Chapter 1 Issues and Trends in Pediatric Nursing

Multiple Choice
Identify the choice that best completes the statement or answers the question.

____	1.	The nurse has provided a presentation to middle school children about nursing as a career. One of the children stated that he wanted to be a pediatric nurse, because he wants to take care of babies and little “kids.” What would be an appropriate response to this middle school–aged child?
1.	“Nursing is a general practice; all nurses must know how to take care of all ages of patients.”	
2.	“As a pediatric nurse, you would get to care for babies and little kids as well as children through their teenage years.”	
3.	“What you are describing is actually a neonatal nurse. Neonatal nurses work with newborn babies, toddlers, and preschool-age children.”	
4.	“Being a pediatric nurse requires a master’s degree, so be sure to work hard in school!”	

____	2.	The medical-surgical float nurse is assigned to the pediatric unit for the first time and states that the skills are “the same as general nursing since children are little adults with smaller bodies.” What component of pediatric nursing contraindicates this statement?
1.	Pediatric nursing involves care based on the developmental level of the patient.	
2.	Pediatric nursing involves the patient’s family in the plan of care.	
3.	Pediatric nursing in based on prevention of infectious diseases.	
4.	Pediatric nursing involves cultural sensitivity in patient care.	

____	3.	The culturally sensitive pediatric nurse is aware of the racial makeup of the U.S. population. Which of the following reflects the demographics of the U.S. pediatric population in 2018, based on U.S. Census Bureau data?
1.	The American Indian and Alaska Native population represent one-fifth of the pediatric population.	
2.	About half of the children fall in the category of something other than White non-Hispanic.	
3.	The population of Asian children decreased from 2015 to 2018.	
4.	There was no change in the population of Non-Hispanic children who represent two or more races between 2015 and 2018.	

____	4.	The nurse at a family clinic is providing care to an adolescent patient diagnosed with diabetes. The patient has verbalized discomfort with the feelings of isolation when unable to drink alcohol with their friends. Which of the following would be the most appropriate response to this statement?
1.	“Drinking alcohol is not only illegal but dangerous for your blood sugar control and overall well-being.”	
2.	“You can still drink alcohol, in moderation, if you control the sugar spike with more insulin.”	
3.	“Prepare for alcohol intake with more water and less carbohydrates before drinking to slow sugar spikes.”	
4.	“It is understandable that you want to be included, but perhaps we can work out a plan on how to work through those situations.”	

____	5.	Which statement best describes the common core concepts of the different models of pediatric nursing?
1.	All models focus on the open communication between the child and nurse.	
2.	All models focus on importance of family relationship to the child.	
3.	All models focus on safeguarding the child’s dignity during care.	
4.	All models focus on coordination of care needs that arise during illness.	

____	6.	Which of the following tasks is associated with the pediatric medical home care model of pediatric nursing?
1.	The nurse refers the family to a childhood cancer support group prior to discharge from the hospital.	
2.	The nurse includes a simple explanation of the procedure to the child based on the child’s developmental level.	
3.	The nurse includes the family’s cultural celebrations and observations while providing care to the child.	
4.	The nurse develops the plan of care with the child and family as the focal point of the interventions.	

____	7.	The pediatric nurse begins a research project on 8-year-old patients with the medical diagnosis of pediatric acute-onset neuropsychiatric syndrome (PANS). The family has consented to the research, but as the nurse begins to administer the intervention, the patient refuses to cooperate. What is the appropriate response to this refusal?
1.	The nurse should discuss with the family the options of performing the intervention without the child’s knowledge.	
2.	The nurse should explain to the child that this is necessary and promise a reward at the end of the research project.	
3.	The nurse should refuse to perform the intervention until the child consents to the intervention and project.	
4.	The nurse should discuss the pros and cons of the research project with the child and focus on the outcomes.	

