A laboratory technician is performing a blood draw on a toddler. The toddler is holding still but crying loudly. The nurse should take which action?

A laboratory technician is performing a blood draw on a toddler. The toddler is holding still but crying loudly. The nurse should take which action?

a. Have the lab technician stop the procedure until the child stops crying.
b. Do nothing. It's Okay for a child to cry during a painful procedure.
c. Tell the child to stop crying; it's only a small prick.
d. Tell the child to stop crying because the procedure is almost over.


Answer: B

The nurse on a pediatric unit is writing guidelines for age-specific preparation of children for procedures based on developmental characteristics. What guideline is accurate?

The nurse on a pediatric unit is writing guidelines for age-specific preparation of children for procedures based on developmental characteristics. What guideline is accurate?

a. Inform toddlers about an upcoming procedure 2 hours before the procedure is to be performed.
b. Inform school-age children about an upcoming procedure immediately before the procedure is scheduled to occur.
c. Discourage parent presence during procedures on infants and toddlers.
d. Use simple diagrams of anatomy and physiology to explain a procedure to a school-age child.


Answer: D

A preschool child needs a dressing change. To prepare the child, what strategy should the nurse implement?

A preschool child needs a dressing change. To prepare the child, what strategy should the nurse implement?

a. Explain the procedure using medical terminology.
b. Plan a 30-minute teaching session.
c. Give choices when possible but avoid delay.
d. Allow time after the procedure for questions and discussion.


Answer: C

A 1-month-old infant is admitted to the hospital. The infant's mother is 17 years old and single and lives with her parents. Who signs the informed consent for the 1-month-old infant?

A 1-month-old infant is admitted to the hospital. The infant's mother is 17 years old and single and lives with her parents. Who signs the informed consent for the 1-month-old infant?

a. The infant's mother
b. The maternal grandparents of the infant
c. The paternal grandparents of the infant
d. Both the infant's mother and the maternal grandparents


Answer: A

What is a priority intervention for an infant with a temporary colostomy for Hirschsprung disease?

What is a priority intervention for an infant with a temporary colostomy for Hirschsprung disease?

a. Teaching how to irrigate the colostomy
b. Protecting the skin around the colostomy
c. Discussing the implications of a colostomy during puberty
d. Using simple, straightforward language to prepare the child


Answer: B

Parents are being taught how to feed their infant using a newly placed gastrostomy tube (G-tube). What is essential information for the parents to receive?

Parents are being taught how to feed their infant using a newly placed gastrostomy tube (G-tube). What is essential information for the parents to receive?

a. Verify placement before each feeding.
b. Use a syringe with a plunger to give the infant bolus feedings.
c. Position the infant on the right side during and after the feeding.
d. Beefy red tissue around the G-tube site must be reported to the practitioner.


Answer: C

What is the best method to verify the placement of a nasogastric tube before each use?

What is the best method to verify the placement of a nasogastric tube before each use?

a. Radiologic confirmation
b. Auscultation of injected air
c. Aspiration of stomach contents
d. Verification of tape placement on tube


Answer: C

When teaching a mother how to administer eye drops, where should the nurse tell her to place them?

When teaching a mother how to administer eye drops, where should the nurse tell her to place them?

a. At the lacrimal duct
b. On the sclera while the child looks to the outside
c. In the conjunctival sac when the lower eyelid is pulled down
d. Carefully under the eyelid while it is gently pulled upward


Answer: C

What is an advantage of the ventrogluteal muscle as an injection site in young children?

What is an advantage of the ventrogluteal muscle as an injection site in young children?

a. Easily accessible from many directions
b. Free of significant nerves and vascular structures
c. Can be used until child reaches a weight of 9 kg (20 lb)
d. Increased subcutaneous fat, which provides sustained drug absorption


Answer: B

Guidelines for intramuscular administration of medication in school-age children include what standard?

Guidelines for intramuscular administration of medication in school-age children include what standard?

a. Inject medication as rapidly as possible.
b. Insert needle quickly, using a dartlike motion.
c. Have the child stand if at all possible and if the child is cooperative.
d. Penetrate the skin immediately after cleansing the site while the skin is moist.


Answer: B

The practitioner has ordered a liquid oral antibiotic for a toddler with otitis media. The prescription reads 1 1/2 tsp four times per day. What should the nurse consider in teaching the mother how to give the medicine?

The practitioner has ordered a liquid oral antibiotic for a toddler with otitis media. The prescription reads 1 1/2 tsp four times per day. What should the nurse consider in teaching the mother how to give the medicine?

a. A measuring spoon should be used, and the medication must be given every 6 hours.
b. The mother is not able to handle this regimen. Long-acting intramuscular antibiotics should be administered.
c. A hollow-handled medication spoon is advisable, and the medication should be equally spaced while the child is awake.
d. A household teaspoon should be used and the medicine given when the child wakes up, around lunch time, at dinner time, and before bed.


Answer: C

An appropriate method for administering oral medications that are bitter to an infant or small child should be to mix them with which?

An appropriate method for administering oral medications that are bitter to an infant or small child should be to mix them with which?

a. Bottle of formula or milk
b. Any food the child is going to eat
c. One teaspoon of something sweet-tasting such as jam
d. Carbonated beverage, which is then poured over crushed ice


Answer: C

The nurse has just collected blood by venipuncture in the antecubital fossa. What should the nurse do next?

The nurse has just collected blood by venipuncture in the antecubital fossa. What should the nurse do next?

a. Keep the child's arm extended while applying a Band-Aid to the site.
b. Keep the child's arm extended and apply pressure to the site for a few minutes.
c. Apply a Band-Aid to the site and keep the arm flexed for 10 minutes.
d. Apply a gauze pad or cotton ball to the site and keep the arm flexed for several minutes.


Answer: B

A child has a central venous access device for intravenous (IV) fluid administration. A blood sample is needed for a complete blood count, hemogram, and electrolytes. What is the appropriate procedure to implement for this blood sample?

A child has a central venous access device for intravenous (IV) fluid administration. A blood sample is needed for a complete blood count, hemogram, and electrolytes. What is the appropriate procedure to implement for this blood sample?

a. Perform a new venipuncture to obtain the blood sample.
b. Interrupt the IV fluid and withdraw the blood sample needed.
c. Withdraw a blood sample equal to the amount of fluid in the device, discard, and then withdraw the sample needed.
d. Flush the line and central venous device with saline and then aspirate the required amount of blood for the sample.


Answer: C

Frequent urine tests for specific gravity are required on a 6-month-old infant. What method is the most appropriate way to collect small amounts of urine for these tests?

Frequent urine tests for specific gravity are required on a 6-month-old infant. What method is the most appropriate way to collect small amounts of urine for these tests?

a. Apply a urine collection bag to the perineal area.
b. Tape a small medicine cup inside of the diaper.
c. Aspirate urine from cotton balls inside the diaper with a syringe without a needle.
d. Use a syringe without a needle to aspirate urine from a superabsorbent disposable diaper.


Answer: C

A 2-year-old child is being admitted to the hospital for possible bacterial meningitis. When preparing for a lumbar puncture, what should the nurse do?

A 2-year-old child is being admitted to the hospital for possible bacterial meningitis. When preparing for a lumbar puncture, what should the nurse do?

a. Set up a tray with equipment the same size as for adults.
b. Apply EMLA to the puncture site 15 minutes before the procedure.
c. Prepare the child for conscious sedation being used for the procedure.
d. Reassure the parents that the test is simple, painless, and risk free.


Answer: C

A nurse must do a venipuncture on a 6-year-old child. What consideration is important in providing atraumatic care?

A nurse must do a venipuncture on a 6-year-old child. What consideration is important in providing atraumatic care?

a. Use an 18-gauge needle if possible.
b. Show the child the equipment to be used before the procedure.
c. If not successful after four attempts, have another nurse try.
d. Restrain the child completely.


