Question 1

A nurse is preparing to care for a dying pediatric patient and several immediate family members are at the bedside. The nurse should not use which of the following techniques when communicating with the family?

Accepted Answer

The nurse should not use a technique like explaining everything that is happening to all family members when communicating with the family. The nurse must determine whether there is a spokesperson for the family and how much the patient and family want to know. The nurse needs to allow the family and patient the opportunity for informed choices and assist with the decision-making process if asked. The nurse should encourage expression of feelings, concerns, and fears, as well as reminiscing. The nurse needs to be honest and truthful and let the patient and family know that they will not be abandoned. Extend touch and hold the patient's or family member's hand, if appropriate.

Question 2

A clinical nurse specialist is giving a report to a nursing assistant who will accompany her in caring for a pediatric patient who has hand restraints. The nurse instructs the nursing assistant to assess the skin integrity of the hands every:

Accepted Answer

The nurse instructs the nursing assistant to assess the skin integrity of the hands every thirty minutes. Agency guidelines regarding the use of restraints should always be followed.

Question 3

A clinical nurse specialist is preparing a plan of care for a patient who will have an insertion of an internal cervical radiation implant. Which nursing care plan should be included in caring for this patient?

Accepted Answer

A nursing care plan that should be included in caring for this patient is to place the patient in a private room at the endmost part of the hallway. This action provides less of a chance of exposure of radiation to others. The patient's room should be marked with appropriate signs that indicate the presence of radiation. Visitors should be limited to thirty-minute visits. Nurses assigned to this patient should be rotated so that one nurse is not consistently caring for the patient and exposing him or herself to excess amounts of radiation. All linens should be kept in the patient's room until the implant is removed in case the implant has dislodged and needs to be located.

Question 4

Nurses are aware that administering intramuscular injections among young children is difficult because of the small doses and small amounts of tissue involved. What plan of care should not be instituted to minimize this difficulty?

Accepted Answer

Plan of care that should not be instituted to minimize this difficulty is to administer the injection while the child is asleep to prevent aggressiveness. It is advisable to awaken the child, if asleep, before injections and explain that medication is going to be administered under the skin. Be sure to utilize a good technique to minimize discomfort.

Question 5

When a mother of a pediatric patient who is admitted to the intensive care unit with multiple injuries sees her child for the first time, she cries out that she didn't mean to hurt her baby. The nurse should:

Accepted Answer

The nurse should offer support by saying "this must be difficult for you." This response communicates concern and acceptance of the individual.

Question 6

A three-month-old infant with myelomeningocele is scheduled for surgery to close the defect. A nursing intervention that best facilitates a parent-child relationship during the preoperative period is:

Accepted Answer

A nursing intervention that best facilitates a parent-child relationship during the preoperative period is to encourage the parents to provide comfort to their child. Because the child can't be readily held, tactile stimulation meets the child's needs and fosters bonding with the parents.

Question 7

A nurse gives an inaccurate dose of vancomycin to a pediatric patient. Following a thorough assessment of the patient, the nurse completes an incident report. The nurse also notified her supervisor and called the physician to report the occurrence. As a result of medication error, the nurse understands that:

Accepted Answer

As a result of the medication error, the nurse understands that the incident report needs to be completed and is a method of promoting quality care and risk management. Documentation of unusual occurrences, incidents, accidents, and of the nursing actions taken as a result of the occurrence is internal to the institution or agency and allows the nurse and administration to review the quality of care and determine any potential risks present.
Based on the information provided in the question, the nurse's error will not result in suspension, nor will it be documented in the personnel file. The error and the situation presented in the question are not a reason for notifying the board of nursing.

Question 8

A nurse is caring for a child who has terminal cancer. The nurse is aware that the parents are in desperate need of support from the medical staff. The nurse should not include which care plan before the death of a child?

Accepted Answer

The nurse should not include a care plan of assisting them to make final arrangements like contacting a funeral home before the death of a child. This is done after a death occurs.

Question 9

A nurse arrives at work and is told to float in the pediatric intensive care unit for an 8-hour shift because the unit is understaffed and needs additional nurses to care for the patients. The nurse should initially:

Accepted Answer

The nurse should initially report to the PICU and identify tasks that can be performed safely. Floating is an acceptable legal practice used by hospitals to solve their understaffing problems. Legally, a nurse cannot refuse to float unless a union contract guarantees that nurses can work only in a specified area or the nurse can prove the lack of knowledge for the performance of assigned tasks. The nurse should set priorities and identify potential areas of harm to patients.

Question 10

A four-year-old hospitalized child begins to have a seizure while playing with hard plastic toys in the hallway. The nurse should initially:

Accepted Answer

The nurse should initially remove the child's toys from the immediate area. Nursing care for a child having a seizure includes maintaining airway patency, ensuring safety, administering medications, and providing emotional support. Since the seizure has already started, nothing should be forced into the child's mouth and they should not be moved. Of the choices given, first priority would be for safety.

