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

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

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

Test Bank

Chapter 02: Family-Centered Nursing Care

MULTIPLE CHOICE

 

  1. What formula guides the use of “time-out” as a disciplinary method?
a. Use the guideline of one minute per each year of the child’s age.
b. Relate the length of the time-out to the severity of the behavior.
c. Never use time-out for a child younger than age 4 years.
d. Follow the time-out with a treat.

 

 

ANS:   A

 

  Feedback
A In time-out, the child is told to sit on a chair for a predetermined time, usually 1 minute per year of age.
B Relating time to a behavior is subjective and inappropriate when the child is very young.
C Time-out can be used with a toddler.
D Negative behavior should not be reinforced with a positive action.

 

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: pg 42

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. What is the nurse’s best approach when an 8-year-old boy frequently causes a disruption in the playroom by taking toys from other children?
a. Exclude the child from the playroom.
b. Explain to the children in the playroom that he is very ill and should be allowed to have the toys.
c. Approach the child in his room and ask, “Would you like it if the other children took your toys from you?”
d. Approach the child in his room and state, “I am concerned that you are taking the other children’s toys. It upsets them and me.”

 

 

ANS:   D

 

  Feedback
A Banning the child from the playroom will not solve the problem. The problem is the child’s behavior, not the place where he exhibits it.
B Illness is not a reason for a child to be undisciplined. When the child recovers, the parents will have to deal with a child who is undisciplined and unruly.
C The child should not be made to feel guilty and to have his self-esteem attacked.
D The nurse can focus on the behavior most effectively by using “I” rather than “you” messages. A “you” message criticizes the child and uses guilt in an attempt to change behavior.

 

 

DIF:    Cognitive Level: Application             REF:    Text Reference: pg 42

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Psychosocial Integrity

 

  1. Families who deal effectively with stress have which of the following behavior patterns?
a. Focus on family problems.
b. Feel weakened by stress.
c. Expect that some stress is normal.
d. Feel guilty when stress exists.

 

 

ANS:   C

 

  Feedback
A Healthy families focus on family strengths rather than on the problems.
B Healthy families know that stress is temporary and may be positive.
C Healthy families recognize that some stress is normal in all families.
D Because some stress is normal in all families, there is no reason to feel guilty. Guilt only immobilizes the family and does not lead to resolution of the stress.

 

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: pgs 32-33

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

 

  1. Which of the following families will most likely have the greatest difficulty coping with an ill child?
a. A single-parent mother who has the support of her parents and siblings
b. Parents who have just moved to the area and are living in an apartment while they look for a house
c. The family of a child who has had multiple hospitalizations related to asthma and has adequate relationships with the nursing staff
d. A family in which there is a young child and four older married children who live in the area

 

 

ANS:   B

 

  Feedback
A Although only one parent is available, she has the support of her extended family, which will assist in her adjustment to the crisis.
B Parents who are in a new environment will have increased stress related to their lack of a support system.
C Because this family has had positive experiences in the past, they can draw from those experiences and feel confident about the current setting.
D This family has an extensive support system, which will assist the parents in adjusting to the crisis.

 

 

DIF:    Cognitive Level: Application             REF:    Text Reference: pgs 32-33

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

 

  1. Which of the following is the priority nursing intervention for the family of a child who has been admitted to the hospital?
a. Begin discharge teaching.
b. Identify and mobilize internal and external strengths.
c. Identify ways in which the family could have prevented their child’s hospitalization.
d. Instruct the parents on normal growth and development.

 

 

ANS:   B

 

  Feedback
A Although discharge teaching is begun as soon as possible, it is ineffective if trust has not been established with the parents or if the level of stress precludes learning.
B Family interventions should be directed toward enhancing positive coping strategies and directing the family to appropriate resources.
C By identifying weaknesses instead of focusing on strengths, the family’s anxiety and feelings of powerlessness or guilt may increase.
D Normal growth and development should be interwoven into teaching; however, teaching cannot take place until the parents have less stress and are open to information.

 

 

DIF:    Cognitive Level: Application             REF:    Text Reference: pg 44

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Psychosocial Integrity

 

  1. Which of the following characteristics would most likely be found in a Mexican-American family?
a. Stoicism
b. Close extended family
c. Docile children are considered weak
d. Very interested in health-promoting lifestyles

 

 

ANS:   B

 

  Feedback
A Although stoicism may be present in any family, Mexican-American families tend to be more expressive.
B Most Mexican-American families are very close and it is not unusual for children to be surrounded by parents, siblings, grandparents, and godparents. It is important to respect this cultural characteristic and to see it as strength, not a weakness.
C Considering docile children as weak is a characteristic of American Indians.
D Although there is a trend for everyone to embrace more health-promoting lifestyles, it is more prominent in Anglo-Americans.

 

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: pg 39

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

 

  1. While reviewing nursing documentation on dietary intake for a 7-year-old child of Asian descent, the nurse notes that he consistently refuses to eat the food on his tray. Which of the following assumptions is most likely accurate?
a. He is a picky eater.
b. He needs less food because he is on bedrest.
c. He may have culturally related food preferences.
d. He is probably eating between meals and spoiling his appetite.

