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Wong’s Nursing Care of Infants and Children 9th Edition by Marilyn J. Hockenberry – Test Bank 

 

 

Hockenberry: Wong’s Nursing Care of Infants and Children, 9th Edition

 

Chapter 01: Perspectives of Pediatric Nursing

 

Test Bank

 

MULTIPLE CHOICE

 

  1. From a worldwide perspective in reducing infant mortality, the United States:
a. is ranked similar to 20 other developed countries.
b. is ranked highest among 27 other industrialized countries.
c. is ranked last among 27 countries that have a population of at least 25 million.
d. is ranked in the middle of 20 other developed countries.

 

 

ANS:    C

Although the death rate has decreased, the United States still ranks last in infant mortality among nations with a population of at least 25 million. The United States has the highest infant death rate of developed nations.

 

DIF:      Cognitive Level: Knowledge                 REF:     p. 7

TOP:    Nursing Process: Assessment              MSC:   Client Needs: Health Promotion and Maintenance

 

  1. Which of the following is the leading cause of death in infants younger than 1 year?
a. Congenital anomalies
b. Sudden infant death syndrome
c. Disorders related to short gestation and low birth weight
d. Maternal complications specific to the perinatal period

 

 

ANS:    A

Congenital anomalies account for 20.1% of deaths in infants younger than 1 year, compared with sudden infant death syndrome, which accounts for 8.2%; disorders related to short gestation and unspecified low birth weight, which account for 16.5%; and maternal complications such as infections specific to the perinatal period, which account for 6.1% of deaths in infants under 1 year of age.

 

DIF:      Cognitive Level: Knowledge                 REF:     p. 7                      TOP:    Nursing Process: Planning

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. The major cause of death for children older than 1 year is which of the following?
a. Childhood cancer
b. Unintentional injuries
c. Heart disease
d. Congenital anomalies

 

 

ANS:    B

Unintentional injuries (accidents) are the leading cause of death after age 1 year through adolescence. The leading cause of death for those younger than 1 year is congenital anomalies, and childhood cancers and heart disease cause a significantly lower percentage of deaths in children older than 1 year of age.

 

DIF:      Cognitive Level: Comprehension       REF:     p. 3                      TOP:    Nursing Process: Planning

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. In addition to injuries, which of the following are leading causes of death in adolescents and young adults ages 15 to 24 years?
a. Suicide, cancer
b. Suicide, homicide
c. Homicide, heart disease
d. Drowning, cancer

 

 

ANS:    B

Homicide and suicide account for 16.7% of deaths in this age-group. Suicide and cancer account for 10.9% of deaths, and cancer accounts for 3.5% of the deaths in this age-group. Drowning is responsible for less than 2% of the deaths in adolescents.

 

DIF:      Cognitive Level: Knowledge                 REF:     p. 8                      TOP:    Nursing Process: Planning

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. Which of the following is descriptive of deaths caused by injuries?
a. More deaths occur in males.
b. More deaths occur in females.
c. The pattern of deaths does not vary widely among different ethnic groups.
d. The pattern of deaths does not vary according to age and sex.

 

 

ANS:    A

The majority of deaths from unintentional injuries occur in males. The pattern of death does vary greatly among different ethnic groups, and the causes of unintentional deaths vary with age and gender.

 

DIF:      Cognitive Level: Comprehension       REF:     pp. 3,4                TOP:    Nursing Process: Planning

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. Morbidity statistics describe which of the following?
a. Disease occurring regularly within a geographic location
b. The number of individuals who have died over a specific period
c. The prevalence of specific illness in the population at a particular time
d. Disease occurring in more than the number of expected cases in a community

 

 

ANS:    C

Morbidity statistics show the prevalence of specific illness in the population at a particular time. Data regarding disease within a geographic region, or in greater than expected numbers in a community, may be extrapolated from analysis of the morbidity statistics. Mortality statistics refer to the number of individuals who have died over a specific period.

 

DIF:      Cognitive Level: Knowledge                 REF:     p. 8                      TOP:    Nursing Process: Planning

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. Which of the following was created in 1965 under Title XIX of the Social Security Act?
a. Medicaid
b. Child welfare services
c. Aid to Families with Dependent Children
d. Maternal Child Health Services Block Grants

 

 

ANS:    A

Medicaid was created in 1965 to reduce financial barriers to health care for the poor. It is the largest maternal-child health program. Child welfare services began with Title V in 1930, and Aid to Families with Dependent Children was enacted in 1935 as a cash grant program to states. Maternal Child Health Services Block Grants provide services to mothers and children with low income or limited access to health services.

 

DIF:      Cognitive Level: Knowledge                 REF:     p. 10                    TOP:    Nursing Process: Planning

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. Which of the following is most descriptive of family-centered care?
a. Reduces effect of cultural diversity on the family
b. Encourages family dependence on health care system
c. Recognizes that the family is the constant in a child’s life
d. Avoids expecting families to be part of the decision-making process

 

 

ANS:    C

The three key components of family-centered care are respect, collaboration, and support. Family-centered care recognizes the family as the constant in the child’s life. The family should be enabled and empowered to work with the health care system and is expected to be part of the decision-making process. The nurse should also support the family’s cultural diversity, not reduce its effect.

 

DIF:      Cognitive Level: Comprehension       REF:     p. 11

TOP:    Nursing Process: Implementation     MSC:   Client Needs: Health Promotion and Maintenance

 

  1. Which of the following is most descriptive of critical thinking?
a. Purposeful and goal directed
b. A simple developmental process
c. Based on deliberate and irrational thought
d. Assists individuals in guessing what is most appropriate

 

 

ANS:    A

Critical thinking is a complex developmental process based on rational and deliberate thought. When thinking is clear, precise, accurate, relevant, consistent, and fair, a logical connection develops between the elements of thought and the problem at hand.

 

DIF:      Cognitive Level: Comprehension       REF:     p. 15                    TOP:    Nursing Process: Planning

MSC:   Client Needs: Safe and Effective Care Environment: Management of Care

 

  1. Evidence-based practice (EBP), a decision-making model, is best described as:
a. using information in textbooks to guide care.
b. combining knowledge with clinical experience and intuition.
c. using a professional code of ethics as a means for decision making.
d. gathering all evidence that applies to the child’s health and family situation.

 

 

ANS:    B

EBP helps focus on measurable outcomes; the use of demonstrated, effective interventions; and questioning what is the best approach. EBP involves decision making based on data, not all evidence on a particular situation, and involves the latest available data. Nurses can use textbooks to determine areas of concern and potential involvement.

 

DIF:      Cognitive Level: Knowledge                 REF:     p. 14                    TOP:    Nursing Process: Planning

MSC:   Client Needs: Safe and Effective Care Environment: Management of Care

 

  1. Which of the following best describes signs and symptoms as part of a nursing diagnosis?
a. Description of potential risk factors
b. Identification of actual health problems
c. Human response to state of illness or health
d. Cues and clusters derived from patient assessment

 

 

ANS:    D

Signs and symptoms are the cues and clusters of defining characteristics that are derived from a patient assessment and indicate actual health problems. The first part of the nursing diagnosis is the problem statement, also known as the human response to the state of illness or health. The identification of actual health problems may be part of the medical diagnosis. The nursing diagnosis is based on the human response to these problems. The human response is therefore a component of the nursing diagnostic statement. Potential risk factors are used to identify nursing care needs to avoid the development of an actual health problem when a potential one exists.

 

DIF:      Cognitive Level: Comprehension       REF:     p. 16

TOP:    Integrated Process: Communication and Documentation

MSC:   Client Needs: Safe and Effective Care Environment: Management of Care

 

  1. The nurse is talking to a group of parents of school-age children at an after-school program about childhood health problems. Which of the following statements should the nurse include in the teaching?
a. Childhood obesity is the most common nutritional problem among children.
b. Immunizations rates are the same among children of different races and ethnicity.
c. Dental caries is not a problem commonly seen in children since the introduction of fluoridated water.
d. Mental health problems are typically not seen in school-age children but may be diagnosed in adolescents.

 

 

ANS:    A

When teaching parents of school-age children about childhood health problems, the nurse should include information about childhood obesity because it is the most common problem among children and is associated with type 2 diabetes. Teaching parents about ways to prevent obesity is important to include in teaching. Immunization rates differ depending on the child’s race and ethnicity; dental caries continues to be a common chronic disease in childhood; and mental health problems are seen in children as young as school-age, not just in adolescents.

