Price: Pediatric Nursing, 11th Edition

Chapter 01: Child Health Evolution

Testbank

MULTIPLE CHOICE

	1.	Pediatrics as a medical specialty focuses on:
a.	Preventive medicine	
b.	Parental education	
c.	Treatment and care of children	
d.	Inoculations against communicable diseases	

ANS:	C
Pediatrics is a branch of medicine that deals specifically with children, their development, childhood diseases, and their treatment.

DIF:	Cognitive Level: Knowledge	REF:	p. 1	OBJ:	1
TOP:	Evolution of Child Health	KEY:	Nursing Process Step: N/A
MSC:	NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

	2.	Abraham Jacobi promoted the establishment of “milk stations” to provide:
a.	A source of sterile milk for children	
b.	Access to disease-free milk cows	
c.	Vitamin-rich supplements to be added to milk	
d.	A solution to add to milk to make it disease free	

ANS:	A
Abraham Jacobi is considered the “father of pediatrics.” He established milk stations where mothers could bring their children for treatment. The mothers were also taught the importance of pure milk and its preparation.

DIF:	Cognitive Level: Knowledge	REF:	p. 1	OBJ:	3
TOP:	Evolution of Child Health	KEY:	Nursing Process Step: N/A
MSC:	NCLEX: N/A		

	3.	The major outcome of the White House Conference of 1909 was the:
a.	Formulation of guidelines for child labor	
b.	Formation of the Children’s Bureau	
c.	Founding of the free lunch program for needy schoolchildren	
d.	Recommendation of an inoculation schedule for children	

ANS:	B
The White House Conference of 1909 recommended the formation of the Children’s Bureau.

DIF:	Cognitive Level: Comprehension	REF:	p. 3	OBJ:	2
TOP:	Children’s Bureau		KEY:	Nursing Process Step: N/A
MSC:	NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

	4.	The school nurse is aware that the program that provides meals to schoolchildren is:
a.	The Supplemental Food Program for Women, Infants, and Children (WIC)	
b.	The Children and Youth Project from Medicaid	
c.	The Child Nutrition Act of 1966	
d.	Social Security	

ANS:	C
The Child Nutrition Act of 1966 provides meals free or at a reduced rate for low-income children.

DIF:	Cognitive Level: Analysis	REF:	p. 2	OBJ:	2
TOP:	The Child Nutrition Act of 1966	KEY:	Nursing Process Step: Planning
MSC:	NCLEX: Health Promotion and Maintenance: Growth and Development

	5.	The home health nurse instructs a young single mother that the Supplemental Food Program for Women, Infants, and Children (WIC) provides nutritious foods for children up to:
a.	5 years of age	
b.	7 years of age	
c.	8 years of age	
d.	9 years of age	

ANS:	A
WIC offers supplemental nutritious foods to qualified clients for children up to 5 years of age.

DIF:	Cognitive Level: Application	REF:	p. 2	OBJ:	2
TOP:	Supplemental Food Program	KEY:	Nursing Process Step: Implementation
MSC:	NCLEX: Health Promotion and Maintenance: Growth and Development

	6.	The nurse explains that the statistics of infant mortality are expressed in number of infant deaths per:
a.	100 live births	
b.	1000 live births	
c.	10,000 live births	
d.	100,000 live births	

ANS:	B
Infant mortality statistics are expressed in number of infant deaths per 1000 live births.

DIF:	Cognitive Level: Comprehension	REF:	p. 2	OBJ:	3
TOP:	Infant Mortality		KEY:	Nursing Process Step: Implementation
MSC:	NCLEX: Health Promotion and Maintenance: Growth and Development

	7.	A frustrated mother tells the school nurse that her income is too high to qualify for Medicaid and too low to afford private health insurance. The nurse suggests that she may be eligible for:
a.	An HMO	
b.	The Health Insurance Portability and Accountability Act (HIPAA)	
c.	WIC	
d.	The State Children’s Health Insurance Program	

ANS:	D
The State Children’s Health Insurance Program has expanded coverage to many uninsured children who are ineligible for Medicaid. The Division of Maternal and Child Health does not provide insurance. HIPAA protects privacy. WIC is a supplemental food program.

