Wong's Nursing Care of Infants and Children 11th Edition Hockenberry Test Bank Table ofContents
Chapter 1.Perspectives of Pediatric Nursing
... [Show More] ....................................................................................................... 2 Chapter 2.Social, Cultural, Religious, and Family Influences on Child Health Promotion .................................... 17 Chapter 3.Hereditary Influences on Health Promotion of the Child and Family ................................................. 38 Chapter 4.Communication, Physical, and Developmental Assessment of the Child and Family .......................... 56 Chapter 5.Pain in Children: Significance, Assessment, and Management Strategies ........................................... 82 Chapter 6.Childhood Communicable and Infectious Diseases .......................................................................... 102 Chapter 7.Health Promotion of the Newborn and Family ............................................................................... 123 Chapter 8.Health Problems of the Newborn ................................................................................................... 142 Chapter 9.The High-Risk Newborn and Family ............................................................................................... 160 Chapter 10.Health Promotion of the Infant and Family ................................................................................... 188 Chapter 11.Health Problems of the Infant ...................................................................................................... 212 Chapter 12.Health Promotion of the Toddler and Family ................................................................................ 234 Chapter 13.Health Promotion of the Preschooler and Family ......................................................................... 257 Chapter 14.Health Problems of Early Childhood ............................................................................................. 277 Chapter 15.Health Promotion of the School-Age Child and Family .................................................................. 293 Chapter 16.Health Problems of the School-Age Child ...................................................................................... 316 Chapter 17.Health Promotion of the Adolescent and Family ........................................................................... 333 Chapter 18.Health Problems of the Adolescent ............................................................................................... 351 Chapter 19.Impact of Chronic Illness, Disability, or End of Life Care for the Child and Family ........................ 378 Chapter 20.The Child with Cognitive, Sensory, or Communication Impairment ............................................... 402 Chapter 21.Family-Centered Care of the Child During Illness and Hospitalization ........................................... 422 Chapter 22.Pediatric Nursing Interventions and Skills .................................................................................... 446 Chapter 23.The Child with Fluid and Electrolyte Imbalance ........................................................................... 473 Chapter 24.The Child with Renal Dysfunction ................................................................................................ 506 Chapter 25.The Child with Gastrointestinal Dysfunction ................................................................................. 538 Chapter 26.The Child with Respiratory Dysfunction ....................................................................................... 574 Chapter 27.The Child with Cardiovascular Dysfunction .................................................................................. 611 Chapter 28.The Child with Hematologic or Immunologic Dysfunction ............................................................ 645 Chapter 29.The Child with Cancer .................................................................................................................. 681 Chapter 30.The Child with Cerebral Dysfunction ............................................................................................ 715
1 | P a g eChapter 31.The Child with Endocrine Dysfunction ......................................................................................... 750
Chapter 32.The Child with Integumentary Dysfunction .................................................................................. 783
Chapter 33.The Child with Musculoskeletal or Articular Dysfunction.............................................................. 793
Chapter 34.The Child with Neuromuscular or Muscular Dysfunction .............................................................. 824
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 iMenStC: Cl
2. hWich is
Needs: Health Promotion and Maintenance
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
2 | P a g eCongenital 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: PlanningMSC:
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: PlanningMSC:
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 choumnitcide ac
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.
3 | P a g eDIF: Cognitive Level: Remembering REF: MCS: 7 TOP: Nursing Process: PlanningMSC:
Client Needs: Health Promotion and Maintenance
5. The nurse is planning a teaching session to adolescents about hdseabty un
intentional 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 edxpcect
ases 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: PlanningMSC:
4 | P a g eClient 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 ecaoufs
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: NursoicnegssP:rAssessment
:MCSC
lient 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 ofnamthiely.
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 tchheilds life. T
he 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.