 

DIF:      Cognitive Level: Application                 REF:     p. 3                      TOP:    Nursing Process: Planning

MSC:   Client Needs: Health Promotion and Maintenance

 

MULTIPLE RESPONSE

 

  1. Which of the following responsibilities are included in the pediatric nurse’s promotion of the health and well-being of children? Select all that apply.
a. Establishing a therapeutic relationship
b. Promoting disease prevention
c. Providing support and counseling
d. Establishing life-long friendships
e. Providing financial assistance
f. Participating in ethical decision making

 

 

ANS:    A, B, C, F

The pediatric nurse’s role includes establishing a therapeutic relationship, promoting disease prevention, providing support and counseling, and participating in ethical decision making; a pediatric nurse does not need to establish life-long friendships or provide financial assistance to children and their families. Boundaries should be set and clear.

 

DIF:      Cognitive Level: Application                 REF:     p. 18                    TOP:    Nursing Process: Planning

MSC:   Client Needs: Health Promotion and Maintenance

 

 

Hockenberry: Wong’s Nursing Care of Infants and Children, 9th Edition

 

Chapter 02: Social, Cultural, and Religious Influences on Child Health Promotion

 

Test Bank

 

MULTIPLE CHOICE

 

  1. Children are taught the values of their culture through observation and feedback, relative to their own behavior. In teaching a class on cultural competence, the nurse should be aware that which of the following factors may be culturally determined?
a. Ethnicity
b. Racial variation
c. Status
d. Geographic boundaries

 

 

ANS:    C

Status is culturally determined and varies according to each culture. Some cultures ascribe higher status to age or socioeconomic position. Social roles also are influenced by the culture. Ethnicity is an affiliation of a set of persons who share a unique cultural, social, and linguistic heritage. It is one component of culture. Race and culture are two distinct attributes. Racial grouping describes transmissible traits, whereas culture is determined by the pattern of assumptions, beliefs, and practices that unconsciously frames or guides the outlook and decisions of a group of people. Cultural development may be limited by geographic boundaries, but the boundaries are not culturally determined.

 

DIF:      Cognitive Level: Analysis                        REF:     p. 21

TOP:    Integrated Process: Teaching/Learning

MSC:   Client Needs: Psychosocial Integrity

 

  1. When minority groups immigrate to another country, a certain degree of cultural and ethnic blending occurs through the involuntary process of:
a. acculturation.
b. ethnocentrism.
c. cultural shock.
d. cultural sensitivity.

 

 

ANS:    A

Acculturation is the gradual changes that are produced in a culture by the influence of another culture that cause one or both cultures to become more similar. The minority culture is forced to learn the majority culture to survive. Ethnocentrism is the belief that one’s way of living and behaving is the best way. This includes the emotional attitude that the values, beliefs, and perceptions of one’s ethnic group are superior to those of others. Cultural shock is the helpless feeling and state of disorientation felt by an outsider attempting to adapt to a different culture group. Ethnocentrism and cultural shock would limit the amount of blending that would occur. Cultural sensitivity, a component of culturally competent care, is an awareness of cultural similarities and differences.

 

DIF:      Cognitive Level: Comprehension       REF:     p. 23

TOP:    Nursing Process: Assessment              MSC:   Client Needs: Psychosocial Integrity

 

  1. Which of the following terms best describes the emotional attitude that one’s own ethnic group is superior to others?
a. Culture
b. Ethnicity
c. Superiority
d. Ethnocentrism

 

 

ANS:    D

Ethnocentrism is the belief that one’s way of living and behaving is the best way. This includes the emotional attitude that the values, beliefs, and perceptions of one’s ethnic group are superior to those of others. Culture is a pattern of assumptions, beliefs, and practices that unconsciously frames or guides the outlook and decisions of a group of people. A culture is composed of individuals who share a set of values, beliefs, and practices that serve as a frame of reference for individual perception and judgments. Ethnicity is an affiliation of a set of persons who share a unique cultural, social, and linguistic heritage. Superiority is the state or quality of being superior; it does not apply to ethnicity.

 

DIF:      Cognitive Level: Comprehension       REF:     p. 24

TOP:    Nursing Process: Assessment              MSC:   Client Needs: Psychosocial Integrity

 

  1. After the family, which of the following is likely to have the greatest influence on providing continuity between generations?
a. Race
b. Schools
c. Social class
d. Government

 

 

ANS:    B

The schools convey a tremendous amount of culture from the older members to the younger members of society. They prepare children to carry out the traditional social roles that will be expected of them as adults. Race is defined as a division of mankind possessing traits that are transmissible by descent and are sufficient to characterize it as a distinct human type; although race may have an influence on childrearing practices, its role is not as significant as that of schools. Social class refers to the family’s economic and educational levels. The social class of a family may change between generations. The government establishes parameters for children, including amount of schooling, but this is usually at a local level. The school culture has the significant influence on continuity.

 

DIF:      Cognitive Level: Knowledge                 REF:     p. 25

TOP:    Nursing Process: Assessment              MSC:   Client Needs: Psychosocial Integrity

 

  1. The nurse observes that families from certain minority cultural groups often miss or are late for scheduled clinic appointments. The best explanation for this is that certain cultural groups often differ from the dominant culture because they:
a. lack education.
b. avoid health care.
c. are more forgetful.
d. view time differently.

 

 

ANS:    D

Each cultural group has different conceptions of time and waiting. The dominant culture in the United States has a fairly rigid view of time. Persons from other cultures may be late or miss activities because other issues take precedence over the appointment. Education is not the issue, nor is avoidance of health care. The family usually believes that the appointment can be made for a later time. The family does not forget the time, but other issues take priority.

 

DIF:      Cognitive Level: Application                 REF:     p. 30

TOP:    Nursing Process: Assessment              MSC:   Client Needs: Psychosocial Integrity

 

  1. The Asian parent of a child being seen in the clinic avoids eye contact with the nurse. The best explanation for this, considering cultural differences, is that the parent:
a. feels inferior to nurse.
b. is showing respect for nurse.
c. is embarrassed to seek health care.
d. feels responsible for her child’s illness.

 

 

ANS:    B

In some ethnic groups, eye contact is avoided. In the Vietnamese culture an individual may not look directly into the nurse’s eyes as a sign of respect. The nurse providing culturally competent care would recognize that the other answers listed are not why the parent avoids eye contact with the nurse.

 

DIF:      Cognitive Level: Analysis                        REF:     p. 32

TOP:    Nursing Process: Assessment              MSC:   Client Needs: Psychosocial Integrity

 

  1. The nurse is planning care for a patient with a different ethnic background. Which of the following would be an appropriate goal?
a. Adapt, as necessary, ethnic practices to health needs.
b. Attempt, in a nonjudgmental way, to change ethnic beliefs.
c. Encourage continuation of ethnic practices in the hospital setting.
d. Strive to keep ethnic background from influencing health needs.

 

 

ANS:    A

Whenever possible, nurses should facilitate the integration of ethnic practices into health care provision. The ethnic background is part of the individual; it would be difficult to eliminate the influence of ethnic background. The ethnic practices need to be evaluated within the context of the health care setting to determine whether they are conflicting.

 

DIF:      Cognitive Level: Application                 REF:     p. 36

TOP:    Nursing Process: Assessment              MSC:   Client Needs: Psychosocial Integrity

 

  1. The nurse discovers welts on the back of a Vietnamese child during a home health visit. The child’s mother says she has rubbed the edge of a coin on her child’s oiled skin. The nurse should recognize this is which of the following?
a. Child abuse
b. Cultural practice to rid the body of disease
c. Cultural practice to treat enuresis or temper tantrums
d. Child discipline measure common in the Vietnamese culture

 

 

ANS:    B

This is descriptive of coining. The welts are created by repeatedly rubbing a coin on the child’s oiled skin. The mother is attempting to rid the child’s body of disease. Coining is a cultural healing practice. Coining is not specific for enuresis or temper tantrums. This is not child abuse or discipline.

 

DIF:      Cognitive Level: Comprehension       REF:     p. 35

TOP:    Nursing Process: Assessment              MSC:   Client Needs: Psychosocial Integrity

 

  1. A Hispanic toddler has pneumonia. The nurse notices that the parent consistently feeds the child only the broth that comes on the clear liquid tray. Food items, such as Jell-O, Popsicles, and juices, are left. Which of the following would best explain this?
a. Parent is trying to feed child only what child likes most.
b. Hispanics believe the “evil eye” enters when a person gets cold.
c. Parent is trying to restore normal balance through appropriate “hot” remedies.
d. Hispanics believe an innate energy called chi is strengthened by eating soup.

