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Pediatric Nursing An Introductory Text 10th Edition By Price – Test Bank
 
Sample  Questions

 

Price: Pediatric Nursing, 10th Edition

 

Test Bank

 

Chapter 1: Child Health Evolution

 

MULTIPLE CHOICE

 

  1. In the Middle Ages:
a. Adolescence emerged as a separate phase of life
b. A child was considered an adult by age 7
c. Childhood became a separate phase of life
d. The average life span was about 40 years

 

 

ANS:   B

A child was considered an adult by age 7. The average life span was only 30 years. Childhood became a separate phase of life after the work of Erickson and Piaget. Adolescence did not emerge as a separate phase of life until child labor laws were passed.

 

DIF:    Cognitive Level: Knowledge             REF:    Page 1             OBJ:    2

TOP:    Evolution of Child Health                 KEY:   Nursing Process Step: N/A

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. Mothers were taught the importance of pure milk and its preparation by:
a. Abraham Jacobi
b. Lillian Wald
c. Jean Piaget
d. Florence Kelley

 

 

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:    Page 1             OBJ:    2

TOP:    Evolution of Child Health                 KEY:   Nursing Process Step: N/A

MSC:   NCLEX: N/A

 

  1. The establishment of the Medicare system of payment for hospital stays:
a. Had no impact on children’s health
b. Led to shorter hospital stays for acutely ill children
c. Decreased the need for discharge teaching
d. Eliminated the need for home health care

 

 

ANS:   B

The Medicare system of payment had an enormous impact on the rest of the insurance industry. Other insurance companies developed prospective payments plans of their own. The need for discharge teaching and home health care increased as a result of shorter hospital stays.

 

DIF:    Cognitive Level: Comprehension       REF:    Page 4             OBJ:    4

TOP:    Healthcare Today                               KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Safe and Effective Care Environment: Coordinated Care

 

  1. Mrs. Lee, a Chinese American woman, brought her 5-year-old daughter to the clinic following a minor injury to the child’s leg. She talked freely with the female nurse while the nurse completed the health history and assessed vital signs. The nurse left the room to care for other patients. The physician, a male, examined the child with the mother present. He noticed that Mrs. Lee was uncommunicative and would not maintain eye contact. The nurse understands that Mrs. Lee’s response to the physician was related to the fact that:
a. Mrs. Lee did not understand the physician
b. Mrs. Lee injured her child and is afraid she will be reported to the authorities
c. Mrs. Lee is uncomfortable with male health care workers because of her culture
d. Mrs. Lee plans to see a traditional healer after consulting with the physician

 

 

ANS:   C

Mrs. Lee talked freely with the nurse during the assessment. There is insufficient information to suspect abuse. Chinese American clients may consider eye contact impolite. Chinese American women may be very uncomfortable about being examined by a male health care worker. Traditional Chinese healers are usually sought before seeking Western medicine.

 

DIF:    Cognitive Level: Analysis                  REF:    Page 7             OBJ:    7

TOP:    Cultural Considerations                     KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Psychosocial Integrity

 

  1. Your pediatric patient is about to be discharged home. The child will be taking prescription medications on a regular basis. The parent uses herbal supplements and wishes to administer these to the child. You explain to the parent that herbal supplements:
a. Do not provide any benefit to the patient and are harmless
b. Can cause serious interactions with some prescription medications
c. Can be administered in excess of the recommended dosage
d. Are ineffective and are only used by the uninformed

 

 

ANS:   B

Herbal supplements can provide benefit but should never be considered harmless. Herbals have been documented to cause significant and harmful side effects with prescription drugs. Exceeding dosage is not recommended. Herbal supplements have been proven effective for some ailments and may be used in cultural rituals that are meaningful to the client.