____	8.	A nurse is providing relationship-based care to a pediatric patient. Which of the following is a challenge the nurse is likely to encounter while using this model of care?
1.	Maintaining a sterile field for a procedure with a restless toddler	
2.	Communicating with the blended family on regular basis	
3.	Treating children with antibiotic-resistant illnesses	
4.	Caring for a larger number of children with autism spectrum disorders and childhood depression	

____	9.	The pediatric nurse desires to expand his or her career options to become the hospital’s nurse educator of pediatrics. Which of the following is necessary for this nurse to achieve this career goal?
1.	The nurse is recommended to earn a minimum of a master’s degree in nursing.	
2.	The nurse must earn a minimum of a doctorate degree in nursing.	
3.	The nurse must implement and develop research in nursing practice.	
4.	The nurse must implement a plan to obtain certification in pediatrics.	

____	10.	The school nurse is developing a teaching session for the population of children in a middle school. The nurse has determined that the greatest need for the overall health of the children is promotion of healthy foods. Which of the following interventions is most likely to be effective?
1.	Remove all unhealthy snacks from the vending machines.	
2.	Have a poster contest on healthy eating options.	
3.	Survey the student population during lunch breaks.	
4.	Engage the students in healthy choices with cooking lessons.	

____	11.	The nurse recognizes the needs of professional development to provide safe and effective care to the pediatric population by attending which of the following courses?
1.	Procedure with rationale to administer human papilloma vaccine to the middle school population	
2.	Study review of the incidence of bullying and intimidation in the elementary school population	
3.	Demographic study of the U.S. population with regard to cultural diversity and practices	
4.	How to provide individual health care education for the children without parental interference	

____	12.	Which of the following continuing education courses would best enhance the pediatric nurse’s practice in relationship to current trends?
1.	Evidence-based practice on improving antibiotic adherence with education to the family unit	
2.	Evidence-based practice on proper administration of antibiotics for children with autoimmune diseases	
3.	How to enhance communication with children in regards to adherence to antibiotic use	
4.	How to decrease instances of exacerbation of infections of children with autoimmune diseases with antibiotics	

____	13.	The pediatric nurse is developing interventions for a school-aged child based on the nursing diagnosis of imbalanced nutrition related to a body mass index (BMI) of 37 and poor food choices as evidenced by patient’s mother’s food diary for the family and child’s statements of food preferences. Which of the following would be an appropriate nursing intervention?
1.	Provide the child and family with information from https://www.MyPlate.gov for healthy food options.	
2.	Increase the child’s activity by incorporating the child’s friends into a plan of healthy exercise options.	
3.	Explain the importance of balancing diet and exercise to prevent obesity to the child and family.	
4.	Provide information on the increased risk for potential disease processes such as diabetes and hypertension.	

____	14.	The nurse is developing interventions for a transgender adolescent based on the nursing diagnosis decreased self-esteem related to transgender identity as evidenced by statements of feeling “worthless, different, and alone.” What would be the most appropriate intervention based on the diagnosis?
1.	Give positive feedback on personal choices as appropriate.	
2.	Provide gender-affirming care to transgender youth.	
3.	Provide information on support groups for patient and family.	
4.	Assess risk factors for depression and suicidal thoughts.	

____	15.	The pediatric nurse is providing care to an 8-year-old client who has Down’s syndrome and wants to ensure they are providing evidence-based care. Which of the following resources would best offer evidence-based practice guidelines related to the care of this patient?
1.	Journal of Specialists in Pediatric Nursing	
2.	Journal of Child and Adolescent Psychiatric Nursing	
3.	National Database of Nursing Quality Indicators	
4.	American Journal of Maternal/Child Nursing	

Multiple Response
Identify one or more choices that best complete the statement or answer the question.

____	16.	The nurse must obtain data for a routine assessment of the 8-month-old patient. Which of the following are part of that assessment? Select all that apply.
1.	Measure the head circumference and record results.	
2.	Enter length and weight in the growth chart.	
3.	Assess bilateral hand grasp strength and function.	
4.	Input the Tanner scale results in the chart.	
5.	List most recent immunizations in the chart.	

____	17.	Which of the following examples accurately represent the unique role of the pediatric nurse? Select all that apply.
1.	The nurse developed an intervention that correlated with the patient’s particular cultural practice.	
2.	The nurse shared information on the progress and interventions with the family and patient.	
3.	The nurse engaged in one-to-one conversations with the family members as well as the patient.	
4.	The nurse requested the family to leave during invasive procedures to maintain privacy.	
5.	The nurse developed interventions based on the knowledge of human growth and development.	

