Deck 31: Strategies for Goal-Setting, Cultural Sensitivity, and Error-Prevention

Question 1

As a pediatric nurse, which of the following can you use to help a family identify and achieve goals for a child with a new diagnosis of chronic illness, acute illness, or injury?

A) Implement features of the Bright Futures Tool and Resource Kit
B) Refer to the goal set forth by Healthy People 2020
C) Implement the SBAR protocol
D) Demonstrate components of the Family Strengths Model

Answer 1

C

Question 2

Cultural sensitivity is important when determining the primary caregiver of a family. What does cultural sensitivity express to the family?

A) Respect to the primary caregiver
B) Awareness of international child concerns
C) Competence and compassion toward the child
D) That the nurse will provide care in a holistic manner

Answer 2

A

Question 3

Using the Model of Critical Thinking, what can a pediatric nurse use to separate fact from opinion?

A) Healthy People 2020
B) Family-centered care
C) Socratic question-and-answer method
D) The CUS protocol

Answer 3

C

Question 4

As a pediatric nurse, when will you offer the majority of anticipatory guidance to parents or guardians of pediatric patients?

A) Prior to the child reaching 3 years of age
B) During wellness visits
C) After a child has been hospitalized
D) When the child acquires an illness

Question 5

As a pediatric nurse, you should be aware that repeated phlebotomy can have what effect on a pediatric patient?

A) Bruising that resembles child abuse
B) Decreased hemoglobin and hematocrit
C) Occult bleeding
D) Low blood pressure

Question 6

What is the appropriate action a pediatric nurse should take after providing verbal discharge instructions to a patient and their family?

A) Provide written discharge instructions
B) Provide the family with your contact information
C) Develop a follow-up treatment plan
D) Follow up with the family in 24 hours to ensure compliance with instructions

Question 7

When is it appropriate for a pediatric nurse to implement the CUS protocol?

A) During patient handoffs
B) When communicating routine information
C) When communicating a need for heightened awareness of information
D) During a morning huddle

Question 8

As a pediatric nurse, how can you provide pediatric patients with a holistic foundation for safety?

A) Applying QSEN competencies
B) Through critical-thinking methods
C) Providing thorough anticipatory guidance
D) Practicing concept-based medicine

Question 9

If a patient with a skin disorder is prescribed a topical steroidal anti-inflammatory drug and, as a pediatric nurse, you miss one of the applications, what type of error have you made?

A) Act of omission
B) Act of commission
C) Scheduling misperception
D) Noncompliance on the part of the family or child

Question 10

As a pediatric nurse, if you administer pain medication to a child before the patient is due to receive it, what type of error have you made?

A) Act of omission
B) Act of commission
C) Scheduling misperception
D) Noncompliance on the part of the family or child

Question 11

For which of the following reasons are young children inherently vulnerable to mistakes made by the healthcare team?

A) They are not included in discussions regarding their treatment
B) They do not question or monitor their care
C) Their physical immaturity cannot overcome errors in treatment
D) They are not old enough to be provided informed consent

Question 12

Blood transfusions are not acceptable for those who practice as Jehovah's Witnesses, even in light of impending death. As a pediatric nurse, what would be an acceptable alternative therapy for individuals in this situation?

A) Stem cell transfusions
B) Plasma protein transfusions
C) Epidural blood patches
D) Crystalloid IV solutions and colloids

Question 13

As a pediatric nurse, what is an appropriate action if you encounter a family who is refusing medical treatment for a child due to religious beliefs?

A) Prevent the family from leaving against medical advice (AMA)
B) Notify the state to take guardianship of child
C) Request the name and contact information for the group whose doctrine in influencing treatment
D) Discontinue communication with the family and act in the best interest of the child

Question 14

How can a pediatric nurse avoid falling into the trap of assuming that cultural factors are always central to a case or following the "trait list approach," in which one assumes that certain traits apply to an entire group?