 

 

ANS:   C

 

  Feedback
A Although the child may be a picky eater, the key point is that he is from a different culture. The foods he is being served may seem strange to him.
B Nutrition plays an important role in healing. Although the child expends less energy while on bed rest, he has increased needs for good nutrition.
C When cultural differences are noted, food preferences should always be obtained. A child will often not eat unfamiliar foods.
D Although it should be determined whether the child is eating food the family has brought from home, it is more important to determine his food preferences.

 

 

DIF:    Cognitive Level: Application             REF:    Text Reference: pg 33

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

 

  1. To resolve family conflict, it is necessary to have open communication, accurate perception of the problem, and a(n):
a. intact family structure.
b. arbitrator.
c. willingness to consider the view of others.
d. balance in personality types.

 

 

ANS:   C

 

  Feedback
A The structure of a family may affect their dynamics, but it is still possible to resolve conflict without an intact family structure if all the ingredients of conflict resolution are present.
B Conflicts can be resolved without the assistance of an arbitrator.
C Without the willingness of the members of a group to consider the views of others, conflict resolution cannot take place.
D Most families have diverse personality types among their members. This may make conflict resolution more difficult; however, it should not impede it if the ingredients of conflict resolution are present.

 

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: pg 32

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Psychosocial Integrity

 

  1. Which statement is true about the characteristics of a healthy family?
a. The parents and children have rigid assignments for all the family tasks.
b. Young families assume the total responsibility for the parenting tasks, refusing any assistance.
c. The family is overwhelmed by the significant changes that occur as a result of childbirth.
d. Adults agree on the majority of basic parenting principles.

 

 

ANS:   D

 

  Feedback
A A significant stressor for families is lack of shared responsibility in the family. Lack of flexibility in parental tasks is likely to create stress and conflict.
B Admitting to and seeking help with problems, rather than refusing assistance, is a trait of a healthy family.
C Adjusting to the birth of a child is a significant change for a family. A sense of feeling overwhelmed by this change indicates the family is not coping effectively.
D A trait of a healthy family is that adults agree on the basic principles of parenting so that minimal discord exists.

 

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: pg 30

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

 

  1. Which characteristics correspond to a child with an easy temperament?
a. Predictable; regular in her daily habits
b. Highly active; adapts slowly to new situations
c. Prefers sedentary activities; shy personality
d. Moody; occasionally expresses negative emotions

 

 

ANS:   A

 

  Feedback
A Children with an easy temperament are even tempered, predictable, and regular in their habits. They react positively to new stimuli.
B A high activity level and adapting slowly to new stimuli are characteristics of a difficult temperament.
C The slow-to-warm-up temperament type prefers to be inactive. Personality type is not a characteristic of temperament.
D Being moody is a characteristic of a slow-to-warm up temperament.

 

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: pg 41

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

 

  1. The parent of a child who has had numerous hospitalizations asks the nurse for advice because her child has been having behavior problems at home and school. In discussing effective discipline, which of the following is an essential component?
a. All children display some degree of acting out and this behavior is normal.
b. The child is manipulative and should have firmer limits set on her behavior.
c. Use positive reinforcement and encouragement to promote cooperation and desired behaviors.
d. Underlying reasons for rules should be given and the child should be allowed to decide on which rules should be followed.

 

 

ANS:   C

 

  Feedback
A Behavior problems should not be disregarded as normal.
B It would be incorrect to assume the child is being manipulative and should have firmer limits set on her behaviors.
C Using positive reinforcement and encouragement to promote cooperation and desired behaviors is one of the three essential components of effective discipline.
D This is a component of permissive parenting and not considered an essential component of effective discipline.

 

 

DIF:    Cognitive Level: Comprehension       REF:    Text Reference: pg 42

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

 

  1. Which of the following descriptions correspond with an authoritative parenting style?
a. Expects children to follow rules without questioning
b. Discusses rules when children do not agree with them
c. Establishes rules but does not consistently enforce them
d. Allows children to decide whether they will follow the rules

 

 

ANS:   B

 

  Feedback
A A parent who expects children to follow rules without questioning is using an authoritarian parenting style.
B A parent who discusses the rules children do not agree with is using an authoritative parenting style.
C A parent who does not consistently enforce rules is using a permissive parenting style.
D A parent who allows the child to decide whether he or she wishes to follow rules is using a permissive parenting style.

 

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: pg 40

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

 

  1. Which of the following would the nurse expect to be problematic for a family whose religious affiliation is Jehovah’s Witness?
a. Immunizations
b. Autopsy
c. Organ donation
d. Blood transfusion

 

 

ANS:   D

 

  Feedback
A Christian Science believers may seek exemption from immunizations.
B Jehovah’s Witness believers can make individual decisions about autopsy.
C Islam believers are opposed to organ donation.
D Jehovah’s Witness believers are opposed to blood transfusions. They may accept alternatives to transfusions, such as non-blood plasma expanders.

