Chapter 28 My Nursing Test Banks

Ball/Bindler/Cowen, Principles of Pediatric Nursing: Caring for Children 5th Edition Test Bank
Chapter 28

Question 1

Type: MCSA

A nurse is caring for four clients in the hospital. Which client should the nurse refer for play therapy?

1. Adolescent with asthma.

2. Preschool child with a fractured femur.

3. School-age child having an appendectomy.

4. Infant with sepsis.

Correct Answer: 2

Rationale 1: Play therapy is often used with preschool and school-age children who are experiencing anxiety, stress, and other specific nonpsychotic mental disorders. In this case, the child who experiences a condition that requires longer hospitalization and recovery, such as a fracture of the femur, should be referred for play therapy. The adolescent with asthma, the school-age child having an appendectomy, and the infant with sepsis do not have as high a need for play therapy as the preschool child with a broken bone.

Rationale 2: Play therapy is often used with preschool and school-age children who are experiencing anxiety, stress, and other specific nonpsychotic mental disorders. In this case, the child who experiences a condition that requires longer hospitalization and recovery, such as a fracture of the femur, should be referred for play therapy. The adolescent with asthma, the school-age child having an appendectomy, and the infant with sepsis do not have as high a need for play therapy as the preschool child with a broken bone.

Rationale 3: Play therapy is often used with preschool and school-age children who are experiencing anxiety, stress, and other specific nonpsychotic mental disorders. In this case, the child who experiences a condition that requires longer hospitalization and recovery, such as a fracture of the femur, should be referred for play therapy. The adolescent with asthma, the school-age child having an appendectomy, and the infant with sepsis do not have as high a need for play therapy as the preschool child with a broken bone.

Rationale 4: Play therapy is often used with preschool and school-age children who are experiencing anxiety, stress, and other specific nonpsychotic mental disorders. In this case, the child who experiences a condition that requires longer hospitalization and recovery, such as a fracture of the femur, should be referred for play therapy. The adolescent with asthma, the school-age child having an appendectomy, and the infant with sepsis do not have as high a need for play therapy as the preschool child with a broken bone.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 02. Contrast pediatric differences and issues related to mental health and cognition.

Question 2

Type: MCSA

A child with autism is being admitted to the hospital because of recent vomiting and diarrhea. Upon admission the nurse should

1. Take the child on a quick tour of the whole unit.

2. Take the child to the playroom immediately for arts and crafts.

3. Orient the child to the hospital room with minimal distractions.

4. Admit the child to a four-bed unit with small children.

Correct Answer: 3

Rationale 1: Autistic children interpret and respond to the environment differently from other individuals. The child needs to be oriented to new settings and adjusts best to a quiet, controlled environment. A hospital room with only one other child is best.

Rationale 2: Autistic children interpret and respond to the environment differently from other individuals. The child needs to be oriented to new settings and adjusts best to a quiet, controlled environment. A hospital room with only one other child is best.

Rationale 3: Autistic children interpret and respond to the environment differently from other individuals. The child needs to be oriented to new settings and adjusts best to a quiet, controlled environment. A hospital room with only one other child is best.

Rationale 4: Autistic children interpret and respond to the environment differently from other individuals. The child needs to be oriented to new settings and adjusts best to a quiet, controlled environment. A hospital room with only one other child is best.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 06. Use evidenced-based practice to plan nursing management for children with cognitive alterations.

Question 3

Type: MCSA

A nurse is planning preoperative teaching for an 8-year-old child scheduled to have a tonsillectomy. The child has a history of attention deficit hyperactivity disorder (ADHD). The nurse plans to

1. Give instructions verbally and use a picture pamphlet, repeating points more than once.

2. Ask other children who have had this procedure to talk to the child.

3. Allow the child to lead the session to gain a sense of control.

4. Play a television show in the background.

Correct Answer: 1

Rationale 1: A teaching session for a child with ADHD should foster attention. Giving instructions verbally and in written form, repeating points, will improve learning for a child with ADHD. The environment needs to be quiet, with minimal distractions. A child who has difficulty concentrating should not lead the session even though the child needs to feel in control. Talking to other children who have had this procedure may not foster understanding, because this child has ADHD. Distractions such as noise from a television should be minimized.

