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more children and adolescents die from _____ than any other cause
the current health care delivery system, based on diagnostic-related groups, improve access to preventitive care, but limit access to _____ care
with the emphasis on reducing costs, ______ guidance and education by pediatric nurses has become ever more important
the comparatively high rate of infant _____ is believe to be related to the high incidence of low-birth-weight infants being born
children's medical records are only shared with legal parents, _____, or others with written authorization by the parents.
what does a pediatric nurse practitioner do
certified specialist
what does a family nurse practitioner do
provides health care across the life span
what does a neonatal nurse practitioner do
specialty within a specialty
what does a clinical nurse specialist do
consults in an area of expertise
what does a case manager do
supervises a group of patients
the nurse is promoting health while caring for a 6y F who has a cold. which of the following interventions best supports healthy people 2010 goals
a) explaining good diet in child's terms
b) promoting frequenty hand washing
c) recommending a helmet for biking
d) telling the mother how to treat head lice
c) recommending that the child wears a protective helmet best supports the goals of healthy people 2010 because unintentional injury is a leading cause of mortality and morbidity for children.  good diet, frequent hand washing and proper head lice treatment are important but do not affect child health status as much as injury prevention does
the nurse is caring for a 14y boy with a debilitating illness who wants to addend school. which of teh following interventions addresses the child' physical health but not his quality of life
a) helping the child modify trendy clothing to his needs
b) consulting with the school nurse at the child's school
c) assessing the child's daily oxygen supplement needs
d) adapting technologies for use outside of the home
c) assessing the child's daily oxygen supplement needs addresses the child' physical health but not the contemporary issue of quality of life.  helping the child modify trendy clothing to his needs, consulting w the school nurse, and adapting technologies for use outside of the home will improve the child's quality of life by building independence and self-esteem
the nurse is talking with the mother of a 2y girl during a scheduled visit.  which of the following teaching subjects least supports the emphasis on preventive care
a) reminding that child will imitate parents
b) explaining how to toddler proof the house
c) describing self-care for brussign teeth
d) explaining how to teach self-hand washing
a) reminding the mother that the child will imitate her parents may prevent the child from imitating dangerous behavior, but this is less likely to be a danger.  explaining how to toddler proof the house helps prevent injury to the child.  explaining how to teach self hand washing helps to prevent infection.  describing self-care for brushing teeth helps prevent dental caries.  these inteventions help avoid common health problems
the nurse is caring for a 7y M w cystic fibrosis whose parents are intensely interested in all aspects of the child's condition and care.  which of the following interventions is least important for empowering these health care consumers
a) teaching the parents how to perform chest physiotherapy
b) educating the parents about the lung transplant list
c) keeping the family apprised of all developments in care
d) locating the best deal on a high frequency chest compression vest
d) helping the family save money on therapy equipment is a consumer assistance activit6y, but is does not empower these health care consumers.  the pedicatric nurse is uniquely positioned to empower this family by performing the role of educator regarding therapy, by being an advocate regardin their wishes to get a lung transplant, and by keeping them informated as equal partners in family-centered care
the nurse is updating the records of a 10y F who had her appendix removed. which of teh following actions could jeopardize the privacy of teh child's medical records
a) changing ID and passwords monthly
b) letting another nurse use the nurse's login session
c) closing files before stepping away from computer
d) printing out confidential information for transmittal
b) it is important to log-off whenever leaving the computer. the person that shares the nurse's log-on session may get called away from teh computer leaving the nurse responsible for any breech in security. keeping IDs and passwords confidential is basic computer security. e-mail is not a safe way to transmit confidential information for transmittal. printing is safer. closing patient files before stepping away from teh computer helps ensure privacy
the nurse is assessing a 9y M during a back-to -school check up. which of teh following findings is a factor for childhood injury
a) records show child weight 2,450g at birth
b) mother reports she has abused alcohol and drugs
c) the parents adopted the boy from Guatemala
d) mother reports the child is hostile to other children
b) one of the factors associated w childhood injuries is parental drug or alcohol abuse. this is the leading cause for child mortality. low-birth-weight babies are at higher risk for infant mortality. foreign-born adoption is a factor for childhood morbidity. the child's hostility toward other children may be an environmental or psychosocial factor for childhood morbidity
the school nurse is caring for several children who witnessed a 8y G get hit by a car on the way to school.  which of the following interventions is least important to the nursing plan of care for these children