 

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: pg 34

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

 

 

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

Test Bank

Chapter 16: The Child with an Infectious Disease

MULTIPLE CHOICE

 

  1. Which of the following statements made by an adolescent girl indicates an understanding about the prevention of sexually transmitted diseases (STDs)?
a. “I know the only way to prevent STDs is not to be sexually active.”
b. “I practice safe sex because I wash myself right after sex.”
c. “I won’t get any kind of STD because I take the pill.”
d. “I only have sex if my boyfriend wears a condom.”

 

 

ANS:   A

 

  Feedback
A Abstinence is the only foolproof way to prevent an STD.
B STDs are transmitted through body fluids (semen, vaginal fluids, blood). Perineal hygiene will not prevent an STD.
C Oral contraceptives do not protect women from contracting STDs.
D A condom can reduce but not eliminate an individual’s chance of acquiring an STD.

 

 

DIF:    Cognitive Level: Comprehension       REF:    Text Reference: pg 450

OBJ:    Nursing Process Step: Evaluation

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. Which sexually transmitted disease would the nurse suspect when an adolescent girl comes to the clinic because she has a vaginal discharge that is white with a fishy smell?
a. Human papillomavirus
b. Bacterial vaginosis
c. Trichomonas
d. Chlamydia

 

 

ANS:   B

 

  Feedback
A Manifestations of the human papillomavirus are anogenital warts that begin as small papules and grow into clustered lesions.
B Bacterial vaginosis is characterized by a profuse, white, malodorous (fishy smelling) vaginal discharge that sticks to the vaginal walls.
C Infections with Trichomonas are frequently asymptomatic. Symptoms in females may include dysuria, vaginal itching, burning, and a frothy, yellowish-green, foul-smelling discharge.
D Many people with chlamydial infection have few or no symptoms. Urethritis with dysuria, urinary frequency, or mucopurulent discharge may indicate chlamydial infection.

 

 

DIF:    Cognitive Level: Analysis                  REF:    Text Reference: pg 453

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

 

  1. A child taking oral corticosteroids for asthma is exposed to varicella. The child has not had the varicella vaccine and has never had the disease. What intervention should be taken to prevent varicella from developing?
a. No intervention is needed unless varicella develops.
b. Administer the varicella vaccine as soon as possible.
c. The child should begin a course of oral acyclovir.
d. Give the child varicella zoster immune globulin (VZIG).

 

 

ANS:   D

 

  Feedback
A Children taking oral corticosteroids are immunosuppressed and are at high risk for serious complications. Intervention must be taken to prevent the disease when exposure occurs.
B The varicella vaccine is a live virus vaccine and would be contraindicated for an immunosuppressed child.
C An antiviral drug, such as acyclovir, is given to individuals at high risk for developing moderate to severe varicella. If administered, it should be started as soon as lesions appear. Acyclovir will not prevent the child from manifesting the disease after exposure.
D For children at high risk for development of severe varicella, VZIG should be given within 96 hours after exposure for maximum effectiveness.

 

 

DIF:    Cognitive Level: Analysis                  REF:    Text Reference: pg 435

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. What is the body’s first line of defense against infection in the innate immune system?
a. Nutritional status
b. Skin integrity
c. Immunization status
d. Proper hygiene practices

 

 

ANS:   B

 

  Feedback
A Nutritional status is an indicator of overall health, but it is not the first line of defense in the innate immune system.
B The first lines of defense in the innate immune system are the skin and intact mucous membranes.
C Immunizations provide artificial immunity or resistance to harmful diseases.
D Practicing good hygiene may reduce susceptibility to disease, but it is not a component of the innate immune system.

 

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: pg 420

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

 

  1. The mother of an infant with multiple anomalies tells the nurse that she had a viral infection in the beginning of her pregnancy. Which viral infection is associated with fetal anomalies?
a. Measles
b. Roseola
c. Rubella
d. Herpes simplex (HSV)

 

 

ANS:   C

 

  Feedback
A Measles is not associated with congenital defects.
B Most cases of roseola occur in children 6 to 18 months old.
C The rubella virus can cross the placenta and infect the fetus, causing fetal anomalies.
D HSV can be transmitted to the newborn infant during vaginal delivery, causing multisystem disease. It is not transmitted transplacentally to the fetus during gestation.

 

 

DIF:    Cognitive Level: Comprehension       REF:    Text Reference: pg 429

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

 

  1. What is the best response to a parent of a 2-month-old infant who asks when the infant should receive the measles vaccine?
a. “Your baby can get the measles vaccine now.”
b. “The first dose is given any time after the first birthday.”
c. “She should be vaccinated between 4 and 6 years of age.”
d. “This vaccine is administered when the child is 11 years old.”

 

 

ANS:   B

 

  Feedback
A Some immunizations are initiated at 2 months of age, but not the measles vaccine.
B The first measles, mumps, rubella (MMR) vaccine is recommended routinely at 1 year of age.
C The second dose of MMR is recommended at 4 to 6 years of age.
D Children should receive their second MMR dose no later than 11 to 12 years of age.

 

 

DIF:    Cognitive Level: Comprehension       REF:    Text Reference: pg 428

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. Which statement made by a parent indicates incorrect information about intervention for a child’s fever?
a. “I should keep her covered lightly when she has a fever.”
b. “I’ll give her plenty of liquids to keep her hydrated.”
c. “I can give her acetaminophen for a temperature higher than 101° F.”
d. “I’ll look for over-the-counter preparations that contain aspirin.”