Rationale 2: A teaching session for a child with ADHD should foster attention. Giving instructions verbally and in written form, repeating points, will improve learning for a child with ADHD. The environment needs to be quiet, with minimal distractions. A child who has difficulty concentrating should not lead the session even though the child needs to feel in control. Talking to other children who have had this procedure may not foster understanding, because this child has ADHD. Distractions such as noise from a television should be minimized.

Rationale 3: A teaching session for a child with ADHD should foster attention. Giving instructions verbally and in written form, repeating points, will improve learning for a child with ADHD. The environment needs to be quiet, with minimal distractions. A child who has difficulty concentrating should not lead the session even though the child needs to feel in control. Talking to other children who have had this procedure may not foster understanding, because this child has ADHD. Distractions such as noise from a television should be minimized.

Rationale 4: A teaching session for a child with ADHD should foster attention. Giving instructions verbally and in written form, repeating points, will improve learning for a child with ADHD. The environment needs to be quiet, with minimal distractions. A child who has difficulty concentrating should not lead the session even though the child needs to feel in control. Talking to other children who have had this procedure may not foster understanding, because this child has ADHD. Distractions such as noise from a television should be minimized.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 06. Use evidenced-based practice to plan nursing management for children with cognitive alterations.

Question 4

Type: MCSA

A child is taking Adderall (amphetamine mixed salts) for attention deficit hyperactivity disorder (ADHD). The parents should be instructed to administer the medication

1. At bedtime.

2. Before lunch.

3. With the evening meal.

4. Early in the am.

Correct Answer: 4

Rationale 1: A side effect of Adderall can be insomnia. Administering the medication early in the day can help alleviate the effect of insomnia.

Rationale 2: A side effect of Adderall can be insomnia. Administering the medication early in the day can help alleviate the effect of insomnia.

Rationale 3: A side effect of Adderall can be insomnia. Administering the medication early in the day can help alleviate the effect of insomnia.

Rationale 4: A side effect of Adderall can be insomnia. Administering the medication early in the day can help alleviate the effect of insomnia.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 06. Use evidenced-based practice to plan nursing management for children with cognitive alterations.

Question 5

Type: MCSA

A child with attention deficit hyperactivity disorder is interested in playing the drums in the school band. The school nurse should

1. Recommend the child take private lessons and not join the band.

2. Encourage the child to join the band.

3. Consult with the physician about allowing the child to participate in band activities.

4. Discourage the child from playing in the band.

Correct Answer: 2

Rationale 1: A child with ADHD may lack connectedness with other children. Participation in a school activity where the rules of working with others can be learned should be encouraged.

Rationale 2: A child with ADHD may lack connectedness with other children. Participation in a school activity where the rules of working with others can be learned should be encouraged.

Rationale 3: A child with ADHD may lack connectedness with other children. Participation in a school activity where the rules of working with others can be learned should be encouraged.

Rationale 4: A child with ADHD may lack connectedness with other children. Participation in a school activity where the rules of working with others can be learned should be encouraged.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 06. Use evidenced-based practice to plan nursing management for children with cognitive alterations.

Question 6

Type: MCSA

A child is being evaluated for depression. An assessment tool the nurse expects the psychologist to use is the

1. Denver Developmental Screening tool.

2. Revised Childrens Manifest Anxiety Scale.

3. Parent Developmental Questionnaire.

4. Disruptive Behavior Disorder Scale.

Correct Answer: 2

Rationale 1: The Revised Childrens Manifest Anxiety Scale is a tool used to assess for depression. The Denver Developmental Screening tool and the Parent Developmental Questionnaire are tools used to assess development. The Disruptive Behavior Disorder Scale is used to assess for autism.

Rationale 2: The Revised Childrens Manifest Anxiety Scale is a tool used to assess for depression. The Denver Developmental Screening tool and the Parent Developmental Questionnaire are tools used to assess development. The Disruptive Behavior Disorder Scale is used to assess for autism.

Rationale 3: The Revised Childrens Manifest Anxiety Scale is a tool used to assess for depression. The Denver Developmental Screening tool and the Parent Developmental Questionnaire are tools used to assess development. The Disruptive Behavior Disorder Scale is used to assess for autism.

Rationale 4: The Revised Childrens Manifest Anxiety Scale is a tool used to assess for depression. The Denver Developmental Screening tool and the Parent Developmental Questionnaire are tools used to assess development. The Disruptive Behavior Disorder Scale is used to assess for autism.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 03. Discuss the clinical manifestations of the major mental health alterations of childhood and adolescence.

