumstances, such as emancipated minors, the
consent can be given by someone younger than 18 years without the parent or legal
guardian. A mental age of 7 years is too young for consent to be informed.
DIF: Cognitive Level: Understand REF: p. 575
TOP: Integrated Process: Nursing Process: Planning
MSC: Area of Client Needs: Safe and Effective Care Environment: Management of Care
2. The nurse is planning to prepare a 4-year-old child for some diagnostic
procedures. Guidelines for preparing this preschooler should include which action?
a. Plan for a short teaching session of about
30 minutes.
b. Tell the child that procedures are never a
form of punishment.
c. Keep equipment out of the child’s view.
d. Use correct scientific and medical
terminology in explanations.
ANS: B
Illness and hospitalization may be viewed as punishment in preschoolers. Always state
directly that procedures are never a form of punishment. Teaching sessions for this age
group should be 10 to 15 minutes in length. Demonstrate the use of equipment, and allow
the child to play with miniature or actual equipment. Explain procedure in simple terms
and how it affects the child.
DIF: Cognitive Level: Apply REF: p. 575
TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Health Promotion and Maintenance
WONG’S Essentials of Pediatric Nursing|10th ed chapter 20 questions
and anwers on Pediatric variations of Nursing Interventions
Hockenberry
,WONG’S Essentials of Pediatric Nursing|10th ed chapter 20 questions
and anwers on Pediatric variations of Nursing Interventions
Hockenberry
3. Katie, 4 years old, is admitted to outpatient surgery for removal of a cyst
on her foot. Her mother puts the hospital gown on her, but Katie is crying because she
wants to leave on her underpants. What is the most appropriate nursing action?
a. Allow her to wear her underpants
b. Discuss with her mother why this is
important to Katie
c. Ask her mother to explain to her why she
cannot wear them
d. Explain in a kind, matter-of-fact manner
that this is hospital policy
ANS: A
It is appropriate for the child to leave her underpants on. This allows her some measure of
control in this procedure, foot surgery. Further discussions may make the child more
upset. Katie is too young to understand what hospital policy means.
DIF: Cognitive Level: Apply REF: p. 578
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Health Promotion and Maintenance
4. Using knowledge of child development, which is the best approach when
preparing a toddler for a procedure?
a. Avoid asking the child to make choices.
b. Demonstrate the procedure on a doll.
c. Plan for the teaching session to last about
20 minutes.
d. Show necessary equipment without
allowing the child to handle it.
ANS: B
Prepare toddlers for procedures by using play. Demonstrate on a doll, but avoid the
child’s favorite doll because the toddler may think the doll is really “feeling” the
procedure. In preparing a toddler for a procedure, allow the child to participate in care
and help whenever possible. Teaching sessions for toddlers should be about 5 to 10
minutes. Use a small replica of the equipment, and allow the child to handle it.
DIF: Cognitive Level: Apply REF: p. 578
TOP: Integrated Process: Nursing Process: Planning
MSC: Area of Client Needs: Health Promotion and Maintenance
5. The nurse is preparing a 12-year-old girl for a bone marrow aspiration.
The girl tells the nurse she wants her mother with her “like before.” What is the most
appropriate nursing action?
a. Grant her request
b. Explain why this is not possible
WONG’S Essentials of Pediatric Nursing|10th ed chapter 20 questions
and anwers on Pediatric variations of Nursing Interventions
Hockenberry
, WONG’S Essentials of Pediatric Nursing|10th ed chapter 20 questions
and anwers on Pediatric variations of Nursing Interventions
Hockenberry
c. Identify an appropriate substitute for her
mother
d. Offer to provide support to her during the
procedure
ANS: A
The parent’s preferences for assisting, observing, or waiting outside the room should be
assessed, along with the child’s preference for parental presence. The child’s choice
should be respected. If the mother and child are agreeable, then the mother is welcome to
stay. An appropriate substitute for the mother is necessary only if the mother does not
wish to stay. Support is offered to the child regardless of parental presence.
DIF: Cognitive Level: Apply REF: p. 596
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Health Promotion and Maintenance
6. The emergency department nurse is cleaning multiple facial abrasions on a
9-year-old child whose mother is present. The child is crying and screaming loudly. What
is the best nursing action?
a. Ask the child to be quieter
b. Have the child’s mother give instructions
about relaxation
c. Tell the child it is okay to cry and scream
d. Remove the mother from the room
ANS: C
The child should be allowed to express feelings of anger, anxiety, fear, frustration, or any
other emotion. The child needs to know it is all right to cry. There is no reason for the
child to be quieter and feelings need to be able to be expressed. The mother should stay in
the room to provide comfort to the child.
DIF: Cognitive Level: Apply REF: p. 577
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Health Promotion and Maintenance
7. In some genetically susceptible children, anesthetic agents can trigger
malignant hyperthermia. The nurse should be alert in observing that, in addition to an
increased temperature, what is an early sign of this disorder?
a. Apnea
b. Bradycardia
c. Muscle rigidity
d. Decreased blood pressure
ANS: C
Early signs of malignant hyperthermia include tachycardia, increasing blood pressure,
tachypnea, mottled skin, and muscle rigidity. Apnea is not a sign of malignant
hyperthermia. Tachycardia, not bradycardia, is an early sign of malignant hyperthermia.
Increased blood pressure, not decreased blood pressure, is characteristic of malignant
WONG’S Essentials of Pediatric Nursing|10th ed chapter 20 questions
and anwers on Pediatric variations of Nursing Interventions
Hockenberry