5 | P a g eDIF: 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
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: PlanningMSC:
Client Needs: Safe and Effective Care Environment
6 | P a g e11. 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
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 epnarts of sch
ool-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
isimportant to include. Immunization rates differ depending on the childs race and ethnicity;
7 | P a g edentalcaries 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.
8 | P a g eANS: 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.
DIF: Cognitive Level: Analyzing REF: MCS: 9 TOP: Integrated Process: CaringMSC:
Client Needs: Psychosocial Integrity
15. The nurse is aware that which age group is at risk for childhood injury because of the
cognitive characteristic of magical and egocentric thinking?
a. Preschool
b. Young school age
c. Middle school age
d. Adolescent
ANS: A
Preschool children have the cognitive characteristic of magical and egocentric thinking, meaning
they are unable to comprehend danger to self or others. Young and middle school-aged children
have transitional cognitive processes, and they may attempt dangerous acts without detailed
planning but recognize danger to themselves or others. Adolescents have formal operational
cognitive processes and are preoccupied with abstract thinking.
DIF: Cognitive Level: Understanding REF: MCS: 4
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment
16. The school nurse is assessing children for risk factors related to childhood injuries. Which
child has the most risk factors related to childhood injury?
a. Female, multiple siblings, stable home life
b. Male, high activity level, stressful home life
9 | P a g ec. Male, even tempered, history of previous injuries
d. Female, reacts negatively to new situations, no serious previous injuries
ANS: B
Boys have a preponderance for injuries over girls because of a difference in behavioral
characteristics, a high taicvity t emperament sisocaisated w ith risk-taking behaviors, and stress
predisposes children to increased risk taking and self-destructive behaviors. Therefore, a male
child with a high activity level and living in a stressful environment has the highest number of
risk factors. A girl with several siblings and a stable home life is low risk. A boy with vpiroeus
injuries has two risk factors, but an even temper is not a risk factor for injuries. A girl who reacts
negatively to new situations but has no previous serious illnesses has only one risk factor.
DIF: Cognitive Level: Analyzing REF: MCS: 4
TOP: NursoicnegssP:rAssessment
MSC: Client Needs: Safe and Effective Care Environment
17. The school unautrisnegistheeval
number of school-age children classified as obese. The
nurse recognizes that the percentile of body mass index that classifies a child as obese is greater
than which?
a. 50th percentile
b. 75th percentile
c. 80th percentile
d. 95th percentile
ANS: D
Obesity in children and adolescents is defined as a body mass index at or greater than the 95th
percentile for youth of the same age and gender.
DIF: Cognitive Level: Remembering REF: MCS: 3 TOP: Nursing Process: EvaluationMSC:
Client Needs: Health Promotion and Maintenance
18. The nurse is teaching parents about the types of behaviors children exhibit when living with
chronic violence. Which statement made by the parents indicates further teaching is needed?
10 | P a g ea. We should watch for aggressive play.
b. Our child may show lasting symptoms of stress.
c. We know that our child will show caring behaviors.
d. Our child may have difficulty concentrating in school.
ANS: C
The statement that the child will show caring behaviors needs further teaching. Children living
with chronic violence may exhibit behaviors such as difficulty concentrating in school, memory
impairment, aggressive play, uncaring behaviors, and lasting symptoms of stress.
DIF: Cognitive Level: Applying REF: MCS: 6
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
19. The nurse is evaluating research studies according to the GRADE criteria and has determined
the quality of evidence on the subject is moderate. Which type of evidence does this
determination indicate?
a. Strong evidence from unbiased observational studies
b. Evidence from randomized clinical trials showed inconsistent results
c. Consistent evidence from well-performed randomized clinical trials
d. Evidence for at least one critical outcome from randomized clinical trials had
serious flaws
ANS: B
Evidence from randomized clinical trials with important limitations indicates that the evidence is
of moderate quality. Strong evidence from unbiased observational studies and consistent
evidence from well-performed randomized clinical trials indicates high quality. Evidence for at
least one ictrical outcome f rom randomizediclailntrials th
at has serious wflas indi cates low
quality.
