Child Health Nursing Partnering With Children & Families 3rd Edition By Jane – Test Bank

Chapter 11
Question 1
Type: MCSA
The nurse is explaining the primary purpose of performing health maintenance activities at each pediatric visit. The best explanation touches on:
1. Planning appropriate disciplinary measures for control of behavior.
2. Reviewing developmental milestones with the parents.
3. Prevention of disease and injury.
4. Teaching growth and development to the parents.
Correct Answer: 3
Rationale 1: While it is important for parents to understand the normal growth and development, developmental milestones, and age-appropriate discipline measures for children of all ages, these are not the primary purposes of performing health maintenance activities at each pediatric visit.
Rationale 2: While it is important for parents to understand the normal growth and development, developmental milestones, and age-appropriate discipline measures for children of all ages, these are not the primary purposes of performing health maintenance activities at each pediatric visit.
Rationale 3: The primary purpose of health maintenance activities is prevention of disease and injury for children of all ages.
Rationale 4: While it is important for parents to understand the normal growth and development, developmental milestones, and age-appropriate discipline measures for children of all ages, these are not the primary purposes of performing health maintenance activities at each pediatric visit.
Global Rationale:

Cognitive Level: Analyzing
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 11-1

Question 2
Type: MCMA
Which of these developmental milestones should the nurse expect to find in children who are between two and three years old?
Standard Text: Select all that apply.
1. Always feeds self
2. Throws ball overhand
3. Kicks a ball
4. Goes up and down stairs
5. Scribbles and draws on paper
Correct Answer: 3,4,5
Rationale 1: Children between the ages of three and four years old feed themselves.
Rationale 2: Children between the ages of four and five years can throw a ball overhead.
Rationale 3: Children between the ages of two and three years old can kick a ball.
Rationale 4: Children between the ages of two and three years old can go up and down stairs.
Rationale 5: Children between the ages of two and three years old can scribble and draw on paper.
Global Rationale:

Cognitive Level: Analyzing
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 11-1

Question 3
Type: MCSA
A nurse who is the manager of an ambulatory pediatric health care center is planning protocols for the routine health care visits of the children. Children within the catchment area of this care center have a high incidence of obesity. The most important assessment data in monitoring the two-year-old child with obesity is:
1. Weight alone.
2. The child’s percentile score of height and weight and weight on the growth chart.
3. Changes in the child’s percentile on the growth chart from birth to the present.
4. The child’s body mass index.
Correct Answer: 4
Rationale 1: Weight cannot be used alone; weight in comparison to height provides clearer information.
Rationale 2: This can be helpful information, but it compares this child’s height to the average child of this age and this child’s weight to the average to the average child. It does not look at this child’s height to weight comparison.
Rationale 3: Children’s percentile findings on the growth chart may change from one evaluation to the next as they alternate between growth spurts and periods of slower growth.
Rationale 4: The body mass index is a comparison of the child’s weight to height and is the best tool for evaluating obesity.
Global Rationale:

Cognitive Level: Applying
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 11-3

Question 4
Type: MCSA
A nurse is preparing to perform a physical assessment on a toddler. Which of these actions should the nurse take?
1. Explain each part of the examination to the child before performing it.
2. Ask the mother to tell the child not to be afraid.
3. Perform the assessment from head to toe.
4. Leave intrusive procedures, such as ear and eye examinations, until the end.
Correct Answer: 4
Rationale 1: Explaining each part before performing it will only make the child more fearful, as it will make the entire procedure last longer.
Rationale 2: This will do little to alleviate the child’s fears.
Rationale 3: The nurse should complete the assessment in whichever order does not upset the child, leaving the head and genital areas for last.
Rationale 4: Intrusive procedures, such as examination of the ears, throat, eye, and genital areas, should be done last to decrease the anxiety of the child during the initial phases of the examination, which include the heart and lungs.
Global Rationale:

Cognitive Level: Applying
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 11-3

Question 5
Type: MCMA
The nurse recommends to the mothers of toddlers and preschoolers that they limit television to two hours a day. The nurse also discusses promoting physical activities that are related to kinesthesia. Which activities would the nurse suggest?
Standard Text: Select all that apply.
1. Walking on a balance beam
2. Reading
3. Playing a memory game
4. Skipping
5. Giving up a pacifier
Correct Answer: 1,4
Rationale 1: Kinesthesia is the sense of one’s body position and movement, and it develops during the preschool years. Activities related to kinesthesia include skipping, walking on a balance beam, and throwing and catching a ball.
Rationale 2: Reading is a cognitive activity.
Rationale 3: Playing a memory game is a cognitive activity.
Rationale 4: Kinesthesia is the sense of one’s body position and movement, and it develops during the preschool years. Activities related to kinesthesia include skipping, walking on a balance beam, and throwing and catching a ball.
Rationale 5: A pacifier is used to soothe and calm infants.
Global Rationale:

Cognitive Level: Analyzing
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 11-3

