Chapter 23 My Nursing Test Banks

Ball/Bindler/Cowen, Principles of Pediatric Nursing: Caring for Children 5th Edition Test Bank
Chapter 23

Question 1

Type: MCSA

The nurse is evaluating the activity tolerance of a 9-month-old with iron deficiency anemia. The finding that indicates the child is tolerating activity is

1. HR of 150.

2. Decreased alertness.

3. Respiratory rate less than 40 with activity.

4. Muscle weakness.

Correct Answer: 3

Rationale 1: Iron deficiency anemia can result in less oxygen reaching the cells and tissues, causing activity intolerance. An indication that a 9-month-old child is tolerating activity and that iron deficiency anemia is resolving would be the childs maintaining a respiratory rate of less than 40 (within a normal range for this age) during activity. Tachycardia (HR > 150), decreased alertness, and muscle weakness are all signs that iron deficiency anemia is not resolving and activity tolerance is not improving.

Rationale 2: Iron deficiency anemia can result in less oxygen reaching the cells and tissues, causing activity intolerance. An indication that a 9-month-old child is tolerating activity and that iron deficiency anemia is resolving would be the childs maintaining a respiratory rate of less than 40 (within a normal range for this age) during activity. Tachycardia (HR > 150), decreased alertness, and muscle weakness are all signs that iron deficiency anemia is not resolving and activity tolerance is not improving.

Rationale 3: Iron deficiency anemia can result in less oxygen reaching the cells and tissues, causing activity intolerance. An indication that a 9-month-old child is tolerating activity and that iron deficiency anemia is resolving would be the childs maintaining a respiratory rate of less than 40 (within a normal range for this age) during activity. Tachycardia (HR > 150), decreased alertness, and muscle weakness are all signs that iron deficiency anemia is not resolving and activity tolerance is not improving.

Rationale 4: Iron deficiency anemia can result in less oxygen reaching the cells and tissues, causing activity intolerance. An indication that a 9-month-old child is tolerating activity and that iron deficiency anemia is resolving would be the childs maintaining a respiratory rate of less than 40 (within a normal range for this age) during activity. Tachycardia (HR > 150), decreased alertness, and muscle weakness are all signs that iron deficiency anemia is not resolving and activity tolerance is not improving.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: LO 02. Summarize the etiology, clinical manifestations, and nursing care for a child with iron deficiency anemia.

Question 2

Type: MCSA

Parents demonstrate understanding of the nurses teaching with regard to prevention of iron-deficient anemia if they

1. Feed their infant with a formula that is not iron fortified.

2. Start iron-fortified infant cereal at 4 to 6 months of age.

3. Introduce cows milk at 6 months of age.

4. Limit vitamin C consumption after 1 year of age.

Correct Answer: 2

Rationale 1: Starting iron-fortified infant cereal at 4 to 6 months of age is recommended for prevention of iron deficiency in children. Infants who are not breast-fed should get iron-fortified formula. Cows milk should not be introduced until 12 months of age. Vitamin C should be started at 6 to 9 months of age and continued, because foods rich in vitamin C improve iron absorption.

Rationale 2: Starting iron-fortified infant cereal at 4 to 6 months of age is recommended for prevention of iron deficiency in children. Infants who are not breast-fed should get iron-fortified formula. Cows milk should not be introduced until 12 months of age. Vitamin C should be started at 6 to 9 months of age and continued, because foods rich in vitamin C improve iron absorption.

Rationale 3: Starting iron-fortified infant cereal at 4 to 6 months of age is recommended for prevention of iron deficiency in children. Infants who are not breast-fed should get iron-fortified formula. Cows milk should not be introduced until 12 months of age. Vitamin C should be started at 6 to 9 months of age and continued, because foods rich in vitamin C improve iron absorption.

Rationale 4: Starting iron-fortified infant cereal at 4 to 6 months of age is recommended for prevention of iron deficiency in children. Infants who are not breast-fed should get iron-fortified formula. Cows milk should not be introduced until 12 months of age. Vitamin C should be started at 6 to 9 months of age and continued, because foods rich in vitamin C improve iron absorption.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: LO 02. Summarize the etiology, clinical manifestations, and nursing care for a child with iron deficiency anemia.