DIF: Cognitive Level: Remembering REF: MCS: 12 TOP: Nursing Process: EvaluationMSC:
Client Needs: Safe and Effective Care Environment
11 | P a g e20. An adolescent patient wants to make decisions about treatment options, along with his
parents. Which moral value is the nurse displaying when supporting the adolescent to make
decisions?
a. Justice
b. Autonomy
c. Beneficence
d. Nonmaleficence
ANS: B
Autonomy is the patients right to be self-governing. The adolescent is trying to be autonomous,
so the nurse is supporting this value. tJhuestice is
concept of fairness. Beneficence is the
obligation to optreomthe pa
tients well-being. Nonmaleficence is the obligation to minimize or
prevent harm.
DIF: Cognitive Level: Analyzing REF: MCS: 11 TOP: Nursing Process: EvaluationMSC:
Client Needs: Health Promotion and Maintenance
21. The nurse manager is compiling a report for a hospital committee on the quality of nursing-
sensitive indicators for a nursing unit. Which does the nurse manager include in the report?
a. The average age of the nurses on the unit
b. The salary ranges for the nurses on the unit
c. The education and certification of the nurses on the unit
d. The number of nurses who have applied but were not hired for the unit
ANS: C
Nursing-sensitive indicators reflect the structure, process, and outcomes of nursing care. For
example, the number of nursing staff, the skill level of the nursing staff, and the education and
certification of nursing staff indicate the structure of nursing care. The average age of the nurses,
salary range, and number of nurses who have applied but were not hired for the unit are not
nursing-sensitive indicators.
DIF: Cognitive Level: Applying REF: MCS: 15
TOP: Integrated Process: Communication and Documentation
12 | P a g eMSC: Client Needs: Safe and Effective Care Environment
MULTIPLE RESPONSE
1. Which responsibilities are included in the pediatric nurses promotion of the health and well-
being of children? (Select all that apply.)
a. Promoting disease prevention
b. Providing financial assistance
c. Providing support and counseling
d. Establishing lifelong friendships
e. Establishing a therapeutic relationship
f. Participating in ethical decision making
ANS: A, C, E, F
The pediatric nurses role includes promoting disease prevention, providing support and
counseling, establishing a therapeutic relationship, and participating in ethical decision making; a
pediatric nurse does not need to establish lifelong friendships or provide financial assistance to
children and their families. Boundaries should be set and clear.
DIF: Cognitive Level: Applying REF: pp. 9-11 TOP: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance
2. The nurse is conducting a teaching session for parents on nutrition. Which characteristics of
families should the nurse consider that can cause families to struggle in providing adequate
nutrition? (Select all that apply.)
a. Homelessness
b. Lower income
c. Migrant status
d. Working parents
e. Single parent status
ANS: A, B, C
Families that struggle with lower incomes, homelessness, and migrant asttus generally lack the
resources to provide their children with adequate food intake, nutritious foods such as fresh
13 | P a g efruitsand vegetables, and appropriate protein intake. Working parents and single parent status do
not mean the families will struggle to provide adequate nutrition.
DIF: Cognitive Level: Applying REF: MCS: 2
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
3. The nurse is preparing to complete documentation on a patients chart. Which should be
included in documentation of nursing care? (Select all that apply.)
a. Reassessments
b. Incident reports
c. Initial assessments
d. Nursing care provided
e. Patients response of care provided
ANS: A, C, D, E
The patients medical record shouldliundce: initial asse
ssments, reassessments, ngursi care
provided, and the patients response of care provided. Incident reports are not documented in
thepatients chart.