 

DIF:    Cognitive Level: Application             REF:    Pages 8-9        OBJ:    7

TOP:    Complementary and Alternative Medicine

KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. Complementary medicine is:
a. Only used when all other measures have been exhausted
b. Reimbursed by most insurance companies
c. Used in place of traditional medicine
d. Advocated by many cultural beliefs

 

 

ANS:   D

Complementary medicine is used with traditional or conventional therapy. It is not considered a last resort. It is not reimbursed by most insurance companies. Many cultural beliefs promote the use of complementary therapy.

 

DIF:    Cognitive Level: Comprehension       REF:    Page 8             OBJ:    7

TOP:    Complementary and Alternative Medicine

KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. A mother inquires about health insurance while visiting your clinic. She states that her income is too high for her to be eligible for Medicare, but too low to afford health insurance. You explain that she may be eligible to receive assistance from the:
a. The Division of Maternal and Child Health
b. The Health Insurance Portability and Accountability Act
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 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:    Page 2             OBJ:    2

TOP:    Government Programs                       KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Safe and Effective Care Environment: Coordinated Care

 

  1. 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 the improved survival of premature infants
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 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:    Page 3             OBJ:    3

TOP:    Changes in Mortality and Morbidity

KEY:   Nursing Process Step: Planning

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. Infant mortality in the United States is:
a. The lowest in the world
b. Improved because the United States has a national health insurance program
c. Highest among non-Hispanic, African-American mothers
d. Not related to maternal complications

 

 

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:    Page 2             OBJ:    3

TOP:    Changes in Mortality and Morbidity

KEY:   Nursing Process Step: N/A

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. In a terrorist attack, the most likely candidate for a bacterial agent release is:
a. Ricin
b. Sarin
c. Anthrax
d. Smallpox

 

 

ANS:   C

Anthrax is the most likely bacterial agent. Ricin is a toxin, sarin is a chemical agent, and smallpox is viral.

 

DIF:    Cognitive Level: Comprehension       REF:    Pages 5-6        OBJ:    5

TOP:    Emergency Preparedness                   KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Safety and Infection Control

 

  1. Nursing care of children focuses on improving 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:    Page 1             OBJ:    4

TOP:    Evolution of Child Care                     KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Safety and Infection Control

 

  1. Emergency preparedness training:
a. Is not carried out by nurses
b. Is not necessary in today’s society
c. Is necessary because of the threat of war, terrorism, or disaster
d. Is considered traumatic for children

 

 

ANS:   C

Emergency preparedness training is carried out by nurses. It is necessary in today’s society, due to the increased occurrence of severe weather events, heightened terrorism threats, and war. Preparing children for emergencies helps lessen the traumatic effect of the event.

 

DIF:    Cognitive Level: Comprehension       REF:    Pages 4-5        OBJ:    5

TOP:    Emergency Preparedness                   KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Safety and Infection Control

 

  1. A family that is caring for a disabled child at home often needs help accessing a network of services. This need is best met by a:
a. Pediatric nurse practitioner
b. Case manager
c. School nurse
d. Hospice counselor

 

 

ANS:   A

The case manager oversees a continuum of care for patients and helps them to access and coordinate needed services.

 

DIF:    Cognitive Level: Application             REF:    Page 10           OBJ:    6

TOP:    Health Care Delivery Settings           KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Psychosocial Integrity

 

  1. A child has been diagnosed with a terminal illness. The child will need additional services and support after the discharge. Which health care delivery setting will provide the child with the most appropriate services?
a. Home health care
b. Hospice
c. Parish nursing
d. Clinic

 

 

ANS:   B

Home care focuses on delivering care to restore the child. Hospice provides care for the dying child. Parish nursing focuses on health promotion and may be able to provide the parents with support following the death of the child. The clinic setting provides preventive and curative care for the child.