Question 7

Type: FIB

A nurse is calculating the maximum recommended dose a 9-year-old child with depression can receive for sertraline (Zoloft). The recommended pediatric dose for sertraline (Zoloft) is 1.5 to 3 mg/kg/day. If the child weighs 31 kg, the maximum recommended dose for this child would be ____ mg.

Standard Text:

Correct Answer: 93

Rationale : The maximum recommended dose for sertraline (Zoloft) is 3 mg/kg/day. If the child weighs 31 kg, it would be 3 31 = 93 mg a day.

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 for the nursing management of children and adolescents with mental health alterations in the hospital and community settings.

Question 8

Type: MCSA

The priority nursing diagnosis for a child with bipolar disorder who has suicidal ideas would be

1. Powerlessness Related to Mood Instability.

2. Social Isolation Related to Disorder.

3. Risk for Injury Related to Suicidal Ideas.

4. Impaired Social Interaction.

Correct Answer: 3

Rationale 1: The priority for a child with bipolar disorder and suicidal ideas is safety. Risk for Injury would be the nursing diagnosis that would address safety for the child. The other diagnoses have a lower priority.

Rationale 2: The priority for a child with bipolar disorder and suicidal ideas is safety. Risk for Injury would be the nursing diagnosis that would address safety for the child. The other diagnoses have a lower priority.

Rationale 3: The priority for a child with bipolar disorder and suicidal ideas is safety. Risk for Injury would be the nursing diagnosis that would address safety for the child. The other diagnoses have a lower priority.

Rationale 4: The priority for a child with bipolar disorder and suicidal ideas is safety. Risk for Injury would be the nursing diagnosis that would address safety for the child. The other diagnoses have a lower priority.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome: LO 03. Discuss the clinical manifestations of the major mental health alterations of childhood and adolescence.

Question 9

Type: MCSA

An adolescent child with panic disorder is taking paroxetine (Paxil), a selective serotonin reuptake inhibitor (SSRI). The child tells the nurse she often takes diet pills because she is trying to lose weight. The nurse should advise the child to

1. Continue with the paroxetine (Paxil) and the diet pills.

2. Stop both the paroxetine (Paxil) and the diet pills.

3. Discontinue use of the diet pills while taking the paroxetine (Paxil).

4. Discuss use of the diet pills with a pharmacist.

Correct Answer: 3

Rationale 1: Serotonin syndrome, the serious and life-threatening side effect of SSRIs, can develop when the drug is taken with diet pills, St. Johns wort, other antidepressants, alcohol, or LSD. In this case the diet pills should be discontinued in order to avoid serotonin syndrome. The Paxil should not be discontinued, and waiting to discuss the use of diet pills with a pharmacist would not be an appropriate option.

Rationale 2: Serotonin syndrome, the serious and life-threatening side effect of SSRIs, can develop when the drug is taken with diet pills, St. Johns wort, other antidepressants, alcohol, or LSD. In this case the diet pills should be discontinued in order to avoid serotonin syndrome. The Paxil should not be discontinued, and waiting to discuss the use of diet pills with a pharmacist would not be an appropriate option.

Rationale 3: Serotonin syndrome, the serious and life-threatening side effect of SSRIs, can develop when the drug is taken with diet pills, St. Johns wort, other antidepressants, alcohol, or LSD. In this case the diet pills should be discontinued in order to avoid serotonin syndrome. The Paxil should not be discontinued, and waiting to discuss the use of diet pills with a pharmacist would not be an appropriate option.

Rationale 4: Serotonin syndrome, the serious and life-threatening side effect of SSRIs, can develop when the drug is taken with diet pills, St. Johns wort, other antidepressants, alcohol, or LSD. In this case the diet pills should be discontinued in order to avoid serotonin syndrome. The Paxil should not be discontinued, and waiting to discuss the use of diet pills with a pharmacist would not be an appropriate option.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 04. Plan for the nursing management of children and adolescents with mental health alterations in the hospital and community settings.

Question 10

Type: MCSA

Parents tell the nurse their child has the following behaviors: excessive handwashing, counting objects, and hoarding substances. The nurse knows this behavior is characteristic of

1. Depression.

2. Separation anxiety disorder.

3. Obsessive-compulsive disorder.

4. Bipolar disorder.

Correct Answer: 3

Rationale 1: Common behaviors of obsessive-compulsive disorder (OCD) are excessive handwashing, counting objects, and hoarding substances. These practices may take up one or more hours each day.