DIF: Cognitive Level: Applying REF: MCS: 14
TOP: Integrated Process: Communication and Documentation
MSC: Client Needs: Safe and Effective Care Environment
4. Which actions by the nurse demonstrate overinvolvement with patients and their families?
(Select all that apply.)
a. Buying clothes for the patients
b. Showing favoritism toward a patient
c. Focusing on technical aspects of care
d. Spending off-duty time with patients and families
e. Asking questions if families are not participating in care
ANS: A, B, D
14 | P a g eActions that show overinvolvement include buying clothes for patients, showing favoritism
toward a patient, and spending off-duty time with patients and families. Focusing on technical
aspects of care is an action that indicates underinvolvement, and asking questions if families are
not participating in care indicates a positive action.
DIF: Cognitive Level: Analyzing REF: pp. 9-10 TOP: Integrated Process: Caring
MSC: Client Needs: Health Promotion and Maintenance
5. Which are included in the evaluation step of the nursing process? (Select all that apply.)
a. Determination if the outcome has been met
b. Ascertaining if the plan requires modification
c. Establish priorities and selecting expected patient goals
d. Selecting alternative interventions if the outcome has not been met
e. Determining if a risk or actual dysfunctional health problem exists
ANS: A, B, D
Evaluation is the last step in the nursing process. The nurse gathers, sorts, and analyzes data to
determine whether (1) the established outcome has been met, (2) tnhuersing interventions
were appropriate, (3) the plan requires modification, or (4) other alternatives should be
considered.
Establishing priorities and selecting expected patient goals are done in the outcomes
identification stage. Determining if a risk or actual dysfunctional health problem exists is done in
the diagnosis stage of the nursing process.
DIF: Cognitive Level: Understanding REF: MCS: 14 TOP: Nursing Process: EvaluationMSC:
Client Needs: Health Promotion and Maintenance
6. Which should the nurse teach to parents regarding oral health of children? (Select all that
apply.)
a. Fluoridated water should be used.
b. Early childhood caries is a preventable disease.
c. Dental caries is a rare chronic disease of childhood.
d. Dental hygiene should begin with the first tooth eruption.
15 | P a g ee. Childhood caries does not happen until after 2 years of age.
ANS: A, B, D
Oral health instructions to parents of children should include use of fluoridated water and dental
hygiene beginning with the first tooth eruption. In addition, early childhood caries is a
preventable disease and should be included in the teaching session. Dental caries is a common,
not rare, chronic disease of childhood. Childhood caries may begin before the first birthday.
DIF: Cognitive Level: Applying REF: MCS: 2
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
7. The school nurse is explaining to older school children that obesity increases the risk for
which disorders? (Select all that apply.)
a. Asthma
b. Hypertension
c. Dyslipidemia
d. Irritable bowel disease
e. Altered glucose metabolism
ANS: B, C, E
Overweight youth have increased risk for a cluster of cardiovascular factors that include
hypertension, altered glucose metabolism,iapniddedmyisal. I
rritable bowel disease and
asthm are not linked to obesity.
DIF: Cognitive Level: Applying REF: MCS: 3
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
8. The nurse is reviewing the Healthy People 2020 leading health indicators for a child health
promotion program. Which are included in the leading healthaitnodrisc? (Select
all that apply.)
a. Decrease tobacco use.
b. Improve immunization rates.
16 | P a g ec. Reduce incidences of cancer.
d. Increase access to health care.
e. Decrease the number of eating disorders.
ANS: A, B, D
The Healthy People 2020 leading health indicators provide a framework for identifying seesntial
components for child health promotion programs designed to prevent future health problems in
our nations children. Some of the leading health indicators include decreasing tobacco use,
improving immunization rates, and increasing access to health care. Reducing the incidence of
cancer and decreasing the number of eating disorders are not olnisthae indicators.
s ltheading heal
DIF: Cognitive Level: Analyzing REF: MCS: 2 TOP: Nursing Process: EvaluationMSC:
Client Needs: Health Promotion and Maintenance
9. Which actions by the nurse demonstrate clinical reasoning? (Select all that apply.)
a. Basing decisions on intuition
b. Considering alternative action
c. Using formal and informal thinking to gather data
d. Giving deliberate thought to a patients problem
e. Developing an outcome focused on optimum patient care
ANS: B, C, D, E
Clinical reasoning is a cognitive process that uses formal and informal thinking to gather and
analyze patient data, evaluate the significance of the information, and consider alternative actions.