DIF:	Cognitive Level: Application	REF:	p. 2	OBJ:	2
TOP:	State Children’s Health Insurance Program		
KEY:	Nursing Process Step: Implementation		
MSC:	NCLEX: Safe, Effective Care Environment: Coordinated Care	

	8.	The nurse is aware that the prevalence of chronic health conditions in children is:
a.	Decreasing as a result of advances in health care and treatment	
b.	Increasing as a result of advances in health care and treatment	
c.	Increasing as a result of decreased incidence of childhood injury	
d.	Decreasing as a result of decreased incidence of childhood injury	

ANS:	B
The prevalence of chronic health conditions in children is increasing as a result of advanced health care and treatment. The increased number of surviving premature infants has increased the number of children with chronic conditions. The number of children who survive childhood injury has increased, leading to increased numbers of disabled children.

DIF:	Cognitive Level: Comprehension	REF:	p. 4	OBJ:	3
TOP:	Changes in Mortality and Morbidity			
KEY:	Nursing Process Step: Planning	
MSC:	NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

	9.	Infant mortality in the United States is highest among:
a.	Eastern European-American mothers	
b.	Asian mothers	
c.	African-American mothers	
d.	Italian-American mothers	

ANS:	C
Infant mortality in the United States is highest among non-Hispanic African-American mothers. The United States does not have the lowest infant mortality rate in the world. The United States does not have a national insurance program. Infant mortality is related to maternal complications.

DIF:	Cognitive Level: Comprehension	REF:	p. 2	OBJ:	3
TOP:	Changes in Mortality and Morbidity			
KEY:	Nursing Process Step: N/A	
MSC:	NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

	10.	The nurse takes into consideration that the primary cause of infant mortality according to Healthy People 2010 statistics is:
a.	Congenital deformities	
b.	Low birth weight	
c.	Sudden infant death syndrome	
d.	Systemic infection	

ANS:	A
According to a Healthy People 2010 study, the leading cause of infant mortality is congenital malformations.

DIF:	Cognitive Level: Comprehension	REF:	p. 2	OBJ:	5
TOP:	Emergency Preparedness	KEY:	Nursing Process Step: Planning
MSC:	NCLEX: Health Promotion and Maintenance: Growth and Development

	11.	Nursing care of children focuses on improving a child’s quality of care by:
a.	Providing an environment for optimal growth and development	
b.	Focusing on curing childhood illnesses	
c.	Addressing problems caused by communicable disease	
d.	Improving sanitation	

ANS:	A
Pediatric nursing is now focused on providing an environment for optimal growth and development. Sanitation has improved. Communicable diseases and other illnesses have mostly been eradicated or controlled by immunizations, prenatal care, and antibiotics.

DIF:	Cognitive Level: Comprehension	REF:	p. 1	OBJ:	4
TOP:	Evolution of Child Care	KEY:	Nursing Process Step: N/A
MSC:	NCLEX: Health Promotion and Maintenance: Prevention and Detection of Disease

	12.	The nurse cautions a group of parents that the leading cause of childhood mortality is:
a.	Chronic disease	
b.	Homicide	
c.	Suicide	
d.	Accidents	

ANS:	D
Childhood mortality has declined, but the leading cause of death in children is from unintentional injuries, usually motor vehicle accidents.

DIF:	Cognitive Level: Comprehension	REF:	p. 2	OBJ:	3
TOP:	Childhood Mortality		KEY:	Nursing Process Step: Implementation
MSC:	NCLEX: Safe, Effective Care Environment: Safety and Infection Control

	13.	The home health nurse practices anticipatory guidance for a family with a 12-month-old child by giving information and brochures about:
a.	Methods to decrease teething discomfort	
b.	Methods to introduce solid food	
c.	Advantages of breastfeeding	
d.	Accident-proofing their home	

ANS:	D
Accident-proofing the home is to lessen the possibility of accidents to the child who is beginning to ambulate independently. Covering electrical outlets, installing childproof catches on low cabinets, and padding sharp furniture edges can help avoid accidents. All other options are not timely for this family.

