Hockenberry & Wilson: Wong’s Nursing Care of Infants and Children,
8th Edition

Chapter 01: Perspectives of Pediatric Nursing

Test Bank

MULTIPLE CHOICE

	1.	From a worldwide perspective, infant mortality in the United States:
1.	Follows that of 20 other developed nations	
2.	Lags behind that of five other industrialized nations	
3.	Is the highest of the other industrialized nations	
4.	Is the lowest infant death rate of developed nations	

ANS:	3

	Feedback	
1	The United States has the highest infant death rate of developed nations.	
2	The United States has the highest infant death rate of developed nations.	
3	Although the death rate has decreased, the United States still ranks last among nations with the lowest infant death rates.	
4	The United States has the highest infant death rate of developed nations.	

DIF:	Cognitive Level: Knowledge	REF:	p. 3	
OBJ:	Integrated process: Nursing Process: Assessment	
TOP:	Area of client needs: Health Promotion and Maintenance/Prevention and Early Detection of Disease		

	2.	Which of the following is the leading cause of death in infants younger than 1 year?
1.	Congenital anomalies	
2.	Sudden infant death syndrome	
3.	Respiratory distress syndrome	
4.	Infections specific to the perinatal period	

ANS:	1

	Feedback	
1	Congenital anomalies account for 20.6% of deaths in infants younger than 1 year.	
2	Sudden infant death syndrome accounts for 7.7% of deaths in this age-group.	
3	Respiratory distress syndrome accounts for 3.6% of deaths in this age-group.	
4	Infections specific to the perinatal period account for 2.9% of deaths in this age-group.	

DIF:	Cognitive Level: Knowledge	REF:	p. 4	
OBJ:	Integrated process: Nursing Process: Planning	
TOP:	Area of client needs: Health Promotion and Maintenance/Prevention and Early Detection of Disease		

	3.	The major cause of death for children older than 1 year is which of the following?
1.	Cancer	
2.	Injuries	
3.	Infection	
4.	Congenital abnormalities	

ANS:	2

	Feedback	
1	There have been major declines in deaths attributed to these disorders because of improved therapies.	
2	Unintentional injuries (accidents) are the leading cause of death after age 1 year through adolescence.	
3	There have been major declines in deaths attributed to these disorders because of improved therapies.	
4	The leading cause of death in those younger than 1 year, congenital abnormalities are less significant in this age-group.	

DIF:	Cognitive Level: Comprehension	REF:	p. 4	
OBJ:	Integrated process: Nursing Process: Planning	
TOP:	Area of client needs: Health Promotion and Maintenance/Prevention and Early Detection of Disease		

	4.	In addition to injuries, which of the following are leading causes of death in adolescents and young adults ages 15 to 24 years?
1.	Suicide, cancer	
2.	Suicide, homicide	
3.	Homicide, heart disease	
4.	Drowning, cancer	

ANS:	2

	Feedback	
1	Suicide and cancer account for 14.4% of deaths in this age-group.	
2	Homicide and suicide account for 22.6% of deaths in this age-group.	
3	Homicide and heart disease account for 14.5% of deaths in this age-group.	
4	Cancer accounts for 3.5% of the deaths in this age group. Drowning is responsible for less than 2% of the deaths in adolescents.	

DIF:	Cognitive Level: Knowledge	REF:	p. 4	
OBJ:	Integrated process: Nursing Process: Planning	
TOP:	Area of client needs: Health Promotion and Maintenance/Prevention and Early Detection of Disease		

	5.	Which of the following is descriptive of deaths caused by injuries?
1.	More deaths occur in males.	
2.	More deaths occur in females.	
3.	The pattern of deaths varies widely in Western societies.	
4.	The pattern of deaths does not vary according to age and sex.	

ANS:	1

	Feedback	
1	The majority of deaths from unintentional injuries occur in males.	
2	Males account for a greater number of deaths from unintentional injuries.	
3	The pattern of death caused by unintentional injuries is consistent in Western societies.	
4	Causes of unintentional deaths vary with age and gender.	

