Chapter 17 My Nursing Test Banks

Ball/Bindler/Cowen, Principles of Pediatric Nursing: Caring for Children 6th Edition Test Bank
Chapter 17

Question 1

Type: MCSA

Concerned parents call the school nurse because of changes in their 15-year-old adolescents behavior. Which behavior would the nurse indicate as indicative of adolescent substance abuse?

1. Buying baggy, oversized clothing at thrift shops and dying her hair black

2. 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

3. Receiving numerous detentions lately from teachers for sleeping in class

4. Becoming very moody, dramatically crying and weeping one minute and then being cheerful and excited the next

Correct Answer: 3

Rationale 1: Mood swings, experimenting with clothes and hair, periodically distancing themselves from their parents, and preferring involvement with their peers are all normal adolescent behaviors. Even though most teens do prefer staying up late, they are not usually so tired that they would fall asleep during the day, especially while engaged in classroom activities. This behavior is abnormal and may indicate involvement with substance abuse or an underlying pathology.

Rationale 2: Mood swings, experimenting with clothes and hair, periodically distancing themselves from their parents, and preferring involvement with their peers are all normal adolescent behaviors. Even though most teens do prefer staying up late, they are not usually so tired that they would fall asleep during the day, especially while engaged in classroom activities. This behavior is abnormal and may indicate involvement with substance abuse or an underlying pathology.

Rationale 3: Mood swings, experimenting with clothes and hair, periodically distancing themselves from their parents, and preferring involvement with their peers are all normal adolescent behaviors. Even though most teens do prefer staying up late, they are not usually so tired that they would fall asleep during the day, especially while engaged in classroom activities. This behavior is abnormal and may indicate involvement with substance abuse or an underlying pathology.

Rationale 4: Mood swings, experimenting with clothes and hair, periodically distancing themselves from their parents, and preferring involvement with their peers are all normal adolescent behaviors. Even though most teens do prefer staying up late, they are not usually so tired that they would fall asleep during the day, especially while engaged in classroom activities. This behavior is abnormal and may indicate involvement with substance abuse or an underlying pathology.

Global Rationale: Mood swings, experimenting with clothes and hair, periodically distancing themselves from their parents, and preferring involvement with their peers are all normal adolescent behaviors. Even though most teens do prefer staying up late, they are not usually so tired that they would fall asleep during the day, especially while engaged in classroom activities. This behavior is abnormal and may indicate involvement with substance abuse or an underlying pathology.

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub: 

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 17.4 Examine the effects of substance use, physical activity, and other lifestyle patterns on health.

Question 2

Type: MCSA

During a well-child exam, the parents of a preschool-age child inform the nurse that they are thinking of buying a television for their childs bedroom and ask for advice as to whether this is appropriate. Which response by the nurse is the most appropriate?

1. Research has shown that children with a television in their bedroom spend significantly less time playing outside than other children, and physical inactivity in children has been linked to many chronic diseases such as obesity and type 2 diabetes.

2. Research has shown that watching educational television shows improves a childs performance in school.

3. Dont buy a television for your childs room; he is much too young for that.

4. 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.

Correct Answer: 1

Rationale 1: Young children need to be physically active at this age. Research has shown that children with a television in their bedroom spend significantly less time playing outside than other children, and physical inactivity in children has been linked to many chronic diseases such as obesity and type 2 diabetes is the best response because it gives the parents an evidence-based rationale for not placing a television in the childs room. Dont buy a television for your childs room; he is much too young for that does not give parents a rationale and may seem opinionated to them. While there may be some truth in the comment Research has shown that watching educational television shows improves a childs performance in school, this statement may encourage increased television watching by the child, and the childs developmental need for physical activity is greater than the benefit that he may obtain by watching educational programs. 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 is correct in that limiting television viewing to less than two hours per day is appropriate, but the probability of this occurring with a television in the childs room is low, and the child will most likely be watching much more than two hours per day.

Rationale 2: Young children need to be physically active at this age. Research has shown that children with a television in their bedroom spend significantly less time playing outside than other children, and physical inactivity in children has been linked to many chronic diseases such as obesity and type 2 diabetes is the best response because it gives the parents an evidence-based rationale for not placing a television in the childs room. Dont buy a television for your childs room; he is much too young for that does not give parents a rationale and may seem opinionated to them. While there may be some truth in the comment Research has shown that watching educational television shows improves a childs performance in school, this statement may encourage increased television watching by the child, and the childs developmental need for physical activity is greater than the benefit that he may obtain by watching educational programs. 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 is correct in that limiting television viewing to less than two hours per day is appropriate, but the probability of this occurring with a television in the childs room is low, and the child will most likely be watching much more than two hours per day.

Rationale 3: Young children need to be physically active at this age. Research has shown that children with a television in their bedroom spend significantly less time playing outside than other children, and physical inactivity in children has been linked to many chronic diseases such as obesity and type 2 diabetes is the best response because it gives the parents an evidence-based rationale for not placing a television in the childs room. Dont buy a television for your childs room; he is much too young for that does not give parents a rationale and may seem opinionated to them. While there may be some truth in the comment Research has shown that watching educational television shows improves a childs performance in school, this statement may encourage increased television watching by the child, and the childs developmental need for physical activity is greater than the benefit that he may obtain by watching educational programs. 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 is correct in that limiting television viewing to less than two hours per day is appropriate, but the probability of this occurring with a television in the childs room is low, and the child will most likely be watching much more than two hours per day.

