Test Bank For Pediatric Nursing The Critical Components of Nursing Care 1st Edition By Rudd

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Pediatric Nursing The Critical Components of Nursing Care 1st Edition By Rudd

 

Chapter 1: Issues and Trends

 

 

 

Multiple Choice

 

 

 

  1. A 3-year-old is an inpatient on an orthopedic floor. The mother is participating in care as much as possible. The nurse knows that the participation of parents with the care of a child is known as:
  2. Family-Centered Care Model.
  3. Medical Care Model of Care.
  4. Patient-Centered Care Model.
  5. Illness Care Model.

 

ANS: 1

  Feedback
1. Family-Centered Care emphasizes the planning, delivery, and evaluation of health care that is grounded in mutually beneficial partnerships among health-care providers, patients, and families.
2. Traditional approach to the diagnosis and treatment of illness as practiced by physicians. Diagnoses a defect, or dysfunction, within the patient, using a problem-solving approach.
3. Includes consideration of patients’ cultural traditions, their personal preferences and values, their family situations, and their lifestyles.
4. Pathways of care that are made up of the dimensions of life to maintain an overall feeling of wellness and/or health.

KEY: Content Area: Professional| Integrated Processes: Caring | Client Need: Safe and Effective Care Environment | Cognitive Level: Knowledge | REF: Chapter 1 | Type: Multiple Choice

 

 

 

  1. A nurse is explaining the physical maturity of a 12-year-old boy to a nursing student. The nursing student knows that all except one the following areincluded in assessing physical maturity:
  2. Mastering fine motor skills.
  3. Language development.
  4. Linear growth.

 

ANS: 2

  Feedback
1. Fine motor skills are part of the physical maturation.
2. Language development is a part of cognitive maturation.
3. Immunizations are part of the physical maturation.
4. Linear growth is part of the physical maturation.

KEY: Content Area: Growth and Development | Integrated Processes: Nursing Process | Client Need: Health Promotion and Maintenance| Cognitive Level: Comprehension | REF: Chapter 1 | Type: Multiple Choice

 

 

 

  1. Promotion for family-centered care consists of all except one of the following strategies:
  2. Emphasizing family strengths.
  3. Identifying family coping skills.
  4. Developing unidirectional communication.
  5. Promotion of family empowerment.

 

ANS: 3

 

  Feedback
1. Identification of family strategies allows for confidence to be built.
2. Identification of coping skills allows for family members to know when help is needed.
3. Uni-directional communication is limited in communication with others, thus not benefitting the child.
4. Family advocacy is important so all needs for the child can be met.

KEY: Content Area: Family| Integrated Processes: Communication/Documentation | Client Need: Psychosocial Integrity | Cognitive Level: Knowledge | REF: Chapter 1 | Type: Multiple Choice

 

 

 

  1. Culturally sensitive care is noted when a nurse:
  2. Asks the family what time they should prepare the child for prayer.
  3. Enters the room during prayer time to deliver a medication because it is due.
  4. Provides a Muslim family with meal trays that contain pork.
  5. Comments on the lack of personal hygiene for the child and siblings.

 

ANS: 1

  Feedback
1. Culturally sensitive care is noted because the nurse is planning care around the sacred prayer time.
2. Culturally sensitive care is not being noted. The nurse is not considerate of the need for prayer time.
3. Muslim families do not eat pork.
4. Levels of hygiene may be related to the family culture.

KEY: Content Area: Culture | Integrated Processes: Nursing Care | Client Need: Psychosocial Integrity | Cognitive Level: Comprehension | REF: Chapter 1 | Type: Multiple Choice

 

 

 

  1. Levi’s mother has requested a priest to baptize him during his hospitalization. Baptism in the Christian faith is seen as:
  2. A rite of passage for all people.
  3. A ritual performed before the death of a child.
  4. A prayer service.
  5. A ritual for persons to be followers of Jesus Christ.

 

ANS: 4

 

  Feedback
1. Baptism is a ritual in which Christians give their life to the following of Jesus Christ.
2. Can be performed prior to death. Baptism is a ritual in which Christians give their life to the following of Jesus Christ.
3. Baptism is a ritual in which Christians give their life to the following of Jesus Christ.
4. Baptism is a ritual in which Christians give their life to the following of Jesus Christ.

KEY: Content Area: Cultural/Religion | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Comprehension | REF: Chapter 1 | Type: Multiple Choice

 

 

 

  1. The leading infant mortality risk in the United States is:
  2. Birth defects.
  3. Prematurity/low birth weight.
  4. Sudden Infant Death Syndrome (SIDS).
  5. Unintentional injury.

 

ANS: 1

 

  Feedback
1. The leading risk for infant mortality in the United States.
2. The second leading risk for infant mortality in the United States.
3. The third leading risk for infant mortality in the United States.
4. The fifth leading risk for infant mortality in the United States.

KEY: Content Area: Health Promotion | Integrated Processes: Caring | Client Need: Safe and Effective Care Environment | Cognitive Level: Knowledge | REF: Chapter 1 | Type: Multiple Choice

 

 

 

  1. The nurse is speaking to a group of teenagers about health promotion. The nurse knows the leading cause of mortality for this age range is:
  2. Cancer.
  3. Homicide.
  4. Unintentional injury.
  5. Suicide.

 

ANS: 3

  Feedback
1. Cancer is lower on the scale for mortality rate for this age range.
2. Homicide is lower on the scale for mortality rate for this age range.
3.  Unintentional injury is the leading cause for mortality rate in this age range.
4. Suicide is lower on the scale for mortality rate for this age range.

KEY: Content Area: Health Promotion | Integrated Processes: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Comprehensions | REF: Chapter 1 | Type: Multiple Choice

 

 

 

  1. A staff nurse explains relationship-based care to an inpatient daughter’s father as:
  2. “Your family is one of many on this unit. We will work to take care of your daughter to the best of our ability.”
  3. “You and your family are part of the plan of care so we all, staff and doctors, can meet the needs of your daughter.”
  4. “I am sorry, but I do not have time to speak with you right now. I will have the charge nurse come answer your questions.”
  5. “The staff values input and will ask you when we have questions about your daughter.”

ANS: 2

 

  Feedback
1. The comment is offhand and does not show the father that his daughter is going to receive individualized care, which is a major component of relationship-based care.
2. The nurse addresses the needs of the father at this time.
3. The nurse states that she does not have time, but by delegating this conversation to someone else, the father does not have a relationship with the nurse, which is not suitable.
4. The nurse did not allow the father to give input about his daughter freely. The nurse requires him to have permission.

KEY: Content Area: Relationship | Integrated Processes: Communication/Documentation | Client Need: Psychosocial Integrity | Cognitive Level: Analysis | REF: Chapter 1 | Type: Multiple Choice

 

 

 

  1. In the last 10 years in pediatric nursing, there has been an increase in:
  2. Obesity.
  3. Diabetes.
  4. Hypertension.
  5. All of the above.

 

ANS: 4

  Feedback
1. All have been increasing in the last 10 years.
2. All have been increasing in the last 10 years.
3. All have been increasing in the last 10 years.
4. Correct

KEY: Content Area: Disease Processes          | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: Chapter 1 | Type: Multiple Choice

 

 

 

  1. The purpose of the Best Pharmaceuticals for Children Act of 2007 was:
  2. To regulate the types of medications given to children.
  3. To require manufacturers to test medication on children if the intention is for use with children.
  4. To provide safety caps on all medications with children in the household.
  5. To increase awareness of medication use in children.

 

ANS: 2

  Feedback
1. Medications were being given to children before the act was passed.
2. The testing done on children helps to predict the outcomes when used with other children. Up until this point, medications that were tested on adults were being used for children.
3. The act does not deal with home safety for medications.
4. The act does increase awareness, but is not the best answer for this question.

KEY: Content Area: Legal | Integrated Processes: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Application | REF: Chapter 1 | Type: Multiple Choice

 

 

 

  1. For which of the following is a master’s degree required?
  2. Pediatric outpatient nurse
  3. Pediatric intensive care unit nurse
  4. Clinical nurse specialist
  5. Home care nurse

 

ANS: 3

  Feedback
1. RN licensure required
2. RN licensure required
3. Master’s degree required
4. RN licensure required

KEY: Content Area: Safe and Effective Care Environment | Integrated Processes: Teaching/Learning | Client Need: Safe and Effective Care Environment | Cognitive Level: Cognitive | REF: Chapter 1 | Type: Multiple Choice

 

 

 

  1. A pediatric nurse with undergraduate preparation has a wide range of career opportunities, which might include the following:
  2. Pediatric hospice nurse.
  3. Neonatal nurse practitioner.
  4. Pediatric nursing professor.
  5. Pediatric clinical nurse specialist.

 

ANS: 1

  Feedback
1. Requires undergraduate preparation
2. Requires a graduate-level degree
3. Requires a graduate-level degree
4. Requires a graduate-level degree

 

KEY: Content Area: Professionalism | Integrated Processes: Teaching/Learning | Client Need: Safe and Effective Care Environment | Cognitive Level: Application | REF: Chapter 1 | Type: Multiple Choice

 

 

 

  1. A staff nurse may be required to complete additional training or certification for a pediatric unit, which might include:
  2. Pediatric Advanced Life Support.
  3. Certified Pediatric Oncology Nurse.
  4. Certification for neonatal or pediatric critical care.
  5. All of the above.

 

ANS: 4

  Feedback
1. PALs may be required for advanced training for a pediatric floor.
2. Certification may be required if the population base is high in oncology patients.
3. Neonatal or pediatric critical care certification may be required, in order to have highly trained individuals in the units.
4. All of the above-listed training and certifications might be required for a staff nurse.

 

KEY: Content Area: Safe and Effective Care Environment | Integrated Processes: Teaching/Learning | Client Need: Safe and Effective Care Environment | Cognitive Level: Knowledge | REF: Chapter 1 | Type: Multiple Choice

 

 

 

  1. Pediatric nurses are confronted with an increase in lifestyle-related illnesses of children, such as:
  2. Diabetes.
  3. Hypertension.
  4. Obesity.
  5. All of the above.

 

ANS: 4

  Feedback
1. Diabetes is a lifestyle-related illness for some children.
2. Hypertension is increasing in the population because of diet and lack of exercise.
3. Obesity is rising in children because of diet and exercise issues.
4. All of the responses are correct. Diabetes, hypertension, and obesity are all increasing lifestyle illnesses in children.

 

KEY: Content Area: Health Promotion and Maintenance | Integrated Processes: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Analysis | REF: Chapter 1 | Type: Multiple Choice

 

 

 

  1. The Best Pharmaceuticals for Children Act, the Pediatric Research Equity Act, and the Pediatric Medical Device Safety and Improvement Act enhance pediatric related research and practice by:
  2. Not requiring parental consent.
  3. Increasing the potential number of children included as research study participants.
  4. Not requiring Hospital Institutional Review Boards to review research protocols.
  5. Requiring consent from a close family member.