A) Maintain a faith-centered approach
B) Maintain a concept-centered approach
C) Maintain a patient-centered approach
D) Maintain an evidence-based approach

Question 15

If you are taking care of a child of Arab descent who is recovering from surgery, which action should you take to adhere to the child's culture?

A) Allow time for "laying on of hands" prayer groups
B) Make sure to conserve the energy of the child
C) Ensure the child receives a vegan diet
D) Disallow the use of pork- or beef-based medicines

Question 16

As a pediatric nurse, when would it be appropriate to communicate information that is shared during shift changes, as well as the latest information found on current assessments and care?

A) During handoffs
B) During huddles
C) During multidisciplinary rounding
D) During chart review

Question 17

In U.S. healthcare settings, why are healthcare providers often seen to have higher power distance?

A) They have expertise that a patient does not possess.
B) They are responsible for the well-being of the patient.
C) They generally have one-sided conversations with patients.
D) They are held to a higher standard than the rest of the population.

Question 18

As a pediatric nurse, when can you benefit from the structure of the SBAR protocol?

A) If you are new to a team or setting
B) If there is a power differential in the relationship
C) If the changes in process or status are happening rapidly
D) If there is a clinical problem that must be communicated

Question 19

As a pediatric nurse, what information can you gather from the 1-minute Apgar score?

A) The nutritional needs of the child
B) The cognitive function of the child
C) How the neonate tolerated the birthing process
D) How the neonate is adapting to breathing and extrauterine life

Question 20

When caring for the neonate, which information should the pediatric nurse have access to?

A) Birth weight and oxygen saturation
B) Oxygen saturation and nutritional needs
C) Apgar scores and screening test results
D) Birth history and Apgar scores

Question 21

As a pediatric nurse, you should be aware that neonates require which of the following to dilate their pulmonary vessels for ventilation and closure of the three fetal shunts?

A) Surfactant
B) Thermoregulation
C) Adequate nutrition
D) Inspired environmental oxygen

Question 22

What anticipatory guidance can you give parents regarding administering medications to infants?

A) Mix medications in bottles
B) Mixing with flavored syrup is recommended
C) Use the smallest amount of fluid possible
D) Topical medications are preferred

Question 23

As a pediatric nurse, you should expect that it may take as many as three adults to perform what procedure on a toddler?

A) Intravenous line insertion
B) Vastus lateralis intramuscular (IM) injection
C) Urinary catheter insertion
D) Accessing a central line/dressing change

Question 24

As a pediatric nurse, how can you avoid a toddler having a temper tantrum when attempting to administer oral medications?

A) Allow the child to self-administer
B) Give the child a choice of flavors
C) Do not give advanced warning of administration
D) Offer the child a fluid chaser to mask the flavor

Question 25

The varicella vaccine is given as a subcutaneous injection that is first administered during the toddler period, between 12 and 15 months of age. Which of the following is the best time for the vaccine to be repeated?

A) Within 3 months of the first administration
B) Prior to the child's second birthday
C) Between the ages of 4 and 6 years
D) Between the ages of 6 and 8 years

Question 26

For what reason is it important that a full "time-out" be performed prior to administering a medication to a toddler?

A) Because toddlers are notorious for taking off their identification tags
B) Because toddlers cannot be entrusted to take the medication as prescribed
C) To ensure the toddler is receiving the appropriate medication
D) To verify the toddler has no contraindications to the medication being administered

Question 27

For which of the following reasons should unplanned snacking be discouraged and monitored for preschoolers?

A) It could lead to obesity
B) It will affect meal consumption
C) It will provide a choking risk
D) It will lead to an unhealthy lifestyle

Question 28

As a pediatric nurse, what action can you take to limit a child's anticipatory distress when receiving vaccinations?

