Nursing Care of Children Principles and Practice 3rd edition by Susan R. James – Test Bank A+

$35.00
Nursing Care of Children Principles and Practice 3rd edition by Susan R. James – Test Bank A+

Nursing Care of Children Principles and Practice 3rd edition by Susan R. James – Test Bank A+

$35.00
Nursing Care of Children Principles and Practice 3rd edition by Susan R. James – Test Bank A+


MSC: NCLEX: Health Promotion and Maintenance

  1. Which of the following parental behaviors is the most important in fostering moral development?
a.Telling the child what is right and wrong
b.Vigilantly monitoring the child and her peers
c.Weekly family meetings to discuss behavior
d.Living as the parents say they believe

ANS: D

Feedback
ATelling the child what is right and wrong is not effective unless the child has experienced what she hears. Parents need to live according to the values they are teaching to their children.
BVigilant monitoring of the child and her peers is an inappropriate action for the parent to initiate. It does not foster moral development and reasoning in the child.
CWeekly family meetings to discuss behaviors may or may not be helpful in the development of moral reasoning.
DParents living what they believe give nonambivalent messages and foster the child’s moral development and reasoning.

DIF: Cognitive Level: Comprehension REF: Text Reference: pg 170

OBJ: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance

  1. Which of the following behaviors by parents or teachers will best assist the child in negotiating the developmental task of industry?
a.Identifying failures immediately and asking the child’s peers for feedback
b.Structuring the environment so the child can master tasks
c.Completing homework for children who are having difficulty in completing assignments
d.Decreasing expectations to eliminate potential failures

ANS: B

Feedback
AAsking peers for feedback reinforces the child’s feelings of failure.
BThe task of the caring teacher or parent is to identify areas in which a child is competent and to build on successful experiences to foster feelings of mastery and success. Structuring the environment to enhance self-confidence and to provide the opportunity to solve increasingly more complex problems will promote a sense of mastery.
CWhen teachers or parents complete children’s homework for them, it sends the message that you do not trust them to do a good job. Providing assistance and suggestions and praising their best efforts are more appropriate.
DDecreasing expectations to eliminate failures will not promote a sense of achievement or mastery.

DIF: Cognitive Level: Application REF: Text Reference: pg 169

OBJ: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

  1. The older school-age child’s cognitive development can be evaluated by assessing which of the following?
a.The child’s addition and subtraction ability
b.The child’s ability to classify
c.The child’s vocabulary
d.The child’s play activity

ANS: B

Feedback
ASubtraction and addition are appropriate cognitive activities for the young school-age child.
BThe ability to classify things from simple to complex and to identify differences and similarities are cognitive skills of the older school-age child; this demonstrates use of classification and logical thought processes.
CVocabulary is not as valid an assessment of cognitive ability as is the child’s ability to classify.
DPlay activity is not as valid an assessment of cognitive function as is the ability to classify.

DIF: Cognitive Level: Knowledge REF: Text Reference: pg 168

OBJ: Nursing Process Step: Evaluation

MSC: NCLEX: Health Promotion and Maintenance

  1. Which of following is an appropriate disciplinary intervention for the school-age child?
a.Using time-out periods
b.Using a consequence that is consistent with the inappropriate behavior
c.Using physical punishment
d.Using lengthy dialog about inappropriate behavior

ANS: B

Feedback
ATime-out periods are more appropriate for younger children.
BA consequence that is related to the inappropriate behavior is the recommended discipline.
CPhysical intervention is an inappropriate form of discipline. It does not connect the discipline with the child’s inappropriate behavior.
DLengthy discussions typically are not helpful.

DIF: Cognitive Level: Comprehension REF: Text Reference: pg 174

OBJ: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

MULTIPLE RESPONSE

  1. Which of the following demonstrates the school-age child’s developing logic in the stage of concrete operations? Select all that apply.
a.The school-age child is able to recognize that 1 pound of feathers is equal to 1 pound of metal.
b.The school-age child is able to recognize that he can be a son, brother, or nephew at the same time.
c.The school-age child understands the principles of adding, subtracting, and reversibility.
d.The school-age child has thinking that is characterized by egocentrism, animism, and centration.