a) determining that the children were traumatized by what they saw
b) arranging for counseling for the children that saw the accident
c) indlucing friends of the injured child to receive counseling too
d) making phone calls to the parents of the children counseled
d) making phone calls to the parents of the children who were determinded to need counseling is least imortant to the nursing plan of care. it is, no doubt, mandatory for the nurse to inform and support the parents. however, this intervention is the least important based on the nursing diagnosis of teh children's need for counseling, the intervention to arrange for a counselor, and the adaptation of the intervention by providing counseling for the friends of the injured child
the nurse is assessing a 9y F w pneumonia.  which of the following findings is a factor for this child's morbidity
a) records show the child has asthma
b) the mother says she is a single parent
c) the mother was 16 when she delivered this child
d) the mother's boyfriend abused the child
a) the fact that th echild has asthma is a factor for morbidity. the other findings, single parenthood, young maternal age at birth and child abuse are factors for child mortality
the nurse is caring for 16y M w injuries from a car accident.  which of the following activities is least likely to be part of teh nurse's role as case manager
a) facilitating the doctor's diagnosis and treatment
b) prescribing services needed to improve the outcome
c) helping the child and family access the services neeeded.
d) evaluating the child's progress toward recovery
b) the nurse would not prescribe services. if the nurse's evaluation and monitoring disclosed a needed service that would imporve the child's outcome, the nurse would advocate for the hcild. other activities involved in care management include facilitating the doctor's diagnosis and treatment plan, helping the family access the services they need and evaluating the child's progress toward recovery
the nurse is promoting good health to a 15y F during an annual visit.  which of the following health promotions is most important for the child?
a) assessing for signs of depression or anxiety
b) discussing ways to plan and enjoy a healthy diet
c) recommending the child get a vaccination for flu
d) promoting safe sex to avoid pregnancy and disease
d) the leading cause for hospitalization by far, for this child's age group is pregnancy and childbirth. mental illness is second and is a growing concern. respiratory diseases and obesity are major concerns, but lesser than responsible sexual behavior
the nurse is preparing a program for adolescents concerning health promotion.  based upon the leading cause of mortality for this age group, the best focus for the program will be
a) communicable disease prevention
b) safety and reduction of risks
c) tobacco use
d) nurtirtional counseling
b) the leading cause of death in adolescents is accidents.  educational programs focusing on prevention of accidents and reduction of reisk factors would be most beneficial in this age group
during a well-child visit, a mother laughingly reports that her 10y child's teacher ahs recommended a mental health evaluation for the child.  what response by the nurse is most appropriate
a) your child is too young to be concerned about mental health problems
b) mental health issues in children are pretty rare
c) does anyone in your family have mental health issues
d) what types of issues is the teacher concerned about
d) an increasing number of children are being diagnosed w mental health disorders.  the best way to determine the reliability of the teacher's concerns would be to determine the behaviors being noticed
a nurse is considering employment in a practice that promotes family-centered care.  when considering this position, the nurse recognizes that this philosophy
a) will embrace teaching the parents to manage the health care needs of their child
b) will p[romote the involvement of the child and parents as members of the heath care team
c) will focus primarily on the use of herbal recedies to manage health concerns
d) will consider the wishes of the child as the leading force in planning care
b) family centered care involves a mutually beneficial partnership between the child, the family and health care professionals. it applies to the planning, delivery and evaluation of health care for children of all ages in any setting
the nursery nurse is preparing a consent form for the circumcision of a newborn baby.  the mother of the child is 16y.  the baby's father is not participating in the care.  when planning to complete the surgical consent, the action by the nurse is more appropriate
a) ask the grandmother of the newborn to sign the surgical consent
b) determin if the baby's father is older than 18y and if so ask for him to sign
c) recommend that the court appoint a guardian for the baby
d) ask for the baby's mother to sign the surgical consent
d) the consent of a parent or guardian is required for completion of a surgical procedure such as a circumcision.  the parent is the case is under age.  she may, however, consent for health care treatment of her child
the parents of a 12y child preparing to undergo surgery expain to the nurse that their religious beliefs do not allow for blood transfusions.  what initial action by the nurse is most appropriate
a) explain to teh parents that the surgeon will make the final decision in teh event a blood transfusion is needed by the child
b) ask the child what their preference will be
c) contact the hospital attorney
d) document the parents' requests.