Answer: B

An 11-month-old hospitalized boy is restrained because he is receiving intravenous (IV) fluids. His grandmother has come to stay with him for the afternoon and asks the nurse if the restraints can be removed. What nurse's response is best?

An 11-month-old hospitalized boy is restrained because he is receiving intravenous (IV) fluids. His grandmother has come to stay with him for the afternoon and asks the nurse if the restraints can be removed. What nurse's response is best?

a. "Restraints need to be kept on all the time."
b. "That is fine as long as you are with him."
c. "That is fine if we have his parents' consent."
d. "The restraints can be off only when the nursing staff is present."


Answer: B

A child who has cystic fibrosis is admitted to the pediatric unit with methicillin-resistant Staphylococcus aureus (MRSA) infection. The nurse recognizes that in addition to a private room, the child is placed on what precautions?

A child who has cystic fibrosis is admitted to the pediatric unit with methicillin-resistant Staphylococcus aureus (MRSA) infection. The nurse recognizes that in addition to a private room, the child is placed on what precautions?

a. Droplet
b. Contact
c. Airborne
d. Standard


Answer: B

The nurse gives an injection in a patient's room. How should the nurse dispose of the needle?

The nurse gives an injection in a patient's room. How should the nurse dispose of the needle?

a. Remove the needle from the syringe and dispose of it in a proper container.
b. Dispose of the syringe and needle in a rigid, puncture-resistant container in the patient's room.
c. Close the safety cover on the needle and return it to the medication preparation area for proper disposal.
d. Place the syringe and needle in a rigid, puncture-resistant container in an area outside of the patient's room.


Answer: B

A critically ill child has hyperthermia. The parents ask the nurse to give an antipyretic such as acetaminophen. How should the nurse respond to the parents?

A critically ill child has hyperthermia. The parents ask the nurse to give an antipyretic such as acetaminophen. How should the nurse respond to the parents?

a. Febrile seizures can result.
b. Antipyretics may cause malignant hyperthermia.
c. Antipyretics are of no value in treating hyperthermia.
d. Liver damage may occur in critically ill children.


Answer: C

A child, age 7 years, has a fever associated with a viral illness. She is being cared for at home. What is the principal reason for treating fever in this child?

A child, age 7 years, has a fever associated with a viral illness. She is being cared for at home. What is the principal reason for treating fever in this child?

a. Relief of discomfort
b. Reassurance that illness is temporary
c. Prevention of secondary bacterial infection
d. Avoidance of life-threatening complications


Answer: A

A 14-year-old adolescent is hospitalized with cystic fibrosis. What nursing note entry represents best documentation of his breakfast meal?

A 14-year-old adolescent is hospitalized with cystic fibrosis. What nursing note entry represents best documentation of his breakfast meal?

a. Tolerated breakfast well
b. Finished all of breakfast ordered
c. One pancake, eggs, and 240 ml OJ
d. No documentation is needed for this age child.

Answer: C

A 6-year-old boy is hospitalized for intravenous antibiotic therapy. He eats very little on his "regular diet" trays. He tells the nurse that all he wants to eat is pizza, tacos, and ice cream. What nursing action is the most appropriate?

A 6-year-old boy is hospitalized for intravenous antibiotic therapy. He eats very little on his "regular diet" trays. He tells the nurse that all he wants to eat is pizza, tacos, and ice cream. What nursing action is the most appropriate?

a. Request these favorite foods for him.
b. Identify healthier food choices that he likes.
c. Explain that he needs fruits and vegetables.
d. Reward him with ice cream at the end of every meal that he eats.


Answer: A

A 7-year-old is identified as being at risk for skin breakdown. What intervention should the nursing care plan include?

A 7-year-old is identified as being at risk for skin breakdown. What intervention should the nursing care plan include?

a. Massaging reddened bony prominences
b. Teaching the parents to turn the child every 4 hours
c. Ensuring that nutritional intake meets requirements
d. Minimizing use of extra linens, which can irritate the child's skin


Answer: C

A 10-year-old child requires daily medications for a chronic illness. Her mother tells the nurse that the child continually forgets to take the medicine unless reminded. What nursing action is most appropriate to promote adherence to the medication regimen?

A 10-year-old child requires daily medications for a chronic illness. Her mother tells the nurse that the child continually forgets to take the medicine unless reminded. What nursing action is most appropriate to promote adherence to the medication regimen?

a. Establish a contract with her, including rewards.
b. Suggest time-outs when she forgets her medicine.
c. Discuss with her mother the damaging effects of her rescuing the child.
d. Ask the child to bring her medicine containers to each appointment so they can be counted.


Answer: A

A 5-year-old child returns from the pediatric intensive care unit after abdominal surgery. The orders state to monitor vital signs every 2 hours. On assessment, the nurse observes that the child's heart rate is 20 beats/min less than it was preoperatively. What should be the nurse's next action?

A 5-year-old child returns from the pediatric intensive care unit after abdominal surgery. The orders state to monitor vital signs every 2 hours. On assessment, the nurse observes that the child's heart rate is 20 beats/min less than it was preoperatively. What should be the nurse's next action?

a. Follow the orders and check in 2 hours.
b. Ask the parents if this is the child's usual heart rate.
c. Recheck the pulse and blood pressure in 15 minutes.
d. Notify the surgeon that the child is probably going into shock.


Answer: C

A toddler is being sent to the operating room for surgery at 9 AM. As the nurse prepares the child, what is the priority intervention?

A toddler is being sent to the operating room for surgery at 9 AM. As the nurse prepares the child, what is the priority intervention?

a. Administering preoperative antibiotic
b. Verifying that the child and procedure are correct
c. Ensuring that the toddler has been NPO since midnight
d. Informing the parents where they can wait during the procedure


Answer: B

A 6-year-old child needs to drink 1 L of GoLYTELY in preparation for a computed tomography scan of the abdomen. To encourage the child to drink, what should the nurse do?

A 6-year-old child needs to drink 1 L of GoLYTELY in preparation for a computed tomography scan of the abdomen. To encourage the child to drink, what should the nurse do?

a. Give him a large cup with ice so it tastes better.
b. Restrict him to his room until he drinks the GoLYTELY.
c. Use little cups and make a game to reward him for each cup he drinks.
d. Tell him that if he does not finish drinking by a set time, the practitioner will be angry.


Answer: C

A bone marrow biopsy will be performed on a 7-year-old girl. She wants her mother to hold her during the procedure. How should the nurse respond?

A bone marrow biopsy will be performed on a 7-year-old girl. She wants her mother to hold her during the procedure. How should the nurse respond?

a. Holding your child is unsafe.
b. Holding may help your child relax.
c. Hospital policy prohibits this interaction.
d. Holding your child is unnecessary given the child's age.


Answer: B

The nurse is preparing a 9-year-old boy before obtaining a blood specimen by venipuncture. The child tells the nurse he does not want to lose his blood. What approach is best by the nurse?

The nurse is preparing a 9-year-old boy before obtaining a blood specimen by venipuncture. The child tells the nurse he does not want to lose his blood. What approach is best by the nurse?

a. Explain that it will not be painful.
b. Suggest to him that he not worry about losing just a little bit of blood.
c. Discuss with him how his body is always in the process of making blood.
d. Tell the child that he will not even need a Band-Aid afterward because it is a simple procedure.


Answer: C

Using knowledge of child development, what approach is best when preparing a toddler for a procedure?

Using knowledge of child development, what approach is best when preparing a toddler for a procedure?

a. Avoid asking the child to make choices.
b. Plan for a teaching session to last about 20 minutes.
c. Demonstrate on a doll how the procedure will be done.
d. Show the necessary equipment without allowing child to handle it.


Answer: C

A 4-year-old girl is admitted to outpatient surgery for removal of a cyst on her back. Her mother puts the hospital gown on her, but the child is crying because she wants to leave on her underpants. What is the most appropriate nursing action at this time?