DIF:	Cognitive Level: Application	REF:	p. 5	OBJ:	1
TOP:	Anticipatory Guidance	KEY:	Nursing Process Step: Implementation
MSC:	NCLEX: Safe, Effective Care Environment: Safety and Infection Control

	14.	The nurse planning care is aware that the primary focus of the nursing process is the:
a.	Physical disorder and its remedy	
b.	Nurse and patient relationship	
c.	Child and family	
d.	Information and support	

ANS:	C
The focus of the nursing process is that of the child and family.

DIF:	Cognitive Level: Application	REF:	p. 5	OBJ:	6
TOP:	Nursing Process		KEY:	Nursing Process Step: Planning
MSC:	NCLEX: Safe, Effective Care Environment: Coordinated Care	

	15.	The documentation relative to a patient problem that is correct and includes all necessary legal requirements is:
a.	10:00 AM Dr. Jones notified of one-inch circular red macular rash on patient’s left cheek. Area is inflamed, and patient complains of itching. Left order for calamine lotion BID. 	
b.	MD called R/T to rash on left cheek. Left orders.	
c.	10 Dr. Jones L/O for calamine lotion for rash on cheek.	
d.	10:00 AM Dr Jones notified of one-inch circular red macular rash on patient’s left cheek. Area is inflamed, and patient complains of itching. Left orders.	

ANS:	A
The legal requirements for documentation include the time, person notified, a description of the complaint, the result of the call, and signature.

DIF:	Cognitive Level: Analysis	REF:	pp. 5-6	OBJ:	8
TOP:	Documentation		KEY:	Nursing Process Step: Implementation
MSC:	NCLEX: Safe, Effective Care Environment: Coordinated Care	

	16.	Which action upholds a patient’s right to privacy and is not in conflict with the Health Insurance Portability and Accountability Act (HIPAA)?
a.	Informing the oncoming shift that a new patient is depressed about her divorce	
b.	Giving a treatment progress to the daughter-in-law of a patient	
c.	Telling a nurse from another floor that a patient is taking medication for AIDS	
d.	Telling the patient in an adjoining room that another patient is going to surgery for a face lift	

ANS:	A
Medical information can be shared with oncoming shifts or persons who will be caring for the patient, but it cannot be shared with others without the patient’s consent.

DIF:	Cognitive Level: Analysis	REF:	p. 6	OBJ:	7
TOP:	Cultural and Religious Considerations		
KEY:	Nursing Process Step: Implementation		
MSC:	NCLEX: Psychosocial and Physiological Integrity

	17.	The nurse takes into consideration as she counsels with the parents of a child with cerebral palsy that the Crippled Children’s Service offers assistance to disabled children up to:
a.	7 years of age	
b.	10 years of age	
c.	15 years of age	
d.	21 years of age	

ANS:	D
The Crippled Children’s Service offers support and services to disabled children up to 21 years of age.

DIF:	Cognitive Level: Comprehension	REF:	p. 3	OBJ:	2
TOP:	Crippled Children’s’ Service	KEY:	Nursing Process Step: Planning
MSC:	NCLEX: Safe, Effective Care Environment: Coordinated Care	

	18.	The nurse assures the adolescent male patient that anything he says will be held in confidence unless the information pertains to his:
a.	Sexual preference	
b.	Use of marijuana	
c.	Dislike of his physician	
d.	Fear of upcoming surgery	

ANS:	B
All patients, but especially adolescents, need to be assured that their information will be held in confidence and not divulged without consent. Exceptions to the confidentiality rule are drug or alcohol abuse, or plans to harm themselves or others.

DIF:	Cognitive Level: Application	REF:	p. 6	OBJ:	5
TOP:	Confidentiality		KEY:	Nursing Process Step: Implementation
MSC:	NCLEX: Safe, Effective Care Environment: Coordinated Care	

COMPLETION

	1.	Nurses can examine research literature, analyze important evidence, and improve the quality of patient care by applying the philosophy of ___________.

ANS:	
Evidence-based practice
The examination of current research can base their care on evidence.