 

ANS: 2

  Feedback
1. Consent is required by the parents/guardian.
2. These acts have increased the potential number of children being included as research study participants.
3. Hospital Institutional Review Boards are required to review research proposals.
4. Consent is required by the parent or guardian.

 

KEY: Content Area: Safety | Integrated Processes: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Comprehension | REF: Chapter 1 | Type: Multiple Choice

 

 

 

  1. As a nursing student in a pediatric course, one should reasonably expect the following training:
  2. Simulated-learning environments with infant/child human patient simulators and use of standardized patient scenarios.
  3. Insurance approval mechanisms.
  4. Health promotion and disease prevention.
  5. 1 and 3.

 

ANS: 1

  Feedback
1. Simulation allows for nursing students to practice and have patients with situations that are not present during clinical times.
2. Insurance approval mechanisms are not typically covered in a pediatric nursing course.
3. Health promotion and disease prevention aid in decreasing issues related to illnesses that are preventable in children.
4. Simulation allows for nursing students to practice on and have patients with situations that are not present during clinical times. Health promotion and disease prevention aid in decreasing issues related to illnesses that are preventable in children.

 

KEY: Content Area: Safety | Integrated Processes: Teaching/Learning | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: Chapter 1 | Type: Multiple Choice

 

 

 

  1. The prudent pediatric nurse must explore beyond the traditional view of culture as being simply ethnicity to deliver culturally sensitive care. Assessment of the patient/family should include:
  2. Physical assessment.
  3. Signed consent to treat.
  4. Family constellation (blended, single parent, cohabitating, gay/lesbian, etc.).
  5. Birth history.

 

ANS: 3

  Feedback
1. This should be included, but one must consider what is acceptable to the culture of the patient.
2. Consents are still required, but this does not include the factors of culture and ethnicity.
3. Family constellation (blended, single parent, cohabitating, gay/lesbian, etc.) should be considered in order to deliver culturally sensitive care.
4. Birth history is objective information; it does not, in itself, need to be considered to provide culturally sensitive care.

 

KEY: Content Area: Culture| Integrated Processes: Nursing Process| Client Need: Psychosocial Integrity | Cognitive Level: Application | REF: Chapter 1 | Type: Multiple Choice

 

 

 

  1. A trend of increased pediatric hospital admissions can be attributed to:
  2. Fewer pediatricians.
  3. Lack of primary care access.
  4. Better health insurance coverage for children.
  5. An increase in the environmental air quality.

 

ANS: 2

  Feedback
1. The number of pediatricians does not affect the number of hospital admissions.
2. Children who have not obtained primary care have been noted to be sicker when admitted to the hospital than those children who have received with primary care.
3. Hospital admissions have not been attributed to better insurance coverage for children.
4. Increased air quality does not increase pediatric hospital admissions.

 

KEY: Content Area: Health | Integrated Processes: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Evaluation | REF: Chapter 1 | Type: Multiple Choice

 

 

 

  1. Historically, early pediatric nursing care:
  2. Included families in the plan of care and allowed one parent to be present with the child.
  3. Employed relationship-based care.
  4. Included flexibility in family visitation.
  5. Was impersonal and focused primarily on preventing the spread of disease.

 

ANS: 4

  Feedback
1. Parents were not included in the decision making and were not allowed to be present with the child at all times.
2. Relationship-based care was not historically considered.
3. Visitation has historically been rigid.
4. Historically, pediatric care was impersonal and focused on preventing the spread of disease.

 

KEY: Content Area: Health Care | Integrated Processes: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Evaluation | REF: Chapter 1 | Type: Multiple Choice

 

 

 

  1. A pediatric nurse evaluating the state of evidence-based practices may be best served by reviewing peer-reviewed professional journals in addition to which of the following electronic resources?
  2. Blogs regarding specific disease states
  3. Agency for Healthcare Quality and Research
  4. General search engine results
  5. All of the above

 

ANS: 2

  Feedback
1. Blogs do not typically include evidence-based practice.
2. Agency for Healthcare Quality and Research  provides peer-reviewed professional journals.
3. General search engines do not typically provide information to support evidence-based practice.
4. Blogs and general searches do not necessarily provide information on evidence-based practice.

 

KEY: Content Area: Management of Care | Integrated Processes: Teaching/Learning | Client Need: Safe and Effective Care Environment | Cognitive Level: Knowledge | REF: Chapter 1 | Type: Multiple Choice

 

 

 

  1. Relationship-based care expands care delivery beyond core concepts of family-centered care to include:
  2. Informed consent that only includes the parent, regardless of age of the pediatric patient.
  3. The nurse’s developing a relationship with family members through one-on-one conversations.
  4. Focusing on identifying the relationship structure of the family.
  5. Exclusion of siblings from the plan of care.

 

ANS: 2

  Feedback
1. Informed consent includes the parent and sometimes the child, depending on the the child’s age and mental status.
2. Relationship-based nursing includes one-on-one conversations with the family members.
3. Relationship-based nursing does not simply focus on identifying the structure of the family.
4. When appropriate, siblings can be included in the plan of care with relationship-based care.

 

KEY: Content Area: Family Centered Care | Integrated Processes: Nursing Process | Client Need: Safe and Effective Care Management | Cognitive Level: Application | REF: Chapter 1 | Type: Multiple Choice

 

 

 

  1. A nurse is aware that there will be a surgical pediatric patient admitted later in the day, but report has not been called yet. What is the most common surgical procedure for pediatric patients?
  2. Internal fixation of fracture
  3. Cleft lip and palate repair
  4. Appendectomy
  5. Myelomeningocele repair

 

ANS: 3

  Feedback
1. Fractures are not the most common surgical procedure.
2. A cleft lip and palate repair has a low occurrence . These are usually done in infancy.
3. An appendectomy is one of the most common pediatric surgeries.
4. A myelomeningocele repair occurs soon after birth and is not as common as an appendectomy.

 

KEY: Content Area: Surgery | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: Chapter 1 | Type: Multiple Choice

 

 

 

Multiple Response

 

 

 

  1. Identify the statements that define the nursing profession. Select all that apply.
  2. Development and publication of professional standards
  3. Educational opportunities
  4. Professional organizations
  5. Medical research
  6. Certifications of specialty areas

ANS: 1, 2, 3, 5

 

  Feedback
1. Part of the core standards
2. Part of the core standards
3. Part of the core standards
4. Medical research is not appropriate. The use of nursing research is needed.
5. Part of the core standards.

KEY: Content Area: Professionalism | Integrated Processes: Nursing Process | Client Need: Psychosocial Integrity | Cognitive Level: Knowledge | REF: Chapter 1 | Type: Multiple Response

Chapter 3: Family Dynamics and Communicating with Children and Families

 

 

 

Multiple Choice

 

 

 

  1. Latrisha is a 15-year-old girl who is in the clinic for her school physical. Latrisha’s mother informs the nurse that the forms for her school physical must be filled out by the nurse or the doctor so that Latrisha can play on the volleyball team. When speaking with Latrisha and her mom, the nurse knows it is important to:
  2. Be mindful of letting the patient answer questions.
  3. Give attention to the doctor’s schedule and make sure the visit goes as quickly as possible.
  4. Respond quickly to Latrisha’s questions so there are no long pauses in conversation.
  5. Speak loudly so Latrisha and her mother can hear the conversation clearly.

 

ANS: 1

  Feedback
1. Some answers may be sensitive to a teenager and take longer to receive a reply. Giving a patient time to answer is important so that they do not feel rushed.
2. The schedule is important, but the patient needs should be met. The nurse may need to advocate for the patient in this situation.
3. Quick responses increase anxiety.
4. Speaking loudly can increase anxiety.

KEY: Content Area: Communication | Integrated Processes: Communication/Documentation | Client Need: Health Promotion and Maintenance | Cognitive Level: Knowledge | REF: Chapter 3 | Type: Multiple Choice

 

 

 

  1. According to Title III of the Americans with Disabilities Act (ADA), health-care providers must supply:
  2. Quality care for all patients.
  3. Quality care for patients and families.
  4. Auxiliary aids and services for communication with people who are deaf or hard of hearing.
  5. Auxiliary aids and services for communication with people who are blind or have difficulty seeing.

 

ANS: 3

  Feedback
1. The ADA’s Title III does not address the quality of care for patients.
2. The ADA’s Title III does not address the quality of care for patients or families.
3. The ADA’s Title III addresses the needs for hearing-impaired individuals.
4. The ADA’s Title III does not address vision.

KEY: Content Area: Communication | Integrated Processes: Communication/Documentation | Client Need: Health Promotion and Maintenance | Cognitive Level: Knowledge | REF: Chapter 3 | Type: Multiple Choice

 

 

 

  1. A new mother is receiving information about the newborn hearing screens for her baby girl. The nurse knows that the mother understands the reason for the screening when she states:
  2. “My daughter will need this screen, and then a follow-up in three months.”
  3. “My daughter will need the screen done now. It should be repeated if we note she is not meeting developmental milestones.”
  4. “It is my decision to participate in this hearing screen, so I am going to decline the screening because I do not know if my insurance will cover it.”
  5. “I should have a hearing screen done again when she enters school.”

 

ANS: 2

  Feedback
1. Follow-up screens are done only if an abnormality is noted.
2. It is important to assess all the ways the communication and comprehension of a child are not meeting developmental milestones.
3. Hearing screens are done on all newborn infants.
4. A hearing screen may be done when entering school, but that does not address this question.

KEY: Content Area: Communication | Integrated Processes: Teaching/Learning | Client Need: Health Promotion and Maintenance | Cognitive Level: Analysis | REF: Chapter 3 | Type: Multiple Choice

 

 

 

  1. When speaking with a family about the plan of care for the day, Leslie knows she should avoid using:
  2. Medical jargon.
  3. Time for questions.
  4. Active listening skills.
  5. All of the answers should be used for effective communication.
  6. All the answers should not be used for effective communication.

ANS: 1

  Feedback
1. Medical jargon can be confusing for families, thus explaining what terms mean will enable the family to better understand the needs of the child.
2. Time for questions is important in promote understanding for the patient/family.
3. Listening skills are needed for quality communication.
4. One answer is correct.
5. One answer is correct.

KEY: Content Area: Communication | Integrated Processes: Communication/Documentation | Client Need: Heath Promotion and Maintenance | Cognitive Level: Comprehension | REF: Chapter 3 | Type: Multiple Choice

 

 

 

  1. When speaking with a family who is experiencing a medical emergency with their child, it is important for the nurse to:
  2. Allow time for questions.
  3. Avoid false hope.
  4. Allow for a quiet environment.
  5. Be empathetic and sincere.
  6. All of the above are correct.
  7. None of the above are correct.

