Ball3e Tif Ch01

Ball, Child Health Nursing, 3/E
Chapter 1
Question 1
Question 1
Type: MCSA
The nurse in a pediatric acute care unit is assigned the following tasks. Based on recognition that the action
defined requires training beyond the preparation of a registered nurse, the nurse would refuse to:
1. iagnose a si!"year"old with di#ersional acti#ity deficit related to place$ent in isolation.
2. %isten to the concerns of an adolescent about being out of school for a lengthy surgical reco#ery.
3. iagnose an eight"year"old with acute otitis $edia and prescribe an antibiotic.
4. &ro#ide infor$ation to a $other of a newly diagnosed four"year"old diabetic about local support group options.
Corret !ns"er: '
#ationale 1: (ursing diagnoses are a responsibility of the nurse in an acute care unit.
#ationale 2: %istening to concerns is within the e!pectations of a nurse in an acute care unit.
#ationale 3: Ad#anced practice nurse practitioners perfor$ assess$ent, diagnosis, and $anage$ent of health
conditions. The role of the pediatric nurse includes pro#iding nursing assess$ent, direct nursing care
inter#entions, client and fa$ily education at de#elop$entally appropriate le#els, client ad#ocacy, case
$anage$ent, $ini$i)ation of distress, and enhance$ent of coping.
#ationale 4: &ro#iding infor$ation about support groups is within the e!pectations of the nurse in an acute care
unit.
$lo%al #ationale:
Cogniti&e 'e&el: Applying
Client Need:
Client Need (u%:
Nursing/)ntegrated Conepts: (ursing &rocess: *$ple$entation
'earning *uto+e: +"+
Question 2
Type: MCSA
espite the a#ailability of Children,s -ealth *nsurance &rogra$s .C-*&/, $any eligible children are not enrolled.
The nursing inter#ention that can best help eligible children to beco$e enrolled is:
Ball, Child Health Nursing, '01
Copyright 23+4 by &earson 1ducation, *nc.
1. 1ducating the fa$ily about the need for keeping regular well"child #isit appoint$ents.
2. Assessing details of the fa$ily,s inco$e and e!penditures.
3. %i$iting costly, unnecessary duplication of ser#ices through case $anage$ent.
4. Ad#ocating for the child by encouraging the fa$ily to in#estigate C-*& eligibility.
Corret !ns"er: 4
#ationale 1: 5hile it is the nurse,s responsibility to educate the fa$ily, this inter#ention is not what will best help
eligible children to beco$e enrolled.
#ationale 2: 6inancial assess$ent is $ore co$$only the function of a social worker.
#ationale 3: The case $anage$ent acti#ity $entioned will not pro#ide a source of funding.
#ationale 4: *n the role of an ad#ocate, a nurse ad#ances the interests of the child by suggesting that the fa$ily
in#estigate C-*& eligibility.
$lo%al #ationale:
Cogniti&e 'e&el: Analy)ing
Client Need:
Client Need (u%:
Question 3
Type: MCSA
A nurse is e!a$ining different nursing roles. 5hich best illustrates an ad#anced practice nursing role7
1. A clinical nurse specialist with who$ other nurses consult for her e!pertise in caring for high"risk children
2. A clinical nurse specialist working as a staff nurse on a $edical"surgical pediatric unit
3. A registered nurse who is the circulating nurse in surgery
4. A registered nurse who is the $anager of a large pediatric unit
Corret !ns"er: +
#ationale 1: A clinical nurse specialist with who$ other nurses consult for e!pertise in caring for high"risk
children would define an ad#anced practice nursing role. Ad#anced practice nurses ha#e speciali)ed knowledge
and co$petence in a specific clinical area and ha#e earned a $aster,s degree.
#ationale 2: A clinical nurse specialist working as a staff nurse on a $edical"surgical pediatric unit $ight ha#e
the qualifications for an ad#anced practice nursing staff but is not working in that capacity.
#ationale 3: A registered nurse who is a circulating nurse in surgery is defined as a professional nurse and has
graduated fro$ an accredited progra$ in nursing and co$pleted the licensure e!a$ination.