____	18.	The nurse is developing a health fair for children aged 5 and 6 years. Which of the following would be appropriate topics for this population based on current trends? Select all that apply.
1.	How to deal with bullying on the Internet	
2.	How to prevent the flu with hand washing	
3.	How to choose and eat healthy foods	
4.	How to recognize suicidal thoughts	
5.	Ways to stay active and stay healthy	

____	19.	The school nurse is providing care to the student population in the urban elementary school. The nurse notes that the children do not feel safe playing outside during recess due to the recent violent incidents in the surrounding area. What are some disease processes that the nurse may notice due to this inactivity? Select all that apply.
1.	The general population is at higher risk for obesity.	
2.	The students are at higher risk for increased bullying.	
3.	The students are at a higher risk for learning disabilities.	
4.	The students are at higher risk for diabetes mellitus.	
5.	The students are at higher risk for earlier onset of puberty.	

____	20.	The pediatric nurse is providing care to a 5-year-old patient for speech impediments that were caused by repeated incidences of otitis media. Which of the following is an example of current issues regarding this type of medical problem? Select all that apply.
1.	Increased admissions based on environmental risk factors, such as smoking	
2.	Increased admissions based on knowledge deficits due to language barriers	
3.	Increased awareness of childhood health issues from social media and Internet	
4.	Shift in the focus of medical care from disease treatment to disease prevention	
5.	Deficient knowledge that has negatively impacted the adherence to the antibiotic regimen	

Chapter 1 Issues and Trends in Pediatric Nursing
Answer Section

MULTIPLE CHOICE

	1.	ANS:	2
Chapter: Chapter 1 Issues and Trends in Pediatric Nursing
Chapter Learning Objective: 1. Define pediatric nursing.
Page: 3
Heading: Introduction to Pediatric Nursing
Integrated Processes: Teaching and Learning
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Cognition
Difficulty: Moderate

	Feedback	
1	This is incorrect. Nurses can specialize in a number of areas. Pediatrics is one of these areas.	
2	This is correct. Pediatric nursing care requires the nurse to use assessment and evaluation tools that are unique to infants, children, and adolescent populations, not just babies and young children.	
3	This is incorrect. This is not accurate. Neonatal nurses typically provide care to infants. They would not provide care to toddlers or preschool-age children.	
4	This is incorrect. A master’s degree is not required to be a pediatric nurse. However, advanced degrees and additional certification are available for pediatric nurses.	

PTS:	1	CON:	Cognition

	2.	ANS:	1
Chapter: Chapter 1 Issues and Trends in Pediatric Nursing
Chapter Learning Objective: 7. Describe the roles of the pediatric nurse.
Page: 3
Heading: Introduction to Pediatric Nursing > Nursing Care for Children 
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Analysis [Analyzing]
Concept: Safety
Difficulty: Moderate

	Feedback	
1	This is correct. Pediatric nursing involves not only general nursing care and planning but also the developmental level of the patient. The history of pediatric nursing describes how the role has evolved into a specialty. 	
2	This is incorrect. Although this is a component of pediatric nurses, it does not answer the concern regarding the “little adults” comment. 	
3	This is incorrect. Although this is a component of pediatric nurses, it does not answer the concern regarding the “little adults” comment.	
4	This is incorrect. Although this is a component of pediatric nurses, it does not answer the concern regarding the “little adults” comment.	

PTS:	1	CON:	Safety

	3.	ANS:	2
Chapter: Chapter 1 Issues and Trends in Pediatric Nursing
Chapter Learning Objective: 4. Describe the projected racial population changes in the United States.
Page: 5
Heading: Racial Makeup of American Children
Integrated Processes: Nursing Process
Client Need: Health Promotion and Maintenance
Cognitive Level: Application [Applying]
Concept: Population Health
Difficulty: Moderate

	Feedback	
1	This is incorrect. The American Indian and Alaska Native population represent 0.8% of the pediatric population. 	
2	This is correct. About 50% of the children aged 0 to 17 in 2018 were White non-Hispanic.	
3	This is incorrect. There was no change in the population of Asian, non-Hispanic children from 2015 to 2018. 	
4	This is incorrect. The population of non-Hispanic children who represent two or more races increased from 4% in 2015 to 5% in 2018.	