 

ANS: 5

  Feedback
1. This is a component of effective communication for the situation, along with other answers.
2. This is a component of effective communication for the situation, along with other answers.
3. This is a component of effective communication for the situation, along with other answers.
4. This is a component of effective communication for the situation, along with other answers.
5. All of the answers provide effective communication for the situation.
6. One answer is correct.

KEY: Content Area: Communication | Integrated Processes: Communication/Documentation | Client Need: Psychosocial Integrity | Cognitive Level: Knowledge | REF: Chapter 3 | Type: Multiple Choice

 

 

 

  1. Trevon, a 4-year-old has been admitted to the emergency room via ambulance after a motor vehicle accident. Trevon is unconscious and is being given life-sustaining treatment. When the family arrives, the charge nurse takes Trevon’s parents to a family room. It is important that the nurse:
  2. Provides clear information.
  3. Does not provide promises.
  4. Calls a member of the clergy and a social worker to be with the family.
  5. All of the above should be addressed for Trevon’s family.
  6. None of the above should be addressed for Trevon’s family.

 

ANS: 4

  Feedback
1. Needed for effective care for the family, along with other answers
2. Needed for effective care for the family, along with other answers
3. Needed for effective care for the family, along with other answers
4. All the answers provide effective communication for the situation.
5. One answer is correct.

KEY: Content Area: Communication | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Comprehension | REF: Chapter 3 | Type: Multiple Choice

 

 

 

  1. Ellie was adopted at the age of two. Her adoptive family is known as her:
  2. Family of choice.
  3. Family of origin.
  4. Nuclear family.
  5. Nontraditional family.

 

ANS: 2

  Feedback
1. This type of family occurs by marriage or co-habitation, not adoption.
2. This type of family is correct because the adoptive parents are raising Ellie.
3. This defines the members of the family.
4. This defines the members of the family that are not part of a nuclear family.

KEY: Content Area: Family | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Comprehension | REF: Chapter 3 | Type: Multiple Choice

 

 

 

  1. The nurse is reviewing Keirnan’s extended family tree to help the family identify genetic makeup due to Kiernan’s diagnosis of cystic fibrosis. The nurse knows that when looking at the extended family, it usually reviews:
  2. One set of grandparents from the paternal and maternal side.
  3. Three generations of family members from the paternal and maternal sides.
  4. Nontraditional family patterns.
  5. Nuclear family patterns.

 

ANS: 2

  Feedback
1. Extended family goes beyond one generation.
2. Extended family is viewed as reaching the third generation.
3. Nontraditional family patterns review types of families, not the generations.
4. Nuclear family patterns review the families, not the generations.

KEY: Content Area: Family | Integrated Processes: Caring | Client Need: Health Promotion and Maintenance | Cognitive Level: Application | REF: Chapter 3 | Type: Multiple Choice

 

 

 

  1. Alec, a 7-year-old, lives with his biological parents, but they are not married. This type of family would be considered:
  2. A dyad family.
  3. An adoptive family.
  4. A cohabitating family.
  5. An extended family.

 

ANS: 3

  Feedback
1. This type of family does not have children.
2. Alec is a biological child, so adoptive does not apply.
3. This family is living together, but the parents are not married.
4. There is no skip in a generation with this family.

KEY: Content Area: Family | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Knowledge | REF: Chapter 3 | Type: Multiple Choice

 

 

 

  1. Family dynamics for children can impact:
  2. Interactions with all family members.
  3. Communication patterns.
  4. Sibling rivalry.
  5. 1 and 2 only.
  6. All of the above.

 

ANS: 5

  Feedback
1. Family dynamics are influenced by all interactions and other answers.
2. Family dynamics are influenced by all communication patterns and other answers.
3. Family dynamics are influenced by all sibling rivalry and other answers.
4. More than one answer is correct.
5. All the answers influence family dynamics.

KEY: Content Area: Family | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Knowledge | REF: Chapter 3 | Type: Multiple Choice

 

 

 

  1. “Forming” in the Group Theory of Pediatric Nursing discusses the relationships between:
  2. marriage or cohabitation.
  3. family or group accomplishments.
  4. emotional clashes of personalities.
  5. death, divorce, and empty nesters.

 

ANS: 1

  Feedback
1. This is the definition in the Group Family Theory.
2. This is considered “performing” in the Group Family Theory.
3. This is considered “storming” in the Group Family Theory.
4. This is considered “adjourning” in the Group Family Theory.

KEY: Content Area: Family | Integrated Processes: Teaching/Learning | Client Need: Psychosocial Integrity | Cognitive Level: Knowledge | REF: Chapter 3 | Type: Multiple Choice

 

 

 

  1. Lesa is working with a family that has eight children. Lesa knows that the relationships between siblings can be viewed as a subsystem of which theory?
  2. Family Group Theory
  3. Family Systems Theory
  4. Murray Bowen Theory
  5. Satir Family Therapy

 

ANS: 2

  Feedback
1. This theory does not break the family into subsystems.
2. The family is looked at in subsystems to identify interactions.
3. This theory does not break the family into subsystems.
4. This theory does not break the family into subsystems.

KEY: Content Area: Family | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Comprehension | REF: Chapter 3 | Type: Multiple Choice

 

 

 

  1. Cael was diagnosed with terminal cancer six months ago. His family has been adjusting to the changes in Cael’s condition. His diagnosis is affecting each member of the family in a different way. The nurse knows Cael’s family is exhibiting behaviors similar to:
  2. The Death and Dying Theory.
  3. The Resiliency Model of Family Stress, Adjustment, and Adaptation.
  4. Murray Bowen’s Theory.
  5. The Family Group Theory.

 

ANS: 2

  Feedback
1. Death has not occurred, so this theory is not applicable.
2. This model demonstrates how the family adjusts to the changes and adapts.
3. This theory does not address the adaptation of the family members.
4. This theory does not address the adaptation of the family members.

KEY: Content Area: Family | Integrated Processes: Caring | Client Need: Psychological Integrity | Cognitive Level: Comprehension | REF: Chapter 3 | Type: Multiple Choice

 

 

 

  1. How would Bowen’s Family Systems Theory view the relationship of an adoptive daughter who is older than the biological son?
  2. The theory sees each family member as interdependent, so the interactions between the siblings are not of importance in this theory.
  3. The theory is not appropriate for this relationship because of the birth order.
  4. The theory assists with the analysis of behavior and development due to the sibling order.
  5. The theory is not appropriate for this relationship because not enough information is supplied.

 

ANS: 3

  Feedback
1. Sibling order is important to this theory.
2. Sibling order is important to this theory.
3. Behavior and development because of sibling order is part of the theory.
4. There is enough information to identify the theory.

KEY: Content Area: Family | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Application | REF: Chapter 3 | Type: Multiple Choice

 

 

 

  1. The main difference in Duvall’s view of the Family Development Theory and other theorists is:
  2. Family is placed into categories throughout its lifespan.
  3. A healthy family is open-minded and shares love.
  4. A family cutting off emotionally from others is viewed as healthy.
  5. Families are viewed as constantly adjusting due to crisis.

 

ANS: 1

  Feedback
1. The view of family through a lifespan is one of the key elements of Duvall’s theory.
2. This is a different theory.
3. This is a different theory.
4. This is a different theory.

KEY: Content Area: Family | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Comprehension | REF: Chapter 3 | Type: Multiple Choice

 

 

 

  1. Kenisha is a home health pediatric nurse. She has been working with a family for the past month. Kenisha has to fill out paperwork describing the family unit. Kenisha is aware that “family” can be described as all of the following except:
  2. A group of two people.
  3. A blood relationship only between the parent and child.
  4. A same-sex couple with children.
  5. A grandparent, mother, and child living in the house.

 

ANS: 2

  Feedback
1. Can be labeled a family
2. This is not the only way to define a family.
3. Can be labeled a family
4. Can be labeled a family

KEY: Content Area: Family | Integrated Processes: Communication/Documentation | Client Need: Psychosocial Integrity | Cognitive Level: Application | REF: Chapter 3 | Type: Multiple Choice

 

 

 

  1. Stella is assessing the family of her pediatric home health care patient. Stella’s is using Neuman’s Systems Theory to assess the family’s needs. When using this theory, it is important to:
  2. Make sure all members of the family are assessed and able to express their personal needs for the care of the patient.
  3. Focus solely on the patient’s needs.
  4. Work with the family and health-care professionals to provide advanced directives.
  5. Meet the developmental needs of the child.

 

ANS: 1

  Feedback
1. A key factor in Neuman’s theory is to let all members of the family express themselves.
2. Focusing on one family member’s needs is not part of Neuman’s theory.
3. This is a key factor in Family-Focused Care, not Neuman’s theory.
4. This is a key factor in Family-Focused Care, not Neuman’s theory.

KEY: Content Area: Family | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Application | REF: Chapter 3 | Type: Multiple Choice

 

 

 

  1. Miriam, a nursing student, has been learning about theory in regards to family and pediatric nursing. The case study that has been presented describes the role of the provider, therapists, and the child’s caregivers. Miriam knows these descriptors are assessments noted in:
  2. King’s theory.
  3. Roy’s theory of Adaptation.
  4. Family-Focused Theory.
  5. Structural-Functional Theory.

 

ANS: 4

  Feedback
1. This theory reviews family as a social system.
2. This theory reviews how the family deals with life stress.
3. This theory emphasizes family involvement in caregiving.
4. This theory reviews the roles of the provider, therapists, and the child’s caregivers in the care of the child.

KEY: Content Area: Family | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Comprehension | REF: Chapter 3 | Type: Multiple Choice

 

 

 

  1. A student nurse is doing her clinical practicum experience in an outpatient family access clinic. The student nurse watches the registered nurse review the family history with a mother. Important questions to ask on an initial history assessments of a child should include:
  2. Socioeconomic status.
  3. Parenting styles.
  4. Family structure.
  5. All of the above

 

ANS: 4

  Feedback
1. A factor in family assessment, along with other choices
2. A factor in family assessment, along with other choices
3. A factor in family assessment, along with other choices
4. All the factors listed are part of a quality family assessment.

KEY: Content Area: Family | Integrated Processes: Nursing Process | Client Need: Communication/Documentation | Cognitive Level: Comprehension | REF: Chapter 3 | Type: Multiple Choice

 

 

 

  1. Jessica is complaining to the school nurse about her parents. She states that she feels her parents do not let her make any decisions and have strict rules. The school nurse knows this type of parenting style is known as:
  2. Permissive.
  3. Democratic.
  4. Authoritarian.
  5. Ambiguous.

 

ANS: 3

  Feedback
1. Children have full control of decisions in this parenting style.
2. A combination of firm rules and freedom for children to make a decisions characterize this parenting style.
3. Parents have absolute rule and do not let the child make decisions in this parenting style.
4. This is not a parent style.