Question 3

Type: MCSA

A child has been diagnosed with sickle cell disease. The parents are unsure how their child contracted the disease. The nurse should explain that

1. The mother and the father of the child have the sickle cell trait.

2. The mother of the child has the trait, but the father doesnt.

3. The father of the child has the trait, but the mother doesnt.

4. The mother of the child has sickle cell disease, but the father doesnt have the disease or the trait.

Correct Answer: 1

Rationale 1: Sickle cell disease is an autosomal recessive disorder; both parents must have the trait in order for a child to have the disease.

Rationale 2: Sickle cell disease is an autosomal recessive disorder; both parents must have the trait in order for a child to have the disease.

Rationale 3: Sickle cell disease is an autosomal recessive disorder; both parents must have the trait in order for a child to have the disease.

Rationale 4: Sickle cell disease is an autosomal recessive disorder; both parents must have the trait in order for a child to have the disease.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 03. Distinguish pathophysiology and clinical manifestations for chronic disorders of red blood cells.

Question 4

Type: MCSA

You are the nurse in charge on a pediatric unit. A child with sickle cell disease, in splenic sequestration crisis, is being admitted. You would assign this client to a

1. Semiprivate room.

2. Reverse-isolation room.

3. Contact-isolation room.

4. Private room.

Correct Answer: 4

Rationale 1: Splenic sequestration can be life-threatening, and there is profound anemia. The child does not need an isolation room but should not be placed in a room with any child who may have an infectious illness. The private room is appropriate for this child.

Rationale 2: Splenic sequestration can be life-threatening, and there is profound anemia. The child does not need an isolation room but should not be placed in a room with any child who may have an infectious illness. The private room is appropriate for this child.

Rationale 3: Splenic sequestration can be life-threatening, and there is profound anemia. The child does not need an isolation room but should not be placed in a room with any child who may have an infectious illness. The private room is appropriate for this child.

Rationale 4: Splenic sequestration can be life-threatening, and there is profound anemia. The child does not need an isolation room but should not be placed in a room with any child who may have an infectious illness. The private room is appropriate for this child.

Global Rationale:

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 04. Plan nursing care for the child with a chronic disorder of red blood cells.

Question 5

Type: MCSA

The nurse would expect to administer this drug for a sickle cell pain crisis:

1. Morphine sulfate.

2. Meperidine.

3. Acetaminophen.

4. Ibuprofen.

Correct Answer: 1

Rationale 1: The pain during a sickling crisis is severe, and morphine is needed for pain control around the clock or by patient-controlled analgesia (PCA). Meperidine is not used for pain control for clients with sickle cell pain crisis because it could cause seizures. Acetaminophen or ibuprofen is used for mild pain and would not be effective for the severe pain experienced by a child in sickle cell pain crisis.

Rationale 2: The pain during a sickling crisis is severe, and morphine is needed for pain control around the clock or by patient-controlled analgesia (PCA). Meperidine is not used for pain control for clients with sickle cell pain crisis because it could cause seizures. Acetaminophen or ibuprofen is used for mild pain and would not be effective for the severe pain experienced by a child in sickle cell pain crisis.

Rationale 3: The pain during a sickling crisis is severe, and morphine is needed for pain control around the clock or by patient-controlled analgesia (PCA). Meperidine is not used for pain control for clients with sickle cell pain crisis because it could cause seizures. Acetaminophen or ibuprofen is used for mild pain and would not be effective for the severe pain experienced by a child in sickle cell pain crisis.

Rationale 4: The pain during a sickling crisis is severe, and morphine is needed for pain control around the clock or by patient-controlled analgesia (PCA). Meperidine is not used for pain control for clients with sickle cell pain crisis because it could cause seizures. Acetaminophen or ibuprofen is used for mild pain and would not be effective for the severe pain experienced by a child in sickle cell pain crisis.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 04. Plan nursing care for the child with a chronic disorder of red blood cells.