A) Numb the area prior to administering the vaccine
B) Offer the child a toy to distract him or her during the administration of the vaccine
C) Encourage the parents to participate in managing pain associated with vaccines
D) Offer the child a reward if he or she successfully receives the vaccination

Question 29

Because preschoolers are too big for a hospital crib with rails and a topper, the preschooler must be educated in what action?

A) How to use the call light
B) Where the rest room is
C) Where the play area is
D) How to order meals

Question 30

For which reason should supervision for playground and after-school activities on school grounds continue throughout the school-age period?

A) To encourage participation in school activities
B) To ensure the safety of those participating in school activities
C) To prevent bullying from occurring or escalating
D) To prevent children from being abandoned on school property

Question 31

As a pediatric nurse, why should you advise parents to make sure their child consumes the daily required quantity(400 IU) of vitamin D?

A) Prevention of obesity and heart disease
B) Prevention of anemia and type II diabetes mellitus
C) Prevention of osteoporosis and type I diabetes mellitus
D) Prevention of rickets and anemia

Question 32

As a pediatric nurse, what anticipatory guidance would you give to parents who wish to limit and restrict electronics, gaming, social media, and television?

A) Institute a "homework first" rule
B) Ban televisions and computers from the child's bedroom
C) Allow them to recharge their devices once a day
D) Institute a strict "lights out" time

Question 33

As a pediatric nurse, what can provide you with a foundation for referral and rapid intervention for teens at risk for depression, anxiety, or other mental health issues?

A) Early screenings for depression
B) Family mental health history
C) Physical assessment of the teen
D) Teen exhibiting signs of illegal drug use

Question 34

Regardless of how mature a teen might appear to an external audience, as a pediatric nurse, you should plan for what activities as an important part of a teen's healing process?

A) Rest and relaxation
B) Recreation and distraction
C) Education and adherence
D) Compliance and observance

Question 35

A tetanus, diphtheria, and acellular pertussis (Tdap) vaccine booster is required during adolescence. As a pediatric nurse, what advice would you give to patients once the booster is administered?

A) The child should receive a tetanus and diphtheria booster every year following the Tdap booster.
B) The child should receive a tetanus and pertussis booster every year following the Tdap booster.
C) The child should receive a tetanus and diphtheria booster every 10 years following the Tdap booster.
D) The child should receive a tetanus and pertussis booster every 10 years following the Tdap booster.

Question 36

When assessing a child for fatigue, you should assess for which other medical condition as well?

A) Anemia
B) Depression
C) Anxiety
D) Autism

Question 37

You are caring for a child who has repeated emetogenic experiences from chemotherapy and is enduring anticipatory nausea and vomiting. What type of medication would be most effective in treating this child?

A) Anxiolytics
B) Serotonin antagonists
C) Tricyclic antidepressants
D) Corticosteroids

Question 38

While assessing a child for fatigue, it is revealed that the fatigue is associated directly with a mental health issue or physical disorder. Which of the following is the best diagnosis for this child?

A) Primary fatigue
B) Secondary fatigue
C) Fibromyalgia
D) Myalgic encephalomyelitis/chronic fatigue

Question 39

As a pediatric nurse, what is your role when dealing with families experiencing stress?

A) De-escalating the situation
B) Notifying institutional security department
C) Securing a state of immediate safety
D) Maintaining personal safety

Question 40

If a family and child present with evidence of severe neglect or abuse, once the child is in a state of safety, what is the next priority?

A) Notifying local law enforcement
B) Providing interventions to the de-escalate the situation
C) Assessing the severity and symptoms of the child's and family's stress
D) Teaching parents and child proper methods to cope with stress

Question 41

When a child is hospitalized, the family may experience moderate to severe stress. In what manner does applying principles of family-centered care (FCC) provide a structure of support?

A) By focusing on the promotion of well-being
B) By developing coping mechanisms
C) By using effective communication techniques
D) By fostering a therapeutic relationship

Question 42

If a parent presents with an injured child, which of the following parental actions would be suspicious for abuse?