KEY: Content Area: Family | Integrated Processes: Nursing Process | Client Need: Psychosocial Integrity | Cognitive Level: Comprehension | REF: Chapter 3 | Type: Multiple Choice

 

 

 

  1. Dora, a 4-year-old child, has been asked to create a family drawing. This is being asked of Dora because it will show the nurse:
  2. The child’s view of the family members.
  3. The child’s wish for a family.
  4. The child’s perception of family values.
  5. Nothing. This is an activity for the child while the nurse obtains a cognitive assessment.

 

ANS: 1

  Feedback
1. The purpose is to identify how the child views the family.
2. This is not a wish activity.
3. Family values are not assessed in this task.
4. This task can give an indication of the cognitive level of understanding of family, but the main purpose is to see how the child views the family.

KEY: Content Area: Family | Integrated Processes: Nursing Process | Client Need: Psychosocial Integrity | Cognitive Level: Application | REF: Chapter 3 | Type: Multiple Choice

 

 

 

  1. When performing the family APGAR questionnaire on Wesley’s family, the nurse notes that his father spends very little time with him. The nurse knows that with this area being low, the family:
  2. Lacks quality growth and function, so there is risk.
  3. Lacks the ability to devote time to children and has a highly functional pattern.
  4. Is at risk for not nurturing a child and could be at risk for developing a dysfunctional family pattern.
  5. Is at risk for sharing responsibility for the child and is highly dysfunctional.

 

ANS: 3

  Feedback
1. Bonding is the concern for the family based on this type of response from the father
2. Bonding is the concern for the family based on this type of response from the father.
3. The father is not demonstrating a nurturing bond with the child.
4. Bonding is the concern for the family based on this type of response from the father.

KEY: Content Area: Family | Integrated Processes: Nursing Process | Client Need: Psychosocial Integrity | Cognitive Level: Analysis | REF: Chapter 3 | Type: Multiple Choice

 

 

 

  1. Damon is a 3-month-old patient on the pediatric floor for a post-operative stay. Cyndie, his primary nurse, is about to assess Damon for the first time this shift. A therapeutic approach to the assessment would be:
  2. Cooing, speaking in soft tones, and smiling at Damon as she performs the assessment.
  3. Talking loudly and not making eye contact with Damon during the assessment.
  4. Speaking to the parent during the entire assessment so as much information can be gathered from the parent as possible.
  5. To not talk and try to keep Damon as quiet as possible to during the assessment.

 

ANS: 1

  Feedback
1. This action is appropriate because a 3-month-old responds to quiet interactions and likes to watch faces.
2. Talking loudly can upset small infants and cause restlessness.
3. It is important to gather information from the parent, but this should be done before or after the physical assessment is completed.
4. It is important to keep the baby quiet during the assessment, but the lack of human interaction is not therapeutic for an infant.

KEY: Content Area: Communication/Assessment | Integrated Processes: Communication/Documentation/Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Application | REF: Chapter 3 | Type: Multiple Choice

 

 

 

  1. When attempting to get the blood pressure of a 3 year old, it is important to:
  2. Encourage questions.
  3. Let the child touch, smell, and see the equipment prior to taking the blood pressure.
  4. Place the cuff on a teddy bear so the child can see what is going to occur.
  5. All are appropriate actions when taking the blood pressure of a 3 year old.
  6. 1 and 2 are appropriate actions for attempting to take the blood pressure of a 3 year old.

 

ANS: 4

  Feedback
1. Correct action, along with others
2. Correct action, along with others
3. Correction action, along with others
4. All the actions are appropriate to let a 3 year old experience prior to taking the blood pressure.
5. All answers are correct.

KEY: Content Area: Assessment | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Application | REF: Chapter 3 | Type: Multiple Choice

 

 

 

  1. When starting an IV on a 9 year old, the nurse knows it is important to:
  2. Answer any questions.
  3. Give the child a task to do for the IV, such as preparing the tape.
  4. Allow time for the child to express how he/she feels about getting an IV.
  5. All of the above are important when starting an IV on the child.
  6. 2 and 3 are important when starting an IV on the child.

 

ANS: 4

  Feedback
1. This age range will ask questions so that they have control of the situation. Other answers are also correct.
2. Giving a task to the child enables them to feel part of the procedure and have control over what is happening. Other answers are also correct.
3. Expressing feelings can help alleviate anxieties about the procedure. Other answers are also correct.
4. This age range will ask questions so that they have control of the situation. Giving a task to the child enables them to feel part of the procedure and have control over what is happening. Expressing feelings can help alleviate anxieties about the procedure.

KEY: Content Area: Assessment | Integrated Processes: Teaching/Learning | Client Need: Psychosocial Integrity | Cognitive Level: Application | REF: Chapter 3 | Type: Multiple Choice

 

 

 

  1. Sarah is a 14-year-old girl about to get her HPV vaccine. The nurse working with Sarah knows that, as a nurse, she should:
  2. Explain that the vaccine is very important and all of her friends are receiving it.
  3. Explain the injection procedure and provide information about the HPV vaccine on her level.
  4. Use language such as “pokie” and “owwie” to describe the possible pain of the injection.
  5. Allow her to text while the injection is occurring so that Sarah is distracted in order to help reduce the pain of the injection.

 

ANS: 2

  Feedback
1. This is not being truthful to the patient and should be avoided.
2. Appropriate answer
3. The terms can be used for younger children. A teenager is beyond this language level.
4. Distraction works, but texting is not appropriate because it requires two hands, thus the nurse would have difficulty administering the vaccine correctly.

KEY: Content Area: Communication | Integrated Processes: Communication/Documentation/Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Application| REF: Chapter 3 | Type: Multiple Choice

 

 

 

  1. Donavon has expressed to the school nurse that his mother’s boyfriend drinks several beers each night. When Donavon’s mother is at work, the boyfriend has offered Donavon a beer. Donavon expresses that he feels like he needs to take care of the boyfriend while his mother is at work. This shift in roles is known as:
  2. Responsible Member Role.
  3. Hero Member Role.
  4. Scapegoat Role.
  5. Lost Child Role.

 

ANS: 1

  Feedback
1. The child has taken on the role of the adult when the mother is not present.
2. The child is not performing a heroic deed, thus this answer is incorrect.
3. The child is not being blamed for the actions of the adult.
4. The child is able to identify that the actions are not safe and does not feel comfortable, but lacks the idea of the child feeing responsible.

KEY: Content Area: Substance Abuse/Family | Integrated Processes: Nursing Process | Client Need: Psychosocial Integrity | Cognitive Level: Knowledge | REF: Chapter 3 | Type: Multiple Choice

 

 

 

True/False

 

 

 

  1. Trey has been admitted from the operating room to the pediatric floor for the repair of a broken humorous. On the chart, it states that Trey has been blind for two years. The nurse should communicate each action prior to performing the action so Trey knows what is going to occur.

 

ANS: T

  Feedback
1. Telling the patient what will occur will help reduce anxiety since the patient cannot see what is occurring.
2. Telling the patient what will occur will help reduce anxiety since the patient cannot see what is occurring.

KEY: Content Area: Communication | Integrated Processes: Communication/Documentation | Client Need: Psychological Integrity | Cognitive Level: Application | REF: Chapter 3 | Type: True/False

 

 

 

Multiple Response

 

 

 

  1. Jared has assessed a family with a 6-year-old boy and an 8-year-old boy for his family assessment project for a nursing course. The faculty member knows that Jared has assessed for family structure, development, and rituals with which of the following comments?
  2. The two boys live with their maternal grandmother and mother.
  3. The family lives in a rundown area of a mobile-home park.
  4. Both boys are in the school-age stages, exhibiting Industry vs. Inferiority.
  5. The family requires “quite time.” During this time, each boy goes to their room in the evening to read or play.
  6. The family receives food stamps.

 

ANS: 1, 3, 4, 5

  Feedback
1. Structural Family Assessment
2. Does not apply and is a biased statement
3. Family Developmental Stage
4. Family Rituals
5. Structural Family Assessment

KEY: Content Area: Assessment | Integrated Processes: Nursing Process | Client Need: Safe and Effective Care Environment/Health Promotion /Maintenance | Cognitive Level: Evaluation | REF: Chapter 3 | Type: Multiple Response

 

Chapter 13: Neurological Disorders and Sensory Disorders

 

 

 

Multiple Choice

 

 

 

  1. The autonomic nervous system is responsible for:
  2. Digesting a meal of hotdogs and chips.
  3. Monitoring the heart rate while running.
  4. Causing the body to perspire in the hot sun.
  5. All of the above are part of the autonomic nervous system.

 

ANS: 4

  Feedback
1. The ANS helps with the digestion of food.
2. The heart is regulated by the ANS.
3. Perspiration occurs because of the ANS for the purpose of thermoregulation.
4. The ANS helps with the digestion of food. The heart is regulated by the ANS. Perspiration occurs because of the ANS for the purpose of thermoregulation.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Comprehension | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. The responsibilities of the central nervous system include:
  2. Deciding to walk instead of run.
  3. Helping to understand a math problem.
  4. Digesting the food in the stomach.
  5. Keeping the hand on a hot stove.

 

ANS: 1

  Feedback
1. The brain is part of the CNS, which helps make decisions about body movements.
2. The CNS does not help with cognitive abilities.
3. Food digestion is part of the ANS.
4. The CNS would tell the hand to move.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Application | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. The blood-brain barrier of an infant is:
  2. Less permeable than that of an adult.
  3. Impermeable for glucose.
  4. Permeable for large proteins.
  5. Permeable for large molecules.

 

ANS: 4

  Feedback
1. There is no difference between the adult and infant blood-brain barrier.
2. Glucose is permeable for the blood-brain barrier.
3. Large proteins are impermeable for the blood-brain barrier.
4. Large molecules are able to cross the blood-brain barrier.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. The first assessment a child receives to identify neurological development is:
  2. APGAR scores.
  3. Scoliosis testing.
  4. The Denver II study.
  5. Kindergarten testing.

 

ANS: 1

  Feedback
1. APGAR stands for Appearance, Pulse, Grimace, Activity, Respiration, indicating responses of the neurological system. This testing is done right after birth.
2. Scoliosis testing does not occur until the child is a preteen.
3. The Denver II test is not used until the infant is older.
4. Kindergarten testing occurs later in the child’s life.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. Questions about neurological function are raised when a child:
  2. Snores.
  3. Shows aggression when previously none was shown.
  4. Wants attention from a parent.
  5. Refuses to follow adult instruction.