Question 11

A pediatric patient was admitted to the hospital due to gastroenteritis. Shortly after the admission, the patient vomits. When cleaning the patient after the vomiting episode, the nurse following standard precaution should wear:

Accepted Answer

When cleaning the patient after the vomiting episode, the nurse following standard precaution should wear gloves. Gloves should be worn when the nurse is exposed to body fluids and blood, as this provides a barrier and protects the nurse.

Question 12

A ten-month-old infant was admitted to the pediatric unit for an emergency major surgical procedure. The seventeen-year-old mother and the grandfather are present at the bedside when the nurse is about to obtain the consent for the operation. Legally, consent for the infant's medical care:

Accepted Answer

Legally, consent for the infant's medical care is the responsibility of the mother and she should be the one to sign the consent. In most places, the age of majority is eighteen years; however, mothers younger than eighteen years are considered emancipated minors and can sign consents for themselves and their child.

Question 13

A nurse suspects that a pediatric patient has been abused. The nurse's primary responsibility should be:

Accepted Answer

The nurse's primary responsibility should be protecting the child from future abuse. Most injuries to abused children are not life threatening; protection takes priority over immediate treatment.

Question 14

A clinical nurse specialist is caring for a nine-year-old patient with meningitis. What transmission-based precautions must be implemented for this patient?

Accepted Answer

A transmission-based precautions that must be implemented for this patient is private room or cohort patient. The disease is transmitted via droplet infection. Precautions for this disease include a private room or cohort patient and use of a standard precaution mask. Private negative airflow pressure rooms and personal respiratory protection devices are required for patients with airborne diseases, such as tuberculosis. When appropriate, a mask must be worn by the patient and not the staff when the patient leaves the room.

Question 15

A nurse is caring for a twelve-year-old patient diagnosed with nosocomial infection due to methicillin-resistant staphylococcus aureus and contact precautions are initiated. The nurse is about to provide colostomy care to the patient and obtain items including:

Accepted Answer

The nurse is about to provide colostomy care to the patient and obtain items including gloves, gown, goggles, and face shield. Shoe protectors are not necessary. Goggles and a face shield are worn to protect the mucous membranes of the eyes during interventions that may produce splashes of blood, body fluids, secretions, or excretions. In addition, contact precautions require the use of gloves and a gown should be worn if direct patient contact is anticipated.

Question 16

A fourteen-year-old patient who survived a motor vehicle accident is in critical condition. At one point, the patient opens his eyes and smiles. The mother runs to the nurse and exclaims, "Look, it indicates that my son will get better soon." The best response by the nurse is:

Accepted Answer

The best response by the nurse is, "We are doing everything we can to help your son." The nurse should emphasize that everything possible is being done because the outcome cannot be predicted. Avoid raising false hopes.

Question 17

A physician ordered a jacket restraint for a pediatric patient. The nurse is aware that all of the following but one should be observed when applying a jacket restraint:

Accepted Answer

The nurse should be aware that all of the listed but one should be observed when applying a jacket restraint, which is: restraint straps that are safely secured at the side rails. A jacket is applied with ties in the back, which are secured out of reach of the back of the wheelchair, underside of the crib, or to the bed frame and never to the side rail to avoid accidental injury in the event that the side rail is released.

Question 18

A nurse is caring for a ten-year-old patient with suspected acute bacterial meningitis. Based on the infection's mode of transmission, the nurse should include which plan of care?

Accepted Answer

Based on the infection's mode of transmission, the nurse should include maintaining respiratory precaution for twenty-four hours after the initiation of antibiotics in the plan of care. A major priority of nursing care for a child suspected of having meningitis is to administer the prescribed antibiotic as soon as it is ordered. The child is also placed on respiratory isolation for at least twenty-four hours while culture results are obtained and the antibiotic is having an effect.

Question 19

A nurse is caring for a pediatric patient with a diagnosis of bronchitis and it was confirmed that the child has respiratory syncytial virus. Which of the following is an appropriate nursing action?

Accepted Answer

An appropriate nursing action is to place the patient in a single room. Respiratory syncytial virus is a highly communicable disorder and is not transmitted via the airborne route. The virus is usually transferred by the hands and meticulous hand washing is necessary to decrease the spread of organisms. The child with respiratory syncytial virus is isolated in a single room or placed in a room with another child with the same infection.

Question 20

Carmela, a clinical nurse specialist, is a newly hired nurse at the pediatric intensive care unit. She is aware that conflicts occur in any organization, including her new unit of assignment. She is also aware that all of the following but one is true about conflict:

Accepted Answer

Carmela is aware that all of the listed facts but one are true about conflict, which is that it should be prevented at all times, as it is not beneficial. Conflicts are beneficial because they allow issues to surface out in the open and can be solved right away. Likewise, members of the team become more conscientious with their work when they are aware that other members of the team are watching them.

Quiz 3: Pediatrics