Chapter 1. Issues and Trends in Pediatric Nursing

MULTIPLE CHOICE

1. A nurse is reviewing changes in healthcare delivery and funding for pediatric populations.

Which current trend in the pediatric setting should the nurse expect to find?

a. Increased hospitalization of children

b. Decreased number of uninsured children

c. An increase in ambulatory care

d. Decreased use of managed care

ANS: C

One effect of managed care is that pediatric healthcare delivery has shifted dramatically from the 

acute care setting to the ambulatory setting. The number of hospital beds being used has 

decreased as more care is provided in outpatient and home settings. The number of uninsured 

children in the United States continues to grow. One of the biggest changes in healthcare has 

been the growth of managed care.

DIF: Cognitive Level: Comprehension REF: p. 3

OBJ: Nursing Process Step: Planning MSC: Safe and Effective Care Environment

2. A nurse is referring a low-income family with three children under the age of 5 years to a

program that assists with supplemental food supplies. Which program should the nurse refer this 

family to?

a. Medicaid

b. Medicare

c. Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program

d. Women, Infants, and Children (WIC) program

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ANS: D

WIC is a federal program that provides supplemental food supplies to low-income women who 

are pregnant or breast-feeding and to their children until the age of 5 years. Medicaid and the 

Medicaid Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program provides 

for well-child examinations and related treatment of medical problems. Children in the WIC 

program are often referred for immunizations, but that is not the primary focus of the program. 

Public Law 99-457 provides financial incentives to states to establish comprehensive early 

intervention services for infants and toddlers with, or at risk for, developmental disabilities. 

Medicare is the program for Senior Citizens.

DIF: Cognitive Level: Application REF: p. 7

OBJ: Nursing Process Step: Implementation

MSC: Health Promotion and Maintenance

3. In most states, adolescents who are not emancipated minors must have parental permission

before:

a. treatment for drug abuse.

b. treatment for sexually transmitted diseases (STDs).

c. obtaining birth control.

d. surgery.

ANS: D

An emancipated minor is a minor child who has the legal competence of an adult. Legal counsel 

may be consulted to verify the status of the emancipated minor for consent purposes. Most states 

allow minors to obtain treatment for drug or alcohol abuse and STDs and allow access to birth 

control without parental consent.

DIF: Cognitive Level: Application REF: p. 12

OBJ: Nursing Process Step: Planning MSC: Safe and Effective Care Environment

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4. A nurse is completing a clinical pathway for a child admitted to the hospital with pneumonia. 

Which characteristic of a clinical pathway is correct?

a. Developed and implemented by nurses

b. Used primarily in the pediatric setting

c. Specific time lines for sequencing interventions

d. One of the steps in the nursing process

ANS: C

Clinical pathways measure outcomes of client care and are developed by multiple healthcare 

professionals. Each pathway outlines specific time lines for sequencing interventions and reflects 

interdisciplinary interventions. Clinical pathways are used in multiple settings and for clients 

throughout the life span. The steps of the nursing process are assessment, diagnosis, planning, 

implementation, and evaluation