Chapter 20 Child Health Nursing Partnering With Children & Families, 3rd Edition

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Chapter 20

Question 1

Type: MCSA

A concerned parent calls the school nurse because of changes in his 15-year-old’s behavior. Which behaviors would the nurse identify as most likely to be abnormal and indicate possible substance abuse in an adolescent?

1. Becoming very involved with friends and in activities related to the basketball team that she is on, never seeming to be home, and, when she is home, preferring to be in her room with the door shut
2. Becoming moody, crying, and weeping one minute and then cheerful and excited the next
3. Receiving numerous detentions lately from teachers for sleeping in class
4. Buying baggy, oversized clothing at thrift shops and dyeing her hair black

Correct Answer: 3

Rationale 1: Periodically distancing themselves from their parents and preferring involvement with their peers are normal adolescent behaviors.

Rationale 2: Mood swings are normal adolescent behaviors.

Rationale 3: Even though most teens do prefer staying up late, they are not usually so tired that they fall asleep during the day, especially while engaged in classroom activities. This behavior is abnormal and could indicate involvement with substance abuse or an underlying pathology.

Rationale 4: Experimenting with clothes and hair is a normal adolescent behavior.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need:

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 20-3

 

Question 2

Type: MCSA

During a well-child exam, the parents of a four-year-old child inform the nurse that they are thinking of buying a television for their child’s bedroom and ask for advice as to whether this is appropriate. The best response from the nurse would be:

1. “It is okay for children to have a television in their room as long as you limit the amount of time they watch it to less than two hours per day.”
2. “Research has shown that watching educational television shows improves a child’s performance in school.”
3. “Don’t buy a television for your child’s room; he is much too young for that.”
4. “Research has shown that children with a television in their bedroom spend significantly less time playing outside than other children.”

Correct Answer: 4

Rationale 1: This information is correct in that limiting television viewing to less than two hours per day is appropriate, but the probability of this occurring with a television in the child’s room is low; the child will most likely be watching much more than two hours per day.

Rationale 2: This statement might encourage the parents to allow the child to watch more television, and the child’s developmental need for physical activity is greater than the benefit that he might obtain by watching educational programs.

Rationale 3: This statement does not give parents a rationale, and it might seem opinionated to them.

Rationale 4: Young children need to be physically active at this age. Research has shown that children with a television in their bedroom spend significantly less time playing outside than do other children, and physical inactivity in children has been linked to many chronic diseases, such as obesity and type 2 diabetes. Telling parents this is the best response because it gives the parents an evidence-based rationale for not placing a television in the child’s room.

Global Rationale:

 

Cognitive Level: Applying

Client Need:

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 20-1

 

Question 3

Type: MCSA

A mother of two children, an 8-year-old and a 10-year-old, tells you that her husband has recently been deployed to the Middle East. The mother is concerned about the children’s constant interest in watching TV news coverage of activities in the Middle East. The most appropriate suggestion for the nurse to make to this mother would be:

1. “Spend time with your children, and take cues from them about how much they want to discuss.”
2. “Allow the children to watch as much television as they want. This is how they are coping with their father’s absence.”
3. “The less that you discuss this, the quicker the children will adjust to their father’s absence. Try to keep them busy and use distractions to keep their mind off of it.”
4. “It will just take some time to adjust to their father’s absence and then everything will return to normal.”

Correct Answer: 1

Rationale 1: Children need to be able to discuss their feelings and concerns with an adult; otherwise, their emotional distress could increase.

Rationale 2: Constant viewing of the TV coverage of the war might increase the children’s anxiety and fear for their father’s safety.

Rationale 3: Children need to be able to discuss their feelings and concerns with an adult; otherwise, their emotional distress could increase.

Rationale 4: The mother should be aware that even though the children might appear to have adjusted, there could be delayed reactions or regressions in behavior.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need:

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 20-1

 

Question 4

Type: MCSA

A seven-year-old child has been seen in the pediatric clinic three times in the last two months for complaints of abdominal pain. On each occasion, the physical exam and all ordered lab work have been normal. The most important information to assess at this time would be:

1. The child’s normal eating habits.
2. Recent viral illnesses or other infectious symptoms.
3. Review of the child’s immunization history.
4. Changes in school or home life.

Correct Answer: 4

Rationale 1: Because of the abdominal complaints, the child’s eating habits would have already been discussed.

Rationale 2: With normal blood work and tests, the chance of any illness over the last few months is unlikely.

Rationale 3:

Rationale 4: With a normal exam and lab work, there is a high probability that this child’s abdominal pain is stress-related, and it is most important to identify the possible stressors in this child’s life to aid in diagnosis and treatment. Asking about changes in home or school life is most likely to get to information about recent stresses in the child’s life.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need:

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 20-1