Rationale 4: Young children need to be physically active at this age. Research has shown that children with a television in their bedroom spend significantly less time playing outside than other children, and physical inactivity in children has been linked to many chronic diseases such as obesity and type 2 diabetes is the best response because it gives the parents an evidence-based rationale for not placing a television in the childs room. Dont buy a television for your childs room; he is much too young for that does not give parents a rationale and may seem opinionated to them. While there may be some truth in the comment Research has shown that watching educational television shows improves a childs performance in school, this statement may encourage increased television watching by the child, and the childs developmental need for physical activity is greater than the benefit that he may obtain by watching educational programs. 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 is correct in that limiting television viewing to less than two hours per day is appropriate, but the probability of this occurring with a television in the childs room is low, and the child will most likely be watching much more than two hours per day.

Global Rationale: Young children need to be physically active at this age. Research has shown that children with a television in their bedroom spend significantly less time playing outside than other children, and physical inactivity in children has been linked to many chronic diseases such as obesity and type 2 diabetes is the best response because it gives the parents an evidence-based rationale for not placing a television in the childs room. Dont buy a television for your childs room; he is much too young for that does not give parents a rationale and may seem opinionated to them. While there may be some truth in the comment Research has shown that watching educational television shows improves a childs performance in school, this statement may encourage increased television watching by the child, and the childs developmental need for physical activity is greater than the benefit that he may obtain by watching educational programs. 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 is correct in that limiting television viewing to less than two hours per day is appropriate, but the probability of this occurring with a television in the childs room is low, and the child will most likely be watching much more than two hours per day.

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub: 

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 17.1 Identify major social and environmental factors that influence the health of children and adolescents.

Question 3

Type: MCSA

A high school student calls to ask the nurse for advice on how to care for a new navel piercing. Which response by the nurse is the most appropriate?

1. Apply warm soaks to the area for the first two days to minimize swelling.

2. Do not move or turn the jewelry for the first three days.

3. Avoid contact with another persons bodily fluids until the area is well healed.

4. Apply lotion to the area, rubbing gently, to prevent skin from becoming dry and irritated.

Correct Answer: 3

Rationale 1: Until the piercing has healed, it is a nonintact area of skin that has potential for infection, especially from contact with bodily fluids from someone else. Ice, not warm soaks, should be applied to the area for the first two days to minimize the swelling. The jewelry needs to be gently rotated several times per day to aid with healing. Lotion can provide a medium for bacteria, and rubbing at the site can cause irritation to the area.

Rationale 2: Until the piercing has healed, it is a nonintact area of skin that has potential for infection, especially from contact with bodily fluids from someone else. Ice, not warm soaks, should be applied to the area for the first two days to minimize the swelling. The jewelry needs to be gently rotated several times per day to aid with healing. Lotion can provide a medium for bacteria, and rubbing at the site can cause irritation to the area.

Rationale 3: Until the piercing has healed, it is a nonintact area of skin that has potential for infection, especially from contact with bodily fluids from someone else. Ice, not warm soaks, should be applied to the area for the first two days to minimize the swelling. The jewelry needs to be gently rotated several times per day to aid with healing. Lotion can provide a medium for bacteria, and rubbing at the site can cause irritation to the area.

Rationale 4: Until the piercing has healed, it is a nonintact area of skin that has potential for infection, especially from contact with bodily fluids from someone else. Ice, not warm soaks, should be applied to the area for the first two days to minimize the swelling. The jewelry needs to be gently rotated several times per day to aid with healing. Lotion can provide a medium for bacteria, and rubbing at the site can cause irritation to the area.

Global Rationale: Until the piercing has healed, it is a nonintact area of skin that has potential for infection, especially from contact with bodily fluids from someone else. Ice, not warm soaks, should be applied to the area for the first two days to minimize the swelling. The jewelry needs to be gently rotated several times per day to aid with healing. Lotion can provide a medium for bacteria, and rubbing at the site can cause irritation to the area.

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub: 

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 17.2  List external influences that influence child and adolescent health.

Question 4

Type: MCSA

While working at a weekend free clinic, the nurse is assessing a toddler when the mother of the child confides that it has been very difficult providing for her family of four children on her limited budget. She is not sure that she has enough money to buy food for the rest of the month and the antibiotic that is needed for the childs ear infection. Which intervention would be the most beneficial for this family?

1. Giving the mother enough free samples of the antibiotic for the recommended course of treatment

2. Putting the mother in contact with a local agency that provides food on a regular basis to needy families and helps them access other resources in the community

3. Talking with the mother about the factors that increase a childs risk of acquiring an ear infection

4. Talking with the mother about the importance of a balanced diet in the growth and development of children and providing her with a list of inexpensive, nutritious foods

Correct Answer: 2

Rationale 1: While most of these are good interventions, putting the mother in contact with a local agency is most likely to meet the familys basic need for food and possibly connect the mother to a resource that could supply her with the antibiotic for her child. Also, many uncomplicated ear infections can resolve without antibiotic treatment. Giving antibiotics will only benefit the child, and the question asks what will benefit the child and family.

Rationale 2: While most of these are good interventions, putting the mother in contact with a local agency is most likely to meet the familys basic need for food and possibly connect the mother to a resource that could supply her with the antibiotic for her child. Also, many uncomplicated ear infections can resolve without antibiotic treatment. Giving antibiotics will only benefit the child, and the question asks what will benefit the child and family.

Rationale 3: While most of these are good interventions, putting the mother in contact with a local agency is most likely to meet the familys basic need for food and possibly connect the mother to a resource that could supply her with the antibiotic for her child. Also, many uncomplicated ear infections can resolve without antibiotic treatment. Giving antibiotics will only benefit the child, and the question asks what will benefit the child and family.

