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Pediatric Nursing A Case Based Approach 1st Edition by Gannon Tagher and Lisa Knapp

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Pediatric Nursing A Case Based Approach 1st Edition by Gannon Tagher and Lisa Knapp

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  • August 18, 2024
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Test bank for Pediatric Nursing A Case Based Approach
1st Edition by Gannon Tagher and Lisa Knapp |
9781496394224 |Chapter 1-34 | All Chapters with
Answers and Rationals

A mother has just given birth to an infant with a cleft lip. Sensing that something is wrong, she starts
to cry and asks the nurse, "What is wrong with my baby?" The most appropriate nursing action is to:
a.encourage mother to express her feelings.
b.explain in simple language that the baby has a cleft lip.
c.provide emotional support until practitioner can talk to mother.
d.tell mother a pediatrician will talk to her as soon as the baby is examined. - ANSWER: ANS: B
It is best to explain in simple terms the nature of the defect and to reinforce and help clarify
information given by the practitioner before the infant is shown to the parents. Parents may not be
ready to talk about their feelings during the first few days after birth. The nurse should provide
information about the child's condition while waiting for the practitioner to speak with the family
after the examination. The mother needs simple explanations of what is wrong with her child during
this period of waiting.

Which of the following factors will decrease iron absorption and therefore should not be given at the
same time as an iron supplement?
a.Milk
b.Fruit juice
c.Multivitamin
d.Meat, fish, poultry - ANSWER: ANS: A
Many foods interfere with iron absorption and should be avoided when the iron is consumed. These
foods include phosphates found in milk, phytates found in cereals, and oxalates found in many
vegetables. Vitamin C-containing juices enhance the absorption of iron. Multivitamins may contain
iron; no contraindication exists to taking the two together. Meat, fish, and poultry do not affect
absorption.

The nurse is helping parents achieve a more nutritionally adequate vegetarian diet for their children.
Which of the following is most likely lacking in their particular diet?
a.Fat
b.Protein
c.Vitamins C and A
d.Complete protein - ANSWER: ANS: D
The vegetarian diet can be extremely healthy, meeting the overall nutrition objectives outlined in
Healthy People 2010. Parents should be taught about food preparation to ensure that complete
proteins are available for growth. When parents use a strict vegetarian diet, a likelihood exists of
inadequate protein for growth and calories for energy. Fat and vitamins C and A are readily available
from vegetable sources. Plant proteins are available. Foods must be combined to provide complete
proteins for growth.

The parent of an infant with colic tells the nurse, "All this baby does is scream at me; it is a constant
worry." The nurse's best action is which of the following?
a.Encourage parent to verbalize feelings.
b.Encourage parent not to worry so much.
c.Assess parent for other signs of inadequate parenting.
d.Reassure parent that colic rarely lasts past age 9 months. - ANSWER: ANS: A
Colic is multifactorial, and no single treatment is effective for all infants. The parent is verbalizing
concern and worry. The nurse should allow the parent to put these feelings into words. An
empathetic, gentle, and reassuring attitude, in addition to suggestions about remedies, will help

,alleviate the parent's anxiety. The nurse should reassure the parent that he or she is not doing
anything wrong. The infant with colic is experiencing spasmodic pain that is manifested by loud
crying, in some cases up to 3 hours each day. Telling the parent that it will eventually go away does
not help him or her through the current situation.

Clinical manifestations of failure to thrive (FTT) in a 13-month-old may include which of the following?
a.Irregularity in activities of daily living
b.Preferring solid food to milk or formula
c.Weight that is at or below the 10th percentile
d.Appropriate achievement of developmental landmarks - ANSWER: ANS: A
One of the clinical manifestations of children with FTT is irregularity or low rhythmicity in activities of
daily living. Children with FTT often refuse to switch from liquids to solid foods. Weight below the 5th
percentile is indicative of FTT. Developmental delays, including social, motor, adaptive, and language,
exist.

Which one of the following strategies might be recommended for an infant with failure to thrive (FTT)
to increase caloric intake?
a.Vary schedule for routine activities on a daily basis.
b.Be persistent through 10 to 15 minutes of food refusal.
c.Avoid solids until after the bottle is well accepted.
d.Use developmental stimulation by a specialist during feedings. - ANSWER: ANS: B
Calm perseverance through 10 to 15 minutes of food refusal will eventually diminish negative
behavior. Children with FTT need a structured routine to help establish rhythmicity in their activities
of daily living. Many children with FTT are fed exclusively from a bottle. Solids should be fed first.
Stimulation is reduced during the mealtime to maintain the focus on eating.

