Principles Of Pediatric Nursing 6th Edition By Ball – Test Bank

Chapter 11
Question 1
Type: MCSA
The parents of a critically injured child wish to stay in the room while the child is receiving emergency care. Which action by the nurse is the most appropriate?
1. Escort the parents to the waiting room and assure them that they can see their child soon.
2. Allow the parents to stay with the child.
3. Ask the physician if the parents can stay with the child.
4. Tell the parents that they do not need to stay with the child.
Correct Answer: 2
Rationale 1: Parents should be allowed to stay with their child if they wish to do so. This position is supported by the Emergency Nurses Association and is a key aspect of family-centered care.
Rationale 2: Parents should be allowed to stay with their child if they wish to do so. This position is supported by the Emergency Nurses Association and is a key aspect of family-centered care.
Rationale 3: Parents should be allowed to stay with their child if they wish to do so. This position is supported by the Emergency Nurses Association and is a key aspect of family-centered care.
Rationale 4: Parents should be allowed to stay with their child if they wish to do so. This position is supported by the Emergency Nurses Association and is a key aspect of family-centered care.
Global Rationale: Parents should be allowed to stay with their child if they wish to do so. This position is supported by the Emergency Nurses Association and is a key aspect of family-centered care.

Cognitive Level: Applying
Client Need: Psychosocial Integrity
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: LO 11.6 Integrate the concept of family presence during procedures and nursing strategies used to prepare the family.

Question 2
Type: MCSA
The charge nurse on a hospital unit is developing plans of care related to separation anxiety. The charge nurse recognizes that which hospitalized child at highest risk to experience separation anxiety when parents cannot stay?
1. 6-month-old
2. 18-month-old
3. 3-year-old
4. 4-year-old
Correct Answer: 2
Rationale 1: While all of these children can experience separation anxiety, the young toddler is at highest risk. Toddlers are the group most at risk for a stressful experience when hospitalized. Separation from parents increases this risk greatly.
Rationale 2: While all of these children can experience separation anxiety, the young toddler is at highest risk. Toddlers are the group most at risk for a stressful experience when hospitalized. Separation from parents increases this risk greatly.
Rationale 3: While all of these children can experience separation anxiety, the young toddler is at highest risk. Toddlers are the group most at risk for a stressful experience when hospitalized. Separation from parents increases this risk greatly.
Rationale 4: While all of these children can experience separation anxiety, the young toddler is at highest risk. Toddlers are the group most at risk for a stressful experience when hospitalized. Separation from parents increases this risk greatly.
Global Rationale: While all of these children can experience separation anxiety, the young toddler is at highest risk. Toddlers are the group most at risk for a stressful experience when hospitalized. Separation from parents increases this risk greatly.

Cognitive Level: Applying
Client Need: Psychosocial Integrity
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Diagnosis
Learning Outcome: LO 11.5 Identify nursing strategies to minimize the stressors related to hospitalization.

Question 3
Type: MCSA
A group of children on one hospital unit are all suffering separation anxiety. Which child is experiencing the “despair” stage of separation anxiety?
1. Does not cry if parents return and leave again
2. Screams and cries when parents leave
3. Appears to be happy and content with staff
4. Lies quietly in bed
Correct Answer: 4
Rationale 1: Children in the “despair” stage appear sad, depressed, or withdrawn. A child who is lying in bed might be exhibiting any of these. Screaming and crying are components of the “protest” stage. The young child who appears to be happy and content with everyone is in the “denial” stage, as is the child who does not cry if parents return and leave again.
Rationale 2: Children in the “despair” stage appear sad, depressed, or withdrawn. A child who is lying in bed might be exhibiting any of these. Screaming and crying are components of the “protest” stage. The young child who appears to be happy and content with everyone is in the “denial” stage, as is the child who does not cry if parents return and leave again.
Rationale 3: Children in the “despair” stage appear sad, depressed, or withdrawn. A child who is lying in bed might be exhibiting any of these. Screaming and crying are components of the “protest” stage. The young child who appears to be happy and content with everyone is in the “denial” stage, as is the child who does not cry if parents return and leave again.
Rationale 4: Children in the “despair” stage appear sad, depressed, or withdrawn. A child who is lying in bed might be exhibiting any of these. Screaming and crying are components of the “protest” stage. The young child who appears to be happy and content with everyone is in the “denial” stage, as is the child who does not cry if parents return and leave again.
Global Rationale: Children in the “despair” stage appear sad, depressed, or withdrawn. A child who is lying in bed might be exhibiting any of these. Screaming and crying are components of the “protest” stage. The young child who appears to be happy and content with everyone is in the “denial” stage, as is the child who does not cry if parents return and leave again.