ANS: A, B, C

Feedback
CorrectThe school-age child understands that the properties of objects do not change when their order, form, or appearance does. Conservation occurs in the concrete operations stage. Comprehension of class inclusion occurs as the school-age child’s logic increases. The child begins to understand that a person can be in more than one class at the same time. This is characteristic of concrete thinking and logical reasoning. The school-age child is able to understand principles of adding, subtracting, and the process of reversibility, which occurs in the stage of concrete operations
IncorrectThis type of thinking occurs in the intuitive thought stage, not the concrete operations stage of development.

DIF: Cognitive Level: Knowledge REF: Text Reference: pg 168

OBJ: Nursing Process Step: Evaluation

MSC: NCLEX: Health Promotion and Maintenance

James: Nursing Care of Children: Principles and Practice, 3rd Edition

Test Bank

Chapter 11: The Ill Child in the Hospital and Other Care Settings

MULTIPLE CHOICE

  1. Which of the following situations poses the greatest challenge to the nurse working with a child and family?
a.Twenty-four hour observation
b.Emergency hospitalization
c.Outpatient admission
d.Rehabilitation admission

ANS: B

Feedback
AAlthough preparation time may be limited with a 24-hour observation, this situation does not usually involve the acuteness of the situation and the high levels of anxiety associated with emergency admission.
BEmergency hospitalization involves (1) limited time for preparation both for the child and family, (2) situations that cause fear for the family that the child may die or be permanently disabled, and (3) a high level of activity, which can foster further anxiety.
COutpatient admission generally involves preparation time for family and child. Because of the lower level of acuteness in these settings, anxiety levels are not as high.
DRehabilitation admission follows a serious illness or disease. This type of unit may resemble a home environment, which decreases the child and family’s anxiety.

DIF: Cognitive Level: Comprehension REF: Text Reference: pg 285

OBJ: Nursing Process Step: Planning

MSC: NCLEX: Safe Effective Care Environment

  1. What is the primary disadvantage associated with outpatient and day facility care?
a.Increased cost
b.Increased risk of infection
c.Lack of physical connection to the hospital
d.Longer separation of the child from family

ANS: C

Feedback
AThis type of care decreases cost.
BThis type of care decreases risk of infection.
COutpatient and day facility care do not provide extended care; therefore, a child requiring extended care would have to be transferred to the hospital, causing increased stress to the child and parents.
DThis type of care minimizes separation of the child from family.

DIF: Cognitive Level: Comprehension REF: Text Reference: pg 285

OBJ: Nursing Process Step: Implementation

MSC: NCLEX: Safe Effective Care Environment

  1. Which child would have the most difficulty with separation from family during hospitalization?
a.A 5-month-old infant
b.A 15-month-old toddler
c.A 4-year-old child
d.A 7-year-old child

ANS: B

Feedback
AInfants younger than 6 months of age will generally adapt to hospitalization if their basic needs for food, warmth, and comfort are met.
BSeparation is the major stressor for children hospitalized between the ages of 6 and 30 months.
CAlthough separation anxiety occurs in hospitalized preschoolers, it is usually less obvious and less serious than that experienced by the toddler.
DThe school-age child is accustomed to separation from parents. Although hospitalization is a stressor, the 7-year-old child will have less separation anxiety than a 15-month-old toddler.

DIF: Cognitive Level: Knowledge REF: Text Reference: pg 288

OBJ: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

  1. What is the best explanation for a 2-year-old child who is quiet and withdrawn on the fourth day of a hospital admission?
a.The child is protesting her separation from her caregivers.
b.The child has adjusted to the hospitalization.
c.The child is experiencing the despair stage of separation.
d.The child has reached the stage of detachment.

