,
,Chapter 01: Perspectives of Pediatric Nursing
MULTIPLE CHOICE
1. The clinic nurse is reviewing statistics on infant mortality for the United States versus other countries.
Compared with other countries that have a population of at least 25 million, the nurse makes which
determination?
a. The United States is ranked last among 27 countries.
b. The United States is ranked similar to 20 other developed countries.
c. The United States is ranked in the middle of 20 other developed countries.
d. The United States is ranked highest among 27 other industrialized countries.
ANS: A
Although the death rate has decreased, the United States still ranks last in infant mortality among nations with
a population of at least 25 million. The United States has the highest infant death rate of developed nations.
DIF: Cognitive Level: Remembering
TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
2. Which is the leading cause of death in infants younger than 1 year in the United States?
a. Congenital anomalies
b. Sudden infant death syndrome
c. Disorders related to short gestation and low birth weight
d. Maternal complications specific to the perinatal period
ANS: A
Congenital anomalies account for 20.1% of deaths in infants younger than 1 year compared with sudden infant
death syndrome, which accounts for 8.2%; disorders related to short gestation and unspecified low birth
weight, which account for 16.5%; and maternal complications such as infections specific to the perinatal
period, which account for 6.1% of deaths in infants younger than 1 year of age.
DIF: Cognitive Level: Remembering
MSC: Client Needs: Health Promotion and Maintenance
3. What is the major cause of death for children older than 1 year in the United States?
a. Heart disease
,b. Childhood cancer
c. Unintentional injuries
d. Congenital anomalies
ANS: C
Unintentional injuries (accidents) are the leading cause of death after age 1 year through adolescence. The
leading cause of death for those younger than 1 year is congenital anomalies, and childhood cancers and heart
disease cause a significantly lower percentage of deaths in children older than 1 year of age.
DIF: Cognitive Level: Understanding
MSC: Client Needs: Health Promotion and Maintenance
4. In addition to injuries, what are the leading causes of death in adolescents ages 15 to 19 years?
a. Suicide and cancer
b. Suicide and homicide
c. Drowning and cancer
d. Homicide and heart disease
ANS: B
Suicide and homicide account for 16.7% of deaths in this age group. Suicide and cancer account for 10.9% of
deaths, heart disease and cancer account for approximately 5.5%, and homicide and heart disease account for
10.9% of the deaths in this age group.
DIF: Cognitive Level: Remembering
MSC: Client Needs: Health Promotion and Maintenance
5. The nurse is planning a teaching session to adolescents about deaths by unintentional injuries. Which should
the nurse include in the session with regard to deaths caused by injuries?
a. More deaths occur in males.
b. More deaths occur in females.
c. The pattern of deaths does not vary according to age and sex.
d. The pattern of deaths does not vary widely among different ethnic groups.
ANS: A
The majority of deaths from unintentional injuries occur in males. The pattern of death does vary greatly
,among different ethnic groups, and the causes of unintentional deaths vary with age and gender.
DIF: Cognitive Level: Applying
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
6. What do mortality statistics describe?
a. Disease occurring regularly within a geographic location
b. The number of individuals who have died over a specific period
c. The prevalence of specific illness in the population at a particular time
d. Disease occurring in more than the number of expected cases in a community
ANS: B
Mortality statistics refer to the number of individuals who have died over a specific period .
Morbidity statistics show the prevalence of specific illness in the population at a particular time. Data
regarding disease within a geographic region, or in greater than expected numbers in a community, may be
extrapolated from analyzing the morbidity statistics.
DIF: Cognitive Level: Remembering
MSC: Client Needs: Health Promotion and Maintenance
7. The nurse should assess which age group for suicide ideation since suicide in which age group is the third
leading cause of death?
a. Preschoolers
b. Young school age
c. Middle school age
d. Late school age and adolescents
ANS: D
Suicide is the third leading cause of death in children ages 10 to 19 years; therefore, the age group should be
late school age and adolescents. Suicide is not one of the leading causes of death for preschool and young or
middle school-aged children.