Question 6

Type: MCMA

The nurse is teaching parents how to prevent a sickle cell crisis in the child with sickle cell disease. The nurse will explain that precipitating factors contributing to a sickle cell crisis include

Standard Text: Select all that apply.

1. Fever.

2. Dehydration.

3. Regular exercise.

4. Altitude.

5. Increased fluid intake.

Correct Answer: 1,2,4

Rationale 1: Fever, dehydration, and altitude are precipitating factors contributing to a sickle cell crisis. Regular exercise and increased fluid intake are recommended activities for a child with sickle cell disease and will not contribute to a sickle cell crisis.

Rationale 2: Fever, dehydration, and altitude are precipitating factors contributing to a sickle cell crisis. Regular exercise and increased fluid intake are recommended activities for a child with sickle cell disease and will not contribute to a sickle cell crisis.

Rationale 3: Fever, dehydration, and altitude are precipitating factors contributing to a sickle cell crisis. Regular exercise and increased fluid intake are recommended activities for a child with sickle cell disease and will not contribute to a sickle cell crisis.

Rationale 4: Fever, dehydration, and altitude are precipitating factors contributing to a sickle cell crisis. Regular exercise and increased fluid intake are recommended activities for a child with sickle cell disease and will not contribute to a sickle cell crisis.

Rationale 5: Fever, dehydration, and altitude are precipitating factors contributing to a sickle cell crisis. Regular exercise and increased fluid intake are recommended activities for a child with sickle cell disease and will not contribute to a sickle cell crisis.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 03. Distinguish pathophysiology and clinical manifestations for chronic disorders of red blood cells.

Question 7

Type: MCSA

The nurse is administering packed red blood cells to a child with sickle cell disease (SCD). The nurse knows that a transfusion reaction will most likely occur

1. Six hours after the transfusion is given.

2. Within the first 20 minutes of administration of the transfusion.

3. At the end of the administration of the transfusion.

4. Never; children with SCD do not have reactions.

Correct Answer: 2

Rationale 1: Blood reactions can occur as soon as the blood transfusion begins or within the first 20 minutes. The nurse should remain with the child for the first 20 minutes of the transfusion.

Rationale 2: Blood reactions can occur as soon as the blood transfusion begins or within the first 20 minutes. The nurse should remain with the child for the first 20 minutes of the transfusion.

Rationale 3: Blood reactions can occur as soon as the blood transfusion begins or within the first 20 minutes. The nurse should remain with the child for the first 20 minutes of the transfusion.

Rationale 4: Blood reactions can occur as soon as the blood transfusion begins or within the first 20 minutes. The nurse should remain with the child for the first 20 minutes of the transfusion.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 04. Plan nursing care for the child with a chronic disorder of red blood cells.

Question 8

Type: MCSA

A child who has beta-thalassemia is receiving numerous blood transfusions. The child is also receiving deferoxamine (Desferal) therapy. The parents ask how the deferoxamine will help their child. The nurse explains that the deferoxamine is given to

1. Prevent blood transfusion reactions.

2. Stimulate red blood cell production.

3. Provide vitamin supplementation.

4. Prevent iron overload.

Correct Answer: 4

Rationale 1: Iron overload can be a side effect of a hypertransfusion therapy. Deferoxamine (Desferal) is an iron-chelating drug, which binds excess iron so it can be excreted by the kidneys. It does not prevent blood-transfusion reactions, stimulate red blood cell production, or provide vitamin supplementation.

Rationale 2: Iron overload can be a side effect of a hypertransfusion therapy. Deferoxamine (Desferal) is an iron-chelating drug, which binds excess iron so it can be excreted by the kidneys. It does not prevent blood-transfusion reactions, stimulate red blood cell production, or provide vitamin supplementation.