 

DIF:    Cognitive Level: Application             REF:    Pages 9-10      OBJ:    8

TOP:    Health Care Delivery Settings           KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Psychosocial and Physiological Integrity

 

  1. Today a child in your clinic has been diagnosed with asthma. The parents tell you that the child was planning on attending summer camp. The parents do not want to send their child to camp while he is learning to control the asthma. You tell the parents that:
a. The child cannot attend camp until his asthma is controlled
b. A home care nurse can visit the child at camp
c. There are organized camps for children with asthma
d. They will have to arrange for a private duty nurse to see him at camp

 

 

ANS:   C

Camps for children with asthma are available. The camps are staffed with nurses and other health care professionals that can care for and monitor the child while at camp. Home care nurses do not routinely see clients at camps. A private duty nurse would not be necessary at an asthma camp.

 

DIF:    Cognitive Level: Application             REF:    Page 11           OBJ:    8

TOP:    Health Care Delivery Settings           KEY:   Nursing Process Step: Planning

MSC:   NCLEX: Safety and Infection Control

 

  1. A clinic nurse in an immigrant community has observed that some children have small burned areas on their skin. One child has a burn that has become infected. On exploration, the nurse learns that the burns are applied as a folk remedy for temper tantrums. What is the nurse’s most appropriate initial response?
a. Tell the parents that this type of treatment is ignorant
b. Ask the family if the treatment has been effective
c. Report the family to Child Protective Services
d. Explain the legal consequences of this behavior

 

 

ANS:   D

The parents are using a remedy that has been acceptable in their culture. The nurse must show respect for their culture, but still help the parents to understand that the remedy is not acceptable in this country and could have legal consequences. The next step would be to discuss other options for managing children’s temper tantrums.

 

DIF:    Cognitive Level: Analysis                  REF:    Page 7             OBJ:    7

TOP:    Cultural and Religious Considerations

KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Psychosocial and Physiological Integrity

 

  1. Which of the following regulates working conditions for children under age 18?
a. Children’s Charter
b. Medicaid and Youth Project
c. Children’s Health Insurance Program
d. Fair Labor Standards Act

 

 

ANS:   D

The Fair Labor Standards Act regulates working conditions for children under age 18. It is the only option that specifically addresses employment.

 

DIF:    Cognitive Level: Comprehension       REF:    Page 1             OBJ:    2

TOP:    Evolution of Child Health                 KEY:   Nursing Process Step: N/A

MSC:   NCLEX: Safe and Effective Care Environment

 

  1. The nurse is caring for a patient from a culture not common to the local area. The family demonstrates practices that seem unusual to the nurse and other staff. The appropriate way the nurse can interact with the patient and family is to:
a. Be respectful and open-minded when discussing beliefs
b. Explain that the child must be cared for in ways that differ from their practices
c. Insist that the family changes their beliefs
d. Speak to the family in the language used most commonly by the staff, so that the family can learn the language.

 

 

ANS:   A

Families and patients of any culture should be shown respect regardless of how unusual their practices may seem. The nurse should care for the child is ways that do not interfere with the family’s own beliefs. Patient and family beliefs can seldom be changed. The nurse should discover what language the family speaks most frequently.

 

DIF:    Cognitive Level: Comprehension       REF:    Page 6             OBJ:    7

TOP:    Changes in Mortality and Morbidity

KEY:   Nursing Process Step: Assessment     MSC:   NCLEX: Safety and Infection Control

 

  1. Nurses in a pediatric practice can prepare families for emergencies by:
a. Teaching parents CPR
b. Instructing parents to have a list of emergency phone numbers
c. Instructing parents to have an out-of-state point of contact
d. All of the above

 

 

ANS:   D

All of these interventions will help parents be prepared for emergencies.

 

DIF:    Cognitive Level: Application             REF:    Page 5             OBJ:    5

TOP:    Emergency Preparedness                   KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Safety and Infection Control

 

  1. The nurse in a pediatric clinic notices that a child in the waiting area has begun to experience shortness of breath. The nurse brings him back for immediate attention. The nurse was performing which of the following roles:
a. Anticipatory guidance
b. Triage
c. Case management
d. Evidence-based practice

 

 

ANS:   B

Anticipatory guidance and case management are other roles. Evidence-based practice is a philosophy.