Rationale 4: While most of these are good interventions, putting the mother in contact with a local agency is most likely to meet the familys basic need for food and possibly connect the mother to a resource that could supply her with the antibiotic for her child. Also, many uncomplicated ear infections can resolve without antibiotic treatment. Giving antibiotics will only benefit the child, and the question asks what will benefit the child and family.

Global Rationale: While most of these are good interventions, putting the mother in contact with a local agency is most likely to meet the familys basic need for food and possibly connect the mother to a resource that could supply her with the antibiotic for her child. Also, many uncomplicated ear infections can resolve without antibiotic treatment. Giving antibiotics will only benefit the child, and the question asks what will benefit the child and family.

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub: 

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 17.8 Plan nursing interventions for children related to social and environmental situations.

Question 5

Type: MCSA

A school-age child has been seen in the pediatric clinic three times in the last two months for complaints of abdominal pain. Physical exam and all ordered lab work have been normal. Which question by the nurse would most likely help determine the etiology of the childs abdominal pain?

1. Have there been any changes in your childs school or home life recently?

2. How many meals does your child eat each day?

3. Are your childs immunizations up to date?

4. Has your child had any fevers or viral illnesses in the last three months?

Correct Answer: 1

Rationale 1: With a normal exam and lab work there is a high probability that this childs abdominal pain is stress related, and it is most important to identify the possible stressors in this childs life to aid in diagnosis and treatment. The other questions are also important to ask but are not as relevant to this childs symptoms as Have there been any changes in your childs school or home life recently?

Rationale 2: With a normal exam and lab work there is a high probability that this childs abdominal pain is stress related, and it is most important to identify the possible stressors in this childs life to aid in diagnosis and treatment. The other questions are also important to ask but are not as relevant to this childs symptoms as Have there been any changes in your childs school or home life recently?

Rationale 3: With a normal exam and lab work there is a high probability that this childs abdominal pain is stress related, and it is most important to identify the possible stressors in this childs life to aid in diagnosis and treatment. The other questions are also important to ask but are not as relevant to this childs symptoms as Have there been any changes in your childs school or home life recently?

Rationale 4: With a normal exam and lab work there is a high probability that this childs abdominal pain is stress related, and it is most important to identify the possible stressors in this childs life to aid in diagnosis and treatment. The other questions are also important to ask but are not as relevant to this childs symptoms as Have there been any changes in your childs school or home life recently?

Global Rationale: With a normal exam and lab work there is a high probability that this childs abdominal pain is stress related, and it is most important to identify the possible stressors in this childs life to aid in diagnosis and treatment. The other questions are also important to ask but are not as relevant to this childs symptoms as Have there been any changes in your childs school or home life recently?

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub: 

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 17.1 Identify major social and environmental factors that influence the health of children and adolescents.

Question 6

Type: MCSA

A recently divorced mother who must return to work is concerned about the effects of placing her child in day care full time. In counseling the mother, which factor does the nurse share as the most influential in determining whether or not day care has a positive or negative effect on the child?

1. The ratio of day-care workers to children

2. The closeness of the parentchild relationship

3. The amount of time that the children spend playing outside

4. The cleanliness of the facility

Correct Answer: 2

Rationale 1: While the ratio of child-care workers to the children, the cleanliness of the facility, and how much time the children are able to spend playing outdoors all can contribute to whether or not child care is a positive or negative experience, the closeness of the parentchild relationship is more likely to impact how resilient the child is, and this has a greater impact on the effects of the child-care experience.

Rationale 2: While the ratio of child-care workers to the children, the cleanliness of the facility, and how much time the children are able to spend playing outdoors all can contribute to whether or not child care is a positive or negative experience, the closeness of the parentchild relationship is more likely to impact how resilient the child is, and this has a greater impact on the effects of the child-care experience.

Rationale 3: While the ratio of child-care workers to the children, the cleanliness of the facility, and how much time the children are able to spend playing outdoors all can contribute to whether or not child care is a positive or negative experience, the closeness of the parentchild relationship is more likely to impact how resilient the child is, and this has a greater impact on the effects of the child-care experience.

Rationale 4: While the ratio of child-care workers to the children, the cleanliness of the facility, and how much time the children are able to spend playing outdoors all can contribute to whether or not child care is a positive or negative experience, the closeness of the parentchild relationship is more likely to impact how resilient the child is, and this has a greater impact on the effects of the child-care experience.

Global Rationale: While the ratio of child-care workers to the children, the cleanliness of the facility, and how much time the children are able to spend playing outdoors all can contribute to whether or not child care is a positive or negative experience, the closeness of the parentchild relationship is more likely to impact how resilient the child is, and this has a greater impact on the effects of the child-care experience.

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub: 

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 17.1 Identify major social and environmental factors that influence the health of children and adolescents.

Question 7

Type: MCSA

When examining a toddler-age child during a well-child physical, which assessment is the priority?

1. Visual acuity

2. Helmet use

3. Risk of lead exposure

4. Whether household drinking water contains fluorine

Correct Answer: 3

Rationale 1: Elevated lead levels are neurotoxic to young children and, if untreated, can cause irreparable neurological damage. Visual acuity may be difficult to accurately assess at this age secondary to the childs compliance and ability to understand the directions for the screening test. While teaching helmet use at an early age is important, it is unlikely that this child is riding a bicycle yet, and although early exposure to fluorine is important for good dental health, lack of fluorinated drinking water will not be as harmful to the child as toxic lead levels.