Rationale 3: Iron overload can be a side effect of a hypertransfusion therapy. Deferoxamine (Desferal) is an iron-chelating drug, which binds excess iron so it can be excreted by the kidneys. It does not prevent blood-transfusion reactions, stimulate red blood cell production, or provide vitamin supplementation.

Rationale 4: Iron overload can be a side effect of a hypertransfusion therapy. Deferoxamine (Desferal) is an iron-chelating drug, which binds excess iron so it can be excreted by the kidneys. It does not prevent blood-transfusion reactions, stimulate red blood cell production, or provide vitamin supplementation.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 04. Plan nursing care for the child with a chronic disorder of red blood cells.

Question 9

Type: MCSA

A child has recently been diagnosed with aplastic anemia. Support for the family should include

1. Referrals to support groups and social services.

2. Short-term support.

3. Genetic counseling.

4. Nutrition counseling.

Correct Answer: 1

Rationale 1: Families require support in dealing with a child who has a life-threatening disease. They should be referred to support groups for counseling, if indicated, and to social services. The support will be long term in nature. Aplastic anemia is not a genetically transmitted disease. Nutrition counseling is not a priority and may or may not be needed with aplastic anemia.

Rationale 2: Families require support in dealing with a child who has a life-threatening disease. They should be referred to support groups for counseling, if indicated, and to social services. The support will be long term in nature. Aplastic anemia is not a genetically transmitted disease. Nutrition counseling is not a priority and may or may not be needed with aplastic anemia.

Rationale 3: Families require support in dealing with a child who has a life-threatening disease. They should be referred to support groups for counseling, if indicated, and to social services. The support will be long term in nature. Aplastic anemia is not a genetically transmitted disease. Nutrition counseling is not a priority and may or may not be needed with aplastic anemia.

Rationale 4: Families require support in dealing with a child who has a life-threatening disease. They should be referred to support groups for counseling, if indicated, and to social services. The support will be long term in nature. Aplastic anemia is not a genetically transmitted disease. Nutrition counseling is not a priority and may or may not be needed with aplastic anemia.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 04. Plan nursing care for the child with a chronic disorder of red blood cells.

Question 10

Type: MCSA

A school-age child with hemophilia falls on the playground and goes to the nurses office with superficial bleeding above the knee. The nurse should

1. Apply a warm, moist pack to the area.

2. Perform some passive range of motion to the affected leg.

3. Apply pressure to the area for at least 15 minutes.

4. Keep the affected extremity in a dependent position.

Correct Answer: 3

Rationale 1: If a hemophiliac child experiences a bleeding episode, superficial bleeding should be controlled by applying pressure to the area for at least 15 minutes. Ice should be applied, not heat. The extremity should be immobilized and elevated, so passive range of motion and keeping the extremity in a dependent position would not be appropriate interventions at this time.

Rationale 2: If a hemophiliac child experiences a bleeding episode, superficial bleeding should be controlled by applying pressure to the area for at least 15 minutes. Ice should be applied, not heat. The extremity should be immobilized and elevated, so passive range of motion and keeping the extremity in a dependent position would not be appropriate interventions at this time.

Rationale 3: If a hemophiliac child experiences a bleeding episode, superficial bleeding should be controlled by applying pressure to the area for at least 15 minutes. Ice should be applied, not heat. The extremity should be immobilized and elevated, so passive range of motion and keeping the extremity in a dependent position would not be appropriate interventions at this time.

Rationale 4: If a hemophiliac child experiences a bleeding episode, superficial bleeding should be controlled by applying pressure to the area for at least 15 minutes. Ice should be applied, not heat. The extremity should be immobilized and elevated, so passive range of motion and keeping the extremity in a dependent position would not be appropriate interventions at this time.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 06. Prioritize nursing interventions for a child with a major bleeding disorder.

