Chapter 27 Child Health Nursing Partnering With Children & Families, 3rd Edition

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Chapter 27

Question 1

Type: MCSA

A parent of a newborn asks the nurse why young children seem to become ill so often when compared with older children and adults. Which of the following does the nurse’s best response address?

1. Lower numbers of natural killer cells in younger children
2. High levels of IgA in the newborn
3. Absent lymphoid tissue in the young child
4. Underdeveloped thymus glands in the infant

Correct Answer: 1

Rationale 1: Newborns have lower numbers of natural killer cells than do older children and adults, decreasing their ability to respond to certain antigens.

Rationale 2: IgA is not present at birth. Development of IgA begins at two weeks of age but doesn’t reach adult levels until the age of six.

Rationale 3: Lymphoid tissue, such as the spleen and tonsils, is present at birth.

Rationale 4: The thymus is large at birth and grows during childhood, decreasing by adulthood.

Global Rationale:

 

Cognitive Level: Applying

Client Need:

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 27-2

 

Question 2

Type: MCSA

A premature infant is at greater risk for infection than a full-term infant because of a reduced number of which immunoglobulin?

1. IgE
2. IgG
3. IgA
4. IgM

Correct Answer: 2

Rationale 1: IgE does not cross the placenta and is not present at birth in either preterm or full-term infants.

Rationale 2: Maternal IgG crosses the placenta. Newborns’ levels are similar to their mothers’. Premature infants have lower levels of IgG obtained from their mothers and are at greater risk for infection.

Rationale 3: IgA does not cross the placenta and is not present at birth in either preterm or full-term infants.

Rationale 4: IgM does not cross the placenta. The levels are low at birth in both preterm and full-term infants.

Global Rationale:

 

Cognitive Level: Applying

Client Need:

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 27-1

 

Question 3

Type: MCSA

The nurse is planning care for a child with acquired immune deficiency syndrome (AIDS). Which vaccines should be avoided in the child with AIDS?

1. Inactivated polio vaccine (a killed virus vaccine)
2. Tetanus toxoid vaccination
3. Varicella vaccine (an attenuated virus vaccine)
4. Acellular pertussis vaccine

Correct Answer: 3

Rationale 1: Killed virus vaccines are safe to administer to the child with AIDS as there is no risk of acquiring an infection.

Rationale 2: A toxoid vaccination is made of a toxin that has been produced by the organism but does not include living organisms.

Rationale 3: A child with an immune disorder should not be immunized with a live varicella vaccine because of the risk of contracting the disease.

Rationale 4: Acellular pertussis vaccine contains a protein from pertussis rather than the whole cell.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need:

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 27-2

 

Question 4

Type: MCSA

The nurse is planning to discharge a child newly diagnosed with HIV infection. Which discharge instruction should be included for this child and her family?

1. Eat raw fruits.
2. Avoid playing sports.
3. Restrict school attendance.
4. Cover open wounds.

Correct Answer: 4

Rationale 1: The child should avoid eating raw fruits and vegetables unless they are peeled, to decrease ingestion of microorganisms.

Rationale 2: The child with HIV should participate in sports. While injuries are possible, it is unlikely that large quantities of blood will be present.

Rationale 3: The majority of children with HIV can attend school without restrictions.

Rationale 4: Wounds should be covered, and gloves should be worn when treating a child’s cuts and scrapes.

Global Rationale:

 

Cognitive Level: Applying

Client Need:

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 27-3