Rationale 2: Elevated lead levels are neurotoxic to young children and, if untreated, can cause irreparable neurological damage. Visual acuity may be difficult to accurately assess at this age secondary to the childs compliance and ability to understand the directions for the screening test. While teaching helmet use at an early age is important, it is unlikely that this child is riding a bicycle yet, and although early exposure to fluorine is important for good dental health, lack of fluorinated drinking water will not be as harmful to the child as toxic lead levels.

Rationale 3: Elevated lead levels are neurotoxic to young children and, if untreated, can cause irreparable neurological damage. Visual acuity may be difficult to accurately assess at this age secondary to the childs compliance and ability to understand the directions for the screening test. While teaching helmet use at an early age is important, it is unlikely that this child is riding a bicycle yet, and although early exposure to fluorine is important for good dental health, lack of fluorinated drinking water will not be as harmful to the child as toxic lead levels.

Rationale 4: Elevated lead levels are neurotoxic to young children and, if untreated, can cause irreparable neurological damage. Visual acuity may be difficult to accurately assess at this age secondary to the childs compliance and ability to understand the directions for the screening test. While teaching helmet use at an early age is important, it is unlikely that this child is riding a bicycle yet, and although early exposure to fluorine is important for good dental health, lack of fluorinated drinking water will not be as harmful to the child as toxic lead levels.

Global Rationale: Elevated lead levels are neurotoxic to young children and, if untreated, can cause irreparable neurological damage. Visual acuity may be difficult to accurately assess at this age secondary to the childs compliance and ability to understand the directions for the screening test. While teaching helmet use at an early age is important, it is unlikely that this child is riding a bicycle yet, and although early exposure to fluorine is important for good dental health, lack of fluorinated drinking water will not be as harmful to the child as toxic lead levels.

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub: 

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 17.6 Evaluate the environment for hazards to children, such as exposure to harmful substances and potential for poisoning.

Question 8

Type: MCSA

The nurse is conducting a health promotion class for adolescents. In counseling an adolescent about lifestyle choices, what should the adolescent eliminate in order to decrease the risk of the most preventable cause of adult death?

1. Alcohol use

2. Obesity

3. Tobacco use

4. Cocaine use

Correct Answer: 3

Rationale 1: Although all of these factors are preventable causes of mortality in the United States, tobacco use accounts for 438,000 deaths annually and is the most preventable cause of adult death.

Rationale 2: Although all of these factors are preventable causes of mortality in the United States, tobacco use accounts for 438,000 deaths annually and is the most preventable cause of adult death.

Rationale 3: Although all of these factors are preventable causes of mortality in the United States, tobacco use accounts for 438,000 deaths annually and is the most preventable cause of adult death.

Rationale 4: Although all of these factors are preventable causes of mortality in the United States, tobacco use accounts for 438,000 deaths annually and is the most preventable cause of adult death.

Global Rationale: Although all of these factors are preventable causes of mortality in the United States, tobacco use accounts for 438,000 deaths annually and is the most preventable cause of adult death.

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub: 

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 17.4 Examine the effects of substance use, physical activity, and other lifestyle patterns on health.

Question 9

Type: MCSA

The school nurse is planning a smoking-prevention program for middle school students. Which intervention is most likely to be effective in preventing middle school children from smoking?

1. Having a local high school basketball star come to talk to the students about the importance of not smoking

2. Having the schools biology teacher demonstrate the pathophysiology of the effects of smoking tobacco on the body

3. Developing colorful posters with catchy slogans and placing them all over the school

4. Having a pledge campaign with prizes awarded, during which students sign contracts saying that they will not use tobacco products

Correct Answer: 1

Rationale 1: While all of the strategies are good, the most effective tip would be to have a local high school basketball star come to talk to the students about the importance of not smoking, because students at this age are more likely to listen to and attempt to emulate someone of their own peer group whom they respect and look up to. Information from adults, posters, and signed contracts are not as likely to influence children of this age more than the pressure of their peers.

Rationale 2: While all of the strategies are good, the most effective tip would be to have a local high school basketball star come to talk to the students about the importance of not smoking, because students at this age are more likely to listen to and attempt to emulate someone of their own peer group whom they respect and look up to. Information from adults, posters, and signed contracts are not as likely to influence children of this age more than the pressure of their peers.

Rationale 3: While all of the strategies are good, the most effective tip would be to have a local high school basketball star come to talk to the students about the importance of not smoking, because students at this age are more likely to listen to and attempt to emulate someone of their own peer group whom they respect and look up to. Information from adults, posters, and signed contracts are not as likely to influence children of this age more than the pressure of their peers.

Rationale 4: While all of the strategies are good, the most effective tip would be to have a local high school basketball star come to talk to the students about the importance of not smoking, because students at this age are more likely to listen to and attempt to emulate someone of their own peer group whom they respect and look up to. Information from adults, posters, and signed contracts are not as likely to influence children of this age more than the pressure of their peers.

Global Rationale: While all of the strategies are good, the most effective tip would be to have a local high school basketball star come to talk to the students about the importance of not smoking, because students at this age are more likely to listen to and attempt to emulate someone of their own peer group whom they respect and look up to. Information from adults, posters, and signed contracts are not as likely to influence children of this age more than the pressure of their peers.

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub: 

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 17.8 Plan nursing interventions for children related to social and environmental situations.

Question 10

Type: MCMA

While the nurse is conducting the history of a school-age child, the parents admit to owning firearms. Which safety measures are appropriate to include in the teaching plan for this family?

Standard Text: Select all that apply.