A 4-year-old girl is admitted to outpatient surgery for removal of a cyst on her back. Her mother puts the hospital gown on her, but the child is crying because she wants to leave on her underpants. What is the most appropriate nursing action at this time?

a. Allow her to wear her underpants.
b. Discuss with her mother why this is important to the child.
c. Ask her mother to explain to her why she cannot wear them.
d. Explain in a kind, matter-of-fact manner that this is hospital policy.


Answer: A

The nurse needs to take the blood pressure of a preschool boy for the first time. What action would be best in gaining his cooperation?

The nurse needs to take the blood pressure of a preschool boy for the first time. What action would be best in gaining his cooperation?

a. Tell him that this procedure will help him get well faster.
b. Take his blood pressure when a parent is there to comfort him.
c. Explain to him how the blood flows through the arm and why the blood pressure is important.
d. Permit him to handle the equipment and see the cuff inflate and deflate before putting the cuff in place.


Answer: D

A 16-year-old girl comes to the pediatric clinic for information on birth control. The nurse knows that before this young woman can be examined, consent must be obtained from which source?

A 16-year-old girl comes to the pediatric clinic for information on birth control. The nurse knows that before this young woman can be examined, consent must be obtained from which source?

a. Herself
b. Her mother
c. Court order
d. Legal guardian


Answer: A

What nursing interventions should the nurse plan for a hospitalized toddler to minimize fear of bodily injury?

What nursing interventions should the nurse plan for a hospitalized toddler to minimize fear of bodily injury? 

a. Perform procedures slowly.

b. Maintain parentchild contact.

c. Use progressively smaller dressings on surgical incisions.

d. Tell the child bleeding will stop after the needle is removed.

e. Remove a dressing as quickly as possible from surgical incisions.


Answer: B, C

The nurse relates to parents that there are some beneficial effects of hospitalization for their child. What are beneficial effects of hospitalization?

The nurse relates to parents that there are some beneficial effects of hospitalization for their child. What are beneficial effects of hospitalization? 

a. Recovery from illness

b. Improve coping abilities

c. Opportunity to master stress

d. Provide a break from school

e. Provide new socialization experiences


Answer: A, B, C, E

What are core principles of patient- and family-centered care?

What are core principles of patient- and family-centered care? 

a. Collaboration

b. Empowering families

c. Providing formal and informal support

d. Maintaining strict policy and procedure routines

e. Withholding information that is likely to cause anxiety


Answer: B, C

Parents tell the nurse that siblings of their hospitalized child are feeling left out. What suggestions should the nurse make to the parents to assist the siblings to adjust to the hospitalization of their brother or sister?

Parents tell the nurse that siblings of their hospitalized child are feeling left out. What suggestions should the nurse make to the parents to assist the siblings to adjust to the hospitalization of their brother or sister? 

a. Arrange for visits to the hospital.

b. Limit information given to the siblings.

c. Encourage phone calls to the hospitalized child.

d. Make or buy inexpensive toys or trinkets for the siblings.

e. Identify an extended family member to be their support system.


Answer: A, C, D, E

The nurse is assessing a familys use of complementary medicine practices. What practices are classified as nutrition, diet, and lifestyle or behavioral health changes?

The nurse is assessing a familys use of complementary medicine practices. What practices are classified as nutrition, diet, and lifestyle or behavioral health changes? 

a. Reflexology

b. Macrobiotics

c. Megavitamins

d. Health risk reduction

e. Chiropractic medicine


Answer: B, C, D

The nurse is assessing a familys use of complementary medicine practices. What practices are classified as mindbody control therapies?

The nurse is assessing a familys use of complementary medicine practices. What practices are classified as mindbody control therapies? 

a. Relaxation

b. Acupuncture

c. Prayer therapy

d. Guided imagery

e. Herbal medicine


Answer: A, C, D

What factors can negatively affect parents reactions to their childs illness?

What factors can negatively affect parents reactions to their childs illness? 

a. Additional stresses

b. Previous coping abilities

c. Lack of support systems

d. Seriousness of the threat to the child

e. Previous experience with hospitalization


Answer: A, C, D

What factors influence the effects of a childs hospitalization on siblings?

What factors influence the effects of a childs hospitalization on siblings? 

a. Older siblings

b. Experiencing minimal changes

c. Receiving little information about their ill brother or sister

d. Being cared for outside the home by care providers who are not relatives

e. Perceiving that their parents treat them differently compared with before their siblings hospitalization


Answer: C, D, E

What are signs and symptoms of the stage of detachment in relation to separation anxiety in young children?

What are signs and symptoms of the stage of detachment in relation to separation anxiety in young children? 

a. Appears happy

b. Lacks interest in the environment

c. Regresses to an earlier behavior

d. Forms new but superficial relationships

e. Interacts with strangers or familiar caregivers


Answer: A, D, E

The parents tell a nurse our child is having some short-term negative outcomes since the hospitalization. The nurse recognizes that what can negatively affect short-term negative outcomes?

The parents tell a nurse our child is having some short-term negative outcomes since the hospitalization. The nurse recognizes that what can negatively affect short-term negative outcomes? 

a. Parents anxiety

b. Consistent nurses

c. Number of visitors

d. Length of hospitalization

e. Multiple invasive procedures


Answer: A, D, E

What influences a childs reaction to the stressors of hospitalization?

What influences a childs reaction to the stressors of hospitalization? 

a. Gender

b. Separation

c. Support systems

d. Developmental age

e. Previous experience with illness

Answer: B, C, D, E

What are signs and symptoms of the stage of despair in relation to separation anxiety in young children?

What are signs and symptoms of the stage of despair in relation to separation anxiety in young children? 

a. Withdrawn from others

b. Uncommunicative

c. Clings to parents

d. Physically attacks strangers

e. Forms new but superficial relationships

f. Regresses to early behaviors


Answer: A, B, F

The nurse is assessing a childs functional self-care level for feeding, bathing and hygiene, dressing, and grooming and toileting. The child requires assistance or supervision from another person and equipment or device. What code does the nurse assign for this child?

The nurse is assessing a childs functional self-care level for feeding, bathing and hygiene, dressing, and grooming and toileting. The child requires assistance or supervision from another person and equipment or device. What code does the nurse assign for this child?

a. I

b. II

c. III

d. IV


Answer: C

What choice of words or phrases would be inappropriate to use with a child?

What choice of words or phrases would be inappropriate to use with a child?

a. Rolling bed for stretcher

b. Special medicine for dye

c. Make sleepy for deaden

d. Catheter for intravenous


Answer: D

What parents should have the most difficult time coping with their childs hospitalization?

What parents should have the most difficult time coping with their childs hospitalization?

a.

Parents of a child hospitalized for juvenile arthritis

b.

Parents of a child hospitalized with a recent diagnosis of bronchiolitis

c.

Parents of a child hospitalized for sepsis resulting from an untreated injury

d.

Parents of a child hospitalized for surgical correction of undescended testicles


Answer: C

The nurse needs to assess a 15-month-old child who is sitting quietly on his fathers lap. What initial action by the nurse would be most appropriate?

The nurse needs to assess a 15-month-old child who is sitting quietly on his fathers lap. What initial action by the nurse would be most appropriate?

a. Ask the father to place the child on the exam table.

b. Undress the child while he is still sitting on his fathers lap.

c. Talk softly to the child while taking him from his father.

d. Begin the assessment while the child is in his fathers lap.


Answer: D

A parent needs to leave a hospitalized toddler for a short period of time. What action should the nurse suggest to the parent to ease the separation for the toddler?

A parent needs to leave a hospitalized toddler for a short period of time. What action should the nurse suggest to the parent to ease the separation for the toddler?

a. Bring a new toy when returning.

b. Leave when the child is distracted.

c. Tell the child when they will return.

d. Leave a favorite article from home with the child.


Answer: D

When a preschool-age child is hospitalized without adequate preparation, the nurse should recognize that the child may likely see hospitalization as what?