The parents of a 3-month-old infant report that their infant sleeps supine (face up) but is often prone
(face down) while awake. The nurse's response should be based on knowledge that this is:
a.acceptable to encourage head control and turning over.
b.acceptable to encourage fine motor development.
c.unacceptable because of the risk of sudden infant death syndrome (SIDS).
d.unacceptable because it does not encourage achievement of developmental milestones. - ANSWER:
ANS: A
These parents are implementing the guidelines to reduce the risk of SIDS. Infants should sleep on
their backs to reduce the risk of SIDS and then be placed on their abdomens when awake to enhance
achievement of milestones such as head control. These position changes encourage gross motor
development, not fine motor.

An important nursing responsibility when dealing with a family experiencing the loss of an infant from
sudden infant death syndrome (SIDS) would be which of the following?
a.Discourage parents from making a last visit with the infant.
b.Make a follow-up home visit to parents as soon as possible after the child's death.
c.Explain how SIDS could have been predicted and prevented.
d.Interview parents in depth concerning the circumstances surrounding the child's death. - ANSWER:
ANS: B
A competent, qualified professional should visit the family at home as soon as possible after the
death. Printed information about SIDS should be provided to the family. Parents should be allowed
and encouraged to make a last visit with their child. SIDS cannot always be prevented or predicted,
but parents can take steps to reduce the risk (such as supine sleeping, removing blankets and pillows
from the crib, and not smoking). Discussions about the cause only increase parental guilt. The parents
should be asked only factual questions to determine the cause of death.

Which of the following is an appropriate action when an infant becomes apneic?
a.Shake vigorously.
b.Roll head side to side.
c.Gently stimulate trunk by patting or rubbing.
d.Hold by feet upside down with head supported. - ANSWER: ANS: C

, If the infant is apneic, the infant's trunk should be gently stimulated by patting or rubbing. If the infant
is prone, turn onto the back. Vigorous shaking, rolling of the head, and hanging the child upside down
can cause injury and should not be done.

Decongestant nose drops are recommended for a 10-month-old infant with an upper respiratory tract
infection. Instructions for nose drops should include which of the following?
a.Do not use for more than 3 days.
b.Keep drops to use again for nasal congestion.
c.Administer drops after feedings and at bedtime.
d.Give two drops every 5 minutes until nasal congestion subsides. - ANSWER: ANS: A
Vasoconstrictive nose drops such as Neo-Synephrine should not be used for more than 3 days to
avoid rebound congestion. Drops should be discarded after one illness and not used for other children
because they may become contaminated with bacteria. Drops administered before feedings are more
helpful. Two drops are administered to cause vasoconstriction in the anterior mucous membranes. An
additional two drops are instilled 5 to 10 minutes later for the posterior mucous membranes. No
further doses should be given.

The parent of an infant with nasopharyngitis should be instructed to notify the health professional if
the infant:
a.has a cough.
b.becomes fussy.
c.shows signs of an earache.
d.has a fever higher than 37.5 C (99 F). - ANSWER: ANS: C
If an infant with nasopharyngitis shows signs of an earache, it may indicate respiratory complications
and possibly secondary bacterial infection. The health professional should be contacted to evaluate
the infant. Cough can be a sign of nasopharyngitis. Irritability is common in an infant with a viral
illness. Fever is common in viral illnesses.

It is important that a child with acute streptococcal pharyngitis be treated with antibiotics to prevent:
a. otitis media.
b. diabetes insipidus (DI).
c. nephrotic syndrome.
d. acute rheumatic fever. - ANSWER: ANS: D
Group A -hemolytic streptococcal infection is a brief illness with varying symptoms. It is essential that
pharyngitis caused by this organism be treated with appropriate antibiotics to avoid the sequelae of
acute rheumatic fever and acute glomerulonephritis. The cause of otitis media is either viral or other
bacterial organisms. DI is a disorder of the posterior pituitary. Infections such as meningitis or
encephalitis, not streptococcal pharyngitis, can cause DI. Glomerulonephritis, not nephrotic
syndrome, can result from acute streptococcal pharyngitis.

When caring for a child after a tonsillectomy, the nurse should do which of the following?
a. Watch for continuous swallowing.
b. Encourage gargling to reduce discomfort.
c. Apply warm compresses to the throat.
d. Position the child on the back for sleeping. - ANSWER: ANS: A
Continuous swallowing, especially while sleeping, is an early sign of bleeding. The child swallows the
blood that is trickling from the operative site. Gargling is discouraged, since it could irritate the
operative site. Ice compresses are recommended to reduce inflammation. The child should be
positioned on the side or abdomen to facilitate drainage of secretion.

Parents bring their 15-month-old infant to the emergency department at 3:00 AM because the
toddler has a temperature of 39o C (102.2o F), is crying inconsolably, and is tugging at the ears. A
diagnosis of otitis media (OM) is made. In addition to antibiotic therapy, the nurse practitioner would
instruct the parents to use:
a. decongestants to ease stuffy nose.
b. antihistamines to help the child sleep.
c. aspirin for pain and fever management.

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