ANS: C

Feedback
AIn the protest stage, the child would be agitated, crying, resistant to caregivers, and inconsolable.
BToddlers do not readily “adjust” to hospitalization and separation from caregivers.
CIn the despair stage of separation, the child exhibits signs of hopelessness and becomes quiet, withdrawn, and apathetic.
DThe detachment stage occurs after prolonged separation. During this phase, the child becomes interested in the environment and begins to play.

DIF: Cognitive Level: Comprehension REF: Text Reference: pg 289

OBJ: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity

  1. A 3-year-old child cries, kicks, and clings to the father when the parents try to leave the hospital room. What is the nurse’s best response to the parents about this behavior?
a.“Your child is showing a normal response to the stress of hospitalization.”
b.“Your child is not coping effectively with hospitalization. We’ll need to get a psychologic consult from the doctor.”
c.“It is helpful for parents to stay with children during hospitalization.”
d.“You can avoid this if you wait to leave after your child falls asleep.”

ANS: A

Feedback
AThe child is exhibiting a healthy attachment to the father.
BThe child’s behavior represents the protest stage of separation and does not represent maladaptive behavior.
CThis response places undue stress and guilt on the parents.
DThis response fosters the child’s mistrust.

DIF: Cognitive Level: Application REF: Text Reference: pg 289

OBJ: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity

  1. The hospitalized preschooler fears mutilation and misunderstands illness. Which of the following is the best rationale for this?
a.The child has a fear that mutilation will lead to death.
b.The toddler’s imagination is very active, and he may believe the illness is a result of something he did.
c.The child has a general understanding of body integrity at this age.
d.The child will not have fear related to an IV catheter initiation but will have fear of an impending surgery.

ANS: B

Feedback
APreschoolers do not have the cognitive ability to connect mutilation to death.
BThe child has imaginative thoughts at this stage of growth and development. The child may believe that an illness occurred as a result of some personal deed or thought or perhaps because he touched something or someone.
CPreschoolers do not have a sound understanding of body integrity.
DThe preschooler fears all types of intrusive procedures whether undergoing a simple procedure such as an IV start or something more invasive such as surgery.

DIF: Cognitive Level: Knowledge REF: Text Reference: pg 290

OBJ: Nursing Process Step: Evaluation

MSC: NCLEX: Health Promotion and Maintenance

  1. Which is the most developmentally appropriate intervention when working with the hospitalized adolescent?
a.Encourage peers to call and visit when the adolescent’s condition allows.
b.Be sure the adolescent wears a hospital gown or pajamas throughout the hospitalization.
c.Discourage questions and concerns about the effects of the illness on the adolescent’s appearance.
d.Ask the parents how the adolescent usually copes in new situations.

ANS: A

Feedback
AThe peer group is important to the adolescent’s sense of belonging and identity; therefore separation from friends is a major source of anxiety for the hospitalized adolescent.
BAdolescents should be encouraged to wear their own clothes to foster their sense of identity.
CQuestions and concerns about the adolescent’s appearance and the effects of illness on appearance should be encouraged.
DHow the adolescent copes should be asked directly of the adolescent.

DIF: Cognitive Level: Application REF: Text Reference: pg 292

OBJ: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity

  1. The nurse is discussing toddler development with the mother of a -year-old child. Which statements by the mother indicate she has an understanding of how to help the child succeed in a developmental task?
a.“I always help my daughter complete tasks to help her achieve a sense of accomplishment.”
b.“I provide many opportunities for my daughter to play with other children her age.”
c.“I consistently stress the difference between right and wrong to my daughter.”
d.“I encourage my daughter to do things for herself when she can.”

ANS: D

Feedback
AToddlers should be encouraged to do what they can for themselves.
BToddlers participate in parallel play. They play next to rather than with age mates.
CExcessive stress on the differences between right and wrong can stifle autonomy in the toddler and foster shame and doubt.
DThe toddler’s developmental task is to achieve autonomy. Encouraging toddlers to do things for themselves assists with this developmental task.