PTS:	1	CON:	Population Health

	4.	ANS:	4
Chapter: Chapter 1 Issues and Trends in Pediatric Nursing
Chapter Learning Objective: 2. Describe the differences between nursing care of infants, children, and adolescents and care of the adult population.
Page: 9
Heading: Role of the Pediatric Nurse
Integrated Processes: Communication and Documentation
Client Need: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Application [Applying]
Concept: Safety; Self
Difficulty: Moderate

	Feedback	
1	This is incorrect. This is not a solution to the patient’s issues. The patient reports feeling left out due to the disease process. This does not address the issue in a developmentally appropriate manner to promote the optimal physical, psychological, and social well-being.	
2	This is incorrect. This encourages unsafe health habits and does not address the issue with the disease process and the adolescent’s need for inclusion. 	
3	This is incorrect. This is not therapeutic communication, nor is it safe for the adolescent. It does not care in a developmentally appropriate manner to promote the optimal physical, psychological, and social well-being of the adolescent. 	
4	This is correct. Helping the adolescent develop anticipatory guidance facilitates independence and healthy responses to peer pressure. 	

PTS:	1	CON:	Safety | Self

	5.	ANS:	2
Chapter: Chapter 1 Issues and Trends in Pediatric Nursing
Chapter Learning Objective: 5. Identify models of care applied to pediatric nursing.
Page: 5
Heading: Models of Care in Pediatric Nursing
Integrated Processes: Teaching and Learning
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Analysis [Analyzing]
Concept: Family
Difficulty: Moderate

	Feedback	
1	This is incorrect. This omits the necessity of family relationships in the care and development of the child. 	
2	This is correct. This is a common core concept in family-centered care, relationship-based care, and pediatric medical home care. 	
3	This is incorrect. This is a concept based on patient relationship-based care. 	
4	This is incorrect. This is a component of pediatric medical home care.	

PTS:	1	CON:	Patient-Centered Care	

	6.	ANS:	1
Chapter: Chapter 1 Issues and Trends in Pediatric Nursing
Chapter Learning Objective: 5. Identify models of care applied to pediatric nursing.
Page: 6
Heading: Models of Care in Pediatric Nursing > Pediatric Medical Home
Integrated Processes: Teaching and Learning
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Application [Applying]
Concept: Family
Difficulty: Moderate

	Feedback	
1	This is correct. The pediatric medical home care model coordinates care and includes referrals for community services for nonmedical needs. 	
2	This is incorrect. This is a core concept of relationship-based care. 	
3	This is incorrect. This is a core concept of cultural sensitivity and family-centered care. 	
4	This is incorrect. This is a core concept of relationship-based care. 	

PTS:	1	CON:	Family

	7.	ANS:	3
Chapter: Chapter 1 Issues and Trends in Pediatric Nursing
Chapter Learning Objective: 7. Describe the roles of the pediatric nurse; 9. Identify current issues and trends in pediatric nursing practice, education, and research.
Page: 7
Heading: Issues in Pediatric Nursing
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Analysis [Analyzing]
Concept: Communication; Professionalism
Difficulty: Moderate

	Feedback	
1	This is incorrect. This could be considered assault and battery against the child. Children aged 7 years and older can assent or dissent to be in a clinical trial. 	
2	This is incorrect. This would be considered bribery, and per the Institutional Review Board (IRB) guidelines, a clinical trial should not promise any direct rewards.	
3	This is correct. Children aged 7 years and older can assent or dissent to be in a clinical trial.	
4	This is incorrect. The 8-year-old child may not have the faculties or cognitive development to comprehend “pros and cons” of a research project. 	