 

 

ANS:    C

In several cultures, including Filipino, Chinese, Arabic, and Hispanic, hot and cold describe certain properties completely unrelated to temperature. Respiratory conditions such as pneumonia are “cold” conditions and are treated with “hot” foods. The child may like broth but is unlikely to always prefer it to Jell-O, Popsicles, and juice. The evil eye applies to a state of imbalance of health, not curative actions. Chinese individuals, not Hispanic individuals, believe in chi as an innate energy.

 

DIF:      Cognitive Level: Application                 REF:     p. 34

TOP:    Nursing Process: Assessment              MSC:   Client Needs: Psychosocial Integrity

 

  1. The nurse recognizes that some genetic diseases are more prevalent in certain groups and geographic areas. Which of the following disorders is more likely to be identified in individuals of Mediterranean descent?
a. Phenylketonuria
b. Cystic fibrosis
c. G6PD deficiency
d. Sickle cell anemia

 

 

ANS:    C

Glucose-6 phosphate dehydrogenase (G6PD) deficiency is more commonly found in individuals of Mediterranean descent. Phenylketonuria is more prevalent in individuals of northern European origin. Cystic fibrosis is more prevalent in individuals from England and Scotland. Sickle cell anemia is more prevalent in individuals of African descent.

 

DIF:      Cognitive Level: Application                 REF:     p. 40

TOP:    Nursing Process: Assessment              MSC:   Client Needs: Psychosocial Integrity

 

  1. Which one of the following communicable diseases is more prevalent in certain ethnic groups, such as Vietnamese immigrants?
a. Tuberculosis
b. Rubeola
c. Varicella
d. Pertussis

 

 

ANS:    A

Tuberculosis is a more prevalent communicable disease among certain ethnic groups such Vietnamese immigrants, Native Americans of the Southwest, and Mexican-Americans. Rubeola is a common communicable disease with a geographic constraint. Varicella and pertussis do not have ethnic prevalence.

 

DIF:      Cognitive Level: Application                 REF:     p. 39

TOP:    Nursing Process: Assessment              MSC:   Client Needs: Psychosocial Integrity

 

MULTIPLE RESPONSE

 

  1. The nurse is presenting a staff development program about cultural competency in the health care setting. Which of the following components should the nurse include in the program? Select all that apply.
a. Cultural awareness
b. Cultural knowledge
c. Cultural skills
d. Cultural research
e. Cultural desire
f. Cultural bias

 

 

ANS:    A, B, C, E

Five components that should be discussed in a program about cultural competency include awareness (the nurse appreciates and is sensitive to the family’s cultural values), knowledge (formal and informal education about different cultures, beliefs, and perceptions about health and wellness), skills (the ability to include cultural data in the nursing process), and desire (the genuine motivation to work effectively with minority patients). Cultural research and cultural bias are not components of cultural competency.

 

DIF:      Cognitive Level: Analysis                        REF:     p. 36

TOP:    Integrated Process: Teaching/Learning

MSC:   Client Needs: Psychosocial Integrity

 

Hockenberry: Wong’s Nursing Care of Infants and Children, 9th Edition

 

Chapter 08: Health Promotion of the Newborn and Family

 

Test Bank

 

MULTIPLE CHOICE

 

  1. Which of the following is a function of brown adipose tissue (BAT) in the newborn?
a. Generates heat for distribution to other parts of body
b. Provides ready source of calories in the newborn period
c. Protects the infant from injury during the birth process
d. Insulates the body against lowered environmental temperature

 

 

 

  1. Which of the following characteristics is representative of a full-term infant’s gastrointestinal tract?
a. Transit time is diminished.
b. Peristaltic waves are relatively slow.
c. Pancreatic amylase is overproduced.
d. Stomach capacity is approximately 90 ml.

 

 

 

  1. Which of the following terms is used to describe the newborn’s first stool?
a. Milia
b. Milk stool
c. Meconium
d. Transitional

 

 

 

  1. In term neonates, the first meconium stool should occur no later than how many hours of birth?
a. 6 to 8
b. 8 to 12
c. 12 to 24
d. 24 to 48

 

 

 

  1. Which of the following is true regarding the newborn’s kidney function?
a. Conservation of fluid and electrolytes occurs.
b. Urine has color and odor similar to urine of adults.
c. Ability to concentrate urine is less than that of adults.
d. Normally urination does not occur until 24 hours after delivery.

 

 

 

  1. The Apgar score of a neonate 5 minutes after birth is 8. Which of the following is the nurse’s best interpretation of this?
a. Resuscitation is likely to be needed.
b. Adjustment to extrauterine life is adequate.
c. Additional scoring in 5 more minutes is needed.
d. Maternal sedation or analgesia contributed to low score.

 

 

 

  1. Which of the following statements best represents the first stage or the first period of reactivity in the neonate?
a. Begins when the infant awakes from a deep sleep
b. Is an excellent time to acquaint the parents with the infant
c. Ends when the amounts of respiratory mucus have decreased
d. Provides time for the mother to recover from the childbirth process

 

 

 

  1. Which of the following statements reflects accurate information about patterns of sleep and wakefulness in the infant?
a. States of sleep are independent of environmental stimuli.
b. The quiet alert stage is the best stage for infant stimulation.
c. Cycles of sleep states are uniform in infants of the same age.
d. Muscle twitches and irregular breathing are common during deep sleep.

 

 

 

  1. The nurse observes that a new mother avoids making eye contact with her newborn. The nurse should do which of the following?
a. Ask mother why she won’t look at infant.
b. Examine newborn’s eyes for ability to focus.
c. Assess mother for other attachment behaviors.
d. Recognize this as a common reaction in new mothers.

 

 

 

  1. Which of the following would the nurse practitioner use when assessing the physical maturity of a neonate?
a. Length
b. Apgar score
c. Posture at rest
d. Chest circumference

 

 

  1. The grayish white, cheeselike substance that covers the newborn’s skin is:
a. Milia
b. Meconium
c. Amniotic fluid
d. Vernix caseosa

 

 

 

  1. Which of the following is most descriptive of the shape of the anterior fontanel in a newborn?
a. Circle
b. Square
c. Triangle
d. Diamond

 

 

  1. What term describes irregular areas of deep blue pigmentation seen predominantly in newborns of African, Asian, Native American, or Hispanic descent?
a. Acrocyanosis
b. Mongolian spots
c. Erythema toxicum
d. Harlequin color change

 

 

 

  1. The nurse should expect the apical heart rate of a stabilized neonate to be in which of the following ranges?
a. 60 to 80 beats/min
b. 80 to 100 beats/min
c. 120 to 140 beats/min
d. 160 to 180 beats/min

 

 

 

  1. Which of the following findings in the neonate is considered abnormal?
a. Nystagmus
b. Profuse drooling
c. Dark green or black stools
d. Slight vaginal reddish discharge

 

 

 

  1. When doing the first assessment of a male neonate, the nurse notes that the scrotum is large, edematous, and pendulous. This should be interpreted as:
a. a hydrocele.
b. an inguinal hernia.
c. a normal finding.
d. an absence of testes.

 

 

 

  1. Why are rectal temperatures not recommended in the newborn?
a. They are inaccurate.
b. They do not reflect core body temperature.
c. They can cause perforation of rectal mucosa.
d. They take too long to obtain an accurate reading.

 

 

  1. Which of the following is the name of the suture separating the parietal bones on top center of a neonate’s head?
a. Frontal
b. Sagittal
c. Coronal
d. Occipital

 

 

  1. The nurse observes flaring of nares in a neonate. This should be interpreted as which of the following?
a. Nasal occlusion
b. Sign of respiratory distress
c. Snuffles of congenital syphilis
d. Appropriate newborn breathing

 

 

 

  1. The nurse is assessing the reflexes of a newborn. Stroking the outer sole of the foot assesses which reflex?
a. Grasp
b. Perez
c. Babinski
d. Dance or step

 

 

 

  1. Which of the following is most important in the immediate care of the newborn?
a. Maintain patent airway.
b. Administer prophylactic eye care.
c. Maintain stable body temperature.
d. Establish identification of mother and baby.

 

 

 

 

  1. Nursing interventions to maintain a patent airway in a neonate should include which of the following?
a. Positioning neonate supine after feedings
b. Wrapping neonate as snugly as possible
c. Placing infant to sleep in the prone (on abdomen) position
d. Using a bulb syringe to suction as needed, suctioning nose first and then pharynx

 

 

 

 

  1. The nurse is careful to place the incubator away from fans or air conditioning units. This is to conserve the neonate’s body heat by preventing heat loss through which of the following methods?
a. Radiation
b. Conduction
c. Convection
d. Evaporation

 

 

 

 

  1. A newborn is being discharged at 48 hours of age. The parents ask how the infant should be bathed this first week home. The best recommendation by the nurse is to bathe the newborn:
a. daily with mild soap.
b. daily with an alkaline soap.
c. two or three times this week with mild soap.
d. two or three times this week with plain water.