 

ANS: 2

  Feedback
1. Snoring presents a concern for the airway, not neurological functioning.
2. Changes in personality are signs of abnormal behaviors and should be investigated.
3. Attention-seeking behaviors indicate psychosocial need, not a neurological change.
4. This is normal behavior for a child and does not qualify as a neurological issue.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Comprehension | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. A neonate is born with anencephaly. The prognosis for a neonate with this condition is:
  2. A normal outcome.
  3. A high risk for hydrocephaly.
  4. Can be death.
  5. Mental handicap.

 

ANS: 3

  Feedback
1. The neonate will not have a brain, thus this is not a normal outcome.
2. The child lacks brain tissue, and hydrocephaly is not common.
3. Death is inevitable for a neonate with anencephaly because of the lack of brain structure.
4. A child with anencephaly has a very short life span, and evaluation for mental handicap is not needed.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Comprehension | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. A child with severe mental and physical handicaps is at risk for:
  2. Developing neurocutaneous lesions.
  3. A dysmorphic nose and ears.
  4. Abnormal cranial nerve function.
  5. All of the above are correct.

 

ANS: 4

  Feedback
1. Neurocutaneous lesions occur because of high risk for lack of physical movement.
2. Bone structure may be dysmorphic because of chronic abnormal muscle movements and contractures.
3. Because of neurological dysfunction, cranial nerve function will be abnormal.
4. Neurocutaneous lesions occur because of high risk for lack of physical movement. Bone structure may be dysmorphic because of chronic abnormal muscle movements and contractures. Because of neurological dysfunction, cranial nerve function will be abnormal.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Analysis | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. Neural tube defects can be linked to:
  2. A mother’s drug habit while pregnant.
  3. A mother’s lack of folic acid while pregnant.
  4. A fetus’s exposure to environmental toxins.
  5. A mother’s alcohol consumption while pregnant.

 

ANS: 2

  Feedback
1. Drug habits can be linked to neurological damage and growth retardation.
2. Folic acid is needed for neural tube closure and should be taken as a prenatal vitamin.
3. Exposure to toxins can cause various cognitive and physical anomalies.
4. Alcohol can cause cognitive and physical anomalies if taken while pregnant.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Comprehension | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. A nurse is attempting to position a newborn with a myelomeningocele in the lower lumbar region. The best position for the newborn would be:
  2. Prone.
  3. Laying the newborn on his/her side with support provided to the myelomeningocele.
  4. Supine.
  5. Any position is acceptable for a neonate with a myelomeningocele.

 

ANS: 2

  Feedback
1. Prone does not allow for support of the sac.
2. Laying the newborn on his/her side will provide support for the sac and decrease the chance of a rupture.
3. Supine places too much pressure on the sac and increases the risk for a rupture.
4. Laying the newborn on his/her side will provide the most support for the sac and decrease the chance of a rupture.

KEY: Content Area: Neurological | Integrated Processes: Care | Client Need: Physiological Integrity | Cognitive Level: Application | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. A neonate was born to a 28-year-old mother with an uneventful pregnancy two hours ago. The baby was delivered via cesarean section and taken directly to the neonatal intensive care unit because of an encephalocele. The mother is coming to see the baby. The nurse should:
  2. Be prepared to answer questions about the baby’s care and condition.
  3. Leave the room and give the family time with the neonate.
  4. Prepare the mother prior to entering the room about the dysmorphic features and discuss the supportive care being provided.
  5. Not let the mother see the child at this point.

 

ANS: 3

  Feedback
1. The nurse should be ready to answer questions and needs to prepare the mother for the appearance of her neonate.
2. Time with the neonate is important, but support is the priority for parents at this time.
3. Prior information before seeing the child can help reduce the shock and foster more acceptance of the neonate.
4. The mother needs to see the neonate to help create a bond.

KEY: Content Area: Neurological | Integrated Processes: Care | Client Need: Physiological Integrity | Cognitive Level: Application | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. A child born with Dandy Walker malformation is receiving palliative care in the pediatric unit. A nurse should:
  2. Provide the parents, patient, and family members with supportive care during this time.
  3. Ask the parents to be part of the plan of care as much as possible.
  4. Attempt to provide a primary nurse for this particular patient on each shift.
  5. All of the above are correct.

 

ANS: 4

  Feedback
1. Family support is important in order to provide a high quality of life in a limited amount of time.
2. Parental involvement will create a bond with the child and empower the parents.
3. A primary nurse is able to form a bond with the family and understand the needs of the child because of frequent interactions.
4. Family support is important in order to provide a high quality of life in a limited amount of time. Parental involvement will create a bond with the child and empower the parents. A primary nurse is able to form a bond with the family and understand the needs of the child because of frequent interactions.

KEY: Content Area: Neurological | Integrated Processes: Care | Client Need: Psychological Integrity | Cognitive Level: Application | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. A head circumference is being measured at a 4 month old’s well-baby checkup. It is noted that the head circumference has not grown since the previous assessment. The nurse should:
  2. Ask the mother about the child’s nutrition.
  3. Notify the doctor.
  4. Re-measure the head circumference, check developmental milestones, assess the nutritional status, and discuss the findings with the doctor.
  5. Document the normal findings.

 

ANS: 3

  Feedback
1. Nutritional assessment is important, but not the priority intervention at this time.
2. The doctor will receive the information after a re-measurement is taken to validate the findings.
3. Re-measurement is needed to validate findings, and assessing milestones will indicate the cognitive and physical abilities of the child. Nutritional information will indicate if adequate nutrition is being given. The doctor will be able to prescribe the best course of action after this information is reported.
4. The findings are abnormal, and further investigation is needed.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Analysis | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. A child with a diagnosis of schizencephaly is assigned to a new nurse on the pediatric floor. The new nurse has not worked with a child with this diagnosis before. A career nurse discusses the plan of care needed for the child with the new nurse. It will be important to:
  2. Assess the side of the body that has paralysis for any lesions or sores.
  3. Let the patient do as much as possible for activities of daily.
  4. Discourage the patient to move the paralyzed side of the body.
  5. Provide full care for the patient.

 

ANS: 1

  Feedback
1. Skin breakdown can occur because of the lack of mobility for the affected side of the body.
2. The child may be lower functioning and not be able to understand how to do ADLs or have the physical ability to do them.
3. Movement is important, but not the priority.
4. Encouragement to do as much as possible is important for independence, but the child will need supervision.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Application | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. A nurse is assessing a 6-month-old boy’s suture lines. The nurse notes that the baby has craniosynostosis. The nurse should be concerned because:
  2. The suture line closure will not allow the brain to grow.
  3. This can lead to hydrocephalus.
  4. The child will have immediate developmental delays because of the lack of space for the brain to grow.
  5. The child will not require surgery.

 

ANS: 1

  Feedback
1. Early closure of the sutures will inhibit brain growth.
2. Fluid buildup is not a concern at this time.
3. A progression of developmental delay, rather than immediate delay, will occur.
4. Surgery may be needed to relieve pressure and allow for growth to occur.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Comprehension | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. A child that had a shunt placed four years ago for hydrocephalus is in the emergency room complaining of a rapid onset of vomiting and increased lethargy. The nurse knows that the child will need:
  2. Nothing, as this is a normal complication and not an emergency.
  3. To be placed on IV fluids to help maintain an electrolyte balance.
  4. Small amounts of fluids until the vomiting has subsided.
  5. To consider this a neurological medical emergency and check the child’s head circumference.

 

ANS: 4

  Feedback
1. This should be considered a neurological emergency, and the child should be checked.
2. Electrolyte imbalances are more apt to occur when fluid is removed.
3. The history of having a shunt needs to be addressed first to prevent any neurological damage.
4. Measuring the head circumference will give an indication as to the amount of fluid not draining with the shunt and should be considered a medical emergency.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Analysis | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. Night terrors can occur in adolescents because of:
  2. Emotional stress.
  3. Alcohol use.
  4. Bullying.
  5. All of the above can trigger night terrors in adolescents.

 

ANS: 4

  Feedback
1. Emotional stress can cause increased thoughts and trigger night terrors.
2. Alcohol causes a disturbance to the chemical balance in the brain, causing the night terrors.
3. Bullying can be an emotional stressor, causing the night terrors.
4. Emotional stress can cause increased thoughts and trigger night terrors. Alcohol causes a disturbance to the chemical balance in the brain, causing the night terrors. Bullying can be an emotional stressor, causing the night terrors.

KEY: Content Area: Mental Health | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Comprehension | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. When speaking with a family about their 9-year-old daughter’s nightmares, it is important to ask:
  2. If the child has a history of daytime napping.
  3. What medications the child takes during the day.
  4. How often the child consumes caffeine.
  5. All of the above should be part of the assessment.

 

ANS: 4

  Feedback
1. Daytime napping can cause a sleep disturbance pattern because the child is not reaching the REM cycle.
2. Medications can have a side effect of nightmares for children.
3. Caffeine causes sleep disturbance because it is a stimulant.
4. Daytime napping can cause a sleep disturbance pattern because the child is not reaching the REM cycle. Medications can have a side effect of nightmares for children. Caffeine causes sleep disturbance because it is a stimulant.

KEY: Content Area: Neurological | Integrated Processes: Communication/Documentation | Client Need: Physiological Integrity | Cognitive Level: Evaluation | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. A quality of a partial seizure is:
  2. Status epilepticus.
  3. Tonic movements.
  4. Fluttering eyelids.
  5. Clonic movements.

 

ANS: 4

  Feedback
1. This occurs after a grand mal seizure.
2. Tonic movements occur with a grand mal seizure.
3. Fluttering eyelids are noted in grand mal seizures.
4. Clonic movements occur in partial seizures and can occur in grand mal seizures.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Comprehension | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. A mother is asking the nurse why her daughter continues to have temporal lobe seizures even though she is on medication. The nurse knows this is occurring because:
  2. The medication may not be in the therapeutic range.
  3. Temporal lobe seizures do not respond well to medications.
  4. The daughter may be missing doses of her medication.
  5. The food her daughter eats may have a negative reaction with the medication, causing more seizures.

 

ANS: 2

  Feedback
1. Medication regulation is difficult with temporal lobe seizures.
2. Temporal lobe seizures have a poor response rate to medications.
3. Missing doses of medication can lead to seizures, but temporal lobe seizures don’t respond well to medications.
4. Foods do not have an influence on temporal lobe seizures.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Analysis | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. Which of the following types of epilepsy are photosensitive?
  2. Juvenile myoclonic epilepsy
  3. Temporal lobe epilepsy
  4. Febrile seizures
  5. Childhood absence epilepsy

 

ANS: 1

  Feedback
1. Photosensitivity is common with Juvenile myoclonic epilepsy.
2. Photosensitivity does not usually occur in temporal lobe epilepsy.
3. Febrile seizures are triggered by fevers, not photosensitivity.
4. Childhood absence epilepsy is not influenced by photosensitivity.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Comprehension | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. A child who had a seizure one hour ago is exhibiting signs of paralysis on the left side of the body. The nurse understands the child is exhibiting signs of:
  2. Lethargy due to previous seizure activity.
  3. Postictal paralysis.
  4. Permanent paralysis of the left side of the body.
  5. Major brain damage that is going to have long-term effects.