PTS:	1	CON:	Communication; Professionalism

	8.	ANS:	2
Chapter: Chapter 1 Issues and Trends in Pediatric Nursing
Chapter Learning Objective: 9. Identify current issues and trends in pediatric nursing practice, education, and research. 
Page: 7
Heading: Issues in Pediatric Nursing
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment
Cognitive Level: Analysis [Analyzing]
Concept: Family
Difficulty: Moderate

	Feedback	
1	This is incorrect. This is a fundamental issue in nursing care, not a relationship issue.	
2	This is correct. Maintaining communication with families and caregivers has become more challenging due to the dynamics of current families.	
3	This is incorrect. There has been an increase in the number of antibiotic-resistant illnesses. This is a trend that has influenced nursing roles and responsibilities, not relationship-based care. 	
4	This is incorrect. This is a trend that has influenced nursing roles and responsibilities, not relationship-based care.	

PTS:	1	CON:	Family

	9.	ANS:	1
Chapter: Chapter 1 Issues and Trends in Pediatric Nursing
Chapter Learning Objective: 8. Identify the different fields of pediatric nursing and the education required for each. 
Page: 7
Heading: Role of the Pediatric Nurse > Where Pediatric Nurses Work
Integrated Processes: Nursing Process
Client Need: Physiological Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Professionalism
Difficulty: Moderate

	Feedback	
1	This is correct. Pediatric nurses with master’s degree preparation are often employed as nurse educators. Many academic settings require nursing instructors to have a nursing doctorate or be actively working to obtain a doctorate. 	
2	This is incorrect. Pediatric nurses with master’s degree preparation are often employed as nurse educators. Many academic settings require nursing instructors to have a nursing doctorate or be actively working to obtain a doctorate (keyword: minimum). 	
3	This is incorrect. Although nurses with doctorates may develop and implement research programs for hospitals, this is not necessary to obtain this position. 	
4	This is incorrect. Although nurses may obtain certification in pediatrics, it is often not the minimum requirement for nurse educator. 	

PTS:	1	CON:	Professionalism	

	10.	ANS:	4
Chapter: Chapter 1 Issues and Trends in Pediatric Nursing
Chapter Learning Objective: 9. Identify current issues and trends in pediatric nursing practice, education, and research.
Page: 8
Heading: Trends in Pediatric Nursing Practice > Obesity
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Analysis [Analyzing] 
Concept: Health Promotion
Difficulty: Moderate

	Feedback	
1	This is incorrect. This would only prevent the students from buying unhealthy foods via the vending machine, not help them make choices. 	
2	This is incorrect. Although this may help with a competition, it may not facilitate lifestyle changes.	
3	This is incorrect. Although this may help assess the student’s lunchtime eating habits, it would not help with the full picture of the problem.	
4	This is correct. Engaging the students in healthy options would promote active learning and new skills. 	

PTS:	1	CON:	Health Promotion	

	11.	ANS:	1
Chapter: Chapter 1 Issues and Trends in Pediatric Nursing
Chapter Learning Objective: 9. Identify current issues and trends in pediatric nursing practice, education, and research.
Page: 8
Heading: Trends in Pediatric Nursing Practice
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Cognitive Level: Analysis [Analyzing]
Concept: Safety; Health Promotion
Difficulty: Moderate

	Feedback	
1	This is correct. This is an example of shifting the focus of medical/nursing care from disease treatment to disease prevention. 	
2	This is incorrect. Although this is a safety issue, it would not increase knowledge of the nurse as far as care provision in pediatric nursing practice.	
3	This is incorrect. This may enhance the knowledge base for certain cultural practices, but it does not indicate how this would enhance practice. 	
4	This is incorrect. This contraindicates the nursing model of relationship-based nursing care. 	

PTS:	1	CON:	Safety; Health Promotion

	12.	ANS:	1
Chapter: Chapter 1 Issues and Trends in Pediatric Nursing
Chapter Learning Objective: 9. Identify current issues and trends in pediatric nursing practice, education, and research.
Page: 8
Heading: Trends in Pediatric Nursing Practice 
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Cognitive Level: Application [Applying]
Concept: Health Promotion
Difficulty: Moderate

	Feedback	
1	This is correct. Evidence-based practice may facilitate medication adherence if provided to the family unit. This may help prevent future antibiotic-resistant diseases.	
2	This is incorrect. Although this includes keywords such as evidence-based practice and proper administration of antibiotics to children, lack of family involvement may prevent adherence of proper administration of medications. 	
3	This is incorrect. Although this may help with adherence for the child, the trend is to incorporate the family unit in the child’s care. 	
4	This is incorrect. Although the trend in nursing is disease prevention, this would not be a feasible option, as overuse of antibiotics leads to resistance.	