 

 

ANS:   D

 

  Feedback
A Dressing the child in light clothing and using lightweight covers will help reduce fever and promote the child’s comfort.
B Adequate hydration will help maintain a normal body temperature.
C Acetaminophen or ibuprofen should be used as directed for fever control.
D Aspirin products are avoided because of the possibility of development of Reye’s syndrome. The parent should check labels on all over-the-counter products to be sure they do not contain aspirin.

 

 

DIF:    Cognitive Level: Application             REF:    Text Reference: pg 425

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

 

  1. A parent asks the nurse how many doses of the polio vaccine are needed. The nurse’s best response would be?
a. The American Academy of Pediatrics (AAP) currently recommends one dose of the IPV.
b. The American Academy of Pediatrics (AAP) currently recommends two doses of the IPV.
c. The American Academy of Pediatrics (AAP) currently recommends three doses of the OPV.
d. The American Academy of Pediatrics (AAP) currently recommends four doses of the IPV.

 

 

ANS:   D

 

  Feedback
A The AAP recommends a four-dose (not one) all-IPV vaccine schedule for routine immunization of all infants and children in the United States.
B Four doses are recommended, not two.
C Four doses are recommended, not three. The live virus (OPV) is not currently recommended.
D The AAP recommends a four-dose all-IPV vaccine given either subcutaneously or intramuscularly as the schedule for routine immunization of all infants and children in the United States.

 

 

DIF:    Cognitive Level: Comprehension       REF:    Text Reference: pg 439

OBJ:    Nursing Process Step: Assessment

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. Which symptom should be reported to the primary care provider if it occurs when a child with an infectious disease is febrile?
a. Anorexia
b. Fatigue
c. Itching
d. Headache

 

 

ANS:   D

 

  Feedback
A It would not be abnormal for a child who is febrile to have a loss of appetite.
B Fatigue is an expected response when a child is febrile during the course of an infectious disease.
C Rash and skin lesions occur with many viral illnesses. It would not be unusual for the child to complain of itchiness. The primary care provider may be contacted for interventions to relieve itching.
D Parents should be told that headache is a symptom that should be reported promptly to the child’s primary care provider when a child has an elevated temperature.

 

 

DIF:    Cognitive Level: Analysis                  REF:    Text Reference: pg 425

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

 

  1. A parent asks the nurse how she would know whether her child has fifth disease. The nurse would advise the parent to be alert for which manifestation?
a. Bull’s-eye rash at the site of a tick bite
b. Lesions in various stages of development on the trunk
c. Maculopapular rash on the trunk that lasts for 2 days
d. Bright red rash on the cheeks that looks like slapped cheeks

 

 

ANS:   D

 

  Feedback
A The bull’s-eye rash at the site of a tick bite is a manifestation of Lyme disease.
B Varicella is manifested as lesions in various stages of development—macule, papule, then vesicle, first appearing on the trunk and scalp.
C Roseola manifests as a maculopapular rash on the trunk that can last for hours or up to 2 days.
D Fifth disease presents with an intense, fiery red, edematous rash on the cheeks, which gives a “slapped cheek” appearance.

 

 

DIF:    Cognitive Level: Comprehension       REF:    Text Reference: pg 422

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. Which intervention is appropriate for a hospitalized child who has crops of lesions on the trunk that appear as a macular rash and vesicles?
a. Place the child in strict isolation, airborne precautions.
b. Continue to practice standard precautions.
c. Pregnant women should avoid contact with the child.
d. Screen visitors for immunity to measles.

 

 

ANS:   A

 

  Feedback
A The child’s skin lesions are characteristic of varicella. In the hospital setting, children with varicella should be placed in strict isolation and on airborne precautions. The purpose is to prevent transmission of microorganisms by inhalation of small-particle droplet nuclei and to protect other patients and health care providers from acquiring this disease.
B The child’s skin lesions are characteristic of varicella. Additional measures must be instituted to protect other clients and staff who may be susceptible to the disease.
C Certain viral illnesses such as rubella and fifth disease are known to affect the fetus if the woman contracts the disease during pregnancy. This child appears to have varicella. Pregnancy is not a contraindication to caring for a child with varicella.
D The child appears to have varicella. Screening visitors for immunity to measles is irrelevant. It would be important to screen visitors for immunity to varicella.

 

 

DIF:    Cognitive Level: Application             REF:    Text Reference: pgs 433-435

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. How would the nurse respond to a parent who asks, “How can I protect my baby from whooping cough?”
a. “Don’t worry; your baby will have maternal immunity to pertussis that will last until they are approximately 18 months old.”
b. “Make sure your child gets the pertussis vaccine.”
c. “See the doctor when the baby gets a respiratory infection.”
d. “Have your pediatrician prescribe erythromycin.”

 

 

ANS:   B

 

  Feedback
A Infants do not receive maternal immunity to pertussis and are susceptible to pertussis. Pertussis is highly contagious and is associated with a high infant mortality rate
B Primary prevention of pertussis can be accomplished through administration of the pertussis vaccine.
C Prompt evaluation by the primary care provider for respiratory illness will not prevent pertussis.
D Erythromycin is used to treat pertussis. It will not prevent the disease.