A) Seeking medical care within 12 hours after injury occurred
B) Providing a history that correlates with the nature of the injury
C) Explaining the injury occurred as a result of a high-impact accident
D) Explaining the injury occurred as a result of rough play with a sibling

Question 43

In life-threatening situations such as a skull fracture, even when the history offers clear evidence of maltreatment, what nursing action should take precedence?

A) Stabilizing the patient
B) Reporting the incident to the authorities
C) Vigorously questioning the parents regarding the cause of the injury
D) Collecting specimens such as semen, blood, urine, and human hairs from the child's body

Question 44

If a child presents with multiple, repeated complaints of unknown etiology, as a pediatric nurse, for what syndrome should you be suspicious?

A) Legg-Perthes syndrome
B) Guillain-Barre syndrome
C) Munchausen syndrome by proxy
D) Stevens-Johnson syndrome

Question 45

As a pediatric nurse, you should be aware that only severe dietary deficiencies, such as those associated with which medical condition, are apt to trigger the need for vitamin K administration?

A) Cystic fibrosis
B) Crohn's disease
C) Hirschsprung disease
D) Hypertrophic pyloric stenosis

Question 46

If a child with celiac disease presents with classic symptoms of intussusception, including "currant jelly" stool, pain, abdominal distention, and vomiting, which imaging modality would be used to positively confirm the diagnosis of intussusception?

A) Radiography
B) Ultrasound
C) Computed tomography
D) Magnetic resonance imaging

Question 47

If a patient presents with urgent diarrhea, weight loss, and bloody stools, with blood work revealing abnormal liver function tests, what medical condition should be suspected?

A) Encopresis
B) Crohn's disease
C) Celiac disease
D) Ulcerative colitis

Question 48

If you are caring for a child who was recently diagnosed with phenylketonuria, as a pediatric nurse, whcich action should you take?

A) Immediate referral to an endocrinologist
B) Immediate referral to a nutritionist
C) Immediately initiate fluid resuscitation
D) Immediately assess for neurologic damage

Question 49

If a patient presents with diabetic ketoacidosis, the pediatric nurse should rapidly establish IV access and carefully initiate rehydration with which type of fluids?

A) Isotonic fluids
B) Hypotonic fluids
C) Hypertonic fluids
D) Extracellular fluids

Question 50

As a pediatric nurse educating a diabetic patient with an insulin pump, you should be aware that only what type of insulin is used in insulin pumps?

A) Rapid-acting insulin
B) Regular or short-acting insulin
C) Intermediate-acting insulin
D) Long-acting insulin

Question 51

A child presents with cyanosis and bursts of rapid, short coughs followed by a sudden "whooping" inspiration. This is a classic presentation for pertussis. As a pediatric nurse, what stage of pertussis is this child currently in?

A) Latent stage
B) Catarrhal stage
C) Paroxysmal stage
D) Convalescent stage

Question 52

Nursing care for a child with apnea is based on careful monitoring with an apnea machine and/or cardiac monitoring. Careful monitoring of which serum level may also assist in the treatment of a child with apnea?

A) Serum glucose levels
B) Serum electrolyte levels
C) Serum caffeine levels
D) Serum cholesterol levels

Question 53

If you are caring for a child who was treated in the emergency room for acute exacerbation of asthma, what medication would you administer this child as prophylaxis against relapse?

A) Epinephrine
B) Methylxanthines
C) Anticholinergics
D) Oral corticosteroids

Question 54

If you are caring for a child who requires wound care and the physician orders wet-to-dry dressing changes, which of the following actions is the most correct for you to take as a pediatric nurse?

A) Follow dressing change instructions as specified by the physician
B) Promote healing by maintaining sterile wet-to-wet dressing changes
C) Discuss the appropriateness of the order with the physician
D) Explain to the patient that best evidence supports the provision of a moist wound base

Question 55

If you are caring for a child who presents with skin vesicles, this finding should elicit prompt evaluation for what medical condition?

