Chapter 21 Caring for the Child in the Hospital, the Community, and Across Care Settings

Chapter 21  Caring for the Child in the Hospital, the Community, and Across Care Settings

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. The pediatric nurse clarifies the history of a child who is brought to the emergency room with abdominal pain. The nurse uses the mnemonic OLD CAT to ask the appropriate questions, including which of the following?
A.
Activity
B.
Diet
C.
Output
D.
Timing

ANS: D
The mnemonic OLD CAT stands for: onset (“When did the child become ill?”), location (“Where is the pain?”), duration (“How long does the pain last?”), character (“Can you tell me on a scale of 1 to 10 how bad it is?”), aggravating/alleviating (“What has made the pain better or worse?”), and timing (“When does the pain start/stop?”).

Cognitive Level: Application/Applying
Content Area: Pediatrics/Maternity
Patient Needs: Health Promotion and Maintenance
Integrated Process: Nursing Process: Assessment
Difficulty: Easy

PTS: 1

2. The pediatric nurse takes a comprehensive health history of a 10-year-old patient and asks the parents about their use of herbal products or home remedies. What information does the nurse know regarding herbal products?
A.
Aloe vera can affect clotting time by decreasing platelets.
B.
Bilberry can cause hypersensitivity in patients with allergies to plants.
C.
Echinacea is contraindicated for patients with autoimmune disorders.
D.
Fennel is contraindicated in patients with diabetes, hypertension, or liver disease.

ANS: C
There are no known side effects for topical application of aloe vera. Bilberry can affect clotting time by decreasing platelet aggregation. Echinacea should not be used for patients with autoimmune disorders, diabetes, AIDS, or HIV. Fennel may have a laxative effect; licorice is contraindicated in patients with diabetes, hypertension, or liver and kidney disease.

Cognitive Level: Knowledge/Remembering
Content Area: Pediatrics/Maternity
Patient Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Integrated Process: Nursing Process: Assessment
Difficulty: Difficult

PTS: 1

3. The pediatric nurse performs a health assessment on a 9-year-old girl who weighs 23 kg and is 132 cm tall. How does the nurse document the patient’s BMI?
A.
13.20
B.
13.82
C.
14.25
D.
14.68

ANS: A
The BMI-for-age is calculated by dividing the weight (in kilograms) by the height squared (in meters). However, because most health-care providers obtain height in centimeters, an alternative calculation is to divide the weight (in kilograms) by the height squared (in centimeters), then multiply by 10,000.

Cognitive Level: Analysis
Content Area: Pediatrics/Maternity
Patient Needs: Health Promotion and Maintenance
Integrated Process: Nursing Process: Assessment
Difficulty: Difficult

PTS: 1

4. On physical assessment of the skin of a patient, the nurse documents cyanosis. What other related assessment should the nurse perform?
A.
Ask the parent about yellow and orange vegetable intake.
B.
Draw blood for hemoglobin, hematocrit, and liver function studies.
C.
Palpate all the child’s lymph nodes, assessing for enlargement.
D.
Take the child’s vital signs, including blood pressure and pulse.

ANS: D
Cyanosis may indicate a compromised cardiorespiratory state, and the nurse should assess measures of cardiac output and respiratory function. Taking vital signs will give the nurse information about these two systems. Vegetable intake, laboratory studies (including liver function tests), and palpating lymph nodes are not related to cyanosis.

Cognitive Level: Analysis/Analyzing
Content Area: Pediatrics/Maternity
Patient Needs: Health Promotion and Maintenance
Integrated Process: Nursing Process: Assessment
Difficulty: Moderate

PTS: 1

5. A nursing manager is concerned about frequent errors on the pediatric unit and wants to decrease them. What action by the manager is best?
A.
Have two nurses verify all new orders when they are written.
B.
Institute a standardized handoff format at shift change.
C.
Provide remedial education to nurses who make errors.
D.
Require charge nurses to verify care plans with staff nurses.

ANS: B
The Joint Commission has identified handoff communication as contributing to up to 80% of all serious, preventable errors. To remedy this situation, a standardized handoff communication format is suggested. The other actions might work to some degree, but not to the extent that improving handoff communication would.

Cognitive Level: Analysis/Analyzing
Content Area: Pediatrics/Maternity
Patient Needs: Safe and Effective Care Environment: Safety and Infection Control
Integrated Process: Communication and Documentation
Difficulty: Moderate

PTS: 1