Question 1

A child with a history of asthma presents to the school nurse complaining of wheezing. The nurse assesses the child and notes that the respiratory rate is 36 and expiratory wheezes are heard throughout the lung field. The child's oxygen saturation is 98%. Which is the best initial action by the nurse?

Accepted Answer

The best initial action by the nurse would be to have the child use their metered-dose inhaler, as this is a medication designed to quickly relieve asthma symptoms, such as wheezing. Calling the parents to come pick up the child or having the child lie down would not address the immediate respiratory distress the child is experiencing. Calling 911 for emergency medical assistance may be necessary if the child does not respond to the inhaler or if the symptoms worsen.

Question 2

While working in a pediatrician's office, the nurse frequently steps into the waiting room to speak quickly with the families and children waiting their turn. This allows her the opportunity to observe the children and their families. Based on her observations, which child should the nurse move to the examining room next?

Accepted Answer

The child with a flushed face and rash on all exposed skin may have a contagious condition or an allergic reaction, requiring immediate attention to prevent spreading or to address a potentially life-threatening situation.

Question 3

The pediatric nurse works at a camp for children with diabetes. As a component of the job, the camp nurse works:

Accepted Answer

The camp nurse for children with diabetes would have standard protocols to guide nursing interventions, as diabetes management requires ongoing and consistent care. While the nurse may work collaboratively with the camp doctor and may be called upon to respond to emergency situations, it is not accurate to say that they work directly under the supervision of the doctor or exclusively in emergency situations. Additionally, having EMT training may be beneficial in case of emergencies but it is not necessary for this particular job.

Question 4

A majority of pediatric health care occurs in community-based settings. Community-based health care settings include: Standard Text: Select all that apply.

Accepted Answer

The answer of A majority of pediatric health care occurs...

Question 5

Which of the following should be considered in disaster preparedness for children with special needs?

Accepted Answer

In disaster preparedness for children with special needs, providing advance notification to the utility company about the child's technology-assisted needs is critical to receiving emergency power. This will ensure that power-dependent medical devices, such as ventilators, will continue to function during an emergency. Options A, B, and D are incorrect as they recommend maintaining limited medical information, relying on one caregiver, and having minimal supplies, which are not optimal for disaster preparedness for children with special needs.

Question 6

A child is being discharged after an extended hospitalization. Prior to discharge from a hospital, home health care nurses should assess which aspect of the home setting?

Accepted Answer

Prior to discharge, home health care nurses should assess the readiness of the home for the child who is returning home from the hospital. This includes ensuring that the home is safe and suitable for the child's medical needs and that the necessary equipment and supplies are available. Parents' insurance, income, and home location may have some importance but do not directly affect the child's readiness to return home from the hospital.

Question 7

Which aspect of an Emergency Medical Services (EMS) system is most indicative that EMS providers are prepared to provide emergency care to children?

Accepted Answer

Staff education related to assessment and treatment of children of all ages is crucial as it ensures EMS providers have the necessary knowledge and skills to effectively care for pediatric patients, which is more indicative of preparedness than just having equipment or hospital lists.

Question 8

The community health nurse is planning an education session for recently hired teachers at a childcare center. It is most important that the nurse teach the staff:

Accepted Answer

Principles of infection control are crucial for a childcare center, as infectious diseases can easily spread among young children. The nurse should teach the staff how to prevent the spread of illness, including proper hand washing techniques, use of personal protective equipment, and proper sanitizing and cleaning procedures. Understanding how to interpret health records and the schedule for immunizations may also be important, but infection control should be the priority. Taking a temperature can be taught if time allows, but it is not as critical as preventing the spread of disease.

Question 9

A pediatric nurse has accepted a position in a pediatric office. What nursing functions would the nurse expect to perform in this setting?

Accepted Answer

In a pediatric office, a nurse would typically be involved in identifying children who need urgent care or isolation, as this is part of the triage and assessment process in an outpatient setting.

Question 10

A major goal of home health care nurses working with families is:

Accepted Answer

The goal of home health care nurses working with families is to promote or restore the child's health. This includes providing education and support to the family, monitoring the child's health status, and coordinating care with other healthcare providers. Maximizing the child's dependency on the family is not a goal of home health care, as the goal is to empower the family to care for the child as independently as possible. Curing a chronic illness may not be possible, but managing and minimizing its impact on the child's health is a key goal. While prescribing and administering medication may be a nursing responsibility, it is not the primary goal of home health care nurses working with families.