Clinical reasoning is a complex developmental process based on rational and deliberate thought
and developing an outcome focused on optimum patient care. Clinical reasoning is basedon the
scientific method of inquiry; it is not based solely on intuition.
Chapter 2.Social, Cultural, Religious, and Family Influences on Child Health Promotion
MULTIPLE CHOICE
1. Children are taught the values of their culture through observation and feedback relative to
their own behavior. In teaching a class on cultural competence, the nurse should be aware
thatwhich factor may be culturally determined?
17 | P a g ea. Ethnicity
b. Racial variation
c. Status
d. Geographic boundaries
ANS: C
Status is culturally determined and varies according to each culture. Some cultures ascribe higher
status to age or socioeconomic position. Social roles also are influenced by the culture. Ethnicity
is an affiliation of a set of persons who share a unique cultural, social, and linguistic heritage. It is
one component of culture. Race and culture are two distinct attributes. Whereas racial grouping
describes transmissible traits, culture is determined by the pattern of assumptions, beliefs, and
practices that unconsciously frames or guides the outlook and decisions of a group ofpeople.
Cultural development may be limited by geographic boundaries, but the boundaries are not
culturally determined.
DIF: Cognitive Level: Analyzing REF: MCS: 39
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs:
2P.syTchheonsoucrsiaeliIsnatwegarrietythat if patients different cultures are implied to be inferior, the emotional
attitude the nurse is displaying is what?
a. Acculturation
b. Ethnocentrism
c. Cultural shock
d. Cultural sensitivity
ANS: B
Ethnocentrism is the belief that ones way of living and behaving is the best way. This includes the
emotional attitude that the values, beliefs, and perceptions of ones ethnic group are superior to
those of others. Acculturation is the gradual changes that are produced in a culture by the
influence of another culture that cause one or both cultures to become more similar. The minority
culture is forced to learn the majority culture to survive. Cultural shock is the helpless feeling and
state of disorientation felt by an outsider attempting to adapt to a different culture group.
Cultural sensitivity, a component of culturally competent care, is an awareness of cultural
18 | P a g esimilarities and differences.
DIF: Cognitive Level: Understanding REF: MCS: 35 TOP: Integrated Process: Caring
MSC: Client Needs: Psychosocial Itengrity
3. Which term best describes the sharing of common characteristics that fdeifrentiate s one
groupfrom other groups in a society?
a. Race
b. Culture
c. Ethnicity
d. Superiority
ANS: C
Ethnicity is a classification aimed at grouping individuals who consider themselves, or are
considered by others, to share common characteristics that differentiate them ofrm t he other
collectivities in a society, and from which they develop their distinctive cultural behavior. Race
is a term that groups together people by their outward physical appearance. Culture is a pattern
of assumptions, beliefs, and practices that unconsciously frames or guides the outlook and
decisions of a group of people. A culture is composed of individuals who share a set of values,
beliefs, and practices that serve as a frame of ererfence for
individual perception and judgments.
Superiority is the state or quality of being superior; it does not apply to ethnicity.
DIF: Cognitive Level: Understanding REF: MCS: 39
TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
4. After the family, which has the greatest influence on providing continuity between
generations?
a. Race
b. School
c. Social class
d. Government
ANS: B
Schools convey a tremendous amount of culture from the older members to the younger
19 | P a g emembersocoifetsy.
They prepare children to carry oeutrt th aditional social roles that will be
expected of them as adults.sRdaecfeinied as
a division of humankind possessing traits that are
transmissible by descent and are sufficient torcahcaterize race as a distinct hum an type; although
race may have an influence on childrearing practices, its role is not as significant hasa t of
schools. Social class refers to ethfamilys economic and
educational levels. The social class of a
family may change between generations. The government iesshtaebslparameters for
children,
including amount of schooling, but this is usually at a local level. The school culture has the
most significant influence on continuity besides family.