 

 

 

 

  1. The stump of the umbilical cord usually drops off in how many days?
a. 3
b. 10 to 14
c. 16 to 21
d. 28

 

 

 

  1. The parents of a newborn plan to have him circumcised. They ask the nurse about pain associated with this procedure. The nurse’s response should be based on the knowledge that newborns:
a. experience pain with circumcision.
b. are too young for anesthesia or analgesia.
c. do not experience pain with circumcision.
d. quickly forget about the pain of circumcision.

 

 

 

 

  1. The nurse is teaching a class on breast-feeding to expectant parents. Which of the following is a contraindication for breast-feeding?
a. Mastitis
b. Twin births
c. Inverted nipples
d. Maternal cancer therapy

 

 

 

  1. Successful breast-feeding is most dependent on which of the following?
a. Birth weight of infant
b. Size of mother’s breasts
c. Mother’s desire to breast-feed
d. Family’s socioeconomic level

 

 

 

  1. A mother who breast-feeds her 6-week-old son every 4 hours tells the nurse that he seems “hungry all the time.” The nurse should recommend which of the following?
a. Infant cereal
b. Supplemental formula
c. More frequent feedings
d. No change in feedings

 

 

 

  1. A nursing intervention to promote parent-infant attachment would be which of the following?
a. Encouraging parents to hold child frequently unless fussy
b. Explaining individual differences among infants to the parents
c. Delaying parent-child interactions until the second period of reactivity
d. Alleviating stress for parents by decreasing their participation in the infant’s care

 

 

 

  1. A new mother wants to be discharged with her newborn as soon as possible. Before discharge, the nurse should make certain that:
a. the infant has voided at least once.
b. the newborn does not spit up after feeding.
c. jaundice, if present, appeared before 24 hours.
d. an appointment for follow-up with practitioner is made within next 2 or 3 days.

 

 

 

  1. The nurse is teaching new parents about the benefits of breast-feeding their newborn. Which of the following statements by the parent would indicate a correct understanding of the teaching?
a. “I should breast-feed my baby so that she will grow at a faster rate than a bottle-fed infant.”
b. “One of the advantages of breast-feeding is that the baby will have fewer stools per day.”
c. “I should breast-feed my baby because breast-fed babies adapt more easily to a regular schedule of feedings.”
d. “One of the advantages of breast-feeding is that it is economical and readily available for my baby.”

 

 

 

  1. The nurse is caring for a patient who has chosen to breast-feed her infant. Which of the following statements should the nurse include when teaching the mother about breast-feeding problems that may occur?
a. “If you experience painful nipples, cleanse the nipples with soap two times per day and keep the nipples covered as much as possible.”
b. “If you experience plugged ducts, continue to breast-feed every 2 to 3 hours and alternate feeding positions.”
c. “If mastitis occurs, discontinue breast-feeding while taking prescribed antibiotics and apply warm compresses.”
d. “If engorgement occurs, use cold compresses before a feeding and wear a well-fitting bra at night.”

 

 

MULTIPLE RESPONSE

 

  1. The nurse practitioner is completing a physical and gestational age assessment on a newborn who is 12 hours old. Which of the following components are part of the gestational age assessment? Select all that apply.
a. Arm recoil
b. Popliteal angle
c. Motor performance
d. Primitive reflexes
e. Square window
f. Scarf sign

 

 

 

COMPLETION

 

  1. The nurse is preparing a newborn for a circumcision. Place in the correct order the steps for applying topical anesthetic before the circumcision. Put a comma and space between each answer choice (a, b, c, d, etc.).

 

  1. Cover the penis with a piece of plastic wrap and secure the bottom of the covering with tape.
  2. Remove cream with a clean cloth after an appropriate amount of time has elapsed.
  3. Apply a petroleum jelly–coated dressing to the penis.
  4. Administer prescribed acetaminophen.
  5. Give the infant a pacifier coated with a sucrose solution.
  6. Place a thick layer of EMLA or LMX4 to the penis where the prepuce attaches to the glans.

 

 

 

 

Hockenberry: Wong’s Nursing Care of Infants and Children, 9th Edition

 

Chapter 16: Health Problems of Early Childhood

 

Test Bank

 

MULTIPLE CHOICE

 

  1. Which of the following is described as the time interval between infection or exposure to disease and appearance of initial symptoms?
a. Incubation period
b. Prodromal period
c. Desquamation period
d. Period of communicability

 

 

 

  1. Which of the following is a person or animal that harbors an infectious agent without apparent clinical disease and serves as a potential source of infection?
a. Host
b. Carrier
c. Contact
d. Reservoir

 

 

 

  1. The nurse is concerned with the prevention of communicable disease. Primary prevention results from which of the following?
a. Hand washing
b. Strict isolation
c. Immunizations
d. Early diagnosis

 

 

 

  1. An essential role of the school nurse regarding communicable diseases is:
a. regularly screening for communicable diseases.
b. notifying families about outbreaks.
c. maintaining isolation procedures in the school.
d. diagnosing and treating children with communicable disease.

 

 

 

  1. Which of the following is the causative agent of scarlet fever?
a. Enteroviruses
b. Corynebacterium organisms
c. Scarlet fever virus
d. Group A -hemolytic streptococci (GABHS)

 

 

 

  1. The single parent of a child who has just been diagnosed with chickenpox tells the nurse that she cannot afford to stay home with the child and miss work. The parent asks the nurse if some medication will shorten the course of the illness. Which of the following is the most appropriate nursing intervention?
a. Describe the role of varicella-zoster immune globulin to treat chickenpox.
b. Discuss the risks and benefits of acyclovir to treat chickenpox.
c. Explain that no medication will shorten the course of the illness.
d. Reassure the parent that it is not necessary to stay home with the child.

 

 

 

  1. Acyclovir (Zovirax) is given to children with chickenpox to:
a. minimize scarring.
b. prevent aplastic anemia.
c. prevent spread of the disease.
d. decrease the number of lesions.

 

 

 

  1. The school nurse is concerned about an outbreak of chickenpox because two children at the school have cancer and are immunodeficient from chemotherapy. The nurse should recommend which of the following?
a. No precautions necessary
b. Acyclovir (Zovirax) to minimize symptoms of chickenpox
c. Varicella-zoster immune globulin to prevent chickenpox
d. Temporarily stopping chemotherapy to allow immune system to recover

 

 

 

  1. Vitamin A supplementation is recommended for the young child who has which of the following?
a. Mumps
b. Rubella
c. Measles (rubeola)
d. Erythema infectiosum

 

 

 

 

  1. A parent reports to the nurse that her child has inflamed conjunctivae of both eyes with purulent drainage and crusting of the eyelids, especially on awakening. These manifestations suggest:
a. viral conjunctivitis.
b. allergic conjunctivitis.
c. bacterial conjunctivitis.
d. conjunctivitis caused by foreign body.

 

 

 

 

  1. Which of the following is an important nursing consideration when caring for a child with herpetic gingivostomatitis (HGS)?
a. Drink from a cup, not a straw.
b. Apply topical anesthetics before eating.
c. Wait to brush teeth until lesions are sufficiently healed.
d. Explain to parents how this is sexually transmitted.

 

 

 

  1. A young child is being treated for giardiasis. Which of the following should the nurse recommend to the child’s parent?
a. The child can swim in a pool if wearing diapers.
b. Cloth diapers should be rinsed in the toilet before washing.
c. The parasite is difficult to transmit, so no special precautions are indicated.
d. Diapers must be changed as soon as soiled and disposed of in a closed receptacle.

 

 

 

 

  1. The most common test for diagnosing pinworms in a child is which of the following?
a. Lower gastrointestinal (GI) series
b. Three stool specimens, at intervals of 4 days
c. Observation of presence of worms after child defecates
d. Tape placed in perianal area in the morning as soon as child awakens

 

 

 

  1. A father calls the clinic because he found his young daughter squirting Visine eye drops into her mouth. Which of the following is the most appropriate nursing action?
a. Reassure the father that Visine is harmless.
b. Direct him to seek immediate medical treatment.
c. Recommend inducing vomiting with ipecac.
d. Advise him to dilute Visine by giving his daughter several glasses of water to drink.