1. Using a gun lock on all firearms in the house

2. Taking the child to a shooting range for lessons on how to use a gun properly

3. Storing the guns and ammunition in separate places

4. Keeping all the guns in a locked cabinet

5. Explaining the dangers of a gun to the child and telling her explicitly to never touch it

Correct Answer: 1,3,4

Rationale 1: Over 4,000 youth from 10 to 19 years old die from firearm homicides annually, and approximately 1500 additional youth die from firearm suicide. Firearm homicide is the second leading cause of injury death for youth, and firearm suicide is the fifth leading cause of injury death for youth (CDC, 2011c). The safety measures of using a gun lock, keeping the gun and ammunition separate, and putting the guns in a locked cabinet will at least make the guns less accessible. Telling a child that a gun is dangerous and not to be touched will probably make it more fascinating. Even with knowledge of the proper use of a firearm, a 10-year-old childs judgment may not be mature enough to prevent misuse of it.

Rationale 2: Over 4,000 youth from 10 to 19 years old die from firearm homicides annually, and approximately 1500 additional youth die from firearm suicide. Firearm homicide is the second leading cause of injury death for youth, and firearm suicide is the fifth leading cause of injury death for youth (CDC, 2011c). The safety measures of using a gun lock, keeping the gun and ammunition separate, and putting the guns in a locked cabinet will at least make the guns less accessible. Telling a child that a gun is dangerous and not to be touched will probably make it more fascinating. Even with knowledge of the proper use of a firearm, a 10-year-old childs judgment may not be mature enough to prevent misuse of it.

Rationale 3: Over 4,000 youth from 10 to 19 years old die from firearm homicides annually, and approximately 1500 additional youth die from firearm suicide. Firearm homicide is the second leading cause of injury death for youth, and firearm suicide is the fifth leading cause of injury death for youth (CDC, 2011c). The safety measures of using a gun lock, keeping the gun and ammunition separate, and putting the guns in a locked cabinet will at least make the guns less accessible. Telling a child that a gun is dangerous and not to be touched will probably make it more fascinating. Even with knowledge of the proper use of a firearm, a 10-year-old childs judgment may not be mature enough to prevent misuse of it.

Rationale 4: Over 4,000 youth from 10 to 19 years old die from firearm homicides annually, and approximately 1500 additional youth die from firearm suicide. Firearm homicide is the second leading cause of injury death for youth, and firearm suicide is the fifth leading cause of injury death for youth (CDC, 2011c). The safety measures of using a gun lock, keeping the gun and ammunition separate, and putting the guns in a locked cabinet will at least make the guns less accessible. Telling a child that a gun is dangerous and not to be touched will probably make it more fascinating. Even with knowledge of the proper use of a firearm, a 10-year-old childs judgment may not be mature enough to prevent misuse of it.

Rationale 5: Over 4,000 youth from 10 to 19 years old die from firearm homicides annually, and approximately 1500 additional youth die from firearm suicide. Firearm homicide is the second leading cause of injury death for youth, and firearm suicide is the fifth leading cause of injury death for youth (CDC, 2011c). The safety measures of using a gun lock, keeping the gun and ammunition separate, and putting the guns in a locked cabinet will at least make the guns less accessible. Telling a child that a gun is dangerous and not to be touched will probably make it more fascinating. Even with knowledge of the proper use of a firearm, a 10-year-old childs judgment may not be mature enough to prevent misuse of it.

Global Rationale: Over 4,000 youth from 10 to 19 years old die from firearm homicides annually, and approximately 1500 additional youth die from firearm suicide. Firearm homicide is the second leading cause of injury death for youth, and firearm suicide is the fifth leading cause of injury death for youth (CDC, 2011c). The safety measures of using a gun lock, keeping the gun and ammunition separate, and putting the guns in a locked cabinet will at least make the guns less accessible. Telling a child that a gun is dangerous and not to be touched will probably make it more fascinating. Even with knowledge of the proper use of a firearm, a 10-year-old childs judgment may not be mature enough to prevent misuse of it.

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub: 

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 17.7 Explore the nursing role in prevention and treatment of child abuse and neglect and other forms of violence.

Question 11

Type: MCSA

In counseling an adolescent female about safe sex practices, which question is the most appropriate for the nurse to ask?

1. Do you and your boyfriend use a condom every time you have sex?

2. Do you have a boyfriend, and if so, are you sexually active?

3. Do you have one or more sexual partners?

4. Have you and your boyfriend ever had unprotected sex?

Correct Answer: 3

Rationale 1: Do you have one or more sexual partners? provides the adolescent an opportunity to discuss sexual practices in a homosexual or alternative relationship if this applies to her. All of the other questions assume that the adolescent is involved in heterosexual relationships.

Rationale 2: Do you have one or more sexual partners? provides the adolescent an opportunity to discuss sexual practices in a homosexual or alternative relationship if this applies to her. All of the other questions assume that the adolescent is involved in heterosexual relationships.

Rationale 3: Do you have one or more sexual partners? provides the adolescent an opportunity to discuss sexual practices in a homosexual or alternative relationship if this applies to her. All of the other questions assume that the adolescent is involved in heterosexual relationships.

Rationale 4: Do you have one or more sexual partners? provides the adolescent an opportunity to discuss sexual practices in a homosexual or alternative relationship if this applies to her. All of the other questions assume that the adolescent is involved in heterosexual relationships.

Global Rationale: Do you have one or more sexual partners? provides the adolescent an opportunity to discuss sexual practices in a homosexual or alternative relationship if this applies to her. All of the other questions assume that the adolescent is involved in heterosexual relationships.

