Pediatric Nursing:

The Critical Components of Nursing Care

2nd Edition_Rudd

Test Bank

Rudd Test BankChapter 1. Issues and Trends in Pediatric Nursing

MULTIPLE CHOICE

1. A nurse is reviewing changes in healthcare delivery and funding for pediatric

populations.Which current trend in the pediatric setting should the nurse expect to

find?

a. Increased hospitalization of children

b. Decreased number of uninsured children

c. An increase in ambulatory care

d. Decreased use of managed care

ANS: C

One effect of managed care is that pediatric healthcare delivery has shifted dramatically

from theacute care setting to the ambulatory setting. The number of hospital beds being

used has decreased as more care is provided in outpatient and home settings. The

number of uninsured children in the United States continues to grow. One of the

biggest changes in healthcare has been the growth of managed care.

DIF: Cognitive Level: Comprehension REF: p. 3

OBJ: Nursing Process Step: Planning MSC: Safe and Effective Care Environment

2. A nurse is referring a low-income family with three children under the age of 5 years

to a program that assists with supplemental food supplies. Which program should the

nurse refer thisfamily to?

a. Medicaid

b. Medicare

c. Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program

d. Women, Infants, and Children (WIC) program

ANS: D

WIC is a federal program that provides supplemental food supplies to low-income

women whoare pregnant or breast-feeding and to their children until the age of 5

years. Medicaid and the Medicaid Early and Periodic Screening, Diagnostic, and

Treatment (EPSDT) program providesfor well-child examinations and related

treatment of medical problems. Children in the WIC program are often referred for

immunizations, but that is not the primary focus of the program.Public Law 99-457

provides financial incentives to states to establish comprehensive early intervention

services for infants and toddlers with, or at risk for, developmental disabilities.

Medicare is the program for Senior

Citizens. DIF: Cognitive Level:

Application REF: p. 7 OBJ: Nursing

Process Step: Implementation MSC:

Health Promotion and Maintenance

3. In most states, adolescents who are not emancipated minors must have parental

permissionbefore:

a. treatment for drug abuse.

b. treatment for sexually transmitted diseases (STDs).

c. obtaining birth control.

d. surgery.

ANS: D

An emancipated minor is a minor child who has the legal competence of an adult. Legal

counselmay be consulted to verify the status of the emancipated minor for consent

purposes. Most statesallow minors to obtain treatment for drug or alcohol abuse and

STDs and allow access to birth control without parental consent.

DIF: Cognitive Level: Application REF: p. 12

OBJ: Nursing Process Step: Planning MSC: Safe and Effective Care Environment

4. A nurse is completing a clinical pathway for a child admitted to the hospital with

pneumonia.Which characteristic of a clinical pathway is correct?

a. Developed and implemented by nurses

b. Used primarily in the pediatric setting

c. Specific time lines for sequencing interventions

d. One of the steps in the nursing process

ANS: C

Clinical pathways measure outcomes of client care and are developed by multiple

healthcare professionals. Each pathway outlines specific time lines for sequencing

interventions and reflectsinterdisciplinary interventions. Clinical pathways are used in

multiple settings and for clients throughout the life span. The steps of the nursing

process are assessment, diagnosis, planning, implementation, and evaluation.

DIF: Cognitive Level: Comprehension REF: p. 6

OBJ: Nursing Process Step: Planning MSC: Safe and Effective Care Environment

5. When planning a parenting class, the nurse should explain that the leading cause of

death inchildren 1 to 4 years of age in the United States is:

a. premature birth.

b. congenital anomalies.

c. accidental death.

d. respiratory tract illness.

ANS: C

Accidents are the leading cause of death in children ages 1 to 19 years. Disorders of 

short gestation and unspecified low birth weight make up one of the leading causes of

death in neonates. One of the leading causes of infant death after the first month of life

is congenitalanomalies. Respiratory tract illnesses are a major cause of morbidity in

children.

DIF: Cognitive Level: Application REF:

p. 9 OBJ: Nursing Process Step:

Implementation MSC: Safe and Effective

Care Environment

6. Which statement is true regarding the quality assurance or incident report?

a. The report assures the legal department that there is no problem.

b. Reports are a permanent part of the clients chart.

c. The nurses notes should contain the following: Incident report filed

and copyplaced in chart.

d. This report is a form of documentation of an event that may result in legal action.

ANS: D

An incident report is a warning to the legal department to be prepared for potential

legal action;it is not a part of the clients chart or nurse documentation.

DIF: Cognitive Level: Knowledge REF: p.

14OBJ: Nursing Process Step:

Implementation MSC: Safe and Effective

Care Environment

7. Which client situation fails to meet the first requirement of informed consent?

a. The parent does not understand the physicians explanations.

b. The physician gives the parent only a partial list of possible side

effects andcomplications.

c. No parent is available and the physician asks the adolescent to sign the

consentform.

d. The infants teenage mother signs a consent form because her parent tells her to.

ANS: C

The first requirement of informed consent is that the person giving consent must be

competent.Minors are not allowed to give consent. An understanding of information,

full disclosure, and voluntary consent are requirements of informed consent, but none

of these is the first requirement.

DIF: Cognitive Level: Comprehension REF:

p. 12OBJ: Nursing Process Step:

Implementation MSC: Safe and Effective

Care Environment

8. A nurse assigned to a child does not know how to perform a treatment that has been

prescribedfor the child. What should the nurses first action be?

a. Delay the treatment until another nurse can do it.

b. Make the childs parents aware of the situation.

c. Inform the nursing supervisor of the problem.

d. Arrange to have the child transferred to another unit.

ANS: C

If a nurse is not competent to perform a particular nursing task, the nurse must

immediately communicate this fact to the nursing supervisor or physician. The nurse

could endanger the childby delaying the intervention until another nurse is available.

Telling the childs parents would most likely increase their anxiety and will not resolve

the difficulty. Transfer to another unit delays needed treatment and would create

unnecessary disruption for the child and family.

DIF: Cognitive Level: Application REF: p.

11OBJ: Nursing Process Step:

Implementation MSC: Safe and Effective

Care Environment

9. A nurse is completing a care plan for a child and is finishing the assessment

phase. Whichactivity is not part of a nursing assessment?

a. Writing nursing diagnoses

b. Reviewing diagnostic reports

c. Collecting data

d. Setting priorities

ANS: D

Setting priorities is a part of planning. Writing nursing diagnoses, reviewing diagnostic

reports,and collecting data are parts of assessment.

DIF: Cognitive Level: Comprehension REF: p. 19

OBJ: Nursing Process Step: Planning MSC: Physiological Integrity

10. Which patient outcome is stated correctly?

a. The child will administer his insulin injection before breakfast on 10/31.

b. The child will accept the diagnosis of type 1 diabetes mellitus before discharge.

c. The parents will understand how to determine the childs daily insulin dosage.

d. The nurse will monitor blood glucose levels before meals and at bedtime.

ANS: A

The outcome is stated in client terms, with a measurable verb and a time frame for

action. The verb accept is difficult to measure. The goal of accepting a diagnosis before

hospital discharge isunrealistic. Outcomes should be stated in client terms. Nursing

actions are determined after outcomes are developed in the implementation phase of

the nursing process.

DIF: Cognitive Level: Application REF: p. 20

OBJ: Nursing Process Step: Planning MSC: Safe and Effective Care Environment