 

 

 

 

  1. The nurse suspects that a child has ingested some type of poison. Which of the following clinical manifestations would be most suggestive that the poison was a corrosive product?
a. Tinnitus
b. Disorientation
c. Stupor, lethargy, coma
d. Edema of lips, tongue, pharynx

 

 

 

 

  1. A young boy is found squirting lighter fluid into his mouth. His father calls the emergency department. The nurse taking the call should know that the primary danger is which of the following?
a. Hepatic dysfunction
b. Dehydration secondary to vomiting
c. Esophageal stricture and shock
d. Bronchitis and chemical pneumonia

 

 

 

 

  1. Which of the following is a clinical manifestation of acetaminophen poisoning?
a. Hyperpyrexia
b. Hepatic involvement
c. Severe burning pain in stomach
d. Drooling and inability to clear secretions

 

 

  1. An awake, alert 4-year-old child has just arrived at the emergency department after an ingestion of aspirin at home. The practitioner has ordered activated charcoal. The nurse administers charcoal in the following manner:
a. give half of the solution, and then repeat the other half in 1 hour.
b. mix with a flavorful beverage in an opaque container with a straw.
c. serve in a clear plastic cup so the child can see how much has been drunk.
d. administer through a nasogastric tube, since the child will not drink it because of the taste.

 

 

 

  1. A significant secondary prevention nursing activity for lead poisoning is:
a. chelation therapy.
b. screening children for blood lead levels.
c. removing lead-based paint from older homes.
d. questioning parents about ethnic remedies containing lead.

 

 

 

 

  1. Which of the following is an important nursing consideration when a child is hospitalized for chelation therapy to treat lead poisoning?
a. Maintain bed rest.
b. Maintain isolation precautions.
c. Keep accurate record of intake and output.
d. Institute measures to prevent skeletal fracture.

 

 

 

 

  1. Which of the following is the most common form of child maltreatment?
a. Sexual abuse
b. Child neglect
c. Physical abuse
d. Emotional abuse

 

 

 

 

  1. A child is admitted with a suspected diagnosis of Munchausen syndrome by proxy (MSBP). An important consideration in the care of this child is:
a. monitor the parents whenever they are with the child.
b. reassure parents that the cause of the disorder will be found.
c. teach the parents how to obtain necessary specimens.
d. support parents as they cope with diagnosis of a chronic illness.

 

 

 

 

  1. When only one child is abused in a family, the abuse is usually a result of which of the following?
a. Child is the firstborn.
b. Child is the same gender as the abusing parent.
c. Parent abuses child to avoid showing favoritism.
d. Parent is unable to deal with the child’s behavioral style.

 

 

 

  1. The parents of a 7-year-old boy tell the nurse that lately he has been cruel to their family pets and actually caused physical harm. The nurse’s recommendations should be based on knowledge that this is:
a. expected behavior at this age.
b. a warning sign of a serious problem.
c. harmless venting of anger and frustration.
d. common in children who are physically abused.

 

 

 

 

  1. A 3-month-old infant dies shortly after arrival to the emergency department. The infant has subdural and retinal hemorrhages but no external signs of trauma. The nurse should suspect:
a. unintentional injury.
b. shaken baby syndrome.
c. congenital neurologic problem.
d. sudden infant death syndrome (SIDS).

 

 

 

 

  1. Which of the following statements is correct about young children who report sexual abuse?
a. They may exhibit various behavioral manifestations.
b. In more than half the cases the child has fabricated the story.
c. Their stories should not be believed unless other evidence is apparent.
d. They should be able to retell the story the same way to another person.

 

 

 

  1. Probably the most important criterion on which to base the decision to report suspected child abuse is which of the following?
a. Inappropriate response of child
b. Inappropriate parental concern for the degree of injury
c. Absence of parents for questioning about child’s injuries
d. Incompatibility between the history and injury observed

 

 

 

  1. The nurse is caring for a child with suspected ingestion of some type of poison. Which of the following actions should the nurse take next after initiating cardiopulmonary resuscitation (CPR)?
a. Empty the mouth of pills, plants, or other material.
b. Question the victim and witness.
c. Place child in side-lying position.
d. Call poison control.

 

 

 

 

 

MULTIPLE RESPONSE

 

  1. The nurse is caring for a child with a suspected diagnosis of erythema infectiosum. Which of the following clinical manifestations would the nurse expect to observe? Select all that apply.
a. Slapped face appearance
b. Discrete rose-pink macules
c. High-pitched cough
d. Koplik spots
e. Maculopapular red spots

 

 

 

 

 

 

 

Hockenberry: Wong’s Nursing Care of Infants and Children, 9th Edition

 

Chapter 24: The Child with Cognitive, Sensory, or Communication Impairment

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The American Association on Intellectual and Developmental Disabilities (AAIDD), formerly the American Association on Mental Retardation, classifies cognitive impairment based on:
a. age of onset.
b. subaverage intelligence.
c. adaptive skill domains.
d. causative factors for cognitive impairment.

 

 

 

  1. Secondary prevention activities for cognitive impairment include:
a. genetic counseling.
b. avoidance of prenatal rubella infection.
c. preschool education and counseling services.
d. newborn screening for treatable inborn errors of metabolism.

 

 

 

  1. What is a primary goal in caring for the child with cognitive impairment?
a. Developing vocational skills
b. Promoting optimum development
c. Finding appropriate out-of-home care
d. Helping child and family adjust to future care

 

 

 

 

  1. One of the techniques that have been especially useful for learners having cognitive impairment is called fading. Which of the following best describes this technique?
a. Positive reinforcement when tasks or behaviors are mastered
b. Repeated verbal explanations until tasks are faded into child’s development
c. Negative reinforcement for specific tasks or behaviors that need to be faded out
d. Gradually fading out the assistance given to the child so that the child becomes more independent

 

 

 

  1. The parents of a child with cognitive impairment ask the nurse for guidance with discipline. The nurse’s recommendation should be based on knowledge that:
a. discipline is ineffective with cognitively impaired children.
b. cognitively impaired children do not require discipline.
c. behavior modification is an excellent form of discipline.
d. physical punishment is the most appropriate form of discipline.

 

 

 

  1. Appropriate interventions to facilitate social development of the child with cognitive impairment include which of the following?
a. Provide age-appropriate toys and play activities.
b. Avoid exposure to strangers who may not understand cognitive development.
c. Provide peer experiences, such as infant stimulation and preschool programs.
d. Emphasize mastery of physical skills because they are delayed more often than verbal skills.

 

 

 

  1. The nurse is discussing sexuality with the parents of an adolescent girl who has moderate cognitive impairment. Which of the following should the nurse consider when dealing with this issue?
a. Sterilization is recommended for any adolescent with cognitive impairment.
b. Sexual drive and interest are very limited in individuals with cognitive impairment.
c. Individuals with cognitive impairment need a well-defined, concrete code of sexual conduct.
d. Sexual intercourse rarely occurs unless the individual with cognitive impairment is sexually abused.

 

 

 

 

  1. The mother of a young child with cognitive impairment asks for suggestions about how to teach her child to use a spoon for eating. The nurse should recommend:
a. doing a task analysis first.
b. not expecting this task to be learned.
c. spoon-feeding child until child tries to do it alone.
d. feeding finger foods so spoon-feeding is unnecessary.

 

 

 

  1. A newborn assessment shows separated sagittal suture, oblique palpebral fissures, depressed nasal bridge, protruding tongue, and transverse palmar creases. These findings are most suggestive of which of the following?
a. Microcephaly
b. Cerebral palsy
c. Down syndrome
d. Fragile X syndrome

 

 

 

  1. A 2-week-old infant with Down syndrome is being seen in the clinic. His mother tells the nurse that he is difficult to hold, that “he’s like a rag doll. He doesn’t cuddle up to me like my other babies did.” The nurse’s best interpretation of this lack of clinging or molding is which of the following?
a. Sign of detachment and rejection
b. Indicative of maternal deprivation
c. A physical characteristic of Down syndrome
d. Suggestive of autism associated with Down syndrome

 

 

 

  1. Many of the physical characteristics of Down syndrome present challenges to caregivers. Care of the child should include which of the following?
a. Delay feeding solid foods until the tongue thrust has stopped.
b. Modify diet as necessary to minimize the diarrhea that often occurs.
c. Provide calories appropriate to child’s mental age.
d. Use a cool-mist vaporizer to keep mucous membranes moist and secretions liquefied.