DIF:	Cognitive Level: Comprehension	REF:	p. 8	
OBJ:	Integrated process: Nursing Process: Planning	
TOP:	Area of client needs: Health Promotion and Maintenance/Prevention and Early Detection of Disease		

	6.	Morbidity statistics describe which of the following?
1.	Disease occurring regularly within a geographic location	
2.	The number of individuals who have died over a specific period	
3.	The prevalence of specific illness in the population at a particular time	
4.	Disease occurring in greater than the number of expected cases in a community	

ANS:	3

	Feedback	
1	These data may be extrapolated from analysis of the morbidity statistics.	
2	This refers to mortality statistics.	
3	This is the definition of morbidity statistics.	
4	These data may be extrapolated from analysis of the morbidity statistics.	

DIF:	Cognitive Level: Knowledge	REF:	p. 6	
OBJ:	Integrated process: Nursing Process: Planning	
TOP:	Area of client needs: Health Promotion and Maintenance/Prevention and Early Detection of Disease		

	7.	The type of injury a child is especially susceptible to at a specific age is most closely related to which of the following?
1.	Physical health of the child	
2.	Educational level of the child	
3.	Developmental level of the child	
4.	Number of responsible adults in the home	

ANS:	3

	Feedback	
1	The child’s physical health may facilitate the child’s recovery from an injury.	
2	Educational level is related to developmental level, but it is not as important as the child’s developmental level in determining the type of injury.	
3	The child’s developmental stage determines the type of injury that is likely to occur.	
4	This may affect the number of unintentional injuries, but the type of injury will be related to the child’s developmental stage.	

DIF:	Cognitive Level: Comprehension	REF:	p. 7	
OBJ:	Integrated process: Nursing Process: Planning	
TOP:	Area of client needs: Health Promotion and Maintenance/Prevention and Early Detection of Disease		

	8.	Which of the following was created in 1965 under Title XIX of the Social Security Act?
1.	Medicaid	
2.	Child welfare services	
3.	Aid to Families with Dependent Children	
4.	Maternal Child Health Services Block Grants	

ANS:	1

	Feedback	
1	Medicaid was created in 1965 to reduce financial barriers to health care for the poor. It is the largest maternal-child health program.	
2	Child welfare services began with Title V in 1930.	
3	AFDC was enacted in 1935 as a cash grant program to states.	
4	MCH Services Block Grants provide services to mothers and children with low income or limited access to health services.	

DIF:	Cognitive Level: Knowledge	REF:	p. 12	
OBJ:	Integrated process: Nursing Process: Planning	
TOP:	Area of client needs: Health Promotion and Maintenance/Prevention and Early Detection of Disease		

	9.	Which of the following is most descriptive of family-centered care?
1.	Reduce effect of cultural diversity on the family	
2.	Encourage family dependence on health care system	
3.	Recognize that the family is the constant in a child’s life	
4.	Avoid expecting families to be part of the decision-making process	

ANS:	3

	Feedback	
1	The nurse should support the cultural diversity of the family, not reduce its effect.	
2	The family should be enabled and empowered to work with the health care system.	
3	The three key components of family-centered care are respect, collaboration, and support. Family-centered care recognizes the family as the constant in the child’s life.	
4	The family is expected to be part of the decision-making process.	

DIF:	Cognitive Level: Comprehension	REF:	p. 13	
OBJ:	Integrated process: Nursing Process: Implementation	
TOP:	Area of client needs: Health Promotion and Maintenance/Prevention and Early Detection of Disease		

	10.	The role of the pediatric nurse is influenced by trends in health care. Which of the following is a major trend in health care in the United States?
1.	Primary focus on treatment of disease or disability	
2.	National health care planning on a distributive or episodic basis	
3.	Accountability to professional codes and international standards	
4.	Shift of focus to prevention of illness and maintenance of health	

ANS:	4

	Feedback	
1	This is traditionally the role of the physician.	
2	This is not a major trend.	
3	This is an established responsibility, not a trend.	
4	This is the current focus of health care in which nursing plays a major role.	