When a preschool-age child is hospitalized without adequate preparation, the nurse should recognize that the child may likely see hospitalization as what?

a. Punishment

b. Loss of parental love

c. Threat to the childs self-image

d. Loss of companionship with friends


Answer: A

Parents of a hospitalized child often question the skill of staff. The nurse interprets this behavior by the parents as what?

Parents of a hospitalized child often question the skill of staff. The nurse interprets this behavior by the parents as what?

a. Normal

b. Paranoid

c. Indifferent

d. Wanting attention


Answer: A

The nurse is instructing student nurses about the stress of hospitalization for children from middle infancy throughout the preschool years. What major stress should the nurse relate to the students?

The nurse is instructing student nurses about the stress of hospitalization for children from middle infancy throughout the preschool years. What major stress should the nurse relate to the students?

a. Pain

b. Bodily injury

c. Loss of control

d. Separation anxiety


Answer: D

The nurse is providing support to parents adapting to the hospitalization of their child to the pediatric intensive care unit. The nurse notices that the parents keep asking the same questions. What should the nurse do?

The nurse is providing support to parents adapting to the hospitalization of their child to the pediatric intensive care unit. The nurse notices that the parents keep asking the same questions. What should the nurse do?

a. Patiently continue to answer questions, trying different approaches.

b. Kindly refer them to someone else for answering their questions.

c. Recognize that some parents cannot understand explanations.

d. Suggest that they ask their questions when they are not upset.


Answer: A

The nurse should expect a toddler to cope with the stress of a short period of separation from parents by displaying what?

The nurse should expect a toddler to cope with the stress of a short period of separation from parents by displaying what?

a. Regression

b. Happiness

c. Detachment

d. Indifference


Answer: A

The nurse is caring for a 3-year-old child during a long hospitalization. The parent is concerned about how to support the childs siblings during the hospitalization. What statement is appropriate for the nurse to make?

The nurse is caring for a 3-year-old child during a long hospitalization. The parent is concerned about how to support the childs siblings during the hospitalization. What statement is appropriate for the nurse to make?

a. You should choose one parent to spend every night in the hospital while the other parent stays at home with the other children.

b. You could leave your hospitalized child for periods at night to be at home with the other children.

c. You should discourage the siblings from visiting because this could upset everyone in the family.

d. You could encourage a nightly phone call between the siblings as part of the bedtime routine.


Answer: D

The nurse is caring for a 10-year-old child during a long hospitalization. What intervention should the nurse include in the care plan to minimize loss of control and autonomy during the hospitalization?

The nurse is caring for a 10-year-old child during a long hospitalization. What intervention should the nurse include in the care plan to minimize loss of control and autonomy during the hospitalization?

a. Allow the child to skip morning self-care activities to watch a favorite television program.

b. Create a calendar with special events such as a visit from a friend to maintain a routine.

c. Allow the child to sleep later in the morning and go to bed later at night to promote control.

d. Create a restrictive environment so the child feels in control of sensory stimulation.


Answer: B

A 6-year-old is being discharged home, which is 90 miles from the hospital, after an outpatient hernia repair. In addition to explicit discharge instructions, what should the nurse provide?

A 6-year-old is being discharged home, which is 90 miles from the hospital, after an outpatient hernia repair. In addition to explicit discharge instructions, what should the nurse provide?

a. An ambulance for transport home

b. Verbal information about follow-up care

c. Prescribed pain medication before discharge

d. Driving instructions for a route with less traffic


Answer: C

A 9-year-old boy has an unplanned admission to the intensive care unit (ICU) after abdominal surgery. The nursing staff has completed the admission process, and his condition is beginning to stabilize. When speaking with the parents, the nurse should expect what additional stressor to be evident?

A 9-year-old boy has an unplanned admission to the intensive care unit (ICU) after abdominal surgery. The nursing staff has completed the admission process, and his condition is beginning to stabilize. When speaking with the parents, the nurse should expect what additional stressor to be evident?

a. Usual daynight routine

b. Calming influence of staff

c. Adequate privacy and support

d. Insufficient remembering of his condition and routine


Answer: D

The nurse is doing a prehospitalization orientation for a girl, age 7 years, who is scheduled for cardiac surgery. As part of the preparation, the nurse explains that after the surgery, the child will be in the intensive care unit. How might the explanation by the nurse be viewed?

The nurse is doing a prehospitalization orientation for a girl, age 7 years, who is scheduled for cardiac surgery. As part of the preparation, the nurse explains that after the surgery, the child will be in the intensive care unit. How might the explanation by the nurse be viewed?

a. Unnecessary

b. The surgeons responsibility

c. Too stressful for a young child

d. An appropriate part of the childs preparation


Answer: D

The nurse is notified that a 9-year-old boy with nephrotic syndrome is being admitted. Only semiprivate rooms are available. What roommate should be best to select?

The nurse is notified that a 9-year-old boy with nephrotic syndrome is being admitted. Only semiprivate rooms are available. What roommate should be best to select?

a. A 10-year-old girl with pneumonia

b. An 8-year-old boy with a fractured femur

c. A 10-year-old boy with a ruptured appendix

d. A 9-year-old girl with congenital heart disease


Answer: B

The nurse is admitting a 7-year-old child to the pediatric unit for abdominal pain. To determine what the child understands about the reason for hospitalization, what should the nurse do?

The nurse is admitting a 7-year-old child to the pediatric unit for abdominal pain. To determine what the child understands about the reason for hospitalization, what should the nurse do?

a. Find out what the parents have told the child.

b. Review the note from the admitting practitioner.

c. Ask the child why he came to the hospital today.

d. Question the parents about why they brought the child to the hospital.


Answer: C

The parents of a 3-year-old admitted for recurrent diarrhea are upset that the practitioner has not told them what is going on with their child. What is the priority intervention for this family?

The parents of a 3-year-old admitted for recurrent diarrhea are upset that the practitioner has not told them what is going on with their child. What is the priority intervention for this family?

a. Answer all of the parents questions about the childs illness.

b. Immediately page the practitioner to come to the unit to speak with the family.

c. Help the family develop a written list of specific questions to ask the practitioner.

d. Inform the family of the time that hospital rounds are made so that they can be present.


Answer: C

A 6-year-old child is admitted to the pediatric unit and requires bed rest. Having art supplies available meets which purpose?

A 6-year-old child is admitted to the pediatric unit and requires bed rest. Having art supplies available meets which purpose?

a. Allows the child to create gifts for parents

b. Provides developmentally appropriate activities

c. Is essential for play therapy so the child can work on past problems

d. Lets the child express thoughts and feelings through pictures rather than words


Answer: D

Two hospitalized adolescents are playing pool in the activity room. Neither of them seems enthusiastic about the game. How should the nurse interpret this situation?

Two hospitalized adolescents are playing pool in the activity room. Neither of them seems enthusiastic about the game. How should the nurse interpret this situation?

a. Playing pool requires too much concentration for this age group.

b. Pool is an activity better suited for younger children.

c. The adolescents may be enjoying themselves but have lower energy levels than healthy children.

d. The adolescents lack of enthusiasm is one of the signs of depression.


Answer: C

A 13-year-old child with cystic fibrosis (CF) is a frequent patient on the pediatric unit. This admission, she is sleeping during the daytime and unable to sleep at night. What should be a beneficial strategy for this child?

A 13-year-old child with cystic fibrosis (CF) is a frequent patient on the pediatric unit. This admission, she is sleeping during the daytime and unable to sleep at night. What should be a beneficial strategy for this child?

a. Administer prescribed sedative at night to aid in sleep.

b. Negotiate a daily schedule that incorporates hospital routine, therapy, and free time.

c. Have the practitioner speak with the child about the need for rest when receiving therapy for CF.

d. Arrange a consult with the social worker to determine whether issues at home are interfering with her care.