Question 11

Prior to accepting an assignment as a home health nurse, the nurse must realize that:

Accepted Answer

The family is in charge of their own healthcare, and the nurse should work collaboratively with them to establish goals and plans of care. It is important for the nurse to respect the family's autonomy and empower them to make informed decisions about their healthcare. Option A is incorrect because the nurse should adapt their care plan to meet the family's needs, not the other way around. Option C is incorrect because emergency care decisions should be made alongside the family and with guidance from the healthcare provider. Option D is incorrect because while the healthcare provider may provide orders and recommendations, ultimately, the family is responsible for making decisions about their healthcare.

Question 12

Prior to her return to school, an individualized health plan (IHP) will be developed for the child who has:

Accepted Answer

Developing an individualized health plan (IHP) is crucial for a child who has been newly diagnosed with insulin-dependent diabetes mellitus to ensure proper management and communication between school staff and healthcare providers.

Other options:
- A: Missed two weeks of school due to mononucleosis - while the child may need accommodations upon their return to school, an IHP may not be necessary. 
- C: Recently developed a penicillin allergy - while important information for school staff to be aware of, an IHP may not be necessary unless there are specific needs or accommodations required. 
- D: Been treated for head lice - this does not typically require an IHP.

Question 13

An important goal for pediatric nurses in the office or healthcare setting is:

Accepted Answer

Developing a positive relationship with the child and family is an important goal for pediatric nurses because it helps to build trust and rapport, which in turn can improve communication and lead to better health outcomes. This can involve using child-friendly language, listening to the family's concerns, and providing emotional support. Developing a plan of care and sharing information with the family is important, but it should be done within the context of a positive relationship. Telling the family immediately what's wrong or reassuring them that everything will be okay without a clear understanding of the situation would not be appropriate.

Question 14

The nurse has recommended respite care for the family of a two-year-old child who is medically fragile. The mother asks what respite can do for them. The nurse's response will be based on the knowledge that:

Accepted Answer

Respite care provides temporary relief to families caring for a child with special needs or medical conditions. It offers a much-needed break to caregivers who deal with the daily demands of care. Respite care services may be provided in a residential care facility or in the family's home.

Question 15

The weather report predicts a hurricane may be approaching the area where a child who is medically fragile lives. As a component of the family's disaster planning, the nurse will discuss which actions with the family? Standard Text: Select all that apply.

Accepted Answer

The answer of The weather report predicts a hurricane may...

Question 16

The number of serious injuries of children in a community has doubled in the past year. Based on this information, the most appropriate nursing diagnosis for the community would be:

Accepted Answer

The doubling of serious injuries in children suggests a community-wide issue, pointing towards a general lack of knowledge or understanding about injury prevention measures, making "Knowledge, Deficit injury prevention in children" the most appropriate nursing diagnosis.

Question 17

A child who is dependent on a ventilator is being discharged from the hospital. Prior to discharge, the home health nurse discusses development of an emergency plan of care with the family. Which is the most essential part of the plan?

Accepted Answer

Acquisition of a backup generator is the most essential part of the plan as it ensures that the child's ventilator can continue to function in the event of a power outage. It is important for the family to have a backup power source readily available to prevent any harm or injury to the child. The other options may also be important but they are not as crucial as having a backup generator.

Question 18

As the new school year begins, the school nurse evaluates several children to determine their healthcare needs. Which child would the nurse consider to be medically fragile?

Accepted Answer

The child requiring oxygen and tube feedings secondary to a congenital heart defect, is considered medically fragile because they require ongoing, specialized medical care to maintain their health and safety. Children with congenital heart defects are at an increased risk for complications and may require frequent hospitalizations or medical interventions. This child's need for oxygen and tube feedings also indicates that they have a higher level of medical complexity than the other children described.

Question 19

A 16-year-old client has a long leg cast secondary to a fractured tibia. The child will require a wheelchair for mobility. To effectively facilitate the adolescent's return to school, the school nurse should:

Accepted Answer

Meeting with teachers and administrators at the school to discuss modifications in the student's school routine would be the most effective way to facilitate the adolescent's return to school. This would allow for necessary accommodations to be made, such as scheduling classes on the first floor or providing extra time between classes. It would also ensure that all school staff are aware of the student's needs and can provide appropriate support. Meeting with all of the other students or encouraging homebound schooling are not necessary or effective solutions in this scenario. Developing an individualized health plan may be beneficial in the long term, but it is not the most pressing concern for the student's return to school.

Question 20

A child who is medically fragile is being discharged home after a long hospital stay. The child will require someone to provide medical treatments several times a day. In planning discharge, the nurse will:

Accepted Answer

It is important to involve the family in the care of a medically fragile child to promote family-centered care and assist in the child's continued care at home. However, not all family members may be able or willing to provide the necessary care. It is therefore essential to determine which family members can be trained to provide care for the child. This will also help determine if additional support may be needed, such as a home health nurse. Evaluating the size of the child's room is not pertinent to planning discharge in this case.

Quiz 14: Nursing Care of the Child in the Community