 

ANS: 2

  Feedback
1. Neurological fatigue can occur after a seizure, but it is not the reason for the paralysis.
2. Postictal paralysis will resolve within the next few hours.
3. The paralysis caused by the seizure will resolve within the next few hours.
4. Serial seizures cause brain damage. One seizure will not.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Analysis | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. A child with a known history of Benign Rolandic Epilepsy is having a seizure during lunch at the middle school. The school nurse is called to the cafeteria. What is the school nurse’s priority at this time?
  2. Prevent a possible choking incident by checking the student’s mouth for food.
  3. Lay the child down on the floor and make sure the area is safe.
  4. Call the EMTs for help.
  5. Notify the parents that their daughter is having a seizure.

 

ANS: 1

  Feedback
1. This is the priority because the child is in the lunch room.  The nurse must check for food to decrease the chance of choking.
2. Making the area safe is important, but not the priority at this time.
3. EMTs are not needed for this situation because this is a common occurrence for the diagnosis.
4. The parents should be notified after the child is safe.

KEY: Content Area: Neurological | Integrated Processes: Care | Client Need: Safe and Effective Care Environment | Cognitive Level: Evaluation | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. An 18 month old is having a seizure when the nurse is assessing him. The nurse notes that the child is fluttering his eyes and smacking his lips. The nurse should document this seizure as:
  2. An absence seizure.
  3. A tonic-clonic seizure.
  4. A myoclonic seizure.
  5. A febrile seizure.

 

ANS: 1

  Feedback
1. Eye fluttering and lip smacking are common characteristics of an absence seizure.
2. A tonic-clonic seizure has stiffening of the muscles. This child is not exhibiting this characteristic.
3. The child is not exhibiting muscle rigidity that is common with myoclonic seizures.
4. The child does not have a fever to cause the seizure.

KEY: Content Area: Neurological | Integrated Processes: Communication/Documentation | Client Need: Physiological Integrity | Cognitive Level: Application | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. A 9 month old is admitted to the pediatric unit for seizures of unknown origin. The child has an EEG performed for several hours. The EEG notes several seizures occurring at different intervals. The nurse knows this child:
  2. Will develop at the same rate as his peers.
  3. May have severe mental and physical challenges due to the frequent seizure activity.
  4. May exhibit a slight cognitive delay as he grows.
  5. Will grow out of having seizures.

 

ANS: 2

  Feedback
1. The continual seizure activity can cause hypoxia to the brain.
2. The frequency of the seizures causes hypoxia to the brain, increasing the chance for mental and physical challenges.
3. The frequency of the seizures will increase the level of cognitive delays.
4. Because of the type of seizures, the child will not grow out of having seizures.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Analysis | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. A child has been status epileptics for the last 20 minutes. The child has Depakote, Valporic Acid, and Diazepam gel ordered. The nurse should prepare which medication for administration at this time?
  2. Depakote
  3. Valporic acid
  4. Diazepam
  5. None of the medications. The child will stop on his own.

 

ANS: 3

  Feedback
1. The Depakote is needed on a regular, scheduled basis to help keep the level adequate in the body.
2. Valporic acid needs to be given on a regular schedule to keep the adequate levels in the body.
3. Diazepam can be used as needed to help stop the brain activity for seizures.
4. The seizure activity needs to be stopped because of the hypoxia that is occurring to the brain.

KEY: Content Area: Pharmacology | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Analysis | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. Care for a child during status epilepticus should include all of the following except:
  2. Turn the patient to the right side.
  3. Loosen tight clothes.
  4. Move toys out of the area to prevent injury.
  5. Stay with the patient until the seizure has stopped.

 

ANS: 1

  Feedback
1. Turning the patient to the right side increases the risk for aspiration because of the positioning of the bronchioles.
2. Loosening clothes helps the person move freely and reduces the chance of injury.
3. Moving objects out of the area decreases the chance for injury as the patient moves during the seizure.
4. It is important to make sure the patient stays safe.

KEY: Content Area: Neurological | Integrated Processes: Care | Client Need: Safe and Effective Care Environment | Cognitive Level: Application | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. The nurse is identifying the difference between primary headaches to secondary headaches. Secondary headaches can occur:
  2. Because of stress.
  3. In relation to low blood pressure.
  4. Because of concussions.
  5. Because of migraines.

 

ANS: 3

  Feedback
1. Stress is a primary cause for headaches.
2. Low blood pressure is a primary cause for headaches.
3. Concussions are a cause of secondary headaches because an injury has previously occurred to the brain tissue.
4. Migraines are a primary cause for headaches.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Analysis | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. Cyclic vomiting may:
  2. Last for days.
  3. Require SSRIs to stop hurting.
  4. Not be associated with a headache.
  5. Requires pain medication and Zofran.

 

ANS: 3

  Feedback
1. Usually short lived
2. SSRIs are not an effective method of pain control for the vomiting.
3. The vomiting can occur for random reasons, but a headache is not a symptom.
4. Pain medication is not usually required to stop the vomiting.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Comprehension | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. A child that has rhythmic, repetitive, involuntary movements is exhibiting:
  2. Tremors.
  3. Dystonia.
  4. Contractures.
  5. Tics.

 

ANS: 2

  Feedback
1. Tremors are involuntary and have random movements.
2. Twisting and repetitive, involuntary movements are common with dystonia.
3. Contractures can be a permanent placement of the body because of muscle and ligament rigidity.
4. Tics are not rhythmic in nature.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. Identify a therapeutic management technique for a child with a tic disorder.
  2. Behavioral modification to suppress the tics
  3. Administer anti-psychotic medications to reduce the tics
  4. Education and support for the child and the family
  5. Genetic counseling for the family

 

ANS: 3

  Feedback
1. Behavior modification does not aid in stopping tics form occurring.
2. Tics do not respond to antic-psychotic medications.
3. Support and education are important so that people understand that tics are involuntary.
4. There is little research to prove that tics are genetic in nature.

KEY: Content Area: Neurological | Integrated Processes: Care | Client Need: Health Promotion and Maintenance | Cognitive Level: Application | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. Identify a true statement about Tourette’s Syndrome (TS) is that:
  2. Manifestations rarely change once developed.
  3. Children with TS do not have obsessive compulsive disorders.
  4. The tics of TS can lead to mental deterioration.
  5. The tics are involuntary, and the person cannot control the behavior.

 

ANS: 4

  Feedback
1. Manifestations change related to the stress level and various other factors.
2. There is a strong correlation between TS and obsessive compulsive disorders.
3. The tics do not affect the cognitive ability of a child.
4. The tics are involuntary, and public education about this is important so that the child is not harassed about the behaviors.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Comprehension | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. The assessment a nurse performed on a 12-year-old boy demonstrated a positive Kernig’s sign and a Brudzinski’s sign. Identify the priority for the nurse’s next action.
  2. Document the findings and note as normal.
  3. Further assess the neurological function of the child and call the doctor with a report.
  4. Explain to the patient that the assessment was abnormal and there is no a cause for concern.
  5. Prepare the child for a lumbar puncture.

 

ANS: 2

  Feedback
1. These findings are abnormal and need further neurological testing.
2. Further assessment is needed because these signs should not be present in a 12-year-old child.
3. Explaining the situation to the patient is important, but there is s possible neurological issue that needs to be addressed with further diagnostic testing.
4. A lumbar puncture is invasive, and other tests should be done before the procedure.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Synthesis | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. Results from cerebrospinal fluid that was tested for meningitis have been received by the nurse. The results indicate bacterial meningitis. The nurse knows this because the results show:
  2. A low protein count and a low glucose count.
  3. A low red blood cell count.
  4. An elevated protein count and a low glucose level.
  5. A normal protein count and a high glucose count.

 

ANS: 3

  Feedback
1. Does not indicate infection
2. Some red blood cells may show in the specimen if the lumbar puncture was not a clean catch.
3. Results indicate bacterial meningitis.
4. Results indicate viral meningitis.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Analysis | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. Identify the false statement about bacterial meningitis.
  2. Bacterial meningitis can be fatal if not treated.
  3. Bacterial meningitis can spread quickly.
  4. Bacterial meningitis cannot be effectively treated with antibiotics.
  5. Bacterial meningitis can cause hearing loss in children.

 

ANS: 3

  Feedback
1. The illness can cause death if not treated.
2. The illness can spread quickly and be fatal without treatment.
3. Antibiotic therapy can stop the progression of the illness.
4. Because of the bacteria, the illness attacks the ear drum, creating hearing loss in children if not treated early.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Comprehension | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. The nurse is assessing a 6-month-old boy. Which of the following would be an abnormal finding, indicating possible cerebral palsy?
  2. The infant can pull to a sitting position while holding onto an adult’s hand.
  3. The infant does not exhibit a Moro reflex.
  4. The infant does not exhibit a Babinski’s reflex.
  5. The infant has an obligatory tonic neck flexion.

 

ANS: 4

  Feedback
1. A 6-month-old should be able to pull up with aid from another person.
2. A Moro reflex should not be present after the newborn period.
3. The Babinski’s reflex should not be present after the first few weeks of life.
4. A tonic neck flexion can indicate neurological damage because this is not a normal position for an infant.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Analysis | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. A multidisciplinary meeting is being conducted for a 4-year-old boy with cerebral palsy. A goal for managing this child’s condition would be:
  2. Assistance with motor control of voluntary muscles.
  3. Maximizing the child’s capabilities.
  4. Surgically correcting deformities.
  5. Waiting to place the child in school.

 

ANS: 2

  Feedback
1. It is important to have the child be as independent as possible to maintain optimum function.
2. Concentrating on the capabilities can help the child modify other areas of weakness to have a better quality of life.
3. Surgery is used only in extreme conditions.
4. Planning for school will be important, but the priority is to maximize the capabilities so the child is as independent in school as possible.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Synthesis | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. A common trait of Becker’s Muscular Dystrophy is:
  2. Progressive weakness in the trunk and arms over time.
  3. A quick rate of deterioration of the body.
  4. Cardiomyopathy.
  5. Usually diagnosed by the age of 3.

 

ANS: 3

  Feedback
1. This type of dystrophy has weakening in the legs and pelvis areas.
2. This particular type of muscular dystrophy has a longer life expectancy than most other types of muscular dystrophy.
3. Cardiomyopathy occurs because of abnormality in the protein dystrophin in the body.
4. First diagnosis usually does not occur until between the ages 5 and 15.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Comprehension | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. Brian, a 4-year-old boy, is demonstrating the Gower’s sign, and his mother is wondering why her child is making this movement. The child is doing this because:
  2. The weakness of his arms requires his legs to do more work.
  3. The weakness in his hips and thighs requires help from his arms to stand.
  4. Weakening trunk and back muscles require the legs and arms to help keep an upright position.
  5. Weakening of the trunk requires this movement to help breath.