 

 

 

 

  1. Fragile X syndrome is which of the following?
a. Chromosomal defect affecting only females
b. Second most common genetic cause of cognitive impairment
c. Most common cause of uninherited cognitive impairment
d. Chromosomal defect that follows the pattern of X-linked recessive disorders

 

 

 

 

  1. The nurse should suspect a hearing impairment in an infant who fails to demonstrate which of the following behaviors?
a. Babbling by age 12 months
b. Eye contact when being spoken to
c. Startle or blink reflex to sound
d. Gesturing to indicate wants after age 15 months

 

 

 

  1. The nurse is talking with a 10-year-old boy who wears bilateral hearing aids. The left hearing aid is making an annoying whistling sound that the child cannot hear. Which of the following is the most appropriate nursing action?
a. Ignore the sound.
b. Suggest he reinsert the hearing aid.
c. Ask him to reverse the hearing aids in his ears.
d. Suggest he raise the volume of the hearing aid.

 

 

 

 

  1. Which of the following facilitates lip reading by the hearing-impaired child?
a. Speak at an even rate.
b. Avoid using facial expressions.
c. Exaggerate pronunciation of words.
d. Repeat in exactly the same way if child does not understand.

 

 

 

  1. Which of the following is defined as reduced visual acuity in one eye despite appropriate optical correction?
a. Myopia
b. Hyperopia
c. Amblyopia
d. Astigmatism

 

 

 

 

  1. The school nurse is caring for a child with a penetrating eye injury. Emergency treatment includes which of the following?
a. Place cool compress on eye during transport to the emergency department.
b. Irrigate eye copiously with a sterile saline solution.
c. Remove object with lightly moistened gauze pad.
d. Apply a Fox shield to affected eye and any type of patch to the other eye.

 

 

 

 

  1. A father calls the emergency department nurse saying that his daughter’s eyes burn after getting some dishwasher detergent in them. The nurse recommends that the child be seen in the emergency department or by an ophthalmologist. The nurse also should recommend which of the following before the child is transported?
a. Keep eyes closed.
b. Apply cold compresses.
c. Irrigate eyes copiously with tap water for 20 minutes.
d. Prepare a normal saline solution (salt and water) and irrigate eyes for 20 minutes.

 

 

 

  1. A 5-year-old has bilateral eye patches in place after surgery yesterday morning. Today he can be out of bed. Which of the following is the most important nursing intervention?
a. Speak to him when entering the room.
b. Allow him to assist in feeding himself.
c. Orient him to his immediate surroundings.
d. Reassure him and allow his parents to stay with him.

 

 

 

 

  1. Autism is a complex developmental disorder. The diagnostic criteria for autism include delayed or abnormal functioning in which of the following areas with onset before age 3 years?
a. Parallel play
b. Gross motor development
c. Ability to maintain eye contact
d. Growth below the 5th percentile

 

 

 

  1. Included in the nursing care of a child with autism spectrum disorder (ASD) is:
a. assign multiple staff to care for child.
b. communicate with child at his or her developmental level.
c. provide a wide variety of foods for the child to try.
d. place in semiprivate room with a roommate of similar age.

 

 

 

 

  1. Suggestions for parents regarding stuttering in children should include which of the following?
a. Offer rewards for proper speech.
b. Encourage child to take it easy and go slowly when stuttering.
c. Help the child by supplying word when he or she is experiencing a block.
d. Give child plenty of time and the impression that you are not in a hurry.

 

 

 

  1. Which of the following observations in children would indicate a referral to a specialist regarding a communication impairment?
a. At 2 years of age the child fails to respond consistently to sounds.
b. At 3 years of age the child fails to use sentences of more than five words.
c. At 4 years of age the child has impaired sentence structure.
d. At 5 years of age the child has poor voice quality.

 

 

 

  1. The nurse is performing a physical assessment on a 3-old-child. The parents state that the child excessively rubs the eyes and often tilts the head to one side. Which of the following visual impairment should the nurse suspect?
a. Strabismus
b. Astigmatism
c. Hyperopia, or farsightedness
d. Myopia, or nearsightedness

 

 

 

MULTIPLE RESPONSE

 

  1. The nurse is preparing an education program on hearing impairment for a group of new staff nurses. Which of the following concepts should be included? Select all that apply.
a. A child with a slight hearing loss is usually unaware of a hearing difficulty.
b. A clinical manifestation of a hearing impairment in children is avoidance of social interaction.
c. A child with a severe hearing loss may hear a loud voice if nearby.
d. Children with sensorineural hearing loss can benefit from the use of a hearing aid.
e. A clinical manifestation of hearing impairment in an infant is lack of the startle reflex.
f. Identification of a hearing loss after the first year is essential to facilitate language development in children.

 

 

 

 

 

 

Hockenberry: Wong’s Nursing Care of Infants and Children, 9th Edition

 

Chapter 32: The Child with Respiratory Dysfunction

 

Test Bank

 

MULTIPLE CHOICE

 

  1. Why are cool-mist vaporizers rather than steam vaporizers recommended in the home treatment of respiratory infections?
a. They are safer.
b. They are less expensive.
c. Respiratory secretions are dried by steam vaporizers.
d. A more comfortable environment is produced.

 

 

 

  1. Decongestant nose drops are recommended for a 10-month-old infant with an upper respiratory tract infection. Instructions for nose drops should include which of the following?
a. Do not use for more than 3 days.
b. Keep drops to use again for nasal congestion.
c. Administer drops after feedings and at bedtime.
d. Give two drops every 5 minutes until nasal congestion subsides.

 

 

 

 

  1. The parent of an infant with nasopharyngitis should be instructed to notify the health professional if the infant:
a. has a cough.
b. becomes fussy.
c. shows signs of an earache.
d. has a fever higher than 37.5° C (99° F).

 

 

l

 

  1. It is important that a child with acute streptococcal pharyngitis be treated with antibiotics to prevent:
a. otitis media.
b. diabetes insipidus (DI).
c. nephrotic syndrome.
d. acute rheumatic fever.

 

 

 

  1. When caring for a child after a tonsillectomy, the nurse should do which of the following?
a. Watch for continuous swallowing.
b. Encourage gargling to reduce discomfort.
c. Apply warm compresses to the throat.
d. Position the child on the back for sleeping.

 

 

 

  1. Which of the following statements best represents infectious mononucleosis?
a. Herpes simplex type 2 is principal cause.
b. A complete blood count shows a characteristic leukopenia.
c. A short course of ampicillin is used when pharyngitis is present.
d. Clinical symptoms and blood tests are both needed to establish the diagnosis.

 

 

 

 

  1. Parents bring their 15-month-old infant to the emergency department at 3:00 AM because the toddler has a temperature of 39o C (102.2o F), is crying inconsolably, and is tugging at the ears. A diagnosis of otitis media (OM) is made. In addition to antibiotic therapy, the nurse practitioner would instruct the parents to use:
a. decongestants to ease stuffy nose.
b. antihistamines to help the child sleep.
c. aspirin for pain and fever management.
d. benzocaine ear drops for topical pain relief.

 

 

 

 

  1. An 18-month-old child is seen in the clinic with otitis media (OM). Oral amoxicillin is prescribed. Instructions to the parent should include which of the following?
a. Administer all of the prescribed medication.
b. Continue medication until all symptoms subside.
c. Immediately stop giving medication if hearing loss develops.
d. Stop giving medication and come to the clinic if fever is still present in 24 hours.

 

 

 

 

  1. An infant’s parents ask the nurse about preventing otitis media (OM). Which of the following should be recommended?
a. Avoid tobacco smoke.
b. Use nasal decongestant.
c. Avoid children with OM.
d. Bottle- or breast-feed in supine position.

 

 

 

  1. Chronic otitis media with effusion (OME) differs from acute otitis media (AOM) because it is usually characterized by which of the following?
a. Severe pain in the ear
b. Anorexia and vomiting
c. A feeling of fullness in the ear
d. Fever as high as 40° C (104° F)

 

 

 

  1. A 4-year-old girl is brought to the emergency department. She has a “froglike” croaking sound on inspiration, is agitated, and is drooling. She insists on sitting upright. The nurse should do which of the following?
a. Make her lie down and rest quietly.
b. Examine her oral pharynx and report to the physician.
c. Auscultate her lungs and prepare for placement in a mist tent.
d. Notify the physician immediately and be prepared to assist with a tracheostomy or intubation.