Rationale 2: Common behaviors of obsessive-compulsive disorder (OCD) are excessive handwashing, counting objects, and hoarding substances. These practices may take up one or more hours each day.

Rationale 3: Common behaviors of obsessive-compulsive disorder (OCD) are excessive handwashing, counting objects, and hoarding substances. These practices may take up one or more hours each day.

Rationale 4: Common behaviors of obsessive-compulsive disorder (OCD) are excessive handwashing, counting objects, and hoarding substances. These practices may take up one or more hours each day.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 03. Discuss the clinical manifestations of the major mental health alterations of childhood and adolescence.

Question 11

Type: MCSA

A nurse is concerned about the safety of a suicidal child and wants to be prepared for the use of physical restraints if necessary. The nurse should

1. Obtain a physicians order, and follow the institutions policy for use of restraints.

2. Apply the restraints, and then obtain a physicians order later.

3. Apply the restraints if parental permission is obtained.

4. Ask for the childs permission before applying the restraints.

Correct Answer: 1

Rationale 1: Restraints are used only when ordered by the physician and interdisciplinary team caring for the child. Physical restraint is only a short-term approach to provide immediate safety if necessary. It would not be appropriate to apply the restraints, and then obtain a physicians order. Even if permission is given by the parent and/or child, a physicians order still needs to be obtained.

Rationale 2: Restraints are used only when ordered by the physician and interdisciplinary team caring for the child. Physical restraint is only a short-term approach to provide immediate safety if necessary. It would not be appropriate to apply the restraints, and then obtain a physicians order. Even if permission is given by the parent and/or child, a physicians order still needs to be obtained.

Rationale 3: Restraints are used only when ordered by the physician and interdisciplinary team caring for the child. Physical restraint is only a short-term approach to provide immediate safety if necessary. It would not be appropriate to apply the restraints, and then obtain a physicians order. Even if permission is given by the parent and/or child, a physicians order still needs to be obtained.

Rationale 4: Restraints are used only when ordered by the physician and interdisciplinary team caring for the child. Physical restraint is only a short-term approach to provide immediate safety if necessary. It would not be appropriate to apply the restraints, and then obtain a physicians order. Even if permission is given by the parent and/or child, a physicians order still needs to be obtained.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 04. Plan for the nursing management of children and adolescents with mental health alterations in the hospital and community settings.

Question 12

Type: MCMA

A nurse is doing developmental assessments on several children in the day-care setting. Which child indicates a delay in meeting developmental milestones?

Standard Text: Select all that apply.

1. An 18-month-old toddler who is unable to phrase sentences.

2. A 5-year-old who is unable to button his shirt.

3. A 6-year-old who is unable to sit still for a short story.

4. A 2-year-old who is unable to cut with scissors.

5. A 2-year-old who can not recite her phone number.

Correct Answer: 2,3

Rationale 1: A developmental milestone that can indicate learning disability is a kindergarteners being unable to button his shirt. Inability to phrase sentences is considered a delay if not done by 2 years, inability to sit still for a short story is considered a delay if the child is 3 to 5 years old, and being unable to cut with scissors indicates a delay if not done by kindergarten age. Reciting the phone number is not appropriate for a 2-year-old.

Rationale 2: A developmental milestone that can indicate learning disability is a kindergarteners being unable to button his shirt. Inability to phrase sentences is considered a delay if not done by 2 years, inability to sit still for a short story is considered a delay if the child is 3 to 5 years old, and being unable to cut with scissors indicates a delay if not done by kindergarten age. Reciting the phone number is not appropriate for a 2-year-old.

Rationale 3: A developmental milestone that can indicate learning disability is a kindergarteners being unable to button his shirt. Inability to phrase sentences is considered a delay if not done by 2 years, inability to sit still for a short story is considered a delay if the child is 3 to 5 years old, and being unable to cut with scissors indicates a delay if not done by kindergarten age. Reciting the phone number is not appropriate for a 2-year-old.