 

ANS: 2

  Feedback
1. The weakness is in the hips and thighs, not the arms.
2. The weakness in the hips and thighs makes it difficult to stand, thus requiring the arms to help provide stability.
3. The trunk and back muscles are weak, but are not the reason for the Gower’s sign.
4. The Gower’s sign is seen when attempting to stand.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Application | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. When assessing a 10-year-old child with myasthenia gravis, the nurse notes ptosis and drooping facial expressions. The nurse knows this disease will require all of the following except:
  2. Supportive care, as there is no cure for the disease.
  3. Administering beta blockers to improve the muscle tone.
  4. Check the child for a depressive state due to body image issues.
  5. Explain procedures to the child as needed and provide emotional support.

 

ANS: 2

  Feedback
1. The lack of a cure will require education and support for the family and patient.
2. Administration of cholinesterase inhibitors is the common drug used to help keep the acetylcholine receptors from being blocked.
3. Because of the physical changes, an assessment of emotional and psychosocial issues is important.
4. Education and explanations will allow the child to feel involved in his/her care.

KEY: Content Area: Neurological | Integrated Processes: Care | Client Need: Physiological Integrity | Cognitive Level: Synthesis | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. Infantile spinal muscular atrophy contains all of the following characteristics except:
  2. Muscle wasting of voluntary muscles.
  3. Type 1 can begin in utero.
  4. Inability to suck occurs early in life.
  5. It is associated with children who are intellectually slower.

 

ANS: 4

  Feedback
1. Muscle wasting is noted in these dystrophies.
2. Type 1 may start with the fetus.
3. Suckling is the strongest at the earliest points of life. As time progresses, the muscle weakens, making feeding difficult.
4. Children with the disease show cognitive delays.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Comprehension | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. What should the nurse anticipate when reviewing laboratory results of a patient with Guillain-Barre syndrome?
  2. Elevated CBC
  3. High protein in a cerebral spinal fluid tap
  4. Creatinine phosphokinase elevated
  5. Sensory nerve conduction time increased

 

ANS: 2

  Feedback
1. The CBC should be within normal ranges.
2. The high protein in the cerebral spinal fluid is because of the inflammation to the area.
3. The laboratory results should be within normal limits.
4. The nerve conduction time is decreased.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Synthesis | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. A common treatment for a person with Guillain-Barre syndrome is:
  2. Broad spectrum antibiotics.
  3. Intravenous gamma globulins.
  4. Antihistamines.
  5. Acyclovir.

 

ANS: 2

  Feedback
1. Broad spectrum antibiotics are not an effective treatment for the disease.
2. IGg is given to help the body naturally fight the syndrome.
3. Antihistamines are not an effective treatment for the disease.
4. Acyclovir will not treat the illness.

KEY: Content Area: Pharmacology | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Comprehension | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. After a seizure, a 2-year-old boy would exhibit what type of reaction with the Babinski’s reflex?
  2. Positive
  3. Negative
  4. Will be positive one time and negative the next
  5. Not a reliable test at this age

 

ANS: 4

  Feedback
1. A Babinski’s reflex is not reliable at this age. It should only be done with infants.
2. A Babinski’s reflex is not reliable at this age. It should only be done with infants.
3. There will not be accurate results
4. Because of the child’s age, the results will not be accurate.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Synthesis | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. A teenage boy has received a concussion while playing hockey. A cardinal sign of a concussion is:
  2. Confusion.
  3. Altered level of consciousness.
  4. Loss of consciousness.
  5. Fainting.

 

ANS: 3

  Feedback
1. Confusion is not a cardinal sign, but may be present.
2. A change in the level of consciousness is not considered a cardinal sign.
3. A loss of consciousness is a cardinal sign for a concussion, and the child should be examined by a professional.
4. Fainting rarely occurs with a concussion.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. Tiagabine must be monitored when given to teens because:
  2. It is less effective during puberty.
  3. It has a high incidence of suicidal tendencies in teens.
  4. It needs to be titrated with the teen’s growth pattern.
  5. It is known to be sold as a street drug.

 

ANS: 2

  Feedback
1. The drug can be effective during puberty.
2. The high level of suicidal rates makes monitoring the teen’s behavior a priority.
3. Titration to the growth is not a priority at this time.
4. The medication is not a common street drug.

KEY: Content Area: Mental Health | Integrated Processes: Nursing Process | Client Need: Psychosocial Integrity | Cognitive Level: Comprehension | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. Which cranial nerve may be assessed by noting the strength of an infant’s suck?
  2. Cranial nerve VII
  3. Cranial nerve V
  4. Cranial nerve III
  5. Cranial nerve II

 

ANS: 2

  Feedback
1. Cranial never VII assess acoustic ability.
2. Cranial nerve V, the Trigeminal nerve, controls mastication and facial sensation.
3. Cranial nerve III assesses oculomotor reflex.
4. Cranial nerve II assesses the optic area.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. Which cranial nerve may be assessed by noting the symmetry of the facial expression during crying or smiling?
  2. Cranial nerve VII
  3. Cranial nerve V
  4. Cranial nerve III
  5. Cranial nerve VI

 

ANS: 1

  Feedback
1. Cranial nerve VII, the facial nerve, is responsible for symmetrical facial muscle movement.
2. Cranial nerve V, the Trigeminal nerve, controls mastication and facial sensation.
3. Cranial nerve III assesses oculomotor reflex.
4. Cranial nerve VI assesses the trochlear area.
   

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. Which cranial nerves are involved in sending impulses that are responsible for autonomic functions, like heart beat and the gag reflex?
  2. Cranial nerves VII and IX
  3. Cranial nerves IX, X, and XI
  4. Cranial nerves IX and X
  5. Cranial nerves X and XII

 

ANS: 3

  Feedback
1. Cranial nerves IX, the Glossopharyngeal, and X, the Vagus, send impulses to the heart and throat.
2. Cranial nerve XI assesses the Spinal Accessory.
3. Cranial nerve X assesses the Vagus.
4. Cranial Nerve X  assesses the Vagus, and Cranial Nerve XII assesses the Hypoglossal.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. Which, if any is not true about the brainstem?
  2. It contributes to the regulation of the heart rate and respirations, as well as the body’s ability to manage consciousness and sleep patterns.
  3. It controls autonomic behaviors necessary for the body to survive.
  4. It connects with the spinal cord and houses the connections between the motor and sensory portions of the brain to the rest of the body.
  5. It houses the cranial nerves.

 

ANS: 4

  Feedback
1. The brainstem aids in the regulation of patterns in the body.
2. The brainstem is responsible for controlling the autonomic behaviors of the body.
3. The brainstem connects the spinal cord to the motor-sensory portions of the brain.
4. The brainstem houses 10 of the 12 pairs of cranial nerves.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Comprehension | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. The brain is divided into two sections, called hemispheres. The hemispheres behave in a particular fashion in sending messages to the body. How do the hemispheres communicate information to the body?
  2. The hemispheres relay messages in a direct route.
  3. The hemispheres relay messages in a random fashion.
  4. The hemispheres relay messages in a contralateral fashion.
  5. The hemispheres relay messages in a unilateral route.

 

ANS: 3

  Feedback
1. The hemispheres relay messages in a contralateral fashion.
2. The hemispheres relay messages in a contralateral fashion.
3. The hemispheres relay messages in a contralateral fashion. The right hemisphere sends messages to the left side of the body, and the left hemisphere sends messages to the right side of the body.
4. The hemispheres relay messages in a contralateral fashion.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Application | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. Neural tube defects occur in the brain and spinal cord in the fetal period. When do these defects occur?
  2. Within the first trimester
  3. Within the first 6 weeks
  4. When the egg is fertilized
  5. Within the first 28 days after fertilization

 

ANS: 4

  Feedback
1. This answer is not specific enough.
2. This is outside of the range.
3. Development of the neural tube is minimal at this point.
4. Neural tube defects occur within the first 28 days of fertilization, before the woman knows that she is pregnant.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Application | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. In the neural tube defect spina bifida, which of the following problems can the nurse expect the child to exhibit?
  2. Problems walking
  3. Partial or complete paralysis of the legs
  4. Problems with bowel or bladder control
  5. All of the above

 

ANS: 4

  Feedback
1. There are different types of spina bifida, and the degree of severity will depend on how severely the child is affected.
2. There are different types of spina bifida, and the degree of severity will depend on how severely the child is affected.
3. There are different types of spina bifida, and the degree of severity will depend on how severely the child is affected.
4. There are different types of spina bifida, and the degree of severity will depend on how severely the child is affected.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. When measuring head circumference in an infant, what equipment should the nurse select to perform the task?
  2. Cloth tape measure
  3. Electronic measure
  4. Paper tape measure
  5. Metal tape measure

 

ANS: 3

  Feedback
1. Cloth tape measures can stretch over time and yield an inaccurate measure of the infant’s head.
2. An electronic measure is not realistic for use with infants.
3. The nurse should use a paper tape measure because paper tape is more sanitary and can be discarded after each use.
4. A metal tape measure will not conform to the infant’s head to yield an accurate measurement.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Comprehension | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. Which is true about microcephaly?
  2. Microcephaly is defined as the condition when the circumference of the head is more than two standard deviations below normal.
  3. Microcephaly is defined as the condition when the circumference of the head is more than three standard deviations below normal.
  4. Microcephaly is defined as the condition when the circumference of the head is more than one standard deviation below normal.
  5. Microcephaly is defined as the condition when the circumference of the head is more than two standard deviations above normal.

 

ANS: 1

  Feedback
1. Microcephaly occurs when the brain has not developed properly or has stopped growing, and is often associated with cognitive, motor, and speech delays.
2. Microcephaly occurs when the brain has not developed properly or has stopped growing, and is often associated with cognitive, motor, and speech delays.
3. Microcephaly occurs when the brain has not developed properly or has stopped growing, and is often associated with cognitive, motor, and speech delays.
4. Microcephaly occurs when the brain has not developed properly or has stopped growing, and is often associated with cognitive, motor, and speech delays.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. Which is not true about the assessment of primitive reflexes in infants?
  2. Primitive reflexes are assessed immediately after the baby is born.
  3. Primitive reflexes are assessed at every well-child visit until the age of 6 months.
  4. Absent primitive reflexes can indicate prematurity or lesions in the motor neurons.
  5. Some primitive reflexes remain throughout life, such as blinking.

