Question 1

A child is admitted to the neonatal intensive care unit (NICU). The parents are concerned because they cannot stay for long hours to visit. Which statement made by the nurse is most appropriate?

Accepted Answer

This response acknowledges the parents' concerns and offers an appropriate resource for emotional support. It also validates the common feelings experienced by parents of NICU children. The other choices may not be feasible or may not address the parents' concerns appropriately.

Question 2

A novice nurse in the newborn intensive care unit (NICU) has just performed postmortem care on a premature infant who passed away. The novice nurse asks to be excused near the end of the shift. Which interventions can be implemented to support this nurse? Select all that apply.

Accepted Answer

Additional education on bereavement care, talking with a seasoned nurse, and acknowledging that it is okay to grieve with the family are all appropriate interventions to support the novice nurse who has just performed postmortem care on a premature infant. Transferring to another unit or assigning only stable clients may not address the underlying emotional impact of the situation for the nurse.

Question 3

The nurse is providing care to an adolescent client who is dying. Which assessment findings indicate the client is experiencing a decrease in peripheral circulation? Select all that apply.

Accepted Answer

Cool skin and a mottled appearance are indicative of decreased peripheral circulation. Cheyne-Stokes respirations and increased agitation can be signs of impending death but do not specifically indicate decreased peripheral circulation. Increased urine output is not necessarily related to peripheral circulation.

Question 4

Which intervention is considered supportive care for a family whose infant has died from sudden infant death syndrome (SIDS)?

Accepted Answer

Allowing parents to hold, touch, and rock the infant is considered supportive care for a family whose infant has died from SIDS. This type of care helps parents through their grief and facilitates the bonding process with the infant, which is critical for coping after infant death. It is not necessary to interview parents to determine the cause of the SIDS incident, and sheltering them from the grief by not giving them any personal items of the infant, such as footprints, is not supportive. Advising parents that an autopsy is not necessary is also not appropriate, as an autopsy may be required to determine the cause of death and help elucidate potential risk factors for future pregnancies.

Question 5

A young school-age child is in the pediatric intensive-care unit (PICU) with a fractured femur and head trauma. The child was not wearing a helmet while riding his new bicycle on the highway and collided with a car. Which nursing diagnoses may be appropriate for this family? Select all that apply.

Accepted Answer

These diagnoses address the emotional and psychological responses the family may experience: guilt for not ensuring safety, compromised coping due to the child's critical condition, conflict in parental roles due to the situation, and anger from feeling helpless.

Question 6

Parents of a child in the pediatric intensive care unit (PICU) have been experiencing shock and disbelief regarding their situation. Which statement by the parents indicates they are moving forward into the next stage of coping?

Accepted Answer

The answer of Parents of a child in the pediatric...

Question 7

A school-age child with congenital heart block codes in the emergency department (ED). The parents witness this and stare at the resuscitation scene unfolding before them. Which nursing intervention is most appropriate in this situation?

Accepted Answer

Asking the parents to sit near the child's face and hold her hand is the best nursing intervention in this situation. This provides comfort and support to both the child and the parents, and allows for communication between the child and parents during this stressful time. Asking the parents to leave could cause increased anxiety and fear, while asking the parents to call family to watch the resuscitation can be overwhelming and potentially inappropriate for some families. Asking the parents to stand at the foot of the cart can be impersonal and may not provide the same level of comfort and support as holding the child's hand.

Question 8

Which client in the pediatric intensive care unit (PICU) would most benefit from palliative care?

Accepted Answer

The answer of Which client in the pediatric intensive care...

Question 9

The nurse must prepare parents to see their adolescent daughter in the pediatric intensive-care unit (PICU). The child arrived by life flight after experiencing multiple traumas in a car accident involving a suspected drunk driver. At this time, which statement by the nurse to the family is the most appropriate?

Accepted Answer

The most appropriate statement for the nurse to make is D. It is important for the family to be prepared for the physical appearance of their daughter as it may be shocking or distressing for them to see. Being honest about the severity of the situation and the critical condition of their daughter is also important for the family to understand the urgency and gravity of the situation. Option A is not appropriate as it dismisses the gravity of the situation and does not provide any information or guidance to the family. Option B is also not appropriate as it is not the nurse's place to advise the family on legal matters. Option C may cause unnecessary distress and anxiety for the family and is not a priority to address at this moment.

Question 10

An adolescent with cystic fibrosis is intubated with an endotracheal tube. Which nursing diagnosis is most appropriate for this adolescent?

Accepted Answer

The most appropriate nursing diagnosis for an adolescent with cystic fibrosis who is intubated with an endotracheal tube is "Powerlessness (Moderate) Related to Inability to Speak to or Communicate with Friends." Intubation can significantly impact a patient's ability to communicate, leading to feelings of powerlessness and isolation, especially in adolescents who value their social connections.