 

 

 

 

  1. The nurse is assessing a child with croup in the emergency department. The child has a sore throat and is drooling. Examining the child’s throat using a tongue depressor might precipitate which of the following?
a. Sore throat
b. Inspiratory stridor
c. Complete obstruction
d. Respiratory tract infection

 

 

 

 

  1. The mother of a 20-month-old boy tells the nurse that he has a barking cough at night. His temperature is 37° C (98.6° F). The nurse suspects mild croup and should recommend which of the following?
a. Admit to the hospital and observe for impending epiglottitis.
b. Provide fluids that the child likes and use comfort measures.
c. Control fever with acetaminophen and call if cough gets worse tonight.
d. Try over-the-counter cough medicine and come to the clinic tomorrow if no improvement.

 

 

 

 

  1. The nurse encourages the mother of a toddler with acute laryngotracheobronchitis to stay at the bedside as much as possible. The nurse’s rationale for this action is primarily which of the following?
a. Mothers of hospitalized toddlers often experience guilt.
b. The mother’s presence will reduce anxiety and ease child’s respiratory efforts.
c. Separation from mother is a major developmental threat at this age.
d. The mother can provide constant observations of the child’s respiratory efforts.

 

 

 

  1. An infant with bronchiolitis is hospitalized. The causative organism is respiratory syncytial virus (RSV). The nurse knows that a child infected with this virus requires the following isolation:
a. reverse isolation.
b. airborne isolation.
c. Contact Precautions.
d. Standard Precautions.

 

 

 

  1. An infant has been diagnosed with staphylococcal pneumonia. Nursing care of the child with pneumonia includes which of the following?
a. Administration of antibiotics
b. Frequent complete assessment of the infant
c. Round-the-clock administration of antitussive agents
d. Strict monitoring of intake and output to avoid congestive heart failure

 

 

 

 

  1. Which of the following is the most important consideration in managing tuberculosis (TB) in children?
a. Skin testing
b. Chemotherapy
c. Adequate rest
d. Adequate hydration

 

 

 

  1. A toddler has a unilateral foul-smelling nasal discharge and frequent sneezing. The nurse should suspect:
a. allergies.
b. acute pharyngitis.
c. foreign body in nose.
d. acute nasopharyngitis.

 

 

 

 

  1. The nurse is caring for a child with acute respiratory distress syndrome (ARDS) associated with sepsis. Nursing actions should include which of the following?
a. Force fluids.
b. Monitor pulse oximetry.
c. Institute seizure precautions.
d. Encourage high-protein diet.

 

 

 

  1. The nurse is caring for a child with carbon monoxide (CO) poisoning associated with smoke inhalation. Which of the following is essential in this child’s care?
a. Monitor pulse oximetry.
b. Monitor arterial blood gases.
c. Administer oxygen if respiratory distress develops.
d. Administer oxygen if child’s lips become bright, cherry-red in color.

 

 

 

 

  1. Which of the following diagnostic tests for allergies involves the injection of specific allergens?
a. Phadiatop
b. Skin testing
c. Radioallergosorbent tests (RAST)
d. Blood examination for total immunoglobulin E (IgE)

 

 

 

MSC:   Client Needs: Physiological Integrity: Reduction of Risk Potential

 

  1. Which of the following statements is the most descriptive of asthma?
a. It is inherited.
b. There is heightened airway reactivity.
c. There is decreased resistance in the airway.
d. The single cause of asthma is an allergic hypersensitivity.

 

 

 

 

  1. The leading cause of chronic illness in children is:
a. asthma.
b. pertussis.
c. tuberculosis.
d. cystic fibrosis.

 

 

 

 

  1. A child has a chronic cough and diffuse wheezing during the expiratory phase of respiration. This suggests which of the following?
a. Asthma
b. Pneumonia
c. Bronchiolitis
d. Foreign body in trachea

 

 

 

 

  1. A child with asthma is having pulmonary function tests. Which of the following explains the purpose of the peak expiratory flow rate?
a. To assess severity of asthma
b. To determine cause of asthma
c. To identify “triggers” of asthma
d. To confirm diagnosis of asthma

 

 

 

  1. Inhaled corticosteroids are currently the recommended first-line therapy for children with asthma over the age of 5 years. Children who are taking long-term inhaled steroids should be assessed frequently because which of the following may develop?
a. Cough
b. Osteoporosis
c. Slowed growth
d. Cushing syndrome

 

 

 

 

  1. One of the goals for children with asthma is to maintain the child’s normal functioning. To accomplish this, one of the principles of treatment is to:
a. limit participation in sports.
b. reduce underlying inflammation.
c. minimize use of pharmacologic agents.
d. have yearly evaluations by health care provider.

 

 

 

  1. Which of the following drugs is usually given first in the emergency treatment of an acute, severe asthma episode in a young child?
a. Ephedrine
b. Theophylline
c. Aminophylline
d. Short-acting β2-agonists

 

 

 

  1. Cystic fibrosis (CF) may affect single or multiple systems of the body. The primary factor responsible for possible multiple clinical manifestations is which of the following?
a. Hyperactivity of sweat glands
b. Hypoactivity of autonomic nervous system
c. Atrophic changes in mucosal wall of intestines
d. Mechanical obstruction caused by increased viscosity of mucous gland secretions

 

 

 

 

  1. What is the earliest recognizable clinical manifestation(s) of cystic fibrosis (CF)?
a. Meconium ileus
b. History of poor intestinal absorption
c. Foul-smelling, frothy, greasy stools
d. Recurrent pneumonia and lung infections

 

 

 

  1. Which of the following tests aids in the diagnosis of cystic fibrosis (CF)?
a. Sweat test, stool for fat, chest x-ray films
b. Sweat test, bronchoscopy, duodenal fluid analysis
c. Sweat test, stool for trypsin, biopsy of intestinal mucosa
d. Stool for fat, gastric contents for hydrochloride, chest x-ray films

 

 

 

 

  1. A child with cystic fibrosis (CF) receives aerosolized bronchodilator medication. This medication should be administered:
a. after chest physiotherapy (CPT).
b. before CPT.
c. after receiving 100% oxygen.
d. before receiving 100% oxygen.

 

 

 

  1. A child with cystic fibrosis is receiving recombinant human deoxyribonuclease (DNase). This drug:
a. is given subcutaneously.
b. may cause voice alterations.
c. may cause mucus to thicken.
d. is not indicated for children younger than age 12 years.

 

 

 

  1. The parent of a child with cystic fibrosis (CF) calls the clinic nurse to report that the child has developed tachypnea, tachycardia, dyspnea, pallor, and cyanosis. The nurse should tell the parent to bring the child to the clinic, since these symptoms are suggestive of which of the following?
a. Pneumothorax
b. Bronchodilation
c. Carbon dioxide retention
d. Increased viscosity of sputum

 

 

 

 

  1. Pancreatic enzymes are administered to the child with cystic fibrosis. Nursing considerations should include which of the following?
a. Give pancreatic enzymes between meals if at all possible.
b. Do not administer pancreatic enzymes if child is receiving antibiotics.
c. Decrease dose of pancreatic enzymes if child is having frequent, bulky stools.
d. Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at beginning of meal.

 

 

 

  1. The nurse is giving discharge instructions to the parents of a 5-year-old child who had a tonsillectomy 4 hours ago. Which of the following statements by the parent would indicate a correct understanding of the teaching?
a. “I can use an ice collar on my child for pain control along with analgesics.”
b. “My child should clear the throat frequently to clear the secretions.”
c. “I should allow my child be as active as tolerated.”
d. “My child should gargle and brush teeth at least three times per day.”

 

 

 

 

MULTIPLE RESPONSE

 

  1. The nurse is preparing a staff education program about pediatric asthma. Which of the following concepts should the nurse include when discussing the asthma severity classification system? Select all that apply.
a. Children with mild persistent asthma have nighttime symptoms less than two times a month.
b. Children with moderate persistent asthma use a short-acting β-agonist more than two times per week.
c. Children with severe persistent asthma have a peak expiratory flow (PFE) of 60% to 80% of predicted value.
d. Children with mild persistent asthma have symptoms more than two times per week.
e. Children with moderate persistent asthma have some limitations with normal activity.
f. Children with severe persistent asthma have frequent nighttime symptoms.

 

 

 

 

COMPLETION

 

  1. The nurse is teaching a 9-year-old how to use a metered-dose inhaler for the first time. Place in correct order the steps that the child should follow when using the inhaler. Put a comma and space between each answer choice (a, b, c, d, etc.).
  2. Shake the inhaler and attach spacer.
  3. At end of a normal expiration, depress the top of the inhaler.
  4. Breathe out slowly though the nose.
  5. Hold breath for 5 to 10 seconds.
  6. Insert the mouthpiece into the mouth, forming an airtight seal.
  7. Tilt the head back and breathe out slowly.