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub: 

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 17.4 Examine the effects of substance use, physical activity, and other lifestyle patterns on health.

Question 12

Type: MCSA

A mother of two school-age children tells the nurse that her husband has recently been deployed overseas. The mother is concerned about the childrens constant interest in watching TV news coverage of military activities overseas. Which suggestion from the nurse is the most appropriate?

1. Allow the children to watch as much television as they want. This is how they are coping with their fathers absence.

2. It will just take some time to adjust to their fathers absence, then everything will return to normal.

3. The less that you discuss this, the quicker the children will adjust to their fathers absence. Try to keep them busy, and use distractions to keep their mind off of it.

4. Spend time with your children and take cues from them about how much they want to discuss.

Correct Answer: 4

Rationale 1: Constant viewing of the TV coverage of the war may increase the childrens anxiety and fear for their fathers safety. The mother should be aware that even though the children may appear to have adjusted, there may be delayed reactions or regressions in behavior. Children need to be able to discuss their feelings and concerns with an adult; otherwise, their emotional distress may increase.

Rationale 2: Constant viewing of the TV coverage of the war may increase the childrens anxiety and fear for their fathers safety. The mother should be aware that even though the children may appear to have adjusted, there may be delayed reactions or regressions in behavior. Children need to be able to discuss their feelings and concerns with an adult; otherwise, their emotional distress may increase.

Rationale 3: Constant viewing of the TV coverage of the war may increase the childrens anxiety and fear for their fathers safety. The mother should be aware that even though the children may appear to have adjusted, there may be delayed reactions or regressions in behavior. Children need to be able to discuss their feelings and concerns with an adult; otherwise, their emotional distress may increase.

Rationale 4: Constant viewing of the TV coverage of the war may increase the childrens anxiety and fear for their fathers safety. The mother should be aware that even though the children may appear to have adjusted, there may be delayed reactions or regressions in behavior. Children need to be able to discuss their feelings and concerns with an adult; otherwise, their emotional distress may increase.

Global Rationale: Constant viewing of the TV coverage of the war may increase the childrens anxiety and fear for their fathers safety. The mother should be aware that even though the children may appear to have adjusted, there may be delayed reactions or regressions in behavior. Children need to be able to discuss their feelings and concerns with an adult; otherwise, their emotional distress may increase.

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub: 

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 17.2 List external influences that influence child and adolescent health.

Question 13

Type: MCSA

The pediatric nurse is working with a parent who is suspected of Mnchausen Syndrome by Proxy. Which action by the nurse is the priority?

1. Confront the parent with concerns of possible abuse.

2. Carefully document parentchild interactions.

3. Try to keep the parent separated from the child as much as possible.

4. Explain to the child that the parent is causing the illness and that the health team will prevent the child from being harmed.

Correct Answer: 2

Rationale 1: Mnchausen Syndrome by Proxy is very difficult to prove, and evidence provided by the careful documentation of the nursing staff can be very influential. Care must be taken not to make the parent suspicious and to keep the child in the hospital until enough evidence is collected. Confronting the parent or separating the parent from the child may alienate the parent and cause him or her to leave with the child. Talking to the child about the health-care teams suspicions may be confusing and frightening for the child.

Rationale 2: Mnchausen Syndrome by Proxy is very difficult to prove, and evidence provided by the careful documentation of the nursing staff can be very influential. Care must be taken not to make the parent suspicious and to keep the child in the hospital until enough evidence is collected. Confronting the parent or separating the parent from the child may alienate the parent and cause him or her to leave with the child. Talking to the child about the health-care teams suspicions may be confusing and frightening for the child.

Rationale 3: Mnchausen Syndrome by Proxy is very difficult to prove, and evidence provided by the careful documentation of the nursing staff can be very influential. Care must be taken not to make the parent suspicious and to keep the child in the hospital until enough evidence is collected. Confronting the parent or separating the parent from the child may alienate the parent and cause him or her to leave with the child. Talking to the child about the health-care teams suspicions may be confusing and frightening for the child.

Rationale 4: Mnchausen Syndrome by Proxy is very difficult to prove, and evidence provided by the careful documentation of the nursing staff can be very influential. Care must be taken not to make the parent suspicious and to keep the child in the hospital until enough evidence is collected. Confronting the parent or separating the parent from the child may alienate the parent and cause him or her to leave with the child. Talking to the child about the health-care teams suspicions may be confusing and frightening for the child.

Global Rationale: Mnchausen Syndrome by Proxy is very difficult to prove, and evidence provided by the careful documentation of the nursing staff can be very influential. Care must be taken not to make the parent suspicious and to keep the child in the hospital until enough evidence is collected. Confronting the parent or separating the parent from the child may alienate the parent and cause him or her to leave with the child. Talking to the child about the health-care teams suspicions may be confusing and frightening for the child.

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Safety and Infection Control

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 17.7 Explore the nursing role in prevention and treatment of child abuse and neglect and other forms of violence.

Question 14

Type: MCSA

A child is admitted to the hospital unit with physical injuries. The nurse is taking the childs history. Which statement by the parent would arouse suspicion of abuse?

1. I did not realize that my baby was able to roll over yet, and I was just gone a minute to check on dinner when the baby rolled off of the couch and onto our tile floor.

2. The babys 18-month-old brother was trying to pull the baby out of the crib and dropped the baby on the floor.

3. I placed the baby in the infant swing. His 6-year-old brother was running through the house and tripped over the swing, causing it to fall.