Cognitive Level: Applying
Client Need: Psychosocial Integrity
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: LO 11.2 Explain the effect of hospitalization on the child and family.

Question 4
Type: MCSA
A preschool-age client is seen in the clinic for a sore throat. In this child’s mind, what is the most likely causative agent for the sore throat?
1. Was exposed to someone else with a sore throat.
2. Did not eat the right foods.
3. Yelled at his brother.
4. Did not take his vitamins.
Correct Answer: 3
Rationale 1: Preschoolers understand some concepts of being sick but not the cause of illness. They are likely to think that they are sick as a result of something that they have done. They will frequently view illness as punishment. A child of this age does not yet understand that he can become sick from exposure to someone else who is sick. The other two answers, while not causes of sore throat, can be factors in some illnesses but are beyond the thinking of a 4-year-old.
Rationale 2: Preschoolers understand some concepts of being sick but not the cause of illness. They are likely to think that they are sick as a result of something that they have done. They will frequently view illness as punishment. A child of this age does not yet understand that he can become sick from exposure to someone else who is sick. The other two answers, while not causes of sore throat, can be factors in some illnesses but are beyond the thinking of a 4-year-old.
Rationale 3: Preschoolers understand some concepts of being sick but not the cause of illness. They are likely to think that they are sick as a result of something that they have done. They will frequently view illness as punishment. A child of this age does not yet understand that he can become sick from exposure to someone else who is sick. The other two answers, while not causes of sore throat, can be factors in some illnesses but are beyond the thinking of a 4-year-old.
Rationale 4: Preschoolers understand some concepts of being sick but not the cause of illness. They are likely to think that they are sick as a result of something that they have done. They will frequently view illness as punishment. A child of this age does not yet understand that he can become sick from exposure to someone else who is sick. The other two answers, while not causes of sore throat, can be factors in some illnesses but are beyond the thinking of a 4-year-old.
Global Rationale: Preschoolers understand some concepts of being sick but not the cause of illness. They are likely to think that they are sick as a result of something that they have done. They will frequently view illness as punishment. A child of this age does not yet understand that he can become sick from exposure to someone else who is sick. The other two answers, while not causes of sore throat, can be factors in some illnesses but are beyond the thinking of a 4-year-old.

Cognitive Level: Analyzing
Client Need: Psychosocial Integrity
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: LO 11.1 Compare and contrast the child’s understanding of health and illness according to the child’s developmental level.

Question 5
Type: MCSA
The charge nurse is concerned with reducing the stressors of hospitalization. Which nursing intervention is most helpful in decreasing the stressors for the toddler-age client?
1. Assign the same nurse to the toddler as much as possible.
2. Let the child listen to an audiotape of the mother’s voice.
3. Place a picture of the family at the bedside.
4. Encourage a parent to stay with the child.
Correct Answer: 4
Rationale 1: While all of the interventions are appropriate for the hospitalized toddler, presence of a parent is most important. Separation from parents is the major stressor for the hospitalized toddler.
Rationale 2: While all of the interventions are appropriate for the hospitalized toddler, presence of a parent is most important. Separation from parents is the major stressor for the hospitalized toddler.
Rationale 3: While all of the interventions are appropriate for the hospitalized toddler, presence of a parent is most important. Separation from parents is the major stressor for the hospitalized toddler.
Rationale 4: While all of the interventions are appropriate for the hospitalized toddler, presence of a parent is most important. Separation from parents is the major stressor for the hospitalized toddler.
Global Rationale: While all of the interventions are appropriate for the hospitalized toddler, presence of a parent is most important. Separation from parents is the major stressor for the hospitalized toddler.
Cognitive Level: Analyzing
Client Need: Psychosocial Integrity
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: LO 11.5 Identify nursing strategies to minimize the stressors related to hospitalization.