 

 

 

Hockenberry: Wong’s Nursing Care of Infants and Children, 9th Edition

 

Chapter 40: The Child with Neuromuscular or Muscular Dysfunction

 

Test Bank

 

MULTIPLE CHOICE

 

  1. Cerebral palsy (CP) may result from a variety of causes. It is now known that the most common cause of CP is which of the following?
a. Central nervous system (CNS) diseases
b. Birth asphyxia
c. Cerebral trauma
d. Neonatal encephalopathy

 

 

 

 

  1. Spastic cerebral palsy (CP) is characterized by which of the following?
a. Athetosis, dystonic movements
b. Tremors, lack of active movement
c. Hypertonicity; poor control of posture, balance, and coordinated motion
d. Wide-based gait; poor performance of rapid, repetitive movements

 

 

 

 

  1. Which of the following is the most common type of cerebral palsy (CP)?
a. Ataxic
b. Spastic
c. Dyskinetic
d. Mixed type

 

 

 

 

  1. The parents of an infant with cerebral palsy (CP) ask the nurse if their child will have cognitive impairment. The nurse’s response should be based on which of the following?
a. Affected children have some degree of cognitive impairment.
b. Around 20% of affected children have normal intelligence.
c. About 45% of affected children have normal intelligence.
d. Cognitive impairment is expected if motor and sensory deficits are severe.

 

 

 

 

  1. Gingivitis is a common problem in children with cerebral palsy (CP). Preventive measures include:
a. high-carbohydrate diet.
b. meticulous dental hygiene.
c. minimum use of fluoride.
d. avoidance of medications that contribute to gingivitis.

 

 

 

  1. The major goals of therapy for children with cerebral palsy (CP) include which of the following?
a. Cure underlying defect causing the disorder.
b. Reverse degenerative processes that have occurred.
c. Prevent spread to individuals in close contact with child.
d. Recognize the disorder early and promote optimum development.

 

 

 

  1. The parents of a child with spastic cerebral palsy (CP) state that their child seems to have significant pain. In addition to systemic pharmacologic management, the nurse includes teaching on:
a. patterning.
b. positions to reduce spasticity.
c. stretching exercises after meals.
d. topical analgesics for muscle spasms.

 

 

 

 

  1. A child, age 3 years, has cerebral palsy (CP) and is hospitalized for orthopedic surgery. His mother says he has difficulty swallowing and cannot hold a utensil to feed himself. He is slightly underweight for his height. Which of the following is the most appropriate nursing action related to feeding Jason?
a. Bottle- or tube-feed him a specialized formula until he gains sufficient weight.
b. Stabilize his jaw with caregiver’s hand (either from a front or side position) to facilitate swallowing.
c. Place him in well-supported, semireclining position.
d. Place him in a sitting position with his neck hyperextended to make use of gravity flow.

 

 

 

 

  1. An 8-year-old girl with moderate cerebral palsy (CP) recently began joining a regular classroom for part of the day. Her mother asks the school nurse about joining the after-school Girl Scout troop. The nurse’s response should be based on knowledge that:
a. most activities such as Girl Scouts cannot be adapted for children with CP.
b. after-school activities usually result in extreme fatigue for children with CP.
c. trying to participate in activities such as Girl Scouts leads to lowered self-esteem in children with CP.
d. recreational activities often provide children with CP with opportunities for socialization and recreation.

 

 

 

  1. A 4-month-old with significant head lag meets the criteria for floppy infant syndrome. A diagnosis of progressive infantile spinal muscular atrophy (Werdnig-Hoffmann) is made. Nursing care for this child includes:
a. infant stimulation program.
b. stretching exercises to decrease contractures.
c. limited physical contact to minimize seizures.
d. encouraging parents to have additional children.

 

 

 

 

  1. An 8-year-old child is hospitalized with infectious polyneuritis (Guillain-Barré syndrome [GBS]). When explaining this disease process to the parents, the nurse should consider which of the following?
a. Paralysis is progressive with little hope for recovery.
b. Disease is inherited as an autosomal, sex-linked, recessive gene.
c. Disease results from an apparently toxic reaction to certain medications.
d. Muscle strength slowly returns, and most children recover.

 

 

 

 

  1. A 12-year-old child with Guillain-Barré syndrome (GBS) is admitted to the pediatric intensive care unit. She tells you that yesterday her legs were weak and that this morning she was unable to walk. After the nurse determines the current level of paralysis, the priority assessment includes:
a. swallowing ability.
b. parental involvement.
c. level of consciousness.
d. antecedent viral infections.

 

 

 

 

  1. Which of the following statements is most accurate in describing tetanus?
a. Inflammatory disease that causes extreme, localized muscle spasm
b. Disease affecting the salivary gland with resultant stiffness of the jaw
c. Acute infectious disease caused by an exotoxin produced by an anaerobic spore-forming, gram-positive bacillus
d. Acute infection that causes meningeal inflammation resulting in symptoms of generalized muscle spasm

 

 

 

 

  1. An adolescent whose leg was crushed when she fell off a horse is admitted to the emergency department. She has completed the tetanus immunization series, receiving the last tetanus toxoid booster 8 years ago. The therapeutic management of this adolescent to prevent tetanus should include which of the following?
a. Tetanus toxoid booster is needed because of the type of injury.
b. Human tetanus immunoglobulin is indicated for immediate prophylaxis.
c. Concurrent administration of both tetanus immunoglobulin and tetanus antitoxin is needed.
d. No additional tetanus prophylaxis is indicated. The tetanus toxoid booster is protective for 10 years.

 

 

 

  1. During a well-child visit, the mother tells the nurse that her 4-month-old infant is constipated, is less active than usual, and has a weak-sounding cry. The nurse suspects botulism and questions the mother about the child’s diet. Which of the following might support this diagnosis?
a. Breast-feeding
b. Commercial formula
c. Infant cereal with honey
d. Improperly sterilized bottles

 

 

 

 

  1. An adolescent has just been brought to the emergency department with a spinal cord injury and paralysis from a diving accident. The parents keep asking the nurse, “How bad is it?” The nurse’s response should be based on which of the following?
a. Families adjust better to life-threatening injuries when information is given over time.
b. Immediate loss of function is indicative of the long-term consequences of the injury.
c. Extent and severity of damage cannot be determined for several weeks, or even months.
d. Numerous diagnostic tests will be done immediately to determine extent and severity of damage.

 

 

 

 

  1. A 14-year-old girl is in the intensive care unit after a spinal cord injury 2 days ago. Priority nursing interventions for this child includes which of the following?
a. Minimizing environmental stimuli
b. Administering immunoglobulin
c. Monitoring and maintaining systemic blood pressure
d. Discussing long-term care issues with the family

 

 

 

 

  1. Which of the following would the nurse expect in a child with a spinal cord lesion at C7?
a. Complete respiratory paralysis
b. No voluntary function of upper extremities
c. Inability to roll over or attain sitting position
d. Almost complete independence within limitations of wheelchair

 

 

 

 

  1. An adolescent with a spinal cord injury is admitted to a rehabilitation center. Her parents describe her as being angry, hostile, and uncooperative. The nurse should recognize that this is suggestive of which of the following?
a. Normal phase of adolescent development
b. Severe depression that will require long-term counseling
c. Normal response to her situation that can be redirected in a healthy way
d. Denial response to her situation that makes rehabilitative efforts more difficult

 

 

 

  1. Which of the following statements best describes Duchenne (pseudohypertrophic) muscular dystrophy (DMD)?
a. It has an autosomal dominant inheritance pattern.
b. Onset occurs in later childhood and adolescence.
c. It is characterized by presence of Gower sign, waddling gait, and lordosis.
d. Disease stabilizes during adolescence, allowing for life expectancy to approximately age 40 years.

 

 

 

 

  1. The nurse is preparing a staff education in-service session for a group of new graduate nurses who will be working in a long-term care facility for children; many of the children have cerebral palsy (CP). Which of the following statements should the nurse include in the training?
a. Children with dyskinetic CP have a wide-based gait and repetitive movements.
b. Children with spastic pyramidal CP have a positive Babinski sign and ankle clonus.
c. Children with hemiplegia CP have mouth muscles and one lower limb affected.
d. Children with ataxic CP have involvement of pharyngeal and oral muscles with dysarthria.

 

 

 

 

  1. Which of the following findings would the nurse expect to observe in a 7-month-old infant with Werdnig-Hoffman disease? Select all that apply.
a. Noticeable scoliosis
b. Absent deep tendon reflexes
c. Abnormal tongue movements
d. Failure to thrive
e. Prominent pectus excavatum
f. Significant leg involvement