PTS:	1	CON:	Health Promotion	

	13.	ANS:	1
Chapter: Chapter 1 Issues and Trends in Pediatric Nursing
Chapter Learning Objective: 7. Describe the roles of the pediatric nurse.
Page: 8
Heading: Trends in Pediatric Nursing Practice > Obesity
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Analysis [Analyzing]
Concept: Health Promotion
Difficulty: Moderate

	Feedback	
1	This is correct. Providing information on a reliable resource for both the child and family may facilitate adherence and comprehension. 	
2	This is incorrect. This may incorporate the child’s adherence in exercise due to peer pressure, but it would not facilitate adherence within the family unit. 	
3	This is incorrect. Current trends incorporate the child’s family in the plan of care for better adherence. There is no indication that the child would make healthy choices without the support of the family.	
4	This is incorrect. Giving information on the increased risk would only inform not educate on healthy choices for disease prevention, which is a current trend in pediatric nursing. 	

PTS:	1	CON:	Health Promotion	

	14.	ANS:	3
Chapter: Chapter 1 Issues and Trends in Pediatric Nursing
Chapter Learning Objective: 9. Identify current issues and trends in pediatric nursing practice, education, and research.
Page: 8
Heading: Trends in Pediatric Nursing Practice > Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) Youth
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Analysis [Analyzing]
Concept: Self
Difficulty: Moderate

	Feedback	
1	This is incorrect. Giving positive feedback may help at first, but this does not address the isolation statement. 	
2	This is incorrect. Although it is appropriate to provide gender-affirming care to the patient, it may not address the isolation statement. 	
3	This is correct. By locating support for both the patient and family, the patient may feel less isolated and develop coping skills from peers. 	
4	This is incorrect. This may be an appropriate intervention for a general diagnosis; it does not address the isolation statement. 	

PTS:	1	CON:	Self

	15.	ANS:	1
Chapter: Chapter 1 Issues and Trends in Pediatric Nursing
Chapter Learning Objective: 10. Identify evidence-based resources that are available for pediatric nurses.
Page: 9
Heading: Resources for Evidence-Based Pediatric Nursing Practice
Integrated Processes: Teaching and Learning
Client Need: Psychosocial Integrity
Cognitive Level: Analysis [Analyzing]
Concept: Evidence-Based Practice
Difficulty: Moderate

	Feedback	
1	This is correct. This may include evidence-based resources for special instances of Down’s syndrome.	
2	This is incorrect. This is a developmental issue, not a psychiatric diagnosis. 	
3	This is incorrect. This may provide insight on quality indicators on care; it is not the most appropriate resource for the special needs client. 	
4	This is incorrect. Although Down’s syndrome is often diagnosed early in life, this would not cover the issues for the growing child/adult. 	

PTS:	1	CON:	Evidence-Based Practice

MULTIPLE RESPONSE

	16.	ANS:	1, 2, 5
Chapter: Chapter 1 Issues and Trends in Pediatric Nursing
Chapter Learning Objective: 2. Describe the difference between nursing care of infants, children, and adolescents.
Page: 3
Heading: Introduction to Pediatric Nursing > Nursing Care for Children 
Integrated Processes: Nursing Process
Client Need: Health Promotion and Maintenance
Cognitive Level: Application [Applying]
Concept: Growth and Development
Difficulty: Moderate

	Feedback	
1.	This is correct. The pediatric nurse monitors growth and development, including physical maturation. 	
2. 	This is correct. The pediatric nurse monitors growth and development, including physical maturation.	
3. 	This is incorrect. This is an assessment that is not appropriate for an infant, as the infant would not be able to follow directions for this assessment. 	
4. 	This is incorrect. The Tanner scale is used to assess the onset of puberty. It is not an appropriate assessment for an infant.	
5.	This is correct. The pediatric nurse assessment includes listing of required immunizations in preparation for administering the appropriate ones. 	