DIF: Cognitive Level: Remembering REF: MCS: 33
TOP: NursoicnegssP:rAssessment
:MCSC
lient Needs: Psychosocial Integrity
5. The nurse is planning care for a patient with a different ethnic background. Which should be
an appropriate goal?
a. Adapt, as necessary, ethnic practices to health needs.
b. Attempt, in a nonjudgmental way, to change ethnic beliefs.
c. Encourage continuation of ethnic practices in the hospital setting.
d. Strive to keep ethnic background from influencing health needs.
ANS: A
Whenever possible, nurses should facilitate the integration of ethnic practices into health care
provision. The ethnic background is part of the individual; it should be difficult to eliminate the
influence of ethnic background. The ethnic practices need to be evaluated within the context of
the health care setting to determine whether they are conflicting.
DIF: Cognitive Level: Applying REF: MCS: 34 TOP: Integrated Process: CaringMSC:
Client Needs: Psychosocial Itengrity
6. The nurse discovers welts on the back of a Vietnamese child during a home health visit. The
childs mother says she has rubbed the edge of a coin on her childs oiled skin. The nurse should
recognize this as what?
a. Child abuse
b. Cultural practice to rid the body of disease
20 | P a g ec. Cultural practice to treat enuresis or temper tantrums
d. Child discipline measure common in the Vietnamese culture
ANS: B
This is descriptive of coining. The welts are created by repeatedly rubbing a coin on the childs
oiled skin. The mother is attempting to rid the childs body of disease. Coining is a cultural
healing practice. Coining is not specific for enuresis or temper tantrums. This is not child abuseor
discipline.
DIF: Cognitive Level: Understanding REF: MCS: 41
TOP: NursoicnegssP:rAssessment
:MCSC
lient Needs: Psychosocial Integrity
7. A Hispanic toddler has pneumonia. The nurse notices that the parent consistently feeds the
child only the broth that comes on the clear liquid tray. Food items, such as Jell-O, Popsicles,
and juices, are left. Which statement best explains this?
a. The parent is trying to feed the child only what the child likes most.
b. Hispanics believe the evil eye enters when a person gets cold.
c. The parent is trying to restore normal balance through appropriate hot remedies.
d. Hispanics believe an innate energy called chi is strengthened by eating soup.
ANS: C
In several cultures, including Filipino, Chinese, Arabic, and Hispanic, hot and cold describe
certain properties completely eulnarted to t permature. R espiratory conditions such as
pneumonia are cold conditions and are treated with hot foods. The child may like broth but is
unlikely to alyws
fperreit to
lJl-eO , Popsicles, and juice. The evil eye applies to a state of
imbalance of health, not curative actions. Chinese individuals, not Hispanic individuals, believein
chi as an innate energy.
DIF: Cognitive Level: Applying REF: MCS: 40
TOP: NursoicnegssP:rAssessment
:MCSC
21 | P a g elient Needs: Psychosocial Integrity 8. How aismfily systems theory be
st described?
a. The family is viewed as the sum of individual members. b. A change in one family member cannot create a change in other members. c. Individual family members are readily identified as the source of a problem. d. When the family system is disrupted, change can occur at any point in the system.
ANS: D
Family systems theory describes an interactional model. Any change in one member will create change in others. Although the family is the sum of the individual members, family systems theory focuses on the number of dyad interactions that can occur. The interactions, not the individual members, are considered to be the problem.
DIF: Cognitive Level: Analyzing REF: MCS: 18 TOP: NursoicnegssP:rAssessment
:MCSC
lient Needs: Psychosocial Integrity 9. Which family theory is described as a series of tasks for the family throughout its life span?
a. Exchange theory b. Developmental theory c. Structural-functional theory d. Symbolic interactional theory [Show Less]