Question 11

Type: MCSA

A child with hemophilia plans on participating in a bicycling club. The nurse should recommend the child

1. Consider a swim club instead of the bicycling club.

2. Wear kneepads, elbow pads, and a helmet while bicycling.

3. Participate only in the social activities of the club.

4. Not join the club.

Correct Answer: 2

Rationale 1: Children with hemophilia should be encouraged to participate in noncontact sports activities. Bicycling is an excellent option and is recommended along with swimming. The child should always use kneepads, elbow pads, and a helmet when participating in a physical sport. Participating only in the social aspects of the club would not encourage physical activity. Discouraging a child from joining a club would not foster growth and development.

Rationale 2: Children with hemophilia should be encouraged to participate in noncontact sports activities. Bicycling is an excellent option and is recommended along with swimming. The child should always use kneepads, elbow pads, and a helmet when participating in a physical sport. Participating only in the social aspects of the club would not encourage physical activity. Discouraging a child from joining a club would not foster growth and development.

Rationale 3: Children with hemophilia should be encouraged to participate in noncontact sports activities. Bicycling is an excellent option and is recommended along with swimming. The child should always use kneepads, elbow pads, and a helmet when participating in a physical sport. Participating only in the social aspects of the club would not encourage physical activity. Discouraging a child from joining a club would not foster growth and development.

Rationale 4: Children with hemophilia should be encouraged to participate in noncontact sports activities. Bicycling is an excellent option and is recommended along with swimming. The child should always use kneepads, elbow pads, and a helmet when participating in a physical sport. Participating only in the social aspects of the club would not encourage physical activity. Discouraging a child from joining a club would not foster growth and development.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 06. Prioritize nursing interventions for a child with a major bleeding disorder.

Question 12

Type: MCSA

The nurse is caring for a child with disseminated intravascular coagulation (DIC). A priority nursing intervention for this child is

1. Frequent ambulation.

2. Maintenance of skin integrity.

3. Monitoring of fluid restriction.

4. Preparation for x-ray procedures.

Correct Answer: 2

Rationale 1: Impairment of skin integrity can lead to bleeding in DIC. The child with DIC should be placed on bed rest. Fluids need to be monitored but will not be restricted, and DIC is not diagnosed with x-ray examination but by serum lab studies.

Rationale 2: Impairment of skin integrity can lead to bleeding in DIC. The child with DIC should be placed on bed rest. Fluids need to be monitored but will not be restricted, and DIC is not diagnosed with x-ray examination but by serum lab studies.

Rationale 3: Impairment of skin integrity can lead to bleeding in DIC. The child with DIC should be placed on bed rest. Fluids need to be monitored but will not be restricted, and DIC is not diagnosed with x-ray examination but by serum lab studies.

Rationale 4: Impairment of skin integrity can lead to bleeding in DIC. The child with DIC should be placed on bed rest. Fluids need to be monitored but will not be restricted, and DIC is not diagnosed with x-ray examination but by serum lab studies.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 06. Prioritize nursing interventions for a child with a major bleeding disorder.

Question 13

Type: MCSA

A priority nursing diagnosis for the child with idiopathic thrombocytopenic purpura (ITP) is

1. Risk for Injury.

2. Ineffective Breathing Pattern.

3. Nausea.

4. Fluid-Volume Deficit.

Correct Answer: 1

Rationale 1: ITP is the most common bleeding disorder in children, so risk for injury (bleeding) is the priority nursing diagnosis. The disease process does not usually cause ineffective breathing patterns, nausea, or fluid-volume deficits.

Rationale 2: ITP is the most common bleeding disorder in children, so risk for injury (bleeding) is the priority nursing diagnosis. The disease process does not usually cause ineffective breathing patterns, nausea, or fluid-volume deficits.

Rationale 3: ITP is the most common bleeding disorder in children, so risk for injury (bleeding) is the priority nursing diagnosis. The disease process does not usually cause ineffective breathing patterns, nausea, or fluid-volume deficits.

Rationale 4: ITP is the most common bleeding disorder in children, so risk for injury (bleeding) is the priority nursing diagnosis. The disease process does not usually cause ineffective breathing patterns, nausea, or fluid-volume deficits.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome: LO 05. Distinguish pathophysiology and clinical manifestations for the major bleeding disorders affecting the pediatric population.