Question 6
Type: MCSA
The nurse is working with a school-age child who is hospitalized. Which action by the nurse will promote a sense of industry in this child?
1. Allow the child to assist with her care.
2. Encourage parents to participate in the child’s care.
3. Give the child a detailed scientific explanation of the illness.
4. Speak to the child in a high-pitched voice.
Correct Answer: 1
Rationale 1: Allowing the child to participate in her care will decrease the sense of loss of control and increase a sense of industry. While parents can certainly participate in their child’s care, it does not increase the child’s sense of control. School-age children in general will not understand detailed scientific explanations. Change in voice tone is appropriate when talking to very young children.
Rationale 2: Allowing the child to participate in her care will decrease the sense of loss of control and increase a sense of industry. While parents can certainly participate in their child’s care, it does not increase the child’s sense of control. School-age children in general will not understand detailed scientific explanations. Change in voice tone is appropriate when talking to very young children.
Rationale 3: Allowing the child to participate in her care will decrease the sense of loss of control and increase a sense of industry. While parents can certainly participate in their child’s care, it does not increase the child’s sense of control. School-age children in general will not understand detailed scientific explanations. Change in voice tone is appropriate when talking to very young children.
Rationale 4: Allowing the child to participate in her care will decrease the sense of loss of control and increase a sense of industry. While parents can certainly participate in their child’s care, it does not increase the child’s sense of control. School-age children in general will not understand detailed scientific explanations. Change in voice tone is appropriate when talking to very young children.
Global Rationale: Allowing the child to participate in her care will decrease the sense of loss of control and increase a sense of industry. While parents can certainly participate in their child’s care, it does not increase the child’s sense of control. School-age children in general will not understand detailed scientific explanations. Change in voice tone is appropriate when talking to very young children.

Cognitive Level: Analyzing
Client Need: Psychosocial Integrity
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: LO 11.1 Compare and contrast the child’s understanding of health and illness according to the child’s developmental level.

Question 7
Type: MCSA
The nurse is caring for a client in the pediatric intensive-care unit (PICU). The parents have expressed anger over the nursing care their child is receiving. Which nursing intervention is most appropriate based on the situation?
1. Ask the physician to talk with the family.
2. Explain to the parents that their anger is affecting their child so they will not be allowed to visit the child until they calm down.
3. Acknowledge the parents’ concerns and collaborate with them regarding the care of their child.
4. Call the chaplain to sit with the family.
Correct Answer: 3
Rationale 1: Hospitalization of the child in a pediatric intensive-care unit is a great stressor for parents. If the parents feel that they are not informed or involved in the care of their child, they may become angry and upset. Calling the physician or chaplain may be appropriate at some point, but the nurse must assume the role of supporter in this situation to promote a sense of trust. Telling the parents that they cannot visit their child will only increase their anger.
Rationale 2: Hospitalization of the child in a pediatric intensive-care unit is a great stressor for parents. If the parents feel that they are not informed or involved in the care of their child, they may become angry and upset. Calling the physician or chaplain may be appropriate at some point, but the nurse must assume the role of supporter in this situation to promote a sense of trust. Telling the parents that they cannot visit their child will only increase their anger.
Rationale 3: Hospitalization of the child in a pediatric intensive-care unit is a great stressor for parents. If the parents feel that they are not informed or involved in the care of their child, they may become angry and upset. Calling the physician or chaplain may be appropriate at some point, but the nurse must assume the role of supporter in this situation to promote a sense of trust. Telling the parents that they cannot visit their child will only increase their anger.
Rationale 4: Hospitalization of the child in a pediatric intensive-care unit is a great stressor for parents. If the parents feel that they are not informed or involved in the care of their child, they may become angry and upset. Calling the physician or chaplain may be appropriate at some point, but the nurse must assume the role of supporter in this situation to promote a sense of trust. Telling the parents that they cannot visit their child will only increase their anger.
Global Rationale: Hospitalization of the child in a pediatric intensive-care unit is a great stressor for parents. If the parents feel that they are not informed or involved in the care of their child, they may become angry and upset. Calling the physician or chaplain may be appropriate at some point, but the nurse must assume the role of supporter in this situation to promote a sense of trust. Telling the parents that they cannot visit their child will only increase their anger.

Cognitive Level: Analyzing
Client Need: Psychosocial Integrity
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: LO 11.2 Explain the effect of hospitalization on the child and family.