PTS:	1	CON:	Growth and Development

	17.	ANS:	2, 3, 5
Chapter: Chapter 1 Issues and Trends in Pediatric Nursing
Chapter Learning Objective: 5. Identify models of care applied to pediatric nursing.
Page: 6
Heading: Role of the Pediatric Nurse
Integrated Processes: Teaching and Learning
Client Need: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Application [Applying]
Concept: Family 
Difficulty: Moderate

	Feedback	
1.	This is incorrect. This is not unique to pediatric nursing; this is a general nursing skill. 	
2. 	This is correct. The family-centered care model of pediatric nursing incorporates the family in the plan of care as the focal point of the child’s well-being. 	
3. 	This is correct. The family-centered care model of pediatric nursing incorporates the family in the plan of care as the focal point of the child’s well-being.	
4. 	This is incorrect. This would be a part of adult nursing practice, whereas the pediatric nurse model of care incorporates the family as part of the care of the pediatric nurse. 	
5	This is correct. The pediatric nurse must be mindful of the growth and development of the pediatric patient. 	

PTS:	1	CON:	Family 
	18.	ANS:	1, 2, 3, 5
Chapter: Chapter 1 Issues and Trends in Pediatric Nursing
Chapter Learning Objective: 2. Describe the differences between nursing care of infants, children, adolescents, and adults.
Pages: 7–8
Heading: Trends in Pediatric Nursing Practice 
Integrated Processes: Teaching and Learning
Client Need: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Analysis [Analyzing]
Concept: Health Promotion
Difficulty: Moderate

	Feedback	
1.	This is correct. There is a trend of bullying on the Internet that can influence a child’s overall health. 	
2. 	This is correct. Young children are able to use gross motor skills and some reasoning for proper hand washing.	
3. 	This is correct. This may empower the child to eat healthy items to prevent obesity and the associated disease processes.	
4. 	This is incorrect. Although there is a trend of a higher need of mental health services, small children may not be able to describe suicidal thoughts.	
5	This is correct. This may help facilitate a life skill that they may carry forward to prevent obesity and the disease processes associated with it. 	

PTS:	1	CON:	Health Promotion	

	19.	ANS:	1, 4
Chapter: Chapter 1 Issues and Trends in Pediatric Nursing
Chapter Learning Objective: 9. Identify current issues and trends in pediatric nursing practice, education, and research.
Page: 8
Heading: Trends in Pediatric Nursing Practice 
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment
Cognitive Level: Application [Applying]
Concept: Safety; Growth and Development
Difficulty: Moderate

	Feedback	
1.	This is correct. Inactivity increases the incidences of obesity.	
2. 	This is incorrect. Although this is a safety issue, it a behavioral issue, not a disease process.	
3. 	This is incorrect. Although inactivity may lead to distractive (bored) behavior, it is not a disease process.	
4. 	This is correct. Along with obesity, inactivity may increase the likelihood of diabetes mellitus.	
5.	This is incorrect. There is no correlation to inactivity and earlier onset of puberty.	

PTS:	1	CON:	Safety; Growth and Development

	20.	ANS:	1, 2, 5
Chapter: Chapter 1 Issues and Trends in Pediatric Nursing
Chapter Learning Objective: 9. Identify current issues and trends in pediatric nursing practice, education, and research.
Page: 8
Heading: Trends in Pediatric Nursing Practice
Integrated Processes: Communication and Documentation
Client Need: Health Promotion and Maintenance
Cognitive Level: Application [Applying]
Concept: Health Promotion
Difficulty: Moderate

	Feedback	
1.	This is correct. Trends in pediatric nursing practice have been affected by environmental risk factors. 	
2. 	This is correct. Language barriers directly affect adherence and understanding of the care. When the family-centered care model is used in pediatric nursing, if there is a deficit in communication, care can be negatively impacted. 	
3. 	This is incorrect. There is no correlation stated regarding social media and patient care.	
4. 	This is incorrect. Although this is a current trend in nursing, it does not affect the rationale for the patient’s speech impediment at this time. 	
5	This is correct. Deficit knowledge directly affects adherence and understanding of the care.	

PTS:	1	CON:	Health Promotion