 

DIF:    Cognitive Level: Application             REF:    Page 9             OBJ:    6

TOP:    Health Care Delivery Settings           KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Physiological Integrity

 

MATCHING

 

Match the following maternal-child health programs with their purposes:

a. Social Security
b. Children and Youth Project
c. State Children’s Health Insurance Program
d. Comprehensive Child Immunization Act
e. National School Lunch Act and Child Nutrition Act

 

 

  1. Provides health care coverage for children in families that earn too much for Medicaid but cannot afford private insurance

 

  1. Targets low-income children and children in areas with poor access to health care

 

  1. Provides free or reduced meals to low-income families

 

  1. Provides state and federal funds for maternal-child care and for children with disabilities

 

  1. Ensures that children in the United States are protected against vaccine-preventable diseases at the earliest age possible

 

  1. ANS:   C                     DIF:    Cognitive Level: Knowledge             REF:    Page 3

OBJ:    2                      TOP:    Changes in Mortality and Morbidity

KEY:   Nursing Process Step: Planning         MSC:   NCLEX: Safety and Infection Control

 

  1. ANS:   B                     DIF:    Cognitive Level: Knowledge             REF:    Page 3

OBJ:    2                      TOP:    Changes in Mortality and Morbidity

KEY:   Nursing Process Step: Planning         MSC:   NCLEX: Safety and Infection Control

 

  1. ANS:   E                     DIF:    Cognitive Level: Knowledge             REF:    Page 3

OBJ:    2                      TOP:    Changes in Mortality and Morbidity

KEY:   Nursing Process Step: Planning         MSC:   NCLEX: Safety and Infection Control

 

  1. ANS:   A                     DIF:    Cognitive Level: Knowledge             REF:    Page 3

OBJ:    2                      TOP:    Changes in Mortality and Morbidity

KEY:   Nursing Process Step: Planning         MSC:   NCLEX: Safety and Infection Control

 

  1. ANS:   D                     DIF:    Cognitive Level: Knowledge             REF:    Page 3

OBJ:    2                      TOP:    Changes in Mortality and Morbidity

KEY:   Nursing Process Step: Planning         MSC:   NCLEX: Safety and Infection Control

 

SHORT ANSWER

 

  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

 

DIF:    Cognitive Level: Knowledge             REF:    Page 6             OBJ:    1

TOP:    Current Practice                                 KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Safe and Effective Care Environment: Coordinated Care

 

  1. List three causes of emotional and behavioral problems in children.

 

ANS:

School failure

Violence

Substance abuse

Risky sexual behavior

 

DIF:    Cognitive Level: Comprehension       REF:    Page 3             OBJ:    3

TOP:    Changes in Mortality and Morbidity

KEY:   Nursing Process Step: Assessment     MSC:   NCLEX: Psychosocial Integrity

 

  1. List three factors that contribute to childhood morbidity.

 

ANS:

General health

Socioeconomic Status

Access to health care

Psychosocial factors

Homelessness

Poverty

Daycare

 

DIF:    Cognitive Level: Knowledge             REF:    Page 3             OBJ:    3

TOP:    Changes in Mortality and Morbidity

KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. List three of the Healthy People 2010 objectives.

 

ANS:

Promotion of health behaviors

Promotion of healthy and safe communities

Improvement of systems for personal and public health

Prevention and reduction of diseases and disorders

 

DIF:    Cognitive Level: Knowledge             REF:    Page 4             OBJ:    4

TOP:    Health Promotion                               KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Health Promotion and Maintenance

Price: Pediatric Nursing, 10th Edition

 

Test Bank

 

Chapter 3: Care of the Hospitalized Child

 

MULTIPLE CHOICE

 

  1. Kaylee is 6 years old. She will require hospitalization for correction of a bowel obstruction. She could be hospitalized in a(n):
a. Pediatric hospital
b. A general hospital that admits children
c. The pediatric unit of a general hospital
d. All of the above

 

 

ANS:   D

A child could be admitted to any of these settings.