Question 8
Type: MCSA
A toddler recently diagnosed with a seizure disorder will be discharged home on an anticonvulsant. Which action by the mother best demonstrates understanding of how to give the medication?
1. Verbalizing how to give the medication
2. Acknowledging understanding of written instructions
3. Drawing up the medication correctly in an oral syringe and administering it to the child
4. Observing the nurse draw up the medication and administering it to the child.
Correct Answer: 3
Rationale 1: Verbalization of how to give the medication and acknowledging understanding of written instructions are methods that might be used, but they do not actually demonstrate understanding. Observing the nurse draw up and administer the medication may be used in the teaching process. The best way for the mother to demonstrate understanding is to actually draw up and give the medication.
Rationale 2: Verbalization of how to give the medication and acknowledging understanding of written instructions are methods that might be used, but they do not actually demonstrate understanding. Observing the nurse draw up and administer the medication may be used in the teaching process. The best way for the mother to demonstrate understanding is to actually draw up and give the medication.
Rationale 3: Verbalization of how to give the medication and acknowledging understanding of written instructions are methods that might be used, but they do not actually demonstrate understanding. Observing the nurse draw up and administer the medication may be used in the teaching process. The best way for the mother to demonstrate understanding is to actually draw up and give the medication.
Rationale 4: Verbalization of how to give the medication and acknowledging understanding of written instructions are methods that might be used, but they do not actually demonstrate understanding. Observing the nurse draw up and administer the medication may be used in the teaching process. The best way for the mother to demonstrate understanding is to actually draw up and give the medication.
Global Rationale: Verbalization of how to give the medication and acknowledging understanding of written instructions are methods that might be used, but they do not actually demonstrate understanding. Observing the nurse draw up and administer the medication may be used in the teaching process. The best way for the mother to demonstrate understanding is to actually draw up and give the medication.

Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: LO 11.7 Summarize strategies for preparing children and families for discharge from the hospital setting.

Question 9
Type: MCSA
The nurse must perform a procedure on a toddler. Which technique is the most appropriate when performing the procedure?
1. Ask the mother to restrain the child during the procedure.
2. Ask the child if it is okay to start the procedure.
3. Perform the procedure in the child’s hospital bed.
4. Allow the child to cry or scream.
Correct Answer: 4
Rationale 1: While the toddler will need to be restrained, the parent should not be the one to do this. The nurse should avoid giving the child a choice if there is no choice. The treatment room should be utilized for the procedure so that the hospital bed remains a safe place. The child should be allowed to cry or scream during the procedure.
Rationale 2: While the toddler will need to be restrained, the parent should not be the one to do this. The nurse should avoid giving the child a choice if there is no choice. The treatment room should be utilized for the procedure so that the hospital bed remains a safe place. The child should be allowed to cry or scream during the procedure.
Rationale 3: While the toddler will need to be restrained, the parent should not be the one to do this. The nurse should avoid giving the child a choice if there is no choice. The treatment room should be utilized for the procedure so that the hospital bed remains a safe place. The child should be allowed to cry or scream during the procedure.
Rationale 4: While the toddler will need to be restrained, the parent should not be the one to do this. The nurse should avoid giving the child a choice if there is no choice. The treatment room should be utilized for the procedure so that the hospital bed remains a safe place. The child should be allowed to cry or scream during the procedure.
Global Rationale: While the toddler will need to be restrained, the parent should not be the one to do this. The nurse should avoid giving the child a choice if there is no choice. The treatment room should be utilized for the procedure so that the hospital bed remains a safe place. The child should be allowed to cry or scream during the procedure.

Cognitive Level: Applying
Client Need: Psychosocial Integrity
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: LO 11.5 Identify nursing strategies to minimize the stressors related to hospitalization.

Question 10
Type: MCSA
A young school-age client is in the playroom when the respiratory therapist arrives on the pediatric unit to give the child a scheduled breathing treatment. Which action by the nurse is the most appropriate?
1. Reschedule the treatment for a later time.
2. Show the respiratory therapist to the playroom so the treatment may be performed.
3. Escort the child to his room and ask the child-life specialist to bring toys to the bedside.
4. Assist the child back to his room for the treatment but reassure the child that he may return when the procedure is completed.
Correct Answer: 4