Answer: B

An 8-year-old girl is being admitted to the hospital from the emergency department with an injury from falling off her bicycle. What intervention will help her most in her adjustment to the hospital?

An 8-year-old girl is being admitted to the hospital from the emergency department with an injury from falling off her bicycle. What intervention will help her most in her adjustment to the hospital?

a. Explain hospital schedules to her, such as mealtimes.

b. Use terms such as honey and dear to show a caring attitude.

c. Explain when parents can visit and why siblings cannot come to see her.

d. Orient her parents, because she is too young, to her room and hospital facility.


Answer: A

The parents of a 4-month-old infant cannot visit except on weekends. What action by the nurse indicates an understanding of the emotional needs of a young infant?

The parents of a 4-month-old infant cannot visit except on weekends. What action by the nurse indicates an understanding of the emotional needs of a young infant?

a. Place her in a room away from other children.

b. Assign her to the same nurse as much as possible.

c. Tell the parents that frequent visiting is unnecessary.

d. Assign her to different nurses so she will have varied contacts.


Answer: B

A 10-year-old girl needs to have another intravenous (IV) line started. She keeps telling the nurse, Wait a minute, and, Im not ready. How should the nurse interpret this behavior?

A 10-year-old girl needs to have another intravenous (IV) line started. She keeps telling the nurse, Wait a minute, and, Im not ready. How should the nurse interpret this behavior?

a.

IV insertions are viewed as punishment.

b.

This is expected behavior for a school-age child.

c.

Protesting like this is usually not seen past the preschool years.

d.

The child has successfully manipulated the nurse in the past.


Answer: B

The mother of a 7-month-old infant newly diagnosed with cystic fibrosis is rooming in with her infant. She is breastfeeding and provides all the care except for the medication administration. What should the nurse include in the plan of care?

The mother of a 7-month-old infant newly diagnosed with cystic fibrosis is rooming in with her infant. She is breastfeeding and provides all the care except for the medication administration. What should the nurse include in the plan of care?

a. Ensuring that the mother has time away from the infant

b. Making sure the mother is providing all of the infants care

c. Determining whether other family members can provide the necessary care so the mother can rest

d. Contacting the social worker because of the mothers interference with the nursing care


Answer: A

A spinal tap must be done on a 9-year-old boy. While he is waiting in the treatment room, the nurse observes that he seems composed. When the nurse asks him if he wants his mother to stay with him, he says, I am fine. How should the nurse interpret this situation?

A spinal tap must be done on a 9-year-old boy. While he is waiting in the treatment room, the nurse observes that he seems composed. When the nurse asks him if he wants his mother to stay with him, he says, I am fine. How should the nurse interpret this situation?

a. This child is unusually brave.

b. He has learned that support does not help.

c. Nine-year-old boys do not usually want a parent present during the procedure.

d. Children in this age group often do not request support even though they need and want it.


Answer: D

The psychosexual conflicts of preschool children make them extremely vulnerable to which threat?

The psychosexual conflicts of preschool children make them extremely vulnerable to which threat?

a.

Loss of control

b.

Loss of identity

c.

Separation anxiety

d.

Bodily injury and pain


Answer: D

A child, age 4 years, tells the nurse that she needs a Band-Aid where she had an injection. What nursing action should the nurse implement?

A child, age 4 years, tells the nurse that she needs a Band-Aid where she had an injection. What nursing action should the nurse implement?

a.Apply a Band-Aid.

b.Ask her why she wants a Band-Aid.

c.Explain why a Band-Aid is not needed.

d.Show her that the bleeding has already stopped.


Answer: A

Cognitive development influences response to pain. What age group is most concerned with the fear of losing control during a painful experience?

Cognitive development influences response to pain. What age group is most concerned with the fear of losing control during a painful experience?

a. Toddlers

b. Preschoolers

c. School-age children

d. Adolescents


Answer: D

Because of their striving for independence and productivity, which age group of children is particularly vulnerable to events that may lessen their feeling of control and power?

Because of their striving for independence and productivity, which age group of children is particularly vulnerable to events that may lessen their feeling of control and power?

a. Infants

b. Toddlers

c. Preschoolers

d. School-age children


Answer: D

What behavior should most likely be manifested in an infant experiencing the protest phase of separation anxiety?

What behavior should most likely be manifested in an infant experiencing the protest phase of separation anxiety?

a. Inactivity

b. Depression and sadness

c. Inconsolable and crying

d. Regression to earlier behavior


Answer: C

What are supportive interventions that can assist an adolescent with a chronic illness to meet developmental milestones?

What are supportive interventions that can assist an adolescent with a chronic illness to meet developmental milestones? 

a. Encourage activities appropriate for age.
b. Avoid discussing planning for the future.
c. Provide instruction on interpersonal and coping skills.
d. Emphasize good appearance and wearing of stylish clothes.
e. Understand that the adolescent will not have the same sexual needs.


Answer: A, C, D

What are supportive interventions that can assist a school-age child with a chronic illness to meet developmental milestones?

What are supportive interventions that can assist a school-age child with a chronic illness to meet developmental milestones? 

a. Encourage socialization.
b. Discourage sports activities.
c. Encourage school attendance.
d. Provide instructions on assertiveness.
e. Educate teachers and classmates about the child's condition.


Answer: A, C, E

The parent of a child with a chronic illness tells the nurse, "I feel so hopeless in this situation." The nurse should take which actions to foster hopefulness for the family?

The parent of a child with a chronic illness tells the nurse, "I feel so hopeless in this situation." The nurse should take which actions to foster hopefulness for the family? 

a. Avoid topics that are lighthearted.
b. Convey a personal interest in the child.
c. Be honest when reporting on the child's condition.
d. Do not initiate any playful interaction with the child.
e. Demonstrate competence and gentleness when delivering care.


Answer: B, C, E

What are supportive interventions that can assist a preschooler with a chronic illness to meet developmental milestones?

What are supportive interventions that can assist a preschooler with a chronic illness to meet developmental milestones?

a. Encourage socialization.
b. Encourage mastery of self-help skills.
c. Provide devices that make tasks easier.
d. Clarify that the cause of the child's illness is not his or her fault.
e. Discuss planning for the future and how the condition can affect choices.


Answer: A, B, C, D

The nurse is assessing coping behaviors of a family with a child with a chronic illness. What indicates avoidance coping behaviors?

The nurse is assessing coping behaviors of a family with a child with a chronic illness. What indicates avoidance coping behaviors?

a. Refuses to agree to treatment
b. Avoids staff, family members, or child
c. Is unable to discuss possible loss of the child
d. Recognizes own growth through a passage of time
e. Makes no change in lifestyle to meet the needs of other family members


Answer: A, B, C, E

What are supportive interventions that can assist a toddler with a chronic illness to meet developmental milestones?

What are supportive interventions that can assist a toddler with a chronic illness to meet developmental milestones?

a. Give choices.
b. Provide sensory experiences.
c. Avoid discipline and limit setting.
d. Discourage negative and ritualistic behaviors.
e. Encourage independence in as many areas as possible.


Answer: A, B, E

The nurse is assessing coping behaviors of a family with a child with a chronic illness. What indicates approach coping behaviors?

The nurse is assessing coping behaviors of a family with a child with a chronic illness. What indicates approach coping behaviors?

a. Plans realistically for the future
b. Verbalizes possible loss of the child
c. Uses magical thinking and fantasy
d. Realistically perceives the child's condition
e. Does not share the burden of the disorder with others


Answer: A, B, D

What are supportive interventions that can assist an infant with a chronic illness to meet developmental milestones?

What are supportive interventions that can assist an infant with a chronic illness to meet developmental milestones?

a. Encourage consistent caregivers.
b. Encourage periodic respite from demands of care.
c. Encourage one family member to be the primary caretaker.
d. Encourage parental "rooming in" during hospitalization.
e. Withhold age-appropriate developmental tasks until the child is older.


Answer: A, B, D

The nurse is teaching coping strategies to parents of a child with a chronic illness. What coping strategies should the nurse include?