 

 

DIF:    Cognitive Level: Application             REF:    Text Reference: pgs 443-444

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. Which of the following statements indicates that a parent understands the treatment for his child who has scarlet fever?
a. “I can stop the medicine when my daughter feels better.”
b. “I will apply antibiotic cream to her rash twice a day.”
c. “I will give the penicillin for the full 10 days.”
d. “My daughter can go back to school when she has been on the antibiotic for a week.”

 

 

ANS:   C

 

  Feedback
A The bacteria will not be eradicated if a partial course of antibiotics is given.
B Treatment of scarlet fever does not include topical antibiotic cream.
C It is necessary to give the entire course of antibiotic for 10 to 14 days. Penicillin is the preferred treatment for any streptococcal infection.
D The child is no longer contagious after 24 hours of antibiotic therapy and can return to day care or school.

 

 

DIF:    Cognitive Level: Comprehension       REF:    Text Reference: pg 446

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

 

  1. Which of the following should be included in the follow-up care for a neonate who received aminoglycoside therapy for sepsis?
a. Monitor hemoglobin level
b. Hearing test
c. Serial platelet counts
d. Glucose testing

 

 

ANS:   B

 

  Feedback
A Aminoglycosides do not affect the hemoglobin level.
B A long-term side effect of aminoglycoside therapy is hearing impairment.
C Aminoglycosides do not directly affect platelets.
D Aminoglycosides do not affect glucose control.

 

 

DIF:    Cognitive Level: Comprehension       REF:    Text Reference: pg 441

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

 

  1. What discharge information would the nurse give to the parents of an adolescent who has been diagnosed with the Epstein-Barr virus?
a. It is particularly important to protect the adolescent’s head during physical activities.
b. The teen will feel like himself and be back to his usual routines in a week.
c. The treatment of the Epstein-Barr virus is prolonged bed rest, usually lasting several months.
d. Fatigue may persist, and the adolescent may need to increase school activities gradually.

 

 

ANS:   D

 

  Feedback
A During the acute and recovery phases, activity restrictions, which include no contact sports or rough housing, are implemented to protect the child’s enlarged spleen from rupture.
B The recovery process from infectious mononucleosis is a slow and gradual one.
C Bed rest is indicated during the acute stage of the illness, usually lasting 2 to 4 weeks.
D The recovery period is often lengthy and fatigue may continue, necessitating a gradual return to school activities.

 

 

DIF:    Cognitive Level: Comprehension       REF:    Text Reference: pg 438

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. Which of the following would the nurse expect to observe in the prodromal phase of rubeola?
a. Macular rash on the face
b. Koplik’s spots
c. Petechiae on the soft palate
d. Crops of vesicles on the trunk

 

 

ANS:   B

 

  Feedback
A The macular rash with rubeola appears after the prodromal stage.
B Koplik’s spots appear approximately 2 days before the appearance of a rash.
C Petechiae on the soft palate occur with rubella.
D Crops of vesicles on the trunk are characteristic of varicella.

 

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: pg 427

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

 

  1. Health teaching to prevent Lyme disease would include which of the following?
a. Complete the immunization series in early infancy.
b. Wear long sleeves and pants tucked into socks while in wooded areas.
c. Give low-dose antibiotics to the child before exposure.
d. Restrict activities that might lead to exposure for the child.

 

 

ANS:   B

 

  Feedback
A Currently there is no vaccine available for Lyme disease. The Lyme disease vaccine had been approved for persons aged 15 to 70 years but was withdrawn from the market in 1992.
B Wearing long sleeves and pants and tucking the pants into socks keeps ticks on the clothing and prevents them from hiding on the body.
C Antibiotics are used to treat, not prevent, Lyme disease.
D Children should be allowed to maintain normal growth and development with activities such as hiking.

 

 

DIF:    Cognitive Level: Application             REF:    Text Reference: pg 447

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. Which of the following actions is initiated when a child is scratched by a rabid animal?
a. No intervention unless the child becomes symptomatic
b. Administration of immune globulin around the wound
c. Administration of rabies vaccine on days 3, 7, 14, and 28
d. Administration of both immune globulin and vaccine as soon as possible after exposure

 

 

ANS:   D

 

  Feedback
A Transmission of rabies can occur from bites with contaminated saliva, scratches from the claws of infected animals, airborne transmission in bat-infested caves, or in a laboratory setting. Rabies is fatal if no intervention is taken to prevent the disease.
B Human rabies immune globulin is infiltrated locally around the wound and the other half of the dose is given intramuscularly. This is only part of the treatment after rabies exposure.
C The rabies vaccine is given within 48 hours of exposure and again on days 3, 7, 14, and 28.
D Human rabies immune globulin and the first dose of the rabies vaccine are given after exposure.

 

 

DIF:    Cognitive Level: Application             REF:    Text Reference: pg 439

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

 

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

Test Bank

Chapter 30: The Child with a Cognitive Deficit

MULTIPLE CHOICE

 

  1. A parent whose child has been diagnosed with a cognitive deficit should be counseled that mental retardation:
a. is usually due to a genetic defect.
b. may be caused by a variety of factors.
c. is rarely due to first-trimester events.
d. is usually caused by parental mental retardation.