A) Neurofibromatosis
B) McCue-Albright syndrome
C) Congenital herpes simplex virus infection
D) Congenital HIV infection

Question 56

If a child with cellulitis presents with skin tears in the area of infection, what advice would you give the family regarding treatment of this condition?

A) Use cold compresses to soothe the skin tears.
B) Cover skin tears with non-occlusive dressing.
C) The child should remain in the hospital for IV antibiotics.
D) Treat the skin tears with topical corticosteroids.

Question 57

Fresh-frozen plasma is administered to a child to increase coagulation factors including factor IX (stable) or factor V (unstable). Under what conditions would a child receive fresh-frozen plasma?

A) If the child has evidence of bleeding
B) If the child is immunocompromised
C) If the child sustained traumatic injuries
D) If the child has low hemoglobin/hematocrit

Question 58

If a child with sickle cell disease develops signs of shock, including tachycardia, hypotension, syncope, dizziness, and overall reduced circulatory volume, what type of crisis is this child experiencing?

A) Aplastic crisis
B) Hyperhemolytic crisis
C) Sequestration crisis
D) Vaso-occlusive crisis

Question 59

If you are caring for a child with sickle cell disease in the emergency department, which of the following methods would you use for rapid pain management for this condition?

A) Oral Tylenol with codeine
B) IV Dilaudid
C) IV morphine
D) Intranasal Fentanyl

Question 60

If a child presents with tetralogy of Fallot, the nurse and family should attempt to prevent crying, dehydration, constipation, fever, and pain because these actions can provoke what medical condition in this child?

A) Hypercyanosis
B) Hypertension
C) Hyperglycemia
D) Hemochromatosis

Question 61

If a patient with congestive heart failure is prescribed hydrochlorothiazide for diuresis, what education should you provide to him or her?

A) Nonsteroidal anti-inflammatory drugs increase the effectiveness
B) Nonsteroidal anti-inflammatory drugs decrease the effectiveness
C) Antibiotics increase the effectiveness
D) Antibiotics decrease the effectiveness

Question 62

As a pediatric nurse, which of the following methods results in the most reliable measurement of capillary refill time?

A) Hold the fingertip above the patient's head and hold pressure until the pad of the finger turns white
B) Hold moderate pressure on the fingertip for 5 seconds with an ambient temperature of 68ºF to 77ºF
C) Hold moderate pressure on the sternum for 5 seconds with an ambient temperature of 68ºF to 77ºF
D) Hold moderate pressure on the sole of the foot for 5 seconds with an ambient temperature of 68ºF to 77ºF

Question 63

If a patient presents with white eye reflex and strabismus, as a pediatric nurse, what medical condition should be suspected?

A) Glaucoma
B) Retinoblastoma
C) Retinal detachment
D) Macular degeneration

Question 64

The severity of retinopathy of prematurity (ROP) is classified based on the zone, extent, stage, and presence of disease. There are five stages of ROP; those with the most severe from may have impaired vision and possibly blindness due to which medical condition?

A) Glaucoma
B) Retinoblastoma
C) Retinal detachment
D) Macular degeneration

Question 65

Although this condition leaves few external signs, if a child presents with retinopathy and subdural hemorrhages, as a pediatric nurse you should be aware that these are diagnostic markers for what medical condition?

A) Brain tumor
B) Meningitis
C) Abusive head trauma
D) Seizure disorder

Question 66

If a child presents with a waddling gait and a positive Gower's sign, you should suspect muscular dystrophy. What lab value should be elevated due to muscle breakdown and can be used to confirm this diagnosis?

A) Alkaline phosphatase
B) Serum creatine kinase
C) Serum calcium
D) Serum magnesium

Question 67

While caring for a child with sickle cell disease, the child develops a low-flow priapism. As a pediatric nurse, what method would you suggest to treat this condition?