DIF: Cognitive Level: Understanding
TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
8. Parents of a hospitalized toddler ask the nurse, What is meant by family-centered care? The nurse should
respond with which statement?
,a. Family-centered care reduces the effect of cultural diversity on the family.
b. Family-centered care encourages family dependence on the health care system.
c. Family-centered care recognizes that the family is the constant in a childs life.
d. Family-centered care avoids expecting families to be part of the decision-making process.
ANS: C
The three key components of family-centered care are respect, collaboration, and support. Family-centered
care recognizes the family as the constant in the childs life. The family should be enabled and empowered to
work with the health care system and is expected to be part of the decision-making process. The nurse should
also support the familys cultural diversity, not reduce its effect.
DIF: Cognitive Level: Applying
TOP: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenan ce
9. The nurse is describing clinical reasoning to a group of nursing students. Which is most descriptive of
clinical reasoning?
a. Purposeful and goal directed
b. A simple developmental process
c. Based on deliberate and irrational thought
d. Assists individuals in guessing what is most appropriate
ANS: A
Clinical reasoning is a complex developmental process based on rational and deliberate thought. When
thinking is clear, precise, accurate, relevant, consistent, and fair, a logical connection develops between the
elements of thought and the problem at hand.
DIF: Cognitive Level: Applying
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
10. Evidence-based practice (EBP), a decision-making model, is best described as which?
a. Using information in textbooks to guide care
b. Combining knowledge with clinical experience and intuition
c. Using a professional code of ethics as a means for decision making
,d. Gathering all evidence that applies to the childs health and family situation
ANS: B
EBP helps focus on measurable outcomes; the use of demonstrated, effective interventions; and questioning
what is the best approach. EBP involves decision making based on data, not all evidence on a particular
situation, and involves the latest available data. Nurses can use textbooks to determine areas of concern and
potential involvement.
DIF: Cognitive Level: Remembering
MSC: Client Needs: Safe and Effective Care Environment
11. Which best describes signs and symptoms as part of a nursing diagnosis?
a. Description of potential risk factors
b. Identification of actual health problems
c. Human response to state of illness or health
d. Cues and clusters derived from patient assessment
ANS: D
Signs and symptoms are the cues and clusters of defining characteristics that are derived from a patient
assessment and indicate actual health problems. The first part of the nursing diagnosis is the problem
statement, also known as the human response to the state of illness or health. The identification of actual health
problems may be part of the medical diagnosis. The nursing diagnosis is based on the human response to these
problems. The human response is therefore a component of the nursing diagnostic statement. Potential risk
factors are used to identify nursing care needs to avoid the development of an actual health problem when a
potential one exists.
DIF: Cognitive Level: Understanding
TOP: Integrated Process: Communication and Documentation
MSC: Client Needs: Safe and Effective Care Environment
12. The nurse is talking to a group of parents of school-age children at an after-school program about
childhood health problems. Which statement should the nurse include in the teaching?
a. Childhood obesity is the most common nutritional problem among children.
b. Immunization rates are the same among children of different races and ethnicity.
c. Dental caries is not a problem commonly seen in children since the introduction of fluoridated
water.
d. Mental health problems are typically not seen in school-age children but may be diagnosed in
adolescents.
,ANS: A
When teaching parents of school-age children about childhood health problems, the nurse should include
information about childhood obesity because it is the most common problem among children and is associated
with type 2 diabetes. Teaching parents about ways to prevent obesity is important to include. Immunization
rates differ depending on the childs race and ethnicity; dental caries continues to be a common chronic disease
in childhood; and mental health problems are seen in children as young as school age, not just in adolescents.
DIF: Cognitive Level: Applying
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
13. The nurse is planning care for a hospitalized preschool-aged child. Which should the nurse plan to ensure
atraumatic care?
a. Limit explanation of procedures because the child is preschool aged.
b. Ask that all family members leave the room when performing procedures.
c. Allow the child to choose the type of juice to drink with the administration of oral medications.
d. Explain that EMLA cream cannot be used for the morning lab draw because there is not time for it
to be effective.