DIF: Cognitive Level: Comprehension REF: Text Reference: pg 290

OBJ: Nursing Process Step: Evaluation

MSC: NCLEX: Health Promotion and Maintenance

  1. Which of the following interventions would help a hospitalized toddler feel a sense of control?
a.Assign the same nurses to care for the child.
b.Put a cover over the child’s crib.
c.Require parents to stay with the child.
d.Follow the child’s usual routines for feeding and bedtime.

ANS: D

Feedback
AProviding consistent caregivers is most applicable for the very young child, such as the neonate and infant.
BPlacing a cover over the child’s crib may increase feelings of loss of control.
CParents are encouraged, rather than expected, to stay with the child during hospitalization.
DFamiliar rituals and routines are important to toddlers and give the child a sense of control. Following the child’s usual routines during hospitalization minimizes feelings of loss of control.

DIF: Cognitive Level: Comprehension REF: Text Reference: pg 290

OBJ: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity

  1. Why is observation for 24 hours in an acute-care setting often appropriate for children?
a.Longer hospital stays are more costly.
b.Children become ill quickly and recover quickly.
c.Children feel less separation anxiety when hospitalized for 24 hours.
d.Families experience less disruption during short hospital stays.

ANS: B

Feedback
AA child’s state of wellness, rather than cost, determines the length of stay.
BChildren become ill quickly and recover quickly; therefore, they can require acute care for a shorter period of time.
CSeparation anxiety is primarily a factor of the stage of development not the length of hospital stay.
DFamily disruption is a secondary outcome of a child’s hospitalization; it does not determine length of stay.

DIF: Cognitive Level: Comprehension REF: Text Reference: pg 285

OBJ: Nursing Process Step: N/A MSC: NCLEX: Physiological Integrity

  1. The nurse is aware that separation is the major stressor for which age group?
a.Newborns and infants
b.Infants and toddlers
c.Toddlers and preschoolers
d.Preschoolers and school-age children

ANS: B

Feedback
ANewborns feel little separation anxiety as long as their comfort needs are met.
BSeparation anxiety is at its peak during the infant and toddler ages.
CPreschoolers are most fearful of injury and pain.
DLoss of control is the primary stressor for school-age children.

DIF: Cognitive Level: Knowledge REF: Text Reference: pg 289

OBJ: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

  1. In which age group does the child’s active imagination during unfamiliar experiences increase the stress of hospitalization?
a.Toddlers
b.Preschoolers
c.School-age children
d.Adolescents

ANS: B

Feedback
AA toddler’s primary response to hospitalization is separation anxiety.
BActive imagination is a primary characteristic of preschoolers.
CSchool-age children experience stress with loss of control.
DAdolescents experience stress from separation from their peers.

DIF: Cognitive Level: Knowledge REF: Text Reference: pg 290

OBJ: Nursing Process Step: Planning

MSC: NCLEX: Health Promotion and Maintenance

  1. What are the stages of separation experienced by young children when they are hospitalized?
a.Crying, hopelessness, and withdrawal
b.Protest, apathy, and re-entry
c.Protest, despair, and detachment
d.Fear, hopelessness, and detachment

ANS: C

Feedback
ACrying, hopelessness, and withdrawal are symptoms of separation.
BApathy and re-entry are not stages of separation.
CThe correct sequence for the stages of separation is protest, despair, and detachment.
DFear and hopelessness can be felt by the hospitalized child, but they are not stages of separation.

DIF: Cognitive Level: Knowledge REF: Text Reference: pg 289

OBJ: Nursing Process Step: N/A MSC: NCLEX: Psychosocial Integrity

  1. Having explanations for all procedures and selecting their own meals from hospital menus is an important coping mechanism for which of the following age groups?
a.Toddlers
b.Preschoolers
c.School-age children
d.Adolescents

ANS: C

Feedback
AToddlers need routine and parent involvement for coping.
BPreschoolers need simple explanations of procedures.
CSchool-age children are developmentally ready to accept detailed explanations. School-aged children can select their own menus and become actively involved in other areas of their care.
DDetailed explanations and support of peers help adolescents cope.