Question 6
Type: MCSA
A 27-month-old toddler who is in the pediatric office for a well-child visit begins to cry the moment he is placed on the examination table. The parent attempts to comfort the toddler, but nothing is effective. Which would be the most appropriate action for the nurse to take?
1. Instruct the father to hold the toddler down tightly to complete the examination.
2. Allow the toddler to sit on the parent’s lap and begin the assessment.
3. Ask another nurse in the office to hold the toddler, since the parent is not able to control the toddler’s behavior.
4. Allow the toddler to stand on the floor until the crying stops.
Correct Answer: 2
Rationale 1: The father should not be asked to restrain the child for the entire examination.
Rationale 2: Toddlers are most comfortable when sitting with the parents. Much of the examination can be completed in this way.
Rationale 3: If a child needs to be subdued, then another nurse should be the one to assist. However, in this case the goal is to calm the child so that the assessment can be completed.
Rationale 4: Allowing the toddler to stand on the floor is not going to calm the child so that the assessment can be completed.
Global Rationale:

Cognitive Level: Applying
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 11-4

Question 7
Type: MCSA
Parents of a preschool-age child report that they find it necessary to spank the child at least once a day. Which response should the nurse make to the parents?
1. “Spanking is one form of discipline; however, you want to be certain that you do not leave any marks on the child.”
2. “Let’s talk about other forms of discipline that have a more positive effect on the child.”
3. “I think you are not parenting your child properly, so let’s talk about ways to improve your parenting skills.”
4. “Can you try only spanking the child every other day for one week and see how that affects the child’s behavior?”
Correct Answer: 2
Rationale 1: To suggest spanking is an appropriate form of discipline is inappropriate, especially when the parent is describing daily spanking of the child.
Rationale 2: The behavior reported by the parent was excessive. The only response that is appropriate is to seek a more positive way of influencing the child’s behavior.
Rationale 3: This comment is inappropriate, and it will cause the parents to become defensive of their actions.
Rationale 4: Making the suggestion for parents to spank even every other day is inappropriate.
Global Rationale:

Cognitive Level: Applying
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 11-4

Question 8
Type: MCSA
A parent questions how her toddler will interact with other toddlers. The nurse’s best description of the differences in play between the toddler and the preschooler is:
1. Toddlers play “side by side,” while preschoolers play cooperatively.
2. Toddlers play cooperatively, while preschoolers play interactive games.
3. Toddlers play house and imitate adult roles, while preschoolers become the “mom or dad” while playing house.
4. There are no differences between toddlers and preschoolers because both play cooperatively.
Correct Answer: 1
Rationale 1: Toddlers, although they will play “side by side” with another child, will not interact with the child during play.
Rationale 2: Preschoolers play cooperatively with other children. Toddlers do not play cooperatively.
Rationale 3: Toddlers do not play house or imitate the adult roles.
Rationale 4: Only preschoolers play cooperatively with other children.
Global Rationale:

Cognitive Level: Analyzing
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 11-4

Question 9
Type: MCSA
At a routine health care visit, a nurse measures a toddler and plots the height and weight on the growth charts. The nurse documents that the toddler is above the 95th percentile for weight and is at the 5th percentile for height. How should the nurse interpret these data?
1. The toddler is proportionate for age.
2. The height and weight are disproportionate, and the toddler needs further evaluation.
3. The toddler needs to eat more at each feeding.
4. The family most likely is short.
Correct Answer: 2
Rationale 1: The height and weight for the child described in this question are a concern, and the child might need further endocrine testing.
Rationale 2: Usually, height and weight are at approximately the same percentile. When the weight of a child is found to be at the 95th percentile, the child’s height usually also is greater than the 50th percentile.
Rationale 3: The concern is that the weight is out of proportion to the height. Further evaluation is needed.
Rationale 4: The family might be short, but a difference this great between height and weight needs to be referred for further evaluation and testing.
Global Rationale:

Cognitive Level: Analyzing
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 11-6

Question 10
Type: MCMA
The nurse is teaching a group of mothers of toddlers and preschoolers about oral care and the prevention of caries. Which statements should the nurse include in the presentation?
Standard Text: Select all that apply.
1. “The tendency toward dental caries is inherited.”
2. “Fruit juice is an excellent source of vitamin C, so allow your child to drink as much fruit juice a day as desired.”
3. “If your child is under two, you should use toothpaste without fluoride.”
4. “Three-year-old children are mature enough to be able to brush their teeth independently.”
5. “The child should see a dentist by one year of age.”
Correct Answer: 3,5
Rationale 1: Poor oral care may be passed from parent to child, but dental caries are not inherited.
Rationale 2: Fruit juice is high in sugar and may promote cavities. The amount of juice per day should be limited.
Rationale 3: A young child may be unable to spit out the toothpaste and will swallow it. To avoid children ingesting too much fluoride, parents should use toothpaste without fluoride.
Rationale 4: The three-year-old child is not mature enough to brush independently. Although the child should be allowed to attempt to brush, the parent should ensure the teeth are adequately cleaned.
Rationale 5: Early attention to dental health improves the condition of the primary teeth.
Global Rationale:

Cognitive Level: Applying
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 11-5