DIF:	Cognitive Level: Comprehension	REF:	p. 16	
OBJ:	Integrated process: Nursing Process: Implementation	
TOP:	Area of client needs: Health Promotion and Maintenance/Prevention and Early Detection of Disease		

	11.	Which of the following is most descriptive of critical thinking?
1.	Purposeful and goal directed	
2.	A simple developmental process	
3.	Based on deliberate and irrational thought	
4.	Assists individuals in guessing what is most appropriate	

ANS:	1

	Feedback	
1	Critical thinking is a complex, developmental process based on rational and deliberate thought.	
2	Critical thinking is a complex developmental process.	
3	Critical thinking is based on rational and deliberate thought.	
4	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: Comprehension	REF:	p. 19	
OBJ:	Integrated process: Nursing Process: Planning	
TOP:	Area of client needs: Health Promotion and Maintenance/Prevention and Early Detection of Disease		

	12.	Evidence-based practice (EBP), a decision-making model, is best described as:
1.	Using information in textbooks to guide care	
2.	Combining knowledge with clinical experience and intuition	
3.	Using a professional code of ethics as a means for decision making	
4.	Gathering all evidence that applies to the child’s health and family situation	

ANS:	2

	Feedback	
1	This will assist the nurse in determining areas of concern and potential involvement.	
2	EBP helps focus on measurable outcomes; the use of demonstrated, effective interventions; and questioning what is the best approach.	
3	This is part of a professional role. Although ethics is included in decision making, EBP involves the latest available data also.	
4	It is not possible to gather all the evidence that applies to the family situation. EBP involves decision making based on data.	

DIF:	Cognitive Level: Knowledge	REF:	p. 19	
OBJ:	Integrated process: Nursing Process: Planning	
TOP:	Area of client needs: Health Promotion and Maintenance/Prevention and Early Detection of Disease		

	13.	Which of the following best describes signs and symptoms as part of a nursing diagnosis?
1.	Description of potential risk factors 	
2.	Identification of actual health problems	
3.	Human response to state of illness or health	
4.	Cues and clusters derived from patient assessment	

ANS:	4

	Feedback	
1	Potential risk factors are used to identify nursing care needs to avoid the development of an actual health problem when a potential one exists.	
2	The identification of actual health problems may be part of the medical diagnoses. The nursing diagnosis is based on the human response to these problems.	
3	This is a component of the nursing diagnostic statement.	
4	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.	

DIF:	Cognitive Level: Comprehension	REF:	p. 22	
OBJ:	Integrated process: Communication and Documentation	
TOP:	Area of client needs: Health Promotion and Maintenance/Prevention and Early Detection of Disease		

	14.	The nurse knows that a clinical pathway is used as a basis for care. The pathway details:
1.	Expected outcomes and goals	
2.	All required nursing interventions	
3.	Problems not pertinent to child and family	
4.	Potential health problems of child and family	

ANS:	1

	Feedback	
1	The clinical pathway is a multidisciplinary care plan that has as its central concept to prediction of day-by-day care required to achieve outcomes for a specific patient’s health problems within a specific time frame.	
2	The critical pathway specifies key tasks and outcomes. Many of the nursing interventions are not specifically identified.	
3	These are overall plans and guidelines; each family may not require some of the specific care.	
4	These are addressed if they are a possible outcome during the implementation of the pathway. Other potential health problems are addressed through the use of the individualized plan of care.	

DIF:	Cognitive Level: Comprehension	REF:	p. 24	
OBJ:	Integrated process: Nursing Process: Planning	
TOP:	Area of client needs: Health Promotion and Maintenance/Prevention and Early Detection of Disease