Chapter 1.Perspectives of Pediatric Nursing

MULTIPLE CHOICE

1. The clinic nurse is reviewing statistics on infant mortality for the United States versus other

countries. Compared with other countries that have a population of at least 25 million, the nurse

makes which determination?

a. The United States is ranked last among 27 countries.

b. The United States is ranked similar to 20 other developed countries.

c. The United States is ranked in the middle of 20 other developed countries.

d. The United States is ranked highest among 27 other industrialized countries.

ANS: A

Although the death rate has decreased, the United States still ranks last in infant mortality among 

nations with a population of at least 25 million. The United States has the highest infant death 

rate of developed nations. 

DIF: Cognitive Level: Remembering REF: MCS: 6 

TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

2. Which is the leading cause of death in infants younger than 1 year in the United States?

a. Congenital anomalies

b. Sudden infant death syndrome

c. Disorders related to short gestation and low birth weight

d. Maternal complications specific to the perinatal period

ANS: A

Congenital anomalies account for 20.1% of deaths in infants younger than 1 year compared with 

sudden infant death syndrome, which accounts for 8.2%; disorders related to short gestation and 

unspecified low birth weight, which account for 16.5%; and maternal complications such as

infections specific to the perinatal period, which account for 6.1% of deaths in infants younger 

than 1 year of age. 

DIF: Cognitive Level: Remembering REF: MCS: 7 TOP: Nursing Process: Planning 

MSC: Client Needs: Health Promotion and Maintenance 

3. What is the major cause of death for children older than 1 year in the United States?

a. Heart disease

b. Childhood cancer

c. Unintentional injuries

d. Congenital anomalies

ANS: C

Unintentional injuries (accidents) are the leading cause of death after age 1 year through 

adolescence. The leading cause of death for those younger than 1 year is congenital anomalies, 

and childhood cancers and heart disease cause a significantly lower percentage of deaths in

children older than 1 year of age. 

DIF: Cognitive Level: Understanding REF: MCS: 7 TOP: Nursing Process: Planning 

MSC: Client Needs: Health Promotion and Maintenance

4. In addition to injuries, what are the leading causes of death in adolescents ages 15 to 19 years?

a. Suicide and cancer

b. Suicide and homicide

c. Drowning and cancer

d. Homicide and heart disease

ANS: B

Suicide and homicide account for 16.7% of deaths in this age group. Suicide and cancer account 

for 10.9% of deaths, heart disease and cancer account for approximately 5.5%, and homicide and 

heart disease account for 10.9% of the deaths in this age group. 

DIF: Cognitive Level: Remembering REF: MCS: 7 TOP: Nursing Process: Planning 

MSC: Client Needs: Health Promotion and Maintenance

5. The nurse is planning a teaching session to adolescents about deaths by unintentional injuries.

Which should the nurse include in the session with regard to deaths caused by injuries?

a. More deaths occur in males.

b. More deaths occur in females.

c. The pattern of deaths does not vary according to age and sex.

d. The pattern of deaths does not vary widely among different ethnic groups.

ANS: A

The majority of deaths from unintentional injuries occur in males. The pattern of death does vary 

greatly among different ethnic groups, and the causes of unintentional deaths vary with age and 

gender. 

DIF: Cognitive Level: Applying REF: pp. 7-8 

TOP: Integrated Process: Teaching/Learning

MSC: Client Needs: Health Promotion and Maintenance

6. What do mortality statistics describe?

a. Disease occurring regularly within a geographic location

b. The number of individuals who have died over a specific period

c. The prevalence of specific illness in the population at a particular time

d. Disease occurring in more than the number of expected cases in a community

ANS: B

Mortality statistics refer to the number of individuals who have died over a specific period. 

Morbidity statistics show the prevalence of specific illness in the population at a particular time. 

Data regarding disease within a geographic region, or in greater than expected numbers in a 

community, may be extrapolated from analyzing the morbidity statistics. 

DIF: Cognitive Level: Remembering REF: MCS: 3 TOP: Nursing Process: Planning 

MSC: Client Needs: Health Promotion and Maintenance

7. The nurse should assess which age group for suicide ideation since suicide in which age group

is the third leading cause of death?

a. Preschoolers

b. Young school age

c. Middle school age

d. Late school age and adolescents

ANS: D

Suicide is the third leading cause of death in children ages 10 to 19 years; therefore, the age 

group should be late school age and adolescents. Suicide is not one of the leading causes of death 

for preschool and young or middle school-aged children. 

DIF: Cognitive Level: Understanding REF: MCS: 6 

TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

8. Parents of a hospitalized toddler ask the nurse, What is meant by family-centered care? The

nurse should respond with which statement?

a. Family-centered care reduces the effect of cultural diversity on the family.

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b. Family-centered care encourages family dependence on the health care system.

c. Family-centered care recognizes that the family is the constant in a childs life.

d. Family-centered care avoids expecting families to be part of the decision-making

process.

ANS: C

The three key components of family-centered care are respect, collaboration, and support. 

Family-centered care recognizes the family as the constant in the childs life. The family should 

be enabled and empowered to work with the health care system and is expected to be part of the 

decision-making process. The nurse should also support the familys cultural diversity, not reduce 

its effect. 

