Deck 1: Nurses Role in Care of the Child: Hospital, Community, and Home

Question 1

The telephone triage nurse at a pediatric clinic knows each call is important. Which call would require attentiveness from the nurse because of an increased risk of mortality?
1) A 3-week-old infant born at 35 weeks' gestation with gastroenteritis
2) A term 2-week-old infant of American Indian descent with an upper respiratory infection
3) A postterm 4-week-old infant non-Hispanic black descent with moderate emesis after feeding
4) A 1-week-old infant born at 40 weeks' gestation with symptoms of colic

Answer 1

1

Question 2

A child is being prepared for an invasive procedure. The mother of the child has legal custody but is not present. After details of the procedure are explained, who can provide legal consent on behalf of a minor child for treatment?
1) The divorced parent without custody
2) A cohabitating boyfriend of the child's mother
3) A grandparent who lives in the home with the child
4) A babysitter with written proxy

Answer 2

4

Question 3

Which legal or ethical offense would be committed if a nurse tells family members the condition of a newborn baby without first consulting the parents?
1) A breach of privacy
2) Negligence
3) Malpractice
4) A breach of ethics

Answer 3

1

Question 4

The nurse in a pediatric acute care unit is assigned the following tasks. Which task is not appropriate for the nurse to complete?
1) Diagnose an 8-year-old with acute otitis media and prescribe an antibiotic.
2) Listen to the concerns of an adolescent about being out of school for a lengthy surgical recovery.
3) Provide information to a mother of a newly diagnosed 4-year-old diabetic about local support-group options.
4) Diagnose a 6-year-old with Diversional Activity Deficit related to placement in isolation.

Question 5

A nurse is working with pediatric clients in a research facility. The nurse recognizes that federal guidelines are in place that delineate which pediatrics clients must give assent for participation in research trials. Based upon the client's age, the nurse would seek assent from which children? Select all that apply.
1) The precocious 4-year-old commencing as a cystic fibrosis research-study participant.
2) The 7-year-old leukemia client electing to receive a newly developed medication, now being researched.
3) The 10-year-old commencing in an investigative study for clients with precocious puberty.
4) The 13-year-old client commencing participation in a research program for Attention Deficit Hyperactivity Disorder (ADHD) treatments.

Question 6

Despite the availability of Children's Health Insurance Programs (CHIP), many eligible children are not enrolled. Which nursing intervention would be the most appropriate to help children become enrolled in CHIP?
1) Assess details of the family's income and expenditures
2) Case management to limit costly, unnecessary duplication of services
3) Advocate for the child by encouraging the family to investigate SCHIP eligibility
4) Educate the family about the need for keeping regular well-child-visit appointments

Question 7

Which nursing intervention is most appropriate when providing education to the pediatric client and family?
1) Giving primary care for high-risk children who are in hospital settings
2) Giving primary care for healthy children
3) Working toward the goal of informed choices with the family
4) Obtaining a physician consultation for any technical procedures at delivery

Question 8

Which nursing role is not directly involved when providing family-centered approach to the pediatric population?
1) Advocacy
2) Case management
3) Patient education
4) Researcher

Question 9

Pediatric nurses have foundational knowledge obtained in nursing school and add specific competencies related to the pediatric client. Which would be considered an additional specific expected competency of the pediatric nurse?
1) Physical assessment
2) Anatomical and developmental differences
3) Nursing process
4) Management of healthcare conditions

Question 10

What is the pediatric nurse's best defense against an accusation of malpractice or negligence?
1) Following the physician's written orders
2) Meeting the scope and standards of practice for pediatric nursing
3) Being a nurse practitioner or clinical nurse specialist
4) Acting on the advice of the nurse manager

Question 11

A 12-year-old pediatric client is in need of surgery. Which member of the healthcare team is legally responsible for obtaining informed consent for an invasive procedure?
1) Nurse
2) Physician
3) Unit secretary
4) Social worker

Question 12

A supervisor is reviewing documentation of the nurses in the unit. Which client documentation is the most accurate and contains all the required part for a narrative entry?
1) "2/2/05 1630 Catheterized using an 8 French catheter, 45 mL clear yellow urine obtained, specimen sent to lab, squirmed and cried softly during insertion of catheter. Quiet in mother's arms following catheter removal. M. May RN"
2) "1/9/05 2 pm nasogastric tube placement confirmed and irrigated with 30 ml sterile water. Suction set at low, intermittent. Oxygen via nasal canal at 2 L/min. Nares patent, pink, and nonirritated. K. Earnst RN"
3) "4:00 tracheostomy dressing removed with dime-size stain of dry serous exudate. Site cleansed with normal saline. Dried with sterile gauze. New sterile tracheostomy sponge and trach ties applied. Respirations regular and even throughout the procedure. F. Luck RN"
4) "Feb. '05 Port-A-Cath assessed with Huber needle. Blood return present. Flushed with NaCl solution, IV gamma globulins hung and infusing at 30 cc/hr. Child smiling and playful throughout the procedure. P. Potter, RN"

Question 13

Which of the following are components of family-centered care? Select all that apply.
1) Recognizing and building on family strengths
2) Meeting the emotional, social, and developmental needs of the child and family
3) Respect all parenting practices
4) Support all cultural practices
5) Encourage parent-to-parent support

Question 14

A 7-year-old child is admitted for acute appendicitis. The parents are questioning the nurse about expectations during the child's recovery. Which information tool would be most useful in answering a parent's questions about the timing of key events?
1) Healthy People 2020
2) Clinical pathways
3) Child mortality statistics
4) National clinical practice guidelines

Question 15

A three-week-old infant is returned post-pyloromyotomy three hours ago. The father is refusing pain medication for the infant and states, "The baby is hungry. Can I give the baby a bottle?" How should the nurse best advocate for the infant? Select all that apply.
1) Call the physician to ask if the child can feed yet.
2) The FLACC scale rating is 8 out of 10; try swaddling and rocking the infant.
3) Ask the parent to obtain a FLACC scale rating and let the nurse know what rating they get.
4) Educate the parent about the surgery and why the infant should not have anything by mouth.
5) Inform the parent about the meaning of the pain scale and the need for pain medication.

Question 16

The nurse recognizes that the pediatric client is from a cultural background different from that of the hospital staff. Which goal is most appropriate for this client when planning nursing care?
1) Overlook or minimize the differences that exist.
2) Facilitate the family's ability to comply with the care needed.
3) Avoid inadvertently offending the family by imposing the nurse's perspective.
4) Encourage complementary beneficial cultural practices as primary therapies.

Question 17

A 12-year-old child is admitted to the unit for a surgical procedure. The child is accompanied by two parents and a younger sibling. What is the level of involvement in treatment decision making for this child?
1) Emancipated minor
2) Mature minor
3) Assent
4) None