 

ANS: 2

  Feedback
1. Primitive reflexes are assessed immediately after birth in the APGAR scoring.
2. Assessment of primitive reflexes should continue through the age of 12 months in normal infants.
3. Absent reflexes can indicate prematurity or lesions in the motor neurons.
4. Some primitive reflexes remain for life.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Application | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. Developmental delay occurs when a child does not meet age appropriate milestones in which area(s) of development?
  2. Fine motor skills
  3. Gross motor skills
  4. Language
  5. All of the above

 

ANS: 4

  Feedback
1. Delays can occur in this area and others as well.
2. Delays can occur in this area and others as well.
3. Delays can occur in this area and others as well.
4. Developmental delay, a descriptive term, can be related to an individual milestone delay or a mixed milestone delay.

KEY: Content Area: Growth and Development | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. When assessing for a developmental delay, which element(s) of the child’s history would have a significant impact on reaching developmental milestones?
  2. Poverty
  3. Neglectful parenting
  4. Cultural differences
  5. All of the above

 

ANS: 4

  Feedback
1. The child’s socioeconomic status has a direct impact on the child’s ability to meet developmental milestones.
2. Lack of parental interaction has a direct impact on the child’s ability to meet developmental milestones.
3. Cultures each have a set of norms and values which have a direct impact on the child’s ability to meet developmental milestones.
4. The child’s socioeconomic status, parental connections, and culture have a direct impact on the child’s ability to meet developmental milestones.

KEY: Content Area: Growth and Development | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Comprehension | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. Hydrocephalus occurs when cerebrospinal fluid collects in an abnormal pattern in the brain, causing an enlargement in the ventricles. What feature of young infants helps to compensate for the increased pressure caused by the collection of the cerebrospinal fluid?
  2. They are too young to perceive pain.
  3. They have open fontanels and sutures in the skull to allow for the expansion of the fluid.
  4. Infants grow quickly, so the ventricles accommodate for the fluid.
  5. All of the above

 

ANS: 2

 

  Feedback
1. Pain is perceived at any age.
2. Open fontanels and sutures help to compensate for increases in intracranial pressure. The nurse should gently palpate the fontanel and be alert to changes, such as a tense and bulging fontanel.
3. Infant ventricle growth does not occur fast enough to compensate for the extra fluid.
4. One answer applies.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Application | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. What are the symptoms of increased intracranial pressure in infants and children?
  2. Vomiting, sunsetting eyes, lethargy
  3. Vomiting, irritability, decline in academic performance
  4. Headache, diarrhea, insomnia
  5. Excitability, anorexia, regression in language skills

 

ANS: 1

  Feedback
1. Increased intracranial pressure causes depression of brain function, which results in lethargy. The sunsetting eyes phenomenon occurs when there is pressure on the nerves of the eyes from the increased cerebrospinal fluid, causing the eyes to look downward. The increased intracranial pressure sends signals to other body functions as well, causing vomiting.
2. Academic performance is not assessed for the increased intracranial pressure, as this can have a quick onset.
3. Diarrhea is not a symptom of increased intracranial pressure.
4. The depression of brain function decreases the excitability of the brain.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Application | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. Which of the following is not a symptom of autism spectrum disorder?
  2. Lack of expressive language
  3. Enjoys change in routine
  4. Lack of social skills
  5. Engages in repetitive behavior

 

ANS: 2

  Feedback
1. Children with autism spectrum disorder will exhibit this symptom.
2. Children with autistic spectrum disorder are disturbed or intolerant of changes in daily routines and rituals.
3. Children with autism spectrum disorder will exhibit this symptom.
4. Children with autism spectrum disorder will exhibit this symptom.

KEY: Content Area: Behavioral | Integrated Processes: Teaching/Learning | Client Need: Psychosocial Integrity | Cognitive Level: Knowledge | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. What are characteristics of a seizure?
  2. Loss of awareness
  3. Twitching movements of a part of the body
  4. Rhythmic jerking movements of an extremity
  5. All of the above

 

ANS: 4

  Feedback
1. Symptom of a seizure
2. Symptom of a seizure
3. Symptom of a seizure
4. Seizures can take many forms, including staring, blinking, twitching, drooling, rigidity, atonic muscles, eye deviation and convulsions.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. Which of the following is not true about sleepwalking?
  2. Sleepwalking occurs in REM sleep.
  3. Sleepwalking tends to run in families.
  4. When sleepwalking, a child looks awake and his/her eyes are open.
  5. Sleepwalking is most common between the ages of 4 and 8.

 

ANS: 1

  Feedback
1. Sleepwalking occurs in non-REM sleep.
2. Sleepwalking does run in families.
3. The child’s eyes may be open and appear awake, or they may be closed during sleepwalking.
4. This range is the most common for sleepwalking.

KEY: Content Area: Sleep Patterns | Integrated Processes: Nursing Process | Client Need: Physiological Adaptation | Cognitive Level: Comprehension | REF: Chapter13 | Type: Multiple Choice

 

 

 

  1. Which of the following statements about temporal lobe epilepsy are true?
  2. Temporal lobe epilepsy is the most common partial seizure epilepsy.
  3. Temporal lobe seizures are often resistant to treatment.
  4. Temporal lobe epilepsy is often associated with a specific lesion in the temporal lobe, called hippocampal sclerosis.
  5. All of the above

 

ANS: 4

  Feedback
1. The  most common partial seizure for epilepsy is temporal lobe.
2. Temporal lobe seizures have a high rate of resistance to treatment.
3. The hippocampal sclerosis can sometimes be surgically removed, which can stop or diminish seizure activity.
4. The hippocampal sclerosis can sometimes be surgically removed, which can stop or diminish seizure activity.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Adaptation | Cognitive Level: Comprehension | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. Which of the following is not a feature of Benign Rolandic Epilepsy?
  2. It is more common in girls than boys.
  3. The child has twitching, numbness, or tingling in the face and tongue. The child also remains fully conscious.
  4. Tonic-clonic seizures may occur during sleep.
  5. The EEG has a specific pattern of spikes, called centrotemporal spikes.

 

ANS: 1

  Feedback
1. Benign Rolandic Epilepsy, also called Benign Childhood Epilepsy with Centrotemporal Spikes or BCECTS, is more common in boys than in girls.
2. The symptoms are common in children.
3. Tonic-clonic seizures are common during sleep.
4. This is a symptom of Benign Rolandic Epilepsy.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Adaption | Cognitive Level: Comprehension | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. When a child suffers generalized seizures, it is important for the nurse to do all of the following except:
  2. Turn the child on his/her side in order to allow fluid to flow from his/her mouth.
  3. Time the seizure length
  4. Monitor his/her airway and placing a plastic airway or padded tongue blade in his/her mouth if necessary to keep the airway open.
  5. Protect the child from injury as the body convulses.

 

ANS: 3

  Feedback
1. The nurse should monitor the airway and place the child on his/her side, but should never place anything in the airway of a child having a seizure.
2. The nurse should monitor the airway and time the seizure, but should never place anything in the airway of a child having a seizure.
3. Do not place anything in a child’s mouth during a seizure.
4. Protecting the child from injury is important during a seizure.

KEY: Content Area: Neurological | Integrated Processes: Nursing Assessment | Client Need: Safe and Effective Care Environment | Cognitive Level: Application | REF: Chapter13 | Type: Multiple Choice

 

 

 

  1. Headaches and migraines are common in children and adolescents. In assessing the severity of the headaches in children, the nurse must understand the ability of the child to describe his/her symptoms. What would be an incorrect step for a nurse to take when assessing headache pain in a young child?
  2. Use an approved pain scale, such as the Wong-Baker Faces Pain Rating Scale.
  3. Note the mother or caregiver’s report.
  4. Note the child’s behavior.
  5. Note the nurse’s own beliefs about children’s perception of pain.

 

ANS: 4

  Feedback
1. Pain scales enable the patient to describe the level of pain for documentation and therapy purposes.
2. Caregivers and parents of children are the best sources for information because they know the child the best and can more accurately assess the pain.
3. A child in pain will exhibit irritability and want to pull away from any painful stimulus.
4. Pain is a subjective phenomenon. Young children are often unable to verbalize their symptoms and must be helped when describing their feelings by use of approved pain scales and words that they can understand.

KEY: Content Area: Pain | Integrated Processes: Caring | Client Need: Physiological Integrity | Cognitive Level: Application | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. Which of the following is a symptom of tension headaches?
  2. A feeling of tightness or pressure around the head
  3. Unilateral throbbing or pounding head pain
  4. Nausea, vomiting, anorexia
  5. Sensitivity to light and/or noise

 

ANS: 1

  Feedback
1. The pain is usually mild to moderate and does not usually prevent children from participating in activities.
2. Tension headaches usually have a tightness or pressure around the head, not unilateral throbbing or pounding.
3. This is not noted in tension headaches.
4. This is not noted in tension headaches. This is more often noted in migraine headaches

KEY: Content Area: Pain | Integrated Processes: Nursing Assessment | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. Migraine headaches in children can be debilitating and can be triggered by all of the following except:
  2. Too much or too little sleep.
  3. Overhydration.
  4. Skipping meals.
  5. Unusual stress or the child’s inability to cope with stressors.

 

ANS: 2

  Feedback
1. Sleep is a factor for migraines in children.
2. Inadequate hydration is a factor for migraines in children, not overhydration.
3. Skipping meals is a factor in migraines for children.
4. Stress is a factor in migraines for children.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Application | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. Which is the following is not a characteristic of Tourette’s Syndrome?
  2. Complex motor tics
  3. The child is unaware of his/her behavior
  4. Present for more than one year
  5. Present before the 18th birthday

 

ANS: 2

  Feedback
1. Common symptom of Tourette’s syndrome
2. The child is aware of his/her behavior and often tries to suppress it unsuccessfully.
3. Tourette’s Syndrome can be a life-long issue.
4. Tourette’s Syndrome usually occurs in school-age children.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: Chapter 13 | Type: Multiple Choice

 

 

 

  1. Meningitis is assessed by which of the following after blood tests and a physical assessment are completed?
  2. Lumbar puncture
  3. Urine tests
  4. Kernig’s sign and Brudzinski’s sign
  5. Physical examination

 

ANS: 2

  Feedback
1. Usually done after blood tests and a physical assessment
2. Blood tests are done prior to the lumbar puncture. Urine tests are not.
3. Usually the second assessment done for the disease
4. Usually the first assessment done for the disease

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: Chapter 13 | Type: Multiple Choice

 

 

 

True /False

 

 

 

  1. Neurofibromatosis Type 1 is the most common neurofibromatosis in children.

 

ANS: T

  Feedback
1. Neurofibromatosis Type 1 is the most common neurofibromatosis in children.
2. Neurofibromatosis Type 1 is the most common neurofibromatosis in children.

KEY: Content Area: Neurological | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: Chapter 13 | Type: True /False

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