The nurse is teaching coping strategies to parents of a child with a chronic illness. What coping strategies should the nurse include?

a. Listen to the child.
b. Accept the child's illness.
c. Establish a support system.
d. Learn to care for the child's illness one day at a time.
e. Do not share information with the child about the illness.


Answer: A, B, C, D

The nurse is planning to use an interpreter with a non-English-speaking family. What should the nurse plan with regard to the use of an interpreter?

The nurse is planning to use an interpreter with a non-English-speaking family. What should the nurse plan with regard to the use of an interpreter?

a. Use a family member.
b. The nurse should speak slowly.
c. Use an interpreter familiar with the family's culture.
d. The nurse should speak only a few sentences at a time.
e. The nurse should speak to the interpreter during interactions.


Answer: B, C, D

One of the supervisors for a home health agency asks the nurse to give a family of a child with a chronic illness a survey evaluating the nurses and other service providers. How should the nurse recognize this request?

One of the supervisors for a home health agency asks the nurse to give a family of a child with a chronic illness a survey evaluating the nurses and other service providers. How should the nurse recognize this request?

a. Appropriate to improve quality of care
b. Improper because it is an invasion of privacy
c. Inappropriate unless nurses and other providers agree to participate
d. Not acceptable because the family lacks remembering necessary to evaluate professionals


Answer: A

The nurse asks the mother of a child with a chronic illness many questions as part of the assessment. The mother answers several questions, then stops and says, "I don't know why you ask me all this. Who gets to know this information?" The nurse should respond in what manner?

The nurse asks the mother of a child with a chronic illness many questions as part of the assessment. The mother answers several questions, then stops and says, "I don't know why you ask me all this. Who gets to know this information?" The nurse should respond in what manner?

a. Determine why the mother is so suspicious.
b. Determine what the mother does not want to tell.
c. Explain who will have access to the information.
d. Explain that everything is confidential and that no one else will know what is said.


Answer: C

What behavior seen in children should be addressed by the nurse who is providing care to a child with a chronic illness?

What behavior seen in children should be addressed by the nurse who is providing care to a child with a chronic illness?

a. An infant who is uncooperative
b. A toddler who expresses loneliness
c. A preschooler who refuses to participate in self-care
d. An adolescent who is showing independence


Answer: C

The nurse is planning care for a 3-year-old boy who has Down syndrome and is on continuous oxygen. He recently began walking around furniture. He is spoon fed by his parents and eats some finger foods. What goal is the most appropriate to promote normal development?

The nurse is planning care for a 3-year-old boy who has Down syndrome and is on continuous oxygen. He recently began walking around furniture. He is spoon fed by his parents and eats some finger foods. What goal is the most appropriate to promote normal development?

a. Encourage mobility.
b. Encourage assistance in self-care.
c. Promote oral-motor development.
d. Provide opportunities for socialization.


Answer: A

The nurse has been visiting an adolescent with recently acquired tetraplegia. The teen's mother tells the nurse, "I'm sick of providing all the care while my husband does whatever he wants to, whenever he wants to do it." What reaction should be the nurse's initial response?

The nurse has been visiting an adolescent with recently acquired tetraplegia. The teen's mother tells the nurse, "I'm sick of providing all the care while my husband does whatever he wants to, whenever he wants to do it." What reaction should be the nurse's initial response?

a. Refer the mother for counseling.
b. Listen and reflect the mother's feelings.
c. Ask the father in private why he does not help.
d. Suggest ways the mother can get her husband to help.


Answer: B

When communicating with other professionals about a child with a chronic illness, what is important for nurses to do?

When communicating with other professionals about a child with a chronic illness, what is important for nurses to do?

a. Ask others what they want to know.
b. Share everything known about the family.
c. Restrict communication to clinically relevant information.
d. Recognize that confidentiality is not possible in home care.


Answer: C

The nurse outlines short- and long-term goals for a 10-year-old child with many complex health problems. Who should agree on these goals?

The nurse outlines short- and long-term goals for a 10-year-old child with many complex health problems. Who should agree on these goals?

a. Family and nurse
b. Child, family, and nurse
c. All professionals involved
d. Child, family, and all professionals involved


Answer: D

A child's parents ask the nurse many questions about their child's illness and its management. The nurse does not know enough to answer all the questions. What nursing action is most appropriate at this time?

A child's parents ask the nurse many questions about their child's illness and its management. The nurse does not know enough to answer all the questions. What nursing action is most appropriate at this time?

a. Tell them, "I don't know, but I will find out."
b. Suggest that they ask the physician these questions.
c. Explain that the nurse cannot be expected to know everything.
d. Answer questions vaguely so they do not lose confidence in the nurse.


Answer: A

The nurse has been assigned as a home health nurse for a child who is technology dependent. The nurse recognizes that the family's background differs widely from the nurse's own. The nurse believes some of their lifestyle choices are less than ideal. What nursing intervention is most appropriate to institute?

The nurse has been assigned as a home health nurse for a child who is technology dependent. The nurse recognizes that the family's background differs widely from the nurse's own. The nurse believes some of their lifestyle choices are less than ideal. What nursing intervention is most appropriate to institute?

a. Change the family.
b. Respect the differences.
c. Assess why the family is different.
d. Determine whether the family is dysfunctional.


Answer: B

An adolescent with long-term, complex health care needs will soon be discharged from the hospital. The nurse case manager has been assigned to the teen and family. The adolescent's care involves physical therapy, occupational therapy, and speech therapy in addition to medical and nursing care. Who should be the decision maker in the adolescent's care?

An adolescent with long-term, complex health care needs will soon be discharged from the hospital. The nurse case manager has been assigned to the teen and family. The adolescent's care involves physical therapy, occupational therapy, and speech therapy in addition to medical and nursing care. Who should be the decision maker in the adolescent's care?

a. Adolescent
b. Nurse case manager
c. Adolescent and family
d. Multidisciplinary health care team


Answer: C

For case management to be most effective, who should be recognized as the most appropriate case manager?

For case management to be most effective, who should be recognized as the most appropriate case manager?

a. Nurse
b. Panel of experts
c. Multidisciplinary team
d. Insurance company


Answer: A

A child with a serious chronic illness will soon go home. The case manager requests that the family provide total care for the child for a couple of days while the child is still hospitalized. How should the request be viewed?

A child with a serious chronic illness will soon go home. The case manager requests that the family provide total care for the child for a couple of days while the child is still hospitalized. How should the request be viewed?

a. Improper because of legal issues
b. Supportive because families are usually eager to get involved
c. Unacceptable because the family will have to assume the care soon enough
d. Important because it can be beneficial to the transition from hospital to home


Answer: D

The parents of a child on a ventilator tell the nurse that their insurance company wants the child to be discharged. They explain that they do not want the child home "under any circumstances." What principle should the nurse consider when working with this family?

The parents of a child on a ventilator tell the nurse that their insurance company wants the child to be discharged. They explain that they do not want the child home "under any circumstances." What principle should the nurse consider when working with this family?

a. Desire to have the child home is essential to effective home care.
b. Parents should not be expected to care for a technology-dependent child.
c. Having a technology-dependent child at home is better for both the child and the family.
d. Parents are not part of the decision-making process because of the costs of hospitalization.


Answer: A

What is the single most prevalent cause of disability in children and responsible for the recent increase in childhood disability?

What is the single most prevalent cause of disability in children and responsible for the recent increase in childhood disability?

a. Cancer
b. Asthma
c. Seizures
d. Heart disease


Answer: B

The nurse is talking to the parent of a child with special needs. The parent has expressed worry about how to support the siblings at home. What suggestion is appropriate for the nurse to give to the parent?