DIF: Cognitive Level: Application REF: Text Reference: pg 291

OBJ: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity

  1. What is the best action for the nurse to take when a 5-year-old child who requires another 2 days of IV antibiotics, cries, screams, and resists having his IV restarted?
a.Exit the room and leave the child alone until he stops crying.
b.Tell the child big boys and girls “don’t cry.”
c.Let the child decide which color arm board to use with his IV.
d.Proceed quickly with the IV antibiotics to decrease stress.

ANS: C

Feedback
ALeaving the child alone robs the child of support when a coping difficulty exists.
BCrying is a normal response to stress.
CGiving the preschooler some choice and control, while maintaining boundaries of treatment, supports the child’s coping skills.
DThe child needs time to adjust and support to cope with unfamiliar and painful procedures during hospitalization.

DIF: Cognitive Level: Application REF: Text Reference: pg 290

OBJ: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity

  1. What is the best nursing response to the mother of a 4-year-old child who asks what she can do to help the child cope with a sibling’s repeated hospitalizations?
a.Recommend that the child be sent to visit the grandmother until the sibling returns home.
b.Inform the parent that the child is too young to visit the hospital.
c.Assume the child understands that the sibling will soon be discharged because the child asks no questions.
d.Help the mother give the child a simple explanation of the treatment and encourage the mother to have the child visit the hospitalized sibling.

ANS: D

Feedback
ASeparation from family and home may intensify fear and anxiety.
BParents are experts on their children and need to determine when their child can visit a hospital.
CChildren may have difficulty expressing questions and fears and need the support of parents and other caregivers.
DNeeds of a sibling will be better met with factual information and contact with the ill child.

DIF: Cognitive Level: Application REF: Text Reference: pg 302

OBJ: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity

  1. How would the nurse advise parents whose preschooler used to sleep through the night and now awakens at intervals after a short hospitalization?
a.Regressive behavior after a hospitalization is normal and usually short term.
b.The child is probably expressing anger.
c.Egocentric behavior often manifests itself when the child is left alone to sleep.
d.The child is probably feeling pain and needs further evaluation.

ANS: A

Feedback
ARegression is manifested in a variety of ways, is normal, and usually is short term.
BNighttime waking is not associated with anger.
CEgocentric behavior is not an explanation for nighttime waking.
DMore information is needed before assessment of pain can be made.

DIF: Cognitive Level: Comprehension REF: Text Reference: pg 295

OBJ: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

  1. Which of the following is an appropriate nursing intervention for the hospitalized neonate?
a.Assign the neonate to a room with other neonates.
b.Provide play activities in the hospital room.
c.Offer the neonate a pacifier between feedings.
d.Request that parents bring security object from home.

ANS: C

Feedback
AThe neonate is not aware of other children. The choice of roommate will not affect the neonate socially. It is important for older children to room with similar-age children.
BFormal play activities would not be relevant for the neonate.
CThe neonate needs opportunities for nonnutritive sucking and oral stimulation with a pacifier.
DHaving parents bring a security object from home is applicable to older children.

DIF: Cognitive Level: Comprehension REF: Text Reference: pg 294

OBJ: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

  1. Which approach will best help a 7-year-old child cope with a lengthy course of intravenous antibiotic therapy?
a.Arrange for the child to go to the playroom daily.
b.Ask the child to draw you a picture about himself.
c.Allow the child to participate in injection play.
d.Give the child stickers for cooperative behavior.