 

DIF:    Cognitive Level: Application             REF:    Page 23           OBJ:    2

TOP:    The Hospital Setting                          KEY:   Nursing Process Step: N/A

MSC:   NCLEX: Safe and Effective Care Environment

 

  1. Kaylee has a favorite shirt she would like to wear. Your understanding of the hospital setting helps you understand that:
a. Wearing her own clothes will make her feel more comfortable
b. Wearing her own clothes will present an infection control problem
c. Wearing her own clothes will make caring for the child more difficult
d. Wearing her own clothes will not be permitted

 

 

ANS:   A

Allowing the child to wear her own clothes helps to bridge the gap between home and hospital. Wearing clothes from home should not pose an infection control problem. The nurse can assess the clothing and determine if this is a risk.

 

DIF:    Cognitive Level: Application             REF:    Page 23           OBJ:    3

TOP:    The Hospital Setting                          KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Psychosocial Integrity

 

  1. Kaylee has had her surgery and needs to have a dressing change. You expect that this procedure may be both painful and frightening to the child. This procedure should be performed:
a. In the patient’s room, because the surroundings are familiar
b. In the treatment room, so she will associate positive feelings with her patient room
c. In the playroom, so she will be distracted by the other children playing
d. None of the above

 

 

ANS:   B

Painful and frightening procedures are accomplished in the treatment room. The child needs to feel safe and secure in the patient room. Performing the procedure in front of other children is inappropriate.

 

DIF:    Cognitive Level: Synthesis                REF:    Page 23           OBJ:    2

TOP:    The Hospital Setting                          KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Safe and Effective Care Environment

 

  1. Playrooms are included in most pediatric departments. The purpose of the playroom is:
a. To provide a safe place for the children to go when the nurses take a break
b. To provide an incentive for patients to choose this hospital
c. To provide play therapy, which will alleviate some of the stress the child is experiencing
d. To determine if the child is well enough for discharge

 

 

ANS:   C

Playrooms provide a place for children to play. Many units include a play therapist.

 

DIF:    Cognitive Level: Knowledge             REF:    Page 23           OBJ:    2

TOP:    The Hospital Setting                          KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Safe and Effective Care Environment

 

  1. A 2-year-old patient is on a pediatric unit. The child’s mother leaves the unit for a few hours. When the child realizes the mother is gone, the child protests loudly, watches the door, and then resumes crying. The child is in which of the following stages of separation:
a. Despair
b. Denial
c. Protest
d. Depression

 

 

ANS:   C

The child is in the protest stage. Depression is not a stage of separation.

 

DIF:    Cognitive Level: Application             REF:    Page 24           OBJ:    4

TOP:    The Child’s Reaction to Hospitalization

KEY:   Nursing Process Step: Assessment     MSC:   NCLEX: Psychosocial Integrity

 

  1. Matthew is 7 years old. He is scheduled to have surgery next week. The nurses on the unit offer to give Matthew and his parents a tour of the unit. This is:
a. Correct, because it will allow the parents to meet the people that will be taking care of their child
b. Incorrect, because it will overwhelm and frighten the child
c. Incorrect, because it will be an infection control risk
d. Correct, because the parents will not be allowed to stay with the child

 

 

ANS:   A

A prehospitalization tour or class will help to alleviate the anxiety of the parent and the child. The child will have his parents with him during the tour. It will not be an infection control risk. The parents will be encouraged to stay with the child.