A) Epinephrine injections
B) Oral pseudoephedrine
C) Clot evacuation
D) Surgical intervention

Question 68

When caring for a child with nephrotic syndrome, what education would you provide the parents regarding the child's diet?

A) Child should adhere to a high protein, low-carbohydrate diet
B) Child should adhere to a high protein, low-salt diet
C) Child should adhere to a vegetarian diet
D) Child should adhere to a gluten-free diet

Question 69

You are caring for a child with cerebral palsy who just underwent a surgical rhizotomy. For which of the following reasons would a child with this condition have this surgical intervention?

A) To increase limb movement
B) To reduce spasticity
C) To reduce rigidity to the back and neck area
D) To correct scissoring of the lower extremities

Question 70

In instances where a child is fitted with a plaster cast as a result of a fracture, what should the healthcare team and family remember about handling the cast for the first 24 to 48 hours after the cast has been applied?

A) Do not touch the cast for the first 24 to 48 hours
B) Touch the cast only with fingertips for the first 24 to 48 hours
C) Touch the cast only with the palms of the hands for the first 24 to 48 hours
D) Do not touch the cast with bare hands for the first 24 to 48 hours

Question 71

As a pediatric nurse, you should be aware that if a woman has complications associated with ischemic-hypoxic episodes during the birthing process, the child is more at risk of developing which of the following medical conditions?

A) Autism
B) Anxiety
C) Depression
D) Attention-Deficit/Hyperactivity Disorder

Question 72

A "coordinated specialty care" management program, which integrates medication, education, therapy, family involvement, and academic or employment assistance through a multidisciplinary coordinated effort, is the most successful way to manage which medical condition?

A) Bipolar disorder
B) Schizophrenia
C) Depression
D) Anxiety

Question 73

If a child is prescribed to take an anti-rheumatic drug for treatment of juvenile rheumatoid arthritis, what is the greatest risk associated with these medications?

A) Addiction
B) Bleeding
C) Immune suppression
D) Blood clotting

Question 74

If you are caring for an HIV-positive child, what medication should this child be prescribed for prophylaxis against Pneumocystis jirovecii infections?

A) Isoniazid
B) Trimethoprim/sulfamethoxazole
C) Clarithromycin
D) Rifampin

Question 75

As a pediatric nurse, you should be aware that HIV-positive patients in acute retroviral syndrome will have symptoms that mimic what other infection?

A) Influenza
B) Pneumonia
C) Mononucleosis
D) Tuberculosis

Question 76

As a pediatric nurse, which vaccine would you recommend be given to children 2-5 years old with high risks such as sickle cell disease, HIV, asplenia, nephrotic syndrome, and other immunosuppressive disorders?

A) Varicella vaccine
B) Influenza vaccine
C) Pneumococcal vaccine
D) Rubella vaccine

Question 77

As a pediatric nurse, you should advise that it is important for post-pubertal children be administered which vaccine?

A) Varicella vaccine
B) Influenza vaccine
C) Pneumococcal vaccine
D) Rubella vaccine

Question 78

What action should a pediatric nurse take prior to blood draws, infusions, IV placement, or any other procedure that requires insertion of a needle or cannula through the skin?

A) Distract the patient
B) Give the child a vibrating pain-reducing device
C) Prep the injection site with topical spray anesthetic
D) Prep the injection site with 4% lidocaine cream

Question 79

As a pediatric nurse, how would you educate the parents of a child who requires a PCA machine for pain management?

A) The child should never determine when and if a PCA dose is required.
B) Only the child should determine when a PCA dose is required.
C) The parent should only deliver medication when child is visibly uncomfortable.
D) The parent should never deliver medication under any circumstances.

Question 80

Administering an inaccurate dose of insulin to a diabetic child and not double-checking doses with a second nurse would constitute what type of claim against a nurse?

A) Negligence
B) Malpractice
C) Beneficence
D) Nonmaleficence