 

 

ANS:   B

 

  Feedback
A Only 5% of children with mental retardation are affected by a genetic defect.
B There is a multitude of causes for mental retardation. In nearly half of the cases, a specific cause has not been identified.
C One third of children with mental retardation are affected by first-trimester events.
D Mental retardation can be transmitted to a child only if the parent has a genetic disorder.

 

 

DIF:    Cognitive Level: Comprehension       REF:    Text Reference: pg 1002

OBJ:    Nursing Process Step: Planning

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. Routine developmental assessments during well-child visits are:
a. not necessary unless the parents request them.
b. the best method for early detection of cognitive disorders.
c. frightening to parents and children and should be avoided.
d. valuable in measuring intelligence in children.

 

 

ANS:   B

 

  Feedback
A Developmental assessment is a component of all well-child examinations.
B Early detection of cognitive disorders can be facilitated through assessment of development at each well-child examination.
C Developmental assessments are not frightening when the parent and child are educated about the purpose of the assessment.
D Developmental assessments are not intended to measure intelligence.

 

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: pg 1003

OBJ:    Nursing Process Step: Assessment

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. The father of a child recently diagnosed with developmental delay is very rude and hostile toward the nurses. This father was cooperative during the child’s evaluation a month ago. What is the best explanation for this change in parental behavior?
a. The father is exhibiting symptoms of a psychiatric illness.
b. The father may be abusing the child.
c. The father is resentful of the time he is missing from work for this appointment.
d. The father is in the anger stage of the grief process.

 

 

ANS:   D

 

  Feedback
A One cannot determine that a parent is exhibiting symptoms of a psychiatric illness on the basis of a single situation.
B The scenario does not give any information to suggest child abuse.
C Although the father may have difficulty balancing his work schedule with medical appointments for his child, a more likely explanation for his behavior change is that he is grieving the loss of a normal child.
D After a child is diagnosed with a developmental delay, the family may feel grief. The grief process begins with a stage of disbelief and denial and then progresses to anger.

 

 

DIF:    Cognitive Level: Comprehension       REF:    Text Reference: pg 1007

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

 

  1. An appropriate nursing diagnosis for a child with a cognitive dysfunction who has a limited ability to anticipate danger is:
a. impaired social interaction.
b. deficient knowledge.
c. risk for injury.
d. ineffective coping.

 

 

ANS:   C

 

  Feedback
A Impaired social interaction is indeed a concern for the child with a cognitive disorder but does not address the limited ability to anticipate danger.
B Because of the child’s cognitive deficit, knowledge will not be retained and will not decrease the risk for injury.
C The nurse needs to know that limited cognitive abilities to anticipate danger lead to risk for injury.
D Ineffective individual coping does not address the limited ability to anticipate danger.

 

 

DIF:    Cognitive Level: Application             REF:    Text Reference: pg 1004

OBJ:    Nursing Process Step: Nursing Diagnosis

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. Anticipatory guidance for the family of a preadolescent with a cognitive dysfunction should include information about:
a. institutional placement.
b. sexual development.
c. sterilization.
d. clothing.

 

 

ANS:   B

 

  Feedback
A Preadolescence does require the child to be institutionalized.
B Preadolescents who have a cognitive dysfunction may have normal sexual development without the emotional and cognitive abilities to deal with it. It is important to assist the family and child through this developmental stage.
C Sterilization is not an appropriate intervention when a child has a cognitive dysfunction.
D By the time a child reaches preadolescence, the family should have received counseling on age-appropriate clothing.

 

 

DIF:    Cognitive Level: Application             REF:    Text Reference: pg 1006

OBJ:    Nursing Process Step: Planning

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. The mother of a 9-year-old child with Down syndrome discusses the child’s language abilities. The nurse is not surprised to learn the following about the child’s language development:
a. can take turns during conversation.
b. has good grammar.
c. can speak a foreign language.
d. difficulty in carrying on a conversation.

 

 

ANS:   A

 

  Feedback
A Social language involves maintaining a conversation on a specific topic and taking turns during the conversation. Children with Down syndrome generally have good social language.
B The language development of children with Down syndrome involves difficulty with grammar but strength in social usage.
C It would not be expected for children with Down syndrome to be characterized as typically knowing a foreign language.
D Children with Down syndrome have a general strength in social language such as greeting others and carrying on a conversation in a give-and-take manner and have social skills that exceed expected skills on the basis of intellectual capacity.

 

 

DIF:    Cognitive Level: Comprehension       REF:    Text Reference: pg 1009

OBJ:    Nursing Process Step: Assessment

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. The infant with Down syndrome is closely monitored during the first year of life for which of the following conditions?
a. Thyroid complications
b. Orthopedic malformations
c. Dental malformation
d. Cardiac abnormalities

 

 

ANS:   D

 

  Feedback
A Infants with Down syndrome are not known to have thyroid complications.
B Orthopedic malformations may be present, but special attention is given to assessment for cardiac and gastrointestinal abnormalities.
C Dental malformations are not a major concern compared with the life-threatening complications of cardiac defects.
D The high incidence of cardiac defects in children with Down syndrome makes assessment for signs and symptoms of these defects important during the first year.