DIF: Cognitive Level: Applying REF: MCS: 8 

TOP: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance

9. The nurse is describing clinical reasoning to a group of nursing students. Which is most

descriptive of clinical reasoning?

a. Purposeful and goal directed

b. A simple developmental process

c. Based on deliberate and irrational thought

d. Assists individuals in guessing what is most appropriate

ANS: A

Clinical reasoning is a complex developmental process based on rational and deliberate thought. 

When thinking is clear, precise, accurate, relevant, consistent, and fair, a logical connection

develops between the elements of thought and the problem at hand. 

DIF: Cognitive Level: Applying REF: MCS: 12 

TOP: Integrated Process: Teaching/Learning

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MSC: Client Needs: Health Promotion and Maintenance 

10. Evidence-based practice (EBP), a decision-making model, is best described as which?

a. Using information in textbooks to guide care

b. Combining knowledge with clinical experience and intuition

c. Using a professional code of ethics as a means for decision making

d. Gathering all evidence that applies to the childs health and family situation

ANS: B

EBP helps focus on measurable outcomes; the use of demonstrated, effective interventions; and 

questioning what is the best approach. EBP involves decision making based on data, not all 

evidence on a particular situation, and involves the latest available data. Nurses can use 

textbooks to determine areas of concern and potential involvement. 

DIF: Cognitive Level: Remembering REF: MCS: 11 TOP: Nursing Process: Planning 

MSC: Client Needs: Safe and Effective Care Environment

11. Which best describes signs and symptoms as part of a nursing diagnosis?

a. Description of potential risk factors

b. Identification of actual health problems

c. Human response to state of illness or health

d. Cues and clusters derived from patient assessment

ANS: D

Signs and symptoms are the cues and clusters of defining characteristics that are derived from a 

patient assessment and indicate actual health problems. The first part of the nursing diagnosis is 

the problem statement, also known as the human response to the state of illness or health. The 

identification of actual health problems may be part of the medical diagnosis. The nursing 

diagnosis is based on the human response to these problems. The human response is therefore a 

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component of the nursing diagnostic statement. Potential risk factors are used to identify nursing 

care needs to avoid the development of an actual health problem when a potential one exists. 

DIF: Cognitive Level: Understanding REF: MCS: 13 

TOP: Integrated Process: Communication and Documentation 

MSC: Client Needs: Safe and Effective Care Environment

12. The nurse is talking to a group of parents of school-age children at an after-school program

about childhood health problems. Which statement should the nurse include in the teaching?

a. Childhood obesity is the most common nutritional problem among children.

b. Immunization rates are the same among children of different races and ethnicity.

c. Dental caries is not a problem commonly seen in children since the introduction

of fluoridated water.

d. Mental health problems are typically not seen in school-age children but may be

diagnosed in adolescents.

ANS: A

When teaching parents of school-age children about childhood health problems, the nurse should 

include information about childhood obesity because it is the most common problem among 

children and is associated with type 2 diabetes. Teaching parents about ways to prevent obesity is 

important to include. Immunization rates differ depending on the childs race and ethnicity; dental 

caries continues to be a common chronic disease in childhood; and mental health problems are 

seen in children as young as school age, not just in adolescents. 

DIF: Cognitive Level: Applying REF: MCS: 3 

TOP: Integrated Process: Teaching/Learning

MSC: Client Needs: Health Promotion and Maintenance

13. The nurse is planning care for a hospitalized preschool-aged child. Which should the nurse

plan to ensure atraumatic care?

a. Limit explanation of procedures because the child is preschool aged.

b. Ask that all family members leave the room when performing procedures.

c. Allow the child to choose the type of juice to drink with the administration of oral 

medications.

d. Explain that EMLA cream cannot be used for the morning lab draw because there 

is not time for it to be effective.

ANS: C

The overriding goal in providing atraumatic care is first, do no harm. Allowing the child a choice 

of juice to drink when taking oral medications provides the child with a sense of control. The 

preschool child should be prepared before procedures, so limiting explanations of procedures 

would increase anxiety. The family should be allowed to stay with the child during procedures, 

minimizing stress. Lidocaine/prilocaine (EMLA) cream is a topical local anesthetic. The nurse 

should plan to use the prescribed cream in time for morning laboratory draws to minimize pain. 

DIF: Cognitive Level: Applying REF: pp. 8-9 TOP: Nursing Process: Planning 

MSC: Client Needs: Health Promotion and Maintenance

14. Which situation denotes a nontherapeutic nursepatientfamily relationship? 

a. The nurse is planning to read a favorite fairy tale to a patient.

b. During shift report, the nurse is criticizing parents for not visiting their child.

c. The nurse is discussing with a fellow nurse the emotional draw to a certain 

patient.

d. The nurse is working with a family to find ways to decrease the familys 

dependence on health care providers.

ANS: B

Criticizing parents for not visiting in shift report is nontherapeutic and shows an 

underinvolvement with the parents. Reading a fairy tale is a therapeutic and age appropriate 

action. Discussing feelings of an emotional draw with a fellow nurse is therapeutic and shows a 

willingness to understand feelings. Working with parents to decrease dependence on health care 

providers is therapeutic and helps to empower the family