d) requests of the parents and child must be documented. the surgeon does not have the automatic authority to override the parent's wishes.  the child is under age and does not have decision-making authority.
Which indicates an understanding of the leading cause of childhood mortality
a) HIV
b) congenital anomalies
c) MVA
d) low birthweight
c) MVA
which action would violate child's bill of health care rights?
a) arranging for mom to be with her
b) telling child this will not hurt
c) assuring the test will be done as quickly as possible
d) introducing the child to the lab tech by name
what is the best action by nurse with a child presenting to the emergency room with mom and parents are divorced?
a) contact father for informed consent
b) obtain informed consent from mom
c) get a court order for treatment
d) determine which parent has custody
the mother of an 8 y old F w a fractured arm is the nurturer of the family.  which nursing activity should be focused on her?
a) dealing w insurance coverage
b) determining sucess of treatment
c) teaching proper care procedures
d) transmitting information to family members
the nurse knows there are different parenting styles. which of the following comments, if stated, would be indicitive of the authoritative parent?
a) remember tonight is a school night, so you need to be home by 9pm
b) your curfew is 9pm. i've told you that
c) as long as you have your homework done, I don't care when you come home
d) don't bother me with your plans. just make sure the door is locked when you come in
the nurse is planning care for a child with a different ethnic background. which of the following would be an appropriate goal
a) attempt, in a non-judgemental way, to change ethnic beliefs
b) adapt, if necessary, ethnic practices to health needs
c) encourage continuation of all ethnic practices in the hospital setting
d) strive to keep ethnic background from influencing health needs
the process of increasing desirable behavior and decreasing or eliminating undesirable behaviors is a process known as _______
children's temperaments are categorized into 3 major groups. the largest group of children (40%) is classified as ______ children
the ability to apply knowledge about a child's culture to adapt their health care accordingly is known as cultural _____
when children have been exposed to violence at home and do not appear to suffer negative consequences, they are demonstrating _____
in 2003, ______ was the 3rd leading cause of death in young people, ranging in age from 10 - 24 years.
cultural group:  women as the verbal decision makers; celebrations to mark the states of growth & development; health as harmony with nature; illness due to disharmony, evil spirits
a) asian american
b) african american
c) arab american
d) native american
e) Hispanics
d) native american
use of complementary modalieis with western health care practices; view of life as a cycle with everything connnected to health
a) asian american
b) african american
c) arab american
d) native american
e) Hispanics
a) asian american
illness as due to inadequate diet, shifts in hot and cold, exposure of stomach while sleeping, emotional or spiriatual distress and eveil eye; view of pain as unpleasant requiring immediate relief
a) asian american
b) african american
c) arab american
d) native american
e) Hispanics
c) arab american
health as God's will maintainable with a balance of hot and cold food intake; freedom from pain indicative of good health; pain tolerated stoically due to belief that it is God's will
a) asian american
b) african american
c) arab american
d) native american
e) Hispanics
e) Hispanics
pain and suffering inevitable; relief achieved through prayers and laying on of hands; food as a symbol of health and wealth
a) asian american
b) african american
c) arab american
d) native american
e) Hispanics
b) african american
a 10y girl is living w her grandparents. which nursing intervention is most important w this family structure?