 

 

DIF:    Cognitive Level: Comprehension       REF:    Text Reference: pg 1009

OBJ:    Nursing Process Step: Assessment

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. Which of the following actions is contraindicated when a child with Down syndrome is hospitalized?
a. Determine the child’s vocabulary for specific body functions.
b. Assess the child’s hearing and visual capabilities.
c. Encourage parents to leave the child alone.
d. Have meals served at the child’s usual meal times.

 

 

ANS:   C

 

  Feedback
A To communicate effectively with the child, it is important to know the child’s particular vocabulary for specific body functions.
B Children with Down syndrome have a high incidence of hearing loss and vision problems and should have hearing and vision assessed whenever they are in a health care facility.
C The child with Down syndrome needs routine schedules and consistency. Having familiar people present, especially parents, helps to decrease the child’s anxiety.
D Routine schedules and consistency are important to children.

 

 

DIF:    Cognitive Level: Application             REF:    Text Reference: pgs 1010-1011

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

 

  1. Which of the following statements about autism is correct?
a. Autism is characterized by periods of remission and exacerbation.
b. The onset of autism usually occurs before  years of age.
c. Children with autism have imitation and gesturing skills.
d. Autism can be treated effectively with medication.

 

 

ANS:   B

 

  Feedback
A Autism does not have periods of remissions and exacerbations.
B The onset of autism usually occurs before 30 months of age.
C Autistic children lack imitative skills.
D Medications are of limited use in children with autism.

 

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: pg 1015

OBJ:    Nursing Process Step: Assessment

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. Which of the following should the nurse keep in mind when planning to communicate with a child who is autistic?
a. The child has normal verbal communication.
b. Expect the child to use sign language.
c. The child may exhibit monotone speech and echolalia.
d. The child is not listening if she is not looking at the nurse.

 

 

ANS:   C

 

  Feedback
A The child has impaired verbal communication and abnormalities in the production of speech.
B Some autistic children may use sign language, but it is not assumed.
C Children with autism have abnormalities in the production of speech such as a monotone voice or echolalia, inappropriate volume, pitch, rate, rhythm, or intonation.
D Children with autism often are reluctant to initiate direct eye contact.

 

 

DIF:    Cognitive Level: Comprehension       REF:    Text Reference: pg 1014

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

 

  1. What is the best intervention when a child with autism is hospitalized?
a. Limit the individuals who enter the child’s room.
b. Perform all of the child’s activities of daily living for her.
c. Make sure the nurses know this child may be violent.
d. Assign the strongest nurse to control the child.

 

 

ANS:   A

 

  Feedback
A The child with autism is often unable to tolerate the slightest change in routine. Limiting who enters the child’s room to those knowledgeable about the child’s routine will facilitate the child’s adaptation to the hospital environment.
B The most important nursing consideration when planning care for a child with autism is to assign the child to a nurse who is familiar with the child’s routine and to follow that routine. The child should be encouraged to perform toileting and self-care activities as she normally would if she were not in the hospital.
C There is no indication that the child will be violent. Limiting the number of individuals in contact with the child and maintaining a routine will decrease any chance of violence.
D Strength should not be a consideration in assignments.

 

 

DIF:    Cognitive Level: Application             REF:    Text Reference: pg 1016

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

 

  1. Intense stress and isolation as a result of caring for a child with developmental disabilities often lead parents to which of the following?
a. Heightened parental achievement
b. Overuse of the health care system
c. Overindulgence and obesity
d. Child abuse

 

 

ANS:   D

 

  Feedback
A Stress and isolation may hinder parents from reaching their potential.
B Parents may feel isolated from support and health care services. They report that professionals have limited understanding of their children’s needs.
C Although overindulgence and obesity may occur, the best answer is child abuse.
D Child abuse and developmental disabilities are often associated.

 

 

DIF:    Cognitive Level: Comprehension       REF:    Text Reference: pg 1002

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

 

  1. Occurrence of two or more disorders in an individual is termed:
a. comorbidity.
b. congenital syndrome.
c. mental retardation.
d. developmental impairment.

 

 

ANS:   A

 

  Feedback
A Comorbidity by definition means more than one disorder in an individual.
B Congenital syndrome means the disorder originated before birth.
C Mental retardation refers to subaverage intellectual functioning.
D Developmental impairment refers to functional level.

 

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: pg 997

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

 

  1. Self-injury, fecal smearing, and severe temper tantrums in a preschool child are symptoms of which of the following?
a. Mild retardation
b. Severe retardation
c. Psychosocial deprivation
d. Separation anxiety

 

 

ANS:   B

 

  Feedback
A Mild retardation is characterized by social isolation or depression.
B These are symptoms of severe retardation.
C Psychosocial deprivation may be a cause of retardation. The symptoms listed are characteristic of severe retardation.
D Symptoms of separation anxiety include protest, despair, and detachment.