ANS: C

Feedback
AThe hospitalized child should have opportunities to go to the playroom each day if his condition warrants. This free play does not have any specific therapeutic purpose.
BChildren can express their thoughts and beliefs through drawing. Asking the child to draw a picture of himself may not elicit the child’s feelings about his treatment.
CInjection play is an appropriate intervention for the child who has to undergo frequent blood work, injections, intravenous therapy, or any other therapy involving syringes and needles.
DRewards such as stickers may enhance cooperative behavior. They will not address coping with painful treatments.

DIF: Cognitive Level: Application REF: Text Reference: pg 295

OBJ: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity

  1. A 6-year-old child tells the nurse that she does not like the food at the hospital. A review of intake reveals she has eaten very little for the past 2 days. Which of the following is an appropriate intervention for the nursing diagnosis: Imbalanced Nutrition: Less than body requirements?
a.Select nutritious foods on the menu for the child.
b.Permit the child to eat junk foods at snack times.
c.Arrange the child’s meal tray with generous portions of food.
d.Encourage family members to bring foods from home.

ANS: D

Feedback
AA 6-year-old child should be permitted to make her own menu selections with the assistance of an adult as needed. Allowing the child to select foods gives the child control and provides an opportunity to select foods that the child likes.
BJunk foods have little or no nutritional value. If the child is permitted to eat junk food, she may refuse to eat nutritious food at mealtimes.
CMeals served to children should have small portions. Children may feel overwhelmed by large portions and refuse to eat any of the food.
DHaving the parents bring foods that the child likes and is familiar with will increase the likelihood that she will eat.

DIF: Cognitive Level: Application REF: Text Reference: pg 298

OBJ: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity

  1. A -year-old child who is toilet trained has had several “accidents” since hospital admission. What is the nurse’s best action in this situation?
a.Find out how long the child has been toilet trained at home.
b.Tell the parent it is necessary to begin toilet training again.
c.Explain how to use a bedpan and place it close to the child.
d.Follow home routines of elimination.

ANS: D

Feedback
ASome regression to previous behaviors is normal during hospitalization, even when the child has been practicing the skill for some time.
BHospitalization is a stressful experience and is not an appropriate time to learn or relearn a skill.
CDevelopmentally, the -year-old child cannot use a bedpan independently.
DCooperation will increase and anxiety will decrease if the child’s normal routine and rituals are maintained.

DIF: Cognitive Level: Application REF: Text Reference: pgs 298-299

OBJ: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity

  1. Which question would most likely elicit information about how a family is coping with a child’s hospitalization?
a.“Was this admission an emergency?”
b.“How has your child’s hospitalization affected your family?”
c.“Who is taking care of your other children while you are here?”
d.“Is this the child’s first hospitalization?”

ANS: B

Feedback
AThis is a closed-ended question. The nurse would have to ask other questions to gather additional information.
BOpen-ended questions encourage communication. Ensuring a positive outcome from the hospital experience can be optimized by the nurse addressing the health needs of family members as well as the needs of the child.
CThis is a closed-ended question. The parent answers the question with a short response. The nurse must ask additional questions to learn more about the family.
DThe parent would answer “yes” or “no” to this question and expect the conversation to be over. The nurse must ask additional questions to learn more about the family.

DIF: Cognitive Level: Comprehension REF: Text Reference: pgs 301-302

OBJ: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

  1. What would the nurse advise the mother of a 4-year-old child to bring with her child to the outpatient surgery center on the day of surgery?
a.Snacks
b.Fruit juice boxes
c.All of the child’s medications
d.One of the child’s favorite toys

ANS: D

Feedback
AThe child will be NPO before surgery; therefore, including snacks for the child is contraindicated.
BThe child will be NPO before surgery. Unnecessary stress will result when the child is denied the juice.
CIt is not necessary to bring all medications on the day of surgery. The medication the child has been receiving should have been noted during the preoperative workup. The parent should be knowledgeable of which medications the child has been taking if further information is necessary.
DA familiar toy can be effective in decreasing a child’s stress in an unfamiliar environment.

DIF: Cognitive Level: Application REF: Text Reference: pg 295

OBJ: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

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