DIF:	Cognitive Level: Knowledge	REF:	p. 5	OBJ:	1
TOP:	Current Practice		KEY:	Nursing Process Step: Planning
MSC:	NCLEX: Safe, Effective Care Environment: Coordinated Care	

	2.	In 1938, the Fair Labor Standards Act established the minimum working age to be ___________ years of age.

ANS:	
Sixteen 
In 1938, the Fair Labor Standards Act established the minimum working age to be sixteen years of age.

DIF:	Cognitive Level: Comprehension	REF:	p. 3	OBJ:	2
TOP:	Fair Labor Standards Act	KEY:	Nursing Process Step: N/A
MSC:	NCLEX: Safe, Effective Care Environment: Safety and Infection Control

	3.	The nurse is aware that the law that calls for the protection of privacy of a patient’s health records is the ___________.

ANS:	
Health Insurance Portability and Accountability Act (HIPAA)
This law, developed by the U.S. Department of Health and Human Services, calls for the protection and privacy of a person’s health/medical information.

DIF:	Cognitive Level: Comprehension	REF:	p. 3	OBJ:	4
TOP:	Health Insurance Portability and Accountability Act ( HIPAA)	
KEY:	Nursing Process Step: Planning	
MSC:	NCLEX: Safe, Effective Care Environment: Coordinated Care	

	4.	In order to establish standardized language and diagnostic categories, an approved list of nursing diagnoses is maintained by ___________.

ANS:	
the North American Nursing Diagnosis Association (NANDA)
NANDA maintains, updates, and publishes approved lists of nursing diagnoses for use in nursing care plans.

DIF:	Cognitive Level: Comprehension	REF:	p. 5	OBJ:	6
TOP:	North American Nursing Diagnosis Association (NANDA)	
KEY:	Nursing Process Step: N/A	MSC:	NCLEX: N/A		

	5.	The nurse is aware that the informed consent form for a 16-year-old who is going to have a surgical procedure should be signed by the ___________.

ANS:	
Parent
Consent forms for children younger than 18 years of age are signed by the parent after the physician has explained the procedure and the possible adverse effects. The signature is witnessed by the nurse. It is the nurse’s responsibility to see that the form is signed prior to the procedure.

DIF:	Cognitive Level: Comprehension	REF:	p. 6	OBJ:	8
TOP:	Signed Consent		KEY:	Nursing Process Step: Planning
MSC:	NCLEX: Safe, Effective Care Environment: Coordinated Care	

MULTIPLE RESPONSE

	1.	Factors that contribute to childhood morbidity are: (Select all that apply.)
a.	General health	
b.	Ethnicity	
c.	Psychosocial factors	
d.	Daycare	
e.	Climate	

ANS:	A, C, D
Factors that contribute to childhood morbidity are general health, socioeconomic status, access to health care, psychosocial factors, and regular attendance at daycare facilities.

DIF:	Cognitive Level: Knowledge	REF:	p. 4	OBJ:	3
TOP:	Changes in Mortality and Morbidity			
KEY:	Nursing Process Step: Assessment	
MSC:	NCLEX: Health Promotion and Maintenance: Early Prevention and Detection of Disease

	2.	Objectives of Healthy People 2010 include: (Select all that apply.)
a.	Promotion of healthy behaviors	
b.	Early sexual education	
c.	Promotion of healthy and safe communities	
d.	Promotion of oral health and reduction of tooth decay	
e.	Improvement of systems for personal and public health	

ANS:	A, C, E
The objectives of Healthy People 2010 include promotion of healthy behaviors, promotion of healthy and safe communities, improvement of systems for personal and public health, and prevention and reduction of diseases and disorders.

DIF:	Cognitive Level: Knowledge	REF:	p. 2	OBJ:	2
TOP:	Health Promotion		KEY:	Nursing Process Step: Implementation
MSC:	NCLEX: Health Promotion and Maintenance: Early Prevention and Detection of Disease

	3.	The nurse clarifies that the concept of holistic care approach considers: (Select all that apply.)
a.	Physical	
b.	Artistic	
c.	Spiritual	
d.	Intellectual	
e.	Financial	

ANS:	A, C, D
The basic needs addressed in the holistic approach are the physical, emotional, spiritual, and intellectual.