4. I was walking up the steps and slipped on the ice, falling while carrying my baby.

Correct Answer: 2

Rationale 1: All of the statements made by the parent are plausible from a developmental perspective except the statement The babys 18-month-old brother was trying to pull the baby out of the crib and dropped the baby on the floor. Developmentally, it would be very difficult for an 18-month-old child to pull an infant out of a crib.

Rationale 2: All of the statements made by the parent are plausible from a developmental perspective except the statement The babys 18-month-old brother was trying to pull the baby out of the crib and dropped the baby on the floor. Developmentally, it would be very difficult for an 18-month-old child to pull an infant out of a crib.

Rationale 3: All of the statements made by the parent are plausible from a developmental perspective except the statement The babys 18-month-old brother was trying to pull the baby out of the crib and dropped the baby on the floor. Developmentally, it would be very difficult for an 18-month-old child to pull an infant out of a crib.

Rationale 4: All of the statements made by the parent are plausible from a developmental perspective except the statement The babys 18-month-old brother was trying to pull the baby out of the crib and dropped the baby on the floor. Developmentally, it would be very difficult for an 18-month-old child to pull an infant out of a crib.

Global Rationale: All of the statements made by the parent are plausible from a developmental perspective except the statement The babys 18-month-old brother was trying to pull the baby out of the crib and dropped the baby on the floor. Developmentally, it would be very difficult for an 18-month-old child to pull an infant out of a crib.

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub: 

Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome: LO 17.7 Explore the nursing role in prevention and treatment of child abuse and neglect and other forms of violence.

Question 15

Type: MCSA

The nurse is providing care to a toddler-age child. Which assessment finding is indicative of abuse?

1. Parents indicating that they did not see the event occur

2. Inconsistency of stories between caregivers

3. Bruising noted on the knees and shins

4. Acting out behavior of the child

Correct Answer: 2

Rationale 1: Inconsistency of stories is a red flag for abuse. All other answers are logical explanations for this age group.

Rationale 2: Inconsistency of stories is a red flag for abuse. All other answers are logical explanations for this age group.

Rationale 3: Inconsistency of stories is a red flag for abuse. All other answers are logical explanations for this age group.

Rationale 4: Inconsistency of stories is a red flag for abuse. All other answers are logical explanations for this age group.

Global Rationale: Inconsistency of stories is a red flag for abuse. All other answers are logical explanations for this age group.

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Safety and Infection Control

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 17.7 Explore the nursing role in prevention and treatment of child abuse and neglect and other forms of violence.

Question 16

Type: MCSA

The nurse teaches a group of parents strategies to reduce the risk of lead exposure for their children. Which statements indicate an appropriate understanding of the content presented?

Standard Text: Select all that apply.

1. We will provide our child with frequent snacks high in iron and calcium.

2. We will wash any surfaces that have peeling paint.

3. We will store leftovers in a ceramic pot.

4. We can continue to use our traditional-medicine treatment, azarcon, for any GI upset.

5. We will sand the windowsills to remove the lead-based paint.

Correct Answer: 1,2

Rationale 1: Snacks and meals high in iron and calcium should be encouraged. Lead is absorbed more readily on an empty stomach. Any surface with peeling paint should be washed with a damp sponge. Ceramic pots, if fired improperly, could contain lead. Food should not be prepared or stored in them. Azarcon, a traditional medicine used to treat a coliclike illness, may contain large amounts of lead. Sanding the windowsills will cause the lead to be dispersed in the air, leading to lead poisoning.

Rationale 2: Snacks and meals high in iron and calcium should be encouraged. Lead is absorbed more readily on an empty stomach. Any surface with peeling paint should be washed with a damp sponge. Ceramic pots, if fired improperly, could contain lead. Food should not be prepared or stored in them. Azarcon, a traditional medicine used to treat a coliclike illness, may contain large amounts of lead. Sanding the windowsills will cause the lead to be dispersed in the air, leading to lead poisoning.

Rationale 3: Snacks and meals high in iron and calcium should be encouraged. Lead is absorbed more readily on an empty stomach. Any surface with peeling paint should be washed with a damp sponge. Ceramic pots, if fired improperly, could contain lead. Food should not be prepared or stored in them. Azarcon, a traditional medicine used to treat a coliclike illness, may contain large amounts of lead. Sanding the windowsills will cause the lead to be dispersed in the air, leading to lead poisoning.

Rationale 4: Snacks and meals high in iron and calcium should be encouraged. Lead is absorbed more readily on an empty stomach. Any surface with peeling paint should be washed with a damp sponge. Ceramic pots, if fired improperly, could contain lead. Food should not be prepared or stored in them. Azarcon, a traditional medicine used to treat a coliclike illness, may contain large amounts of lead. Sanding the windowsills will cause the lead to be dispersed in the air, leading to lead poisoning.

Rationale 5: Snacks and meals high in iron and calcium should be encouraged. Lead is absorbed more readily on an empty stomach. Any surface with peeling paint should be washed with a damp sponge. Ceramic pots, if fired improperly, could contain lead. Food should not be prepared or stored in them. Azarcon, a traditional medicine used to treat a coliclike illness, may contain large amounts of lead. Sanding the windowsills will cause the lead to be dispersed in the air, leading to lead poisoning.

Global Rationale: Snacks and meals high in iron and calcium should be encouraged. Lead is absorbed more readily on an empty stomach. Any surface with peeling paint should be washed with a damp sponge. Ceramic pots, if fired improperly, could contain lead. Food should not be prepared or stored in them. Azarcon, a traditional medicine used to treat a coliclike illness, may contain large amounts of lead. Sanding the windowsills will cause the lead to be dispersed in the air, leading to lead poisoning.