 

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: pg 1003

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

 

  1. Throughout their life span, cognitively impaired children are less capable of managing environmental challenges and are at risk for which of the following?
a. Nutritional deficits
b. Visual impairments
c. Physical injuries
d. Psychiatric problems

 

 

ANS:   C

 

  Feedback
A Nutritional deficits are related more to dietary habits and the caregivers’ understanding of nutrition.
B Visual impairments are unrelated to cognitive impairment.
C Safety is a challenge for cognitively impaired children. Decreased capability to manage environmental challenges may lead to physical injuries.
D Psychiatric problems may coexist with cognitive impairment but are not environmental challenges.

 

 

DIF:    Cognitive Level: Comprehension       REF:    Text Reference: pgs 1004-1005

OBJ:    Nursing Process Step: Assessment

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. The parents of a child born at 36 weeks of gestation who had respiratory problems requiring 3 days of oxygen therapy are concerned that the infant may be mentally retarded. The best nursing statement to the parents is which of the following?
a. “A diagnosis of mental retardation is not made until the child enters school and experiences academic failure.”
b. “Routine assessment of development during pediatric visits is the best method of early detection.”
c. “The baby is not at risk for mental retardation.”
d. “Tests for mental retardation are not reliable for children younger than 3 years.”

 

 

ANS:   B

 

  Feedback
A Mental retardation may be detected before school age.
B Routine assessment of development from birth is the best method for early detection of problems.
C The baby may be at risk for mental retardation as a result of poor oxygenation.
D The Denver Developmental Screening test may be unreliable for children younger than 3 years, but other assessment tools are available. Several neuropsychologic tests are available.

 

 

DIF:    Cognitive Level: Application             REF:    Text Reference: pg 1003

OBJ:    Nursing Process Step: Assessment

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. Fragile X syndrome is:
a. most commonly seen in girls.
b. acquired after birth.
c. usually transmitted by the male carrier.
d. usually transmitted by the female carrier.

 

 

ANS:   D

 

  Feedback
A Fragile X syndrome is most common in males.
B Fragile X syndrome is congenital.
C Fragile X syndrome is not transmitted by a male carrier.
D The gene causing fragile X syndrome is transmitted by the mother.

 

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: pg 1011

OBJ:    Nursing Process Step: Assessment

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. The best setting for daytime care for a 5-year-old autistic child whose mother works is which of the following?
a. Private day care
b. Public school
c. His own home with a sitter
d. A specialized program that facilitates interaction by use of behavioral methods

 

 

ANS:   D

 

  Feedback
A Day care programs generally do not have resources to meet the needs of severely impaired children.
B To best meet the needs of an autistic child, the public school may refer the child to a specialized program.
C A sitter might not have the skills to interact with an autistic child.
D Autistic children can benefit from specialized educational programs that address their special needs.

 

 

DIF:    Cognitive Level: Application             REF:    Text Reference: pg 1015

OBJ:    Nursing Process Step: Planning

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. Parents have learned that their 6-year-old child is autistic. The nurse may help the parents to cope by explaining that the child will:
a. have abnormal ways of interacting with other children and adults.
b. outgrow the condition by early adulthood.
c. have average social skills.
d. probably have age-appropriate language skills.

 

 

ANS:   A

 

  Feedback
A Abnormal interaction with people is one of the several characteristics of autism.
B No evidence supports that autism is outgrown.
C Autistic children have abnormal ways of relating to people (social skills).
D Speech and language skills are usually delayed in autistic children.

 

 

DIF:    Cognitive Level: Application             REF:    Text Reference: pg 1014

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Psychosocial Integrity

 

  1. An autistic child is hospitalized with asthma. The nurse should plan care so that the:
a. parents’ expectations are met.
b. child’s routine habits and preferences are maintained.
c. child is supported through the autistic crisis.
d. parents need not be at the hospital.

 

 

ANS:   B

 

  Feedback
A Focus of care is on the child’s needs rather than on the parent’s desires.
B Children with autism are often unable to tolerate even slight changes in routine.
C Autism is a life-long condition.
D The presence of the parents is almost always required when an autistic child is hospitalized.

 

 

DIF:    Cognitive Level: Application             REF:    Text Reference: pg 1016

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

 

MULTIPLE RESPONSE

 

  1. Which of the following treatment guidelines would be contraindicated when counseling the family of an infant with fragile X syndrome? (Select all that apply.)
a. Advise genetic testing for family members.
b. Delay speech therapy until the child is 2 years of age.
c. Educate the family that their child will probably have normal intelligence.
d. Refer the family to an early intervention program.

 

 

ANS:   B, C

 

  Feedback
Correct B., C. Speech therapy should be started in the first year of life and continued on an ongoing basis. Waiting until the child is 2 years old would not be appropriate. Children with fragile X syndrome have a high incidence of intellectual, language, and social dysfunctions. It is the most common inherited cause of mental retardation.
Incorrect A., D. Because fragile X syndrome is an X-linked recessive disorder, genetic testing is appropriate. Early intervention programs assess the child and develop a plan of intervention; this is appropriate.

 

 

DIF:    Cognitive Level: Application             REF:    Text Reference: pgs 1011-1012

OBJ:    Nursing Process Step: Planning

MSC:   NCLEX: Health Promotion and Maintenance

 

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