Rationale 4: A developmental milestone that can indicate learning disability is a kindergarteners being unable to button his shirt. Inability to phrase sentences is considered a delay if not done by 2 years, inability to sit still for a short story is considered a delay if the child is 3 to 5 years old, and being unable to cut with scissors indicates a delay if not done by kindergarten age. Reciting the phone number is not appropriate for a 2-year-old.

Rationale 5: A developmental milestone that can indicate learning disability is a kindergarteners being unable to button his shirt. Inability to phrase sentences is considered a delay if not done by 2 years, inability to sit still for a short story is considered a delay if the child is 3 to 5 years old, and being unable to cut with scissors indicates a delay if not done by kindergarten age. Reciting the phone number is not appropriate for a 2-year-old.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 02. Contrast pediatric differences and issues related to mental health and cognition.

Question 13

Type: MCSA

Parents of a child recently diagnosed with Down syndrome relate to the nurse that they feel guilty about causing the condition. The best response by the nurse is

1. Down syndrome is a condition caused by an extra chromosome; the cause of it is unknown.

2. Down syndrome is a condition that is genetically transmitted from both the father and the mother.

3. Down syndrome is a condition that is carried on the X chromosome, so it came from the mother.

4. Down syndrome is caused by birth trauma, not by genetics.

Correct Answer: 1

Rationale 1: The therapeutic and accurate response is that Down syndrome is a condition caused by an extra chromosome, but we dont know why it occurs. The other responses are nontherapeutic or inaccurate.

Rationale 2: The therapeutic and accurate response is that Down syndrome is a condition caused by an extra chromosome, but we dont know why it occurs. The other responses are nontherapeutic or inaccurate.

Rationale 3: The therapeutic and accurate response is that Down syndrome is a condition caused by an extra chromosome, but we dont know why it occurs. The other responses are nontherapeutic or inaccurate.

Rationale 4: The therapeutic and accurate response is that Down syndrome is a condition caused by an extra chromosome, but we dont know why it occurs. The other responses are nontherapeutic or inaccurate.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 05. Describe characteristics of common cognitive alterations of childhood.

Question 14

Type: MCSA

A child with profound mental retardation has been admitted to the hospital for an appendectomy. The nurse recognizes that the IQ of this child is

1. Between 50 and 70.

2. Below 20.

3. Between 35 and 50.

4. Between 20 and 35.

Correct Answer: 2

Rationale 1: Profound retardation is described as an intelligence quotient (IQ) below 20. Mild mental retardation is described as an IQ between 50 and 70, moderate retardation is an IQ between 35 and 50, and severe retardation is an IQ between 20 and 35.

Rationale 2: Profound retardation is described as an intelligence quotient (IQ) below 20. Mild mental retardation is described as an IQ between 50 and 70, moderate retardation is an IQ between 35 and 50, and severe retardation is an IQ between 20 and 35.

Rationale 3: Profound retardation is described as an intelligence quotient (IQ) below 20. Mild mental retardation is described as an IQ between 50 and 70, moderate retardation is an IQ between 35 and 50, and severe retardation is an IQ between 20 and 35.

Rationale 4: Profound retardation is described as an intelligence quotient (IQ) below 20. Mild mental retardation is described as an IQ between 50 and 70, moderate retardation is an IQ between 35 and 50, and severe retardation is an IQ between 20 and 35.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 06. Use evidenced-based practice to plan nursing management for children with cognitive alterations.

Question 15

Type: MCSA

The family of a child with mental retardation is expressing difficulty with managing the care needs of the child. The nursing diagnosis appropriate for this situation is

1. Hopelessness Related to Terminal Condition of the Child.

2. Compromised Family Coping Related to the Childs Developmental Variations.

3. Family Processes That are Dysfunctional Related to a Child with Mental Retardation.

4. Impaired Parenting Related to Poor Parenting Skills.

Correct Answer: 2

Rationale 1: The family is compromised but not dysfunctional. Hopelessness and impaired parenting are not appropriate in the given situation.

Rationale 2: The family is compromised but not dysfunctional. Hopelessness and impaired parenting are not appropriate in the given situation.

Rationale 3: The family is compromised but not dysfunctional. Hopelessness and impaired parenting are not appropriate in the given situation.

Rationale 4: The family is compromised but not dysfunctional. Hopelessness and impaired parenting are not appropriate in the given situation.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome: LO 04. Plan for the nursing management of children and adolescents with mental health alterations in the hospital and community settings.

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

Copyright 2012 by Pearson Education, Inc.

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