Question 14

Type: MCSA

A child with meningococcemia is being admitted to the pediatric intensive-care unit. This child should be placed in a

1. Semiprivate room.

2. Private room, but not in isolation.

3. Private room, in protective isolation.

4. Private room, in respiratory isolation.

Correct Answer: 4

Rationale 1: Meningococcemia follows an infection with Neisseria meningitidis. N. meningitidis is transmitted through airborne droplets; thus, the child should be placed in a private room in respiratory isolation. A private room with protective isolation (child is essentially kept in a bubble) would not be appropriate.

Rationale 2: Meningococcemia follows an infection with Neisseria meningitidis. N. meningitidis is transmitted through airborne droplets; thus, the child should be placed in a private room in respiratory isolation. A private room with protective isolation (child is essentially kept in a bubble) would not be appropriate.

Rationale 3: Meningococcemia follows an infection with Neisseria meningitidis. N. meningitidis is transmitted through airborne droplets; thus, the child should be placed in a private room in respiratory isolation. A private room with protective isolation (child is essentially kept in a bubble) would not be appropriate.

Rationale 4: Meningococcemia follows an infection with Neisseria meningitidis. N. meningitidis is transmitted through airborne droplets; thus, the child should be placed in a private room in respiratory isolation. A private room with protective isolation (child is essentially kept in a bubble) would not be appropriate.

Global Rationale:

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 04. Plan nursing care for the child with a chronic disorder of red blood cells.

Question 15

Type: MCMA

A child who has undergone a hematopoietic stem cell transplantation (HSCT) is ready for discharge. It is important that the nurse teach the family to

Standard Text: Select all that apply.

1. Recognize the signs of graft-versus-host disease.

2. Return the child to school within six weeks.

3. Practice good handwashing.

4. Avoid obtaining influenza vaccinations.

5. Avoid live plants and fresh vegetables.

Correct Answer: 1,3,5

Rationale 1:

Rationale 2:

Rationale 3:

Rationale 4:

Rationale 5:

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 07. Summarize nursing implications for a child receiving hematopoietic stem cell transplantation (HSCT).

Question 16

Type: MCSA

The nurse is caring for a child who is in sickle cell anemic crisis and has severe pain. The most effective nursing intervention for this child would be

1. Giving comfort measures, such as back rubs.

2. Suggesting diversional activities, such as coloring.

3. Administering pain medication.

4. Preparing the child for painful procedures.

Correct Answer: 3

Rationale 1: Severe pain requires administration of pain medication for pain relief. Comfort measures and diversional activities are not effective against severe pain in children. Comfort measures should be given to every child and can be used after pain medication is given. A child in severe pain is not capable of participating in or enjoying diversional activities. Preparing the child for painful procedures is not appropriate when the child is already in pain.

Rationale 2: Severe pain requires administration of pain medication for pain relief. Comfort measures and diversional activities are not effective against severe pain in children. Comfort measures should be given to every child and can be used after pain medication is given. A child in severe pain is not capable of participating in or enjoying diversional activities. Preparing the child for painful procedures is not appropriate when the child is already in pain.

Rationale 3: Severe pain requires administration of pain medication for pain relief. Comfort measures and diversional activities are not effective against severe pain in children. Comfort measures should be given to every child and can be used after pain medication is given. A child in severe pain is not capable of participating in or enjoying diversional activities. Preparing the child for painful procedures is not appropriate when the child is already in pain.

Rationale 4: Severe pain requires administration of pain medication for pain relief. Comfort measures and diversional activities are not effective against severe pain in children. Comfort measures should be given to every child and can be used after pain medication is given. A child in severe pain is not capable of participating in or enjoying diversional activities. Preparing the child for painful procedures is not appropriate when the child is already in pain.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 04. Plan nursing care for the child with a chronic disorder of red blood cells.

Ball/Bindler/Cowen, Principles of Pediatric Nursing 5th Ed. Test Bank

Copyright 2012 by Pearson Education, Inc.

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