DIF:	Cognitive Level: Comprehension	REF:	p. 1	OBJ:	4
TOP:	Holistic Approach		KEY:	Nursing Process Step: Planning
MSC:	NCLEX: Safe, Effective Care Environment: Coordinated Care	

	4.	During the twentieth century, child mortality was greatly reduced by: (Select all that apply.)
a.	Improved nutrition	
b.	Availability of immunizations	
c.	Advent of antibiotics	
d.	Government housing	
e.	Improved sanitation	

ANS:	B, C, E
Improved sanitation, the advent of antibiotics, the institution of preventive measures such as immunization, and improved sanitation have decreased child mortality.

DIF:	Cognitive Level: Application	REF:	p. 1	OBJ:	3
TOP:	Child Mortality		KEY:	Nursing Process Step: N/A
MSC:	NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

	5.	The nurse counsels a family that causes of emotional and behavioral problems in children can be caused by or are the result of: (Select all that apply.)
a.	School failure	
b.	Nutritional disorders	
c.	Poverty	
d.	Risky sexual behavior	
e.	Religious conflicts	

ANS:	A, D
There is a concern about children who have severe emotional and behavioral problems related to school failure, violence, substance abuse, and risky sexual behavior.

DIF:	Cognitive Level: Comprehension	REF:	p. 4	OBJ:	4
TOP:	Emotional and Behavioral Problems			
KEY:	Nursing Process Step: Assessment	
MSC:	NCLEX: Psychosocial Integrity: Coping and Adaptation

	6.	The nurse explains that use of the Nursing Outcomes Classification (NOC) and Nursing Interventions Classification (NIC) provides the advantages of: (Select all that apply.)
a.	Improved data collection	
b.	Standardized nursing language	
c.	Reduced need to assess	
d.	Clarified prioritizing	
e.	Support to nursing research	

ANS:	A, B, D, E
The use of the NOC and NIC improves data collection and uses standardized nursing language, which is an aid to better prioritizing of patient needs. The use of the standardized language is a support to nursing research. These classifications do not reduce the need for accurate assessments.

DIF:	Cognitive Level: Application	REF:	p. 5	OBJ:	6
TOP:	NOC and NIC			KEY:	Nursing Process Step: Implementation
MSC:	NCLEX: Safe, Effective Care Environment: Coordinated Care	

	7.	The nurse is aware that emancipated minors and those who qualify under the mature minor doctrine may sign consents for their own medical treatment without parent approval. Persons not needing parent approval for medical care would be: (Select all that apply.)
a.	a 14-year-old girl married to a 16-year-old boy	
b.	a 17-year-old serving in the U.S. Navy	
c.	a 17-year-old college freshman living in a school dormitory	
d.	a 17-year-old seeking medical care for a sexually transmitted disease	
e.	a 15-year-old seeking an abortion	

ANS:	A, B, D
Married persons or persons serving in the military are considered emancipated minors automatically. Persons seeking care for sexually transmitted disease, pregnancies, contraception, and drug use qualify under the mature minor doctrine. Requests for abortions need the notification of at least one parent.

DIF:	Cognitive Level: Analysis	REF:	p. 5	OBJ:	8
TOP:	Emancipated Minor		KEY:	Nursing Process Step: Planning
MSC:	NCLEX: Safe, Effective Care Environment: Coordinated Care	

OTHER

	1.	Place the steps of the nursing process in the correct order (Separate letters by a comma and space as follows: A, B, C, D.): 
a. Evaluation
b. Assessment
c. Diagnosis
d. Planning
e. Implementation/intervention

ANS:	
B, C, D, E, A
The sequential steps of the nursing process are: assessment, diagnosis, planning, implementation /intervention, and evaluation.

DIF:	Cognitive Level: Knowledge	REF:	p. 6	OBJ:	6
TOP:	Nursing Process		KEY:	Nursing Process Step: N/A
MSC:	NCLEX: N/A