a) teaching the couple basic child care skills
b) determining who the decision maker is
c) assessing the child for emotional problems
d) helping to access the need for financial aid
c) children living with their grandparents may experience emotional stress if the biological parents are in & out of the childs life. teaching basic child care skills is appropriate for the adolescent family. determining the decision maker is important w an extended family, and financial aid is important for single parents
the nurse is assessing a woman who is prego.  her health history reveals she has 3 young adult children.  which nursing intervention would be most appropriate according to duvall's development theory?
a) assessing the parent's coping abilities
b) providing developmental anticipatory guidance
c) promoting the importance of vaccinations
d) describing nutritional value of breastfeeding
a) it would be most appropriate to assess the pt's coping abilities because they are in the wrong stage of the family life cycle to be having another child. providing anticipatory guidance, describing the nutritional value of breastfeeding, and promoting the importance of vaccinations are interventions for younger parents
the nurse is caring for a 7y child who is being treated for multiple fractures after being involved in an automobile accident.  the nurse observes that the father frequently takes on the role of nurturer in the family.  when planning care, which nursing intervention would most involve the father
a) assuring meds are received on time
b) staying w the child at the hospital
c) meeting w the discharge planner to discuss plans after discharge
d) bathing the child
d) the nurse would focus on the father for decisions about the course of treatment. assuring meds are received on time is the family health manager's role. staying w the child in the hospital will be handled by the family nurturer. all clinical input will be provided to the family gatekeeper for disemination
nurse is providing education concerning discipline to the parents of a 2y F. which of the nurse's comments follows the strategies for good discipline
a) always have the father do the disciplining
b) tell what till result in her being sent to her room.
c) tell her adults can do as they please, children can't
d) you can modify the discipline when she is sick
b) it is important to make the consequence known before the bad behavior. this way the child has the opportunity to avoid misbehaving. effective discipline is performed in close proximity to the misbehavior. it is important to set a good example and avoid hypocritical behavior
the nurse is caring for an arab american child.  the nurse's observations reveal the family follows traditional arab american cultural values. which approach would be most successful
a) inquiring about folk remedies used
b) coordinating care through the mother
c) dealing excusively with the father
d) promoting preventative health care
c) in the arab american culture, women are subordinate to men and children are subordinate to the parents. the nurse would deal directly and exclusively with the father. this family would not place much emphasis on preventative care either. inquiring about folk remedies used may be needed w african american families. coordinating care through the mother is appropriate w a hispanic family
bookish parents have a child with a 3y B w a difficult temperment. which guidance will be most successful for the nurse to use
a) give him timeout for running in the house
b) encourage him to do quiet activities
c) provide a place for him to roughhouse
d) spank him for throwing a tantrum
c) suggesting that th eparents provide a place where the child can roughhouse would be best for the child and them. disciplining him for running in the house, encouraging his to do quiet activities, and spanking him if he has a tantrum are counter to his temperament
the mother of two school age children is getting divorced. which would be the best advice for the nurse to give
a) its best to treat your children like adults
b) make your side of the disagreement clear
c) move out when the children are in school
d) discuss how things will work after the divorce
d) both parents together should discuss w the children how things will work after the divorce. the children should not be expected to act like adults because they are not. tell them about the divorce ahead of time and tell them the reasons in nonjudgmental terms that they can understand
the nurse is caring for a single mother and her two preschool age children.  which is the primary intervention
a) maintaining the vaccination schedule
b) assessing the mother's psychological status
c) referring the mother to parents without partners
d) asking the children about their concerns and fears
a) the physiological health of the children is of the greatest importance. assessment of the family's psychological and emotional status should not be overlooked. if mother needs support, a referral to parents without partners may be helpful
the nurse is assessing for violence in the home. which response by the mother represents the greatest risk to the child
a) the mother says she dreads going home
b) the mother's partner calls the child names
c) the boyfriend is very strict w the child
d) the boyfriend may leave for days at a time
b) if the mother's partner is being verbally abusive of the child, there is a risk of physical violance. there could be a number of reasons other than violence to dread going home. strictness is not necessarily a sign of abuse. the boyfriend's absence may only be a sign or irresponsibility and not of a violent nature
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