 

DIF:    Cognitive Level: Analysis                  REF:    Page 28           OBJ:    5

TOP:    The Family’s Reaction to Hospitalization

KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Psychosocial Integrity

 

  1. A new patient has been admitted to the pediatric unit. The nurse is about to meet the patient and his family. The nurse:
a. Towers over the child to show she is in charge
b. Shows warmth and friendliness to the child and family
c. Should be detached and very formal
d. Hurries through the interview to lessen the stress on the child

 

 

ANS:   B

The nurse will greet the child at eye level. Towering over the child is frightening. The nurse should be warm and friendly. The nurse should be calm and unhurried when talking with the child and family.

 

DIF:    Cognitive Level: Synthesis                REF:    Page 29           OBJ:    5

TOP:    Admission Process                             KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Psychosocial Integrity

 

  1. In pediatric nursing, what is the focus of the nursing process?
a. Child
b. Family
c. Both A and B
d. None of the above

 

 

ANS:   C

In pediatric nursing, both the child and the family are the focus.

 

DIF:    Cognitive Level: Comprehension       REF:    Page 29           OBJ:    6

TOP:    Critical Thinking and the Nursing Process

KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Safe and Effective Care Environment

 

  1. You are performing a review of systems on an 8-month-old infant. The infant is awake and calm. What would be the best way to begin this exam?
a. Perform the most distressing part of the exam first
b. Examine the heart, lungs, and bowel sounds
c. Perform the rectal temperature first
d. Look at the patient’s chart to see what was done first on the previous shift.

 

 

ANS:   B                     DIF:    Cognitive Level: Application             REF:    Page 31

OBJ:    7                      TOP:    Systems Review

KEY:   Nursing Process Step: Assessment     MSC:   NCLEX: Physiological Integrity

 

  1. When auscultating the heart of a 3-year-old girl, you hear an irregular heart beat. You understand that:
a. This is normal for a child under age 4
b. The heart should have a regular rhythm
c. This may be caused by anxiety and should be rechecked in 1 hour
d. This should be rechecked on the following shift

 

 

ANS:   B

A child of 3 should have a regular rhythm. An irregular heart rhythm should be reported to the nurse in charge immediately.

 

DIF:    Cognitive Level: Analysis                  REF:    Page 31           OBJ:    7

TOP:    Systems Review                                 KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Physiological Integrity

 

  1. When monitoring an infant’s pulse, the nurse on the pediatric unit should know that:
a. The normal pulse rate is higher for infants than adults
b. An apical pulse is recommended for infants
c. The nurse should listen for any irregularities in rhythm
d. All of the above

 

 

ANS:   D

The normal pulse rate for an infant is much higher than an adult. The apical pulse is most recommended. Always listen for irregularities in rhythm.

 

DIF:    Cognitive Level: Comprehension       REF:    Pages 31-32    OBJ:    8

TOP:    Vital Signs      KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Physiological Integrity

 

  1. The nurse is assessing the respirations of an infant on the pediatric unit. The nurse knows that which of the following is true:
a. Respirations are counted by observing the movement of the abdominal wall
b. The rate is counted for thirty 30 seconds and then multiplied by 2
c. After 1 year of age, respirations should be measured in the same way as for an adult
d. Respirations are counted by observing the movement of the chest wall

 

 

ANS:   A

Infants are abdominal breathers, so the nurse should watch the movement of the abdominal wall. The rate should be counted for a full minute, because respirations tend to be irregular in infancy. Respirations are measured the same way as an adult after the child reaches 7 years of age.

 

DIF:    Cognitive Level: Application             REF:    Page 32           OBJ:    8

TOP:    Vital Signs      KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Physiological Integrity

 

  1. The normal respiratory rate for a 6- to 12-month-old is:
a. 14-22
b. 12-18
c. 20-25
d. 24-40

 

 

ANS:   D

The normal rate for an infant age 6-12 months is 24-40.

 

DIF:    Cognitive Level: Knowledge             REF:    Page 32           OBJ:    8

TOP:    Vital Signs      KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Physiological Integrity

 

  1. An infant is admitted to your unit. You are required to weigh each infant on admission. You understand that this is required because:
a. You cannot trust the information given by the parents