The nurse is talking to the parent of a child with special needs. The parent has expressed worry about how to support the siblings at home. What suggestion is appropriate for the nurse to give to the parent?

a. "You should help the siblings see the similarities and differences between themselves and your child with special needs."
b. "You should explain that your child with special needs should be included in all activities that the siblings participate in even if they are reluctant."
c. "You should give the siblings many caregiving tasks for your child with special needs so the siblings feel involved."
d. "You should intervene when there are differences between your child with special needs and the siblings."


Answer: A

The nurse notes that the parents of a critically ill child spend a large amount of time talking with the parents of another child who is also seriously ill. They talk with these parents more than with the nurses. How should the nurse interpret this situation?

The nurse notes that the parents of a critically ill child spend a large amount of time talking with the parents of another child who is also seriously ill. They talk with these parents more than with the nurses. How should the nurse interpret this situation?

a. Parent-to-parent support is valuable.
b. Dependence on other parents in crisis is unhealthy.
c. This is occurring because the nurses are unresponsive to the parents.
d. This has the potential to increase friction between the parents and nursing staff.


Answer: A

A 5-year-old child will be starting kindergarten next month. She has cerebral palsy, and it has been determined that she needs to be in a special education classroom. Her parents are tearful when telling the nurse about this and state that they did not realize her disability was so severe. What is the best interpretation of this situation?

A 5-year-old child will be starting kindergarten next month. She has cerebral palsy, and it has been determined that she needs to be in a special education classroom. Her parents are tearful when telling the nurse about this and state that they did not realize her disability was so severe. What is the best interpretation of this situation?

a. This is a sign the parents are in denial.
b. This is a normal anticipated time of parental stress.
c. The parents need to learn more about cerebral palsy.
d. The parents' expectations are too high.


Answer: B

What finding by the nurse is most characteristic of chronic sorrow?

What finding by the nurse is most characteristic of chronic sorrow?

a. Lack of acceptance of child's limitation
b. Lack of available support to prevent sorrow
c. Periods of intensified sorrow when experiencing anger and guilt
d. Periods of intensified sorrow at certain landmarks of the child's development


Answer: D

What manifestation observed by the nurse is suggestive of parental overprotection?

What manifestation observed by the nurse is suggestive of parental overprotection?

a. Gives inconsistent discipline
b. Facilitates the child's responsibility for self-care of illness
c. Persuades the child to take on activities of daily living even when not able
d. Encourages social and educational activities not appropriate to the child's level of capability


Answer: A

Families progress through various stages of reactions when a child is diagnosed with a chronic illness or disability. After the shock phase, a period of adjustment usually follows. This is often characterized by what response?

Families progress through various stages of reactions when a child is diagnosed with a chronic illness or disability. After the shock phase, a period of adjustment usually follows. This is often characterized by what response?

a. Denial
b. Guilt and anger
c. Social reintegration
d. Acceptance of the child's limitations


Answer: B

What nursing intervention is especially helpful in assessing feelings of parental guilt when a disability or chronic illness is diagnosed?

What nursing intervention is especially helpful in assessing feelings of parental guilt when a disability or chronic illness is diagnosed?

a. Ask the parents if they feel guilty.
b. Observe for signs of overprotectiveness.
c. Talk about guilt only after the parents mention it.
d. Discuss the meaning of the parents' religious and cultural background.


Answer: D

The nurse is assessing the coping behaviors of the parents of a child recently diagnosed with a chronic illness. What behavior should the nurse consider an "approach behavior" that results in movement toward adjustment?

The nurse is assessing the coping behaviors of the parents of a child recently diagnosed with a chronic illness. What behavior should the nurse consider an "approach behavior" that results in movement toward adjustment?

a. Being unable to adjust to a progression of the disease or condition
b. Anticipating future problems and seeking guidance and answers
c. Looking for new cures without a perspective toward possible benefit
d. Failing to recognize the seriousness of the child's condition despite physical evidence


Answer: B

Parents ask for help for their other children to cope with the changes in the family resulting from the special needs of their sibling. What strategy does the nurse recommend?

Parents ask for help for their other children to cope with the changes in the family resulting from the special needs of their sibling. What strategy does the nurse recommend?

a. Explain to the siblings that embarrassment is unhealthy.
b. Encourage the parents not to expect siblings to help them care for the child with special needs.
c. Provide information to the siblings about the child's condition only as requested.
d. Invite the siblings to attend meetings to develop plans for the child with special needs.


Answer: D

The parents of a child born with disabilities ask the nurse for advice about discipline. The nurse's response should be based on remembering that discipline is which?

The parents of a child born with disabilities ask the nurse for advice about discipline. The nurse's response should be based on remembering that discipline is which?

a. Essential for the child
b. Not needed unless the child's behavior becomes problematic
c. Best achieved with punishment for misbehavior
d. Too difficult to implement with a special needs child


Answer: A

The nurse observes that a seriously ill child passively accepts all painful procedures. The nurse should recognize that this is most likely an indication that the child is experiencing what emotional response?

The nurse observes that a seriously ill child passively accepts all painful procedures. The nurse should recognize that this is most likely an indication that the child is experiencing what emotional response?

a. Hopefulness
b. Chronic sorrow
c. Belief that procedures are a deserved punishment
d. Understanding that procedures indicate impending death


Answer: C

What nursing intervention is most appropriate in promoting normalization in a school-age child with a chronic illness?

What nursing intervention is most appropriate in promoting normalization in a school-age child with a chronic illness?

a. Give the child as much control as possible.
b. Ask the child's peer to make the child feel normal.
c. Convince the child that nothing is wrong with him or her.
d. Explain to parents that family rules for the child do not need to be the same as for healthy siblings.


Answer: A

A 16-year-old boy with a chronic illness has recently become rebellious and is taking risks such as missing doses of his medication. What should the nurse explain to his parents?

A 16-year-old boy with a chronic illness has recently become rebellious and is taking risks such as missing doses of his medication. What should the nurse explain to his parents?

a. That he needs more discipline
b. That this is a normal part of adolescence
c. That he needs more socialization with peers
d. That this is how he is asking for more parental control


Answer: B

What intervention is most appropriate for fostering the development of a school-age child with disabilities associated with cerebral palsy?

What intervention is most appropriate for fostering the development of a school-age child with disabilities associated with cerebral palsy?

a. Provide sensory experiences.
b. Help develop abstract thinking.
c. Encourage socialization with peers.
d. Give choices to allow for feeling of control.


Answer: C

A feeling of guilt that the child "caused" the disability or illness is especially common in which age group?

A feeling of guilt that the child "caused" the disability or illness is especially common in which age group?

a. Toddler
b. Preschooler
c. School-age child
d. Adolescent


Answer: B

The potential effects of chronic illness or disability on a child's development vary at different ages. What developmental alteration is a threat to a toddler's normal development?

The potential effects of chronic illness or disability on a child's development vary at different ages. What developmental alteration is a threat to a toddler's normal development?

a. Hindered mobility
b. Limited opportunities for socialization
c. Child's sense of guilt that he or she caused the illness or disability
d. Limited opportunities for success in mastering toilet training


Answer: A

What should the nurse determine to be the priority intervention for a family with an infant who has a disability?

What should the nurse determine to be the priority intervention for a family with an infant who has a disability?

a. Focus on the child's disabilities to understand care needs.
b. Institute age-appropriate discipline and limit setting.
c. Enforce visiting hours to allow parents to have respite care.
d. Foster feelings of competency by helping parents learn the special care needs of the infant.


Answer: D

What is a major premise of family-centered care?

What is a major premise of family-centered care?

a. The child is the focus of all interventions.
b. Nurses are the authorities in the child's care.
c. Parents are the experts in caring for their child.
d. Decisions are made for the family to reduce stress.


Answer: C

What is the major health concern of children in the United States?

What is the major health concern of children in the United States?

a. Acute illness
b. Chronic illness
c. Congenital disabilities
d. Nervous system disorders


Answer: B

The abbreviation ADL means:

The abbreviation ADL means:

a) Before meals
b) Abdomen
c) As desired
d) Activities of daily living


Answer: d) Activities of daily living

The agency allows you to record on paper charts. Which is correct?

