Chapter 9 Child Health Nursing Partnering With Children & Families, 3rd Edition

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Chapter 9  Child Health Nursing Partnering With Children & Families, 3rd Edition

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

Question 1
Type: MCSA
During the visit to the pediatric office, a nurse observes the mother frequently looking at and massaging her infant. Based on these observations, the nurse’s conclusion should be:
1. That the mother is displaying positive maternal-infant attachment.
2. That the mother is trying to show the nurse that she can be affectionate to the infant.
3. That there is insufficient data to assess the mother-infant relationship.
4. That the mother might be overwhelmed by the demands of infant care.
Correct Answer: 1
Rationale 1: These behaviors are characteristic of a positive maternal-infant attachment.
Rationale 2: The mother might be trying to show the affection, but the more global answer is that the massaging and looking at the infant indicate positive maternal-infant attachment.
Rationale 3: These are behaviors indicative of positive attachment and sufficient to assess the mother-infant relationship at this time.
Rationale 4: There is no information indicating the mother might be overwhelmed.
Global Rationale:

Cognitive Level: Analyzing
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 9-1

Question 2
Type: MCMA
Which activities should the nurse in the newborn unit perform prior to discharge from the birth hospital?
Standard Text: Select all that apply.
1. Perform a heel stick to obtain blood for the newborn screen.
2. Monitor the mother as she performs the first newborn bath to remove blood and amniotic fluids.
3. Administer a folic acid injection to the infant to prevent bleeding.
4. Perform a hearing screening.
5. Monitor feeding behaviors.
Correct Answer: 1,4,5
Rationale 1: The infant should be screened for state-mandated tests prior to discharge. One such test is for PKU, which is required by all 50 states. PKU should be screened 48 hours after the first formula feeding. If the child is discharged early, the blood will be drawn for screening before discharge and then the test will be repeated at an appropriate time.
Rationale 2: The nurse, not the mother, performs the first bath to remove blood and amniotic fluids. This is a prime opportunity to complete a head-to-toe assessment.
Rationale 3: Vitamin K, not folic acid, is administered. Vitamin K is given prophylactically to prevent bleeding due to vitamin K deficiency.
Rationale 4: A hearing screening is performed on all newborn infants prior to discharge.
Rationale 5: The nurse should assess feeding behaviors of the infant whether the infant is breastfed or bottle-fed.
Global Rationale:

Cognitive Level: Applying
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 9-2

Question 3
Type: MCSA
A mother who is bottle-feeding her newborn requests to be discharged 24 hours post-delivery, because the mother also has twin two-year-olds at home. The nurse should schedule the follow-up visit for the newborn on which of these days?
1. Within 48 hours of discharge
2. When the infant is one month old
3. Within two weeks of discharge
4. Within one week of discharge
Correct Answer: 1
Rationale 1: Newborns discharged before 48 hours old should be seen within 48 hours of discharge.
Rationale 2: A health supervision visit is routinely scheduled at one month of age regardless of age at time of discharge. Newborns should be monitored for jaundice, weight gain, umbilicus healing, and other problems; they should be evaluated 48 hours after early discharge.
Rationale 3: For an infant discharged at 24 hours, waiting two weeks after discharge increases the chance that several common newborn conditions can go undiagnosed (e.g., jaundice and failure to gain weight).
Rationale 4: Waiting one week after discharge of a 24-hour-old increases the chance that several common newborn conditions can go undiagnosed (e.g., jaundice and failure to gain weight).
Global Rationale:

Cognitive Level: Applying
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 9-4

Question 4
Type: MCMA
The nurse in the newborn nursery is admitting a neonate. In order to determine the health and development of the newborn, what will the nurse assess?
Standard Text: Select all that apply.
1. Head and chest circumference
2. Weight and length
3. Body fat determination
4. Presence of newborn reflexes
5. Gestational age of the infant
Correct Answer: 1,2,4,5
Rationale 1: The head circumference of a newborn should be larger than the chest circumference. Chest circumference greater than head circumference is associated with microcephaly and other problems.
Rationale 2: Weight and length should be plotted on a growth chart along with gestational age to determine if intrauterine growth was within the normal range.
Rationale 3: Body fat determination is not a measure that is used during the newborn assessment.
Rationale 4: The newborn reflexes can be an indicator of a number of problems, including injuries to the extremities or the brain.
Rationale 5: Gestational age of the infant can predict health issues that can develop.
Global Rationale:

Cognitive Level: Applying
Client Need:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 9-4

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