ANS: C
The overriding goal in providing atraumatic care is first, do no harm. Allowing the child a choice of juice to
drink when taking oral medications provides the child with a sense of control. The preschool child should be
prepared before procedures, so limiting explanations of procedures would increase anxiety. The family should
be allowed to stay with the child during procedures, minimizing stress. Lidocaine/prilocaine (EMLA) cream is
a topical local anesthetic. The nurse should plan to use the prescribed cream in time for morning laboratory
draws to minimize pain.
DIF: Cognitive Level: Applying
MSC: Client Needs: Health Promotion and Maintenance
14. Which situation denotes a nontherapeutic nursepatientfamily relationship?
a. The nurse is planning to read a favorite fairy tale to a patient.
b. During shift report, the nurse is criticizing parents for not visiting their child.
c. The nurse is discussing with a fellow nurse the emotional draw to a certain patient.
d. The nurse is working with a family to find ways to decrease the familys dependence on health care
providers.
ANS: B
,Criticizing parents for not visiting in shift report is nontherapeutic and shows an underinvolvement with the
parents. Reading a fairy tale is a therapeutic and age appropriate action. Discussing feelings of an emotional
draw with a fellow nurse is therapeutic and shows a willingness to understand feelings. Working with parents
to decrease dependence on health care providers is therapeutic and helps to empower the family.
DIF: Cognitive Level: Analyzing
MSC: Client Needs: Psychosocial Integrity
15. The nurse is aware that which age group is at risk for childhood injury because of the cognitive
characteristic of magical and egocentric thinking?
a. Preschool
b. Young school age
c. Middle school age
d. Adolescent
ANS: A
Preschool children have the cognitive characteristic of magical and egocentric thinking, meaning they are
unable to comprehend danger to self or others. Young and middle school-aged children have transitional
cognitive processes, and they may attempt dangerous acts without detailed planning but recognize danger to
themselves or others. Adolescents have formal operational cognitive processes and are preoccupied with
abstract thinking.
DIF: Cognitive Level: Understanding
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment
16. The school nurse is assessing children for risk factors related to childhood injuries. Which child has the
most risk factors related to childhood injury?
a. Female, multiple siblings, stable home life
b. Male, high activity level, stressful home life
c. Male, even tempered, history of previous injuries
d. Female, reacts negatively to new situations, no serious previous injuries
ANS: B
Boys have a preponderance for injuries over girls because of a difference in behavioral characteristics, a high
activity temperament is associated with risk-taking behaviors, and stress predisposes children to increased risk
taking and self-destructive behaviors. Therefore, a male child with a high activity level and living in a stressful
environment has the highest number of risk factors. A girl with several siblings and a stable home life is low
risk. A boy with previous injuries has two risk factors, but an even temper is not a risk factor for injuries. A
, girl who reacts negatively to new situations but has no previous serious illnesses has only one risk factor.
DIF: Cognitive Level: Analyzing
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment
17. The school nurse is evaluating the number of school-age children classified as obese. The nurse recognizes
that the percentile of body mass index that classifies a child as obese is greater than which?
a. 50th percentile
b. 75th percentile
c. 80th percentile
d. 95th percentile
ANS: D
Obesity in children and adolescents is defined as a body mass index at or greater than the 95th percentile for
youth of the same age and gender.
DIF: Cognitive Level: Remembering
MSC: Client Needs: Health Promotion and Maintenance
18. The nurse is teaching parents about the types of behaviors children exhibit when living with chronic
violence. Which statement made by the parents indicates further teaching is needed?
a. We should watch for aggressive play.
b. Our child may show lasting symptoms of stress.
c. We know that our child will show caring behaviors.
d. Our child may have difficulty concentrating in school.
ANS: C
The statement that the child will show caring behaviors needs further teaching. Children living with chronic
violence may exhibit behaviors such as difficulty concentrating in school, memory impairment, aggressive
play, uncaring behaviors, and lasting symptoms of stress.
DIF: Cognitive Level: Applying
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
19. The nurse is evaluating research studies according to the GRADE criteria and has determined the quality of
evidence on the subject is moderate. Which type of evidence does this determination indicate?