The agency allows you to record on paper charts. Which is correct?

a) Pencil is preferred over ink
b) Only agency-approved abbreviations are used
c) Errors are erased
d) All entries are signed with only your initials


Answer: b) Only agency-approved abbreviations are used

When recording, you should do which of the following?

When recording, you should do which of the following?

a) Record what you saw your peers do
b) Write using abbreviations that are easy to figure out
c) Skip lines
d) Use correct spelling, grammar, and punctuation


Answer: d) Use correct spelling, grammar, and punctuations

When charting, you should record:

When charting, you should record:

a) What co-workers did
b) What co-workers observed
c) What the doctor said
d) Safety measures performed


Answer: d) Safety measures performed

These statements are about charting. Which is correct?

These statements are about charting. Which is correct?

a) You should never use the person's exact words
b) You can chart a procedure before completing it
c) You need to use terms with more than one meaning
d) You need to record facts


Answer: d) You need to record facts

Communication is:

Communication is:

a) The exchange of information
b) The written account of care and observations
c) The medical record
d) The verbal account of care and observations


Answer: a) The exchange of information

Which form has the person's identifying information?

Which form has the person's identifying information?

a) Kardex
b) Progress notes
c) Activities-of-daily-living flow sheet
d) Admission record


Answer: d) Admission record

Agencies have policies about which color ink may be used in the medical records.

Agencies have policies about which color ink may be used in the medical records.

a) True
b) False


Answer: a) True

When should you report changes in the person's condition?

When should you report changes in the person's condition?

a) Before you take your lunch break
b) At once
c) At the end of your shift
d) During the end-of-shift report


Answer: b) At once

Anyone who reads your charting should know which of the following?

Anyone who reads your charting should know which of the following?

a) What you did
b) How long it took you to get the trays delivered
c) When you took your lunch break
d) What your co-workers did


Answer: a) What you did

A nursing assistant is also an EMT who works for the fire department. In her EMT role, she is allowed to start IVs. On the weekend, she works as a nursing assistant at a nursing center. The RN asks her to start an IV on a resident. What should the nursing assistant do?

A nursing assistant is also an EMT who works for the fire department. In her EMT role, she is allowed to start IVs. On the weekend, she works as a nursing assistant at a nursing center. The RN asks her to start an IV on a resident. What should the nursing assistant do?

a) Tell another nurse to do the task
b) Report the RN to the doctor
c) Perform the task that was delegated to her
d) Politely refuse to do the task and explain why


Answer: d) Politely refuse to do the task and explain why

The nursing assistant registry includes information about:

The nursing assistant registry includes information about:

a) Findings of abuse, neglect, or dishonest use of property
b) Marriages
c) Children
d) Prior education


Answer: a) Findings of abuse, neglect, or dishonest use of property

Which tells you what your employer expects?

Which tells you what your employer expects?

a) Code of ethics
b) OBRA
c) The state nurse practice act
d) Your job description


Answer: d) Your job description

Which of the following determines the tasks you can do?

Which of the following determines the tasks you can do?

a) The person's family
b) The doctor's orders
c) The leading nursing assistant
d) State laws


Answer: d) State laws

You may lose your certification as a nursing assistance for which of the following reasons?

You may lose your certification as a nursing assistance for which of the following reasons?

a) Being late to work
b) Giving unsafe care
c) Bringing your children to work
d) Refusing to give family members confidential information


Answer: b) Giving unsafe care

As a nursing assistant, you can:

As a nursing assistant, you can:

a) Report changes in the person's condition to the nurse
b) Discuss the person's diagnosis with the family
c) Give drugs and insert tubes into body openings
d) Take verbal or telephone orders from doctors


Answer: a) Report changes in the person's condition to the nurse

The Omnibus Budget Reconciliation Act of 1987 is a:

The Omnibus Budget Reconciliation Act of 1987 is a:

a) State law
b) Criminal law
c) Federal law
d) Nurse practice act


Answer: c) Federal law

A nurse asks you to perform a task that is beyond the legal limits of your role. What should you do?

A nurse asks you to perform a task that is beyond the legal limits of your role. What should you do?

a) Perform the task so that you do not lose your job
b) Think about it for a few days.
c) Ignore the request
d) With respect, firmly refuse the task


Answer: d) With respect, firmly refuse the task

OBRA requires re-training and/or a new competency evaluation for persons who:

OBRA requires re-training and/or a new competency evaluation for persons who:

a) Were found guilty of abuse or neglect
b) Have not worked as a nursing assistant for 24 months
c) Were convicted of a crime
d) Did not have good performance evaluations


Answer: b) Have not worked as a nursing assistant for 24 months

A nurse asks you to do a urinary catheterization. This involves sterile technique and inserting a tube into the person's bladder. The nurse gives you very clear instructions. What should you do?

A nurse asks you to do a urinary catheterization. This involves sterile technique and inserting a tube into the person's bladder. The nurse gives you very clear instructions. What should you do?

a) Perform the task if another nursing assistant can help you
b) Perform the task. The nurse's directions were clear
c) Perform the task if the nurse is available to answer questions
d) Refuse the task. It is beyond the legal limits of your role


Answer: d) Refuse the task. It is beyond the legal limits of your role

To prevent pressure ulcers, you must:

To prevent pressure ulcers, you must:

a) Keep the person's skin clean and dry
b) Massage pressure points
c) Use soap to clean the skin
d) Scrub and rub the skin during bathing


Answer: a) Keep the person's skin clean and dry

Early signs of pressure ulcers include which of the following?

Early signs of pressure ulcers include which of the following?

a) Black eschar
b) Tingling in the area
c) An open blister
d) Cracked and peeling skin


Answer: b) Tingling in the area

Persons who are bedfast are repositioned at least every:

Persons who are bedfast are repositioned at least every:

a) Hour
b) 1 to 2 hours
c) 3 to 4 hours
d) Shift


Answer: b) 1 to 2 hours

Pressure ulcers can occur where skin has contact with skin. What can you use to prevent such contact?

Pressure ulcers can occur where skin has contact with skin. What can you use to prevent such contact?

a) Pillows
b) Bed cradle
c) Egg crate-like mattress
d) Flotation pad


Answer: a) Pillows

A person can develop a pressure ulcer within 2 to 6 hours after the onset of pressure.

A person can develop a pressure ulcer within 2 to 6 hours after the onset of pressure.

a) True
b) False


Answer: a) True

When layers of the skin rub against each other, this is known as:

When layers of the skin rub against each other, this is known as:

a) Friction
b) Shearing
c) Sloughing
d) Stripping


Answer: b) Shearing

Pressure ulcers usually occur:

Pressure ulcers usually occur:

a) On arms and legs
b) On the hands and feet
c) On the buttocks
d) Over bony prominences


Answer: d) Over bony prominences

Common causes of pressure ulcers include which of the following?

Common causes of pressure ulcers include which of the following?

a) Pressure
b) Use of pillows for positioning
c) A good blood supply
d) Burns


Answer: a) Pressure

A resident has dry skin. What should you do?

A resident has dry skin. What should you do?

a) Use soap during the person's bath
b) Apply moisturizer as directed by the nurse
c) Apply cornstarch to dry areas
d) Apply powder to dry areas


Answer: b) Apply moisturizer as directed by the nurse

The recommended position for preventing and treating pressure ulcers is the:

The recommended position for preventing and treating pressure ulcers is the:

a) Supine position
b) Prone position
c) Fowler's position
d) 30-degree lateral position


Answer: d) 30-degree lateral position

Pressure ulcer prevention involves which of the following?

Pressure ulcer prevention involves which of the following?

a) Identifying persons at risk
b) Limiting the times perineal care is done each day
c) Taking a picture of changes noted in a pressure ulcer
d) Applying heat to any area that appears reddened


Answer: a) Identifying persons at risk