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub: 

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: LO 17.6 Evaluate the environment for hazards to children, such as exposure to harmful substances and potential for poisoning.

Question 17

Type: MCMA

The school nurse is implementing a program to decrease bullying. Which interventions are appropriate for the school nurse to implement?

Standard Text: Select all that apply.

1. Train teachers about the behaviors

2. Ensure adult supervision in the hallways

3. Teach children to report behaviors

4. Ensure that immunizations are up-to-date

5. Set up anti-hazing policies

Correct Answer: 1,2,3

Rationale 1: Appropriate interventions for the school nurse to implement when dealing with bullying in a school include training the teachers on the signs of bullying; ensuring adult supervision in the hallways, as this is where bullying tends to take place; and teach children to report bullying behaviors. Ensuring that immunizations are up to date is not an intervention aimed at decreasing bullying. Hazing and bullying are two separate problems.

Rationale 2: Appropriate interventions for the school nurse to implement when dealing with bullying in a school include training the teachers on the signs of bullying; ensuring adult supervision in the hallways, as this is where bullying tends to take place; and teach children to report bullying behaviors. Ensuring that immunizations are up to date is not an intervention aimed at decreasing bullying. Hazing and bullying are two separate problems.

Rationale 3: Appropriate interventions for the school nurse to implement when dealing with bullying in a school include training the teachers on the signs of bullying; ensuring adult supervision in the hallways, as this is where bullying tends to take place; and teach children to report bullying behaviors. Ensuring that immunizations are up to date is not an intervention aimed at decreasing bullying. Hazing and bullying are two separate problems.

Rationale 4: Appropriate interventions for the school nurse to implement when dealing with bullying in a school include training the teachers on the signs of bullying; ensuring adult supervision in the hallways, as this is where bullying tends to take place; and teach children to report bullying behaviors. Ensuring that immunizations are up to date is not an intervention aimed at decreasing bullying. Hazing and bullying are two separate problems.

Rationale 5: Appropriate interventions for the school nurse to implement when dealing with bullying in a school include training the teachers on the signs of bullying; ensuring adult supervision in the hallways, as this is where bullying tends to take place; and teach children to report bullying behaviors. Ensuring that immunizations are up to date is not an intervention aimed at decreasing bullying. Hazing and bullying are two separate problems.

Global Rationale: Appropriate interventions for the school nurse to implement when dealing with bullying in a school include training the teachers on the signs of bullying; ensuring adult supervision in the hallways, as this is where bullying tends to take place; and teach children to report bullying behaviors. Ensuring that immunizations are up to date is not an intervention aimed at decreasing bullying. Hazing and bullying are two separate problems.

Cognitive Level: Applying

Client Need: Safe and Effective Care Environment

Client Need Sub: Safety and Infection Control

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 17.5 Plan nursing interventions for children who experience violence.

Question 18

Type: MCMA

The nurse is conducting an admission assessment for a preschool-age client in the emergency department. When using the resiliency theory, which findings place this client at risk?

Standard Text: Select all that apply.

1. Loss of health insurance

2. No primary care provider

3. Incomplete immunizations

4. A grandmother who is able to room-in

5. High level language skills from the child

Correct Answer: 1,2,3

Rationale 1: When using the resiliency theory, a child and family will have both protective and risk factors. Risk factors include lack of health insurance, not having a consistent care provider, and incomplete immunizations. Protective factors include a parent or family member being able to room-in with the child, a family who is able to stay with the other children in the family, and a child with the ability to communicate needs to the hospital staff.

Rationale 2: When using the resiliency theory, a child and family will have both protective and risk factors. Risk factors include lack of health insurance, not having a consistent care provider, and incomplete immunizations. Protective factors include a parent or family member being able to room-in with the child, a family who is able to stay with the other children in the family, and a child with the ability to communicate needs to the hospital staff.

Rationale 3: When using the resiliency theory, a child and family will have both protective and risk factors. Risk factors include lack of health insurance, not having a consistent care provider, and incomplete immunizations. Protective factors include a parent or family member being able to room-in with the child, a family who is able to stay with the other children in the family, and a child with the ability to communicate needs to the hospital staff.

Rationale 4: When using the resiliency theory, a child and family will have both protective and risk factors. Risk factors include lack of health insurance, not having a consistent care provider, and incomplete immunizations. Protective factors include a parent or family member being able to room-in with the child, a family who is able to stay with the other children in the family, and a child with the ability to communicate needs to the hospital staff.

Rationale 5: When using the resiliency theory, a child and family will have both protective and risk factors. Risk factors include lack of health insurance, not having a consistent care provider, and incomplete immunizations. Protective factors include a parent or family member being able to room-in with the child, a family who is able to stay with the other children in the family, and a child with the ability to communicate needs to the hospital staff.

Global Rationale: When using the resiliency theory, a child and family will have both protective and risk factors.  Risk factors include lack of health insurance, not having a consistent care provider, and incomplete immunizations. Protective factors include a parent or family member being able to room-in with the child, a family who is able to stay with the other children in the family, and a child with the ability to communicate needs to the hospital staff.

Cognitive Level: Applying

Client Need: Safe and Effective Care Environment

Client Need Sub: Safety and Infection Control

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 17.3 Apply the ecologic model and resiliency theory to assessment of the social and environmental factors in childrens lives

Ball/Bindler/Cowen, Principles of Pediatric Nursing 6th Ed. Test Bank

Copyright 2015 by Pearson Education, Inc.

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