Question 11

Which nursing interventions would be best for the nursing diagnosis of Powerlessness Related to Relinquishing Control to the Healthcare Team? Select all that apply.

Accepted Answer

Providing preparation for procedures, explaining procedures in a way that the child can understand, and incorporating home rituals when possible can all help the child feel less powerless and more in control of their healthcare experience. Providing a primary nursing care model and optimal pain relief may be beneficial interventions in other nursing diagnoses, but they are not directly related to this particular diagnosis.

Question 12

An adolescent client has a stiff neck, a headache, a fever of 103 degrees Fahrenheit, and purpuric lesions noted on the legs. Although the adolescent's physical needs take priority at the present time, the nurse can expect which to be the most significant psychological stressor for this adolescent?

Accepted Answer

The most significant psychological stressor for an adolescent with these symptoms, which suggest a serious condition like meningococcal meningitis, is likely to be separation from friends and the potential for permanent changes in appearance due to purpuric lesions. Adolescents are highly concerned with peer relationships and body image.

Question 13

The emergency-room nurse receives a preschool-age child who was hit by a car. Which nursing interventions are a priority for this child? Select all that apply.

Accepted Answer

A rapid head-to-toe assessment and assessing airway, breathing, and circulation (ABCs) are immediate priorities in trauma care to identify life-threatening conditions and stabilize the patient.

Question 14

A school-age client is admitted to the pediatric intensive care unit (PICU) in critical condition after a motor vehicle accident. Which intervention should be implemented at this time?

Accepted Answer

Maintaining consistent caregivers can help the school-age client feel secure and develop trust during a time of crisis. It also helps to provide continuity of care, which can be important in critical situations. Turning off the lights at night and keeping alarm levels low are not relevant interventions in this case. Consulting with a hospital play therapist may be helpful but is not the priority at this critical time.

Question 15

A school bus carrying children in grades K-12 crashed into a ravine. The critically injured children were transported by ambulance and admitted to the pediatric intensive-care unit (PICU). The nurse is concerned about calming the frightened children. Which nursing intervention is most appropriate to achieve the goal of calming the frightened children?

Accepted Answer

Having their parents present can provide significant emotional support and comfort to children, especially in a frightening and unfamiliar environment like the PICU.

Question 16

A child is on a ventilator in the pediatric intensive care unit (PICU). Which nursing intervention would best meet the psychosocial needs of this child?

Accepted Answer

The answer of A child is on a ventilator in...

Question 17

Siblings of a client in pediatric intensive care unit (PICU) are preparing to visit their brother, who was hit by a car while riding his bike. Which intervention by the nurse will assist the siblings in preparing for the visit?

Accepted Answer

Explaining what the siblings will hear and see when they visit will help them prepare and decrease anxiety. Spending time developing a relationship with the siblings is important, but not a specific intervention for preparing them for the visit. Having the parents go with the siblings when they visit may not alleviate their fears and may even increase anxiety. Encouraging the siblings to talk to a social worker may be helpful, but it is not necessary in this situation.

Question 18

A toddler-age client is in end-stage renal failure. Which nursing intervention will assist this child most?

Accepted Answer

Maintaining the child's normal routines can help provide a sense of stability and comfort for the toddler during a difficult time. It can also help the child cope better with the illness and treatment.

Question 19

A school-aged child is admitted with pneumococcal meningitis. The child weighs 44 pounds. The physician orders: ceftriaxone (Rocephin) 50 mg/kg/dose IV every 12 hours three times and then every 24 hours.
Calculate how many mg/dose of ceftriaxone the child will receive and then calculate mL/hr to infuse via pump. Supply on hand is: a premix of ceftriaxone 1 g/50 mL, administer over 30 minutes.

Accepted Answer

The answer of A school-aged child is admitted with pneumococcal...

Question 20

The parents of a toddler-age child who sustained severe head trauma from falling out a second-story window are arguing in the pediatric intensive-care unit (PICU) and blaming each other for the child's accident. Which nursing diagnosis is most appropriate for this family?

Accepted Answer

The family is experiencing compromised coping related to the child's critical injury, as evidenced by the parents arguing and blaming each other. There is no evidence of parental role conflict or hopelessness, and while anxiety may be present, it is not the primary issue affecting this family.

Quiz 13: The Child With a Life-Threatening Condition and End-Of-Life Care

A child is admitted to the neonatal intensive care unit (NICU) . The parents are concerned because they cannot stay for long hours to visit. Which statement made by the nurse is most appropriate?