#ationale 4: A registered nurse who is the $anager of a large pediatric unit is defined as a professional nurse and
has graduated fro$ an accredited progra$ in nursing and co$pleted the licensure e!a$ination.
$lo%al #ationale:
Client Need:
Client Need (u%:
Nursing/)ntegrated Conepts: (ursing &rocess: Assess$ent
Question 4
Type: MCSA
The role of the registered nurse as a nurse educator is to:
1. &ro#ide pri$ary care for healthy children.
2. Assist the fa$ily in $aking infor$ed decisions by pro#iding infor$ation about the pros and cons of the
treat$ent plan.
3. Assist the pri$ary care nurse with procedures requiring ad#anced practice skills.
4. Co$$unicate with the hospitali)ed school"aged child8s classroo$ teacher to assist the child in achie#ing
classroo$ goals.
Corret !ns"er: 2
#ationale 1: The nurse educator does not pro#ide pri$ary care for healthy children.
#ationale 2: The educator works with the fa$ily toward the goal of $aking infor$ed choices through education
and e!planation.
#ationale 3: The nurse educator does not assist with procedures requiring ad#ance practice skills.
#ationale 4: The nurse educator is concerned with teaching the child and parents health care practices related to
the child8s condition.
$lo%al #ationale:
Client Need:
Client Need (u%:
Nursing/)ntegrated Conepts: (ursing &rocess: &lanning
Question ,
Type: MCSA
A 9"year"old child has been ad$itted for acute appendicitis. The parents are questioning the nurse about
e!pectations during the child,s reco#ery. 5hich infor$ation tool would be $ost useful in answering a parent,s
questions about ti$ing of key e#ents7
1. Healthy People 2020
2. (ational clinical practice guidelines
3. Child $ortality statistics
4. Critical clinical pathways
Corret !ns"er: 4
#ationale 1: Healthy People 2020 contains ob:ecti#es set by the ;.S. go#ern$ent to i$pro#e the health and
reduce the incidence of death in the twenty"first century.
#ationale 2: (ational clinical practice guidelines pro$ote unifor$ity in care for specific disease conditions by
suggesting e!pected outco$es fro$ specific inter#entions.
#ationale 3: Child $ortality statistics can be co$pared with those fro$ other decades for the e#aluation of
achie#e$ent toward health care goals.
#ationale 4: Critical clinical pathways are interdisciplinary docu$ents pro#ided by a hospital to suggest ideal
sequencing and ti$ing of e#ents and inter#entions for specific diseases to i$pro#e efficiency of care and enhance
reco#ery. These pathways ser#e as $odels outlining the typical hospital stay for indi#iduals with specified
conditions.
$lo%al #ationale:
Client Need:
Client Need (u%:
'earning *uto+e: +"2
Question -
Type: MCSA
The telephone triage nurse at a pediatric clinic knows that each call is i$portant. -owe#er, recogni)ing that infant
deaths are $ost frequent in this group, the nurse $ust be e!tra attenti#e during the call fro$ the parent of an
infant who is:
1. Between si! and eight $onths old.
2. <f a (ati#e A$erican fa$ily.
3. <f a non"-ispanic black fa$ily.
4. =ounger than three weeks old.
Corret !ns"er: 4
#ationale 1: About two"thirds of infant deaths occur $uch earlier>in the first 2? days of life.
#ationale 2: (ati#e A$erican and Alaskan nati#es e!perience an infant $ortality rate of ?.' per +33,333 li#e
births.
#ationale 3: uring 2333, the infant $ortality statistics for non"-ispanic blacks was +'.@ per +33,333 li#e births.
#ationale 4: Al$ost two"thirds of all infant deaths occur during the first 2? days after birth.
$lo%al #ationale:
Client Need:
Client Need (u%:
'earning *uto+e: +"'
Question .
Type: MCSA
5hen discussing in:ury pre#ention with the parents of a toddler, which state$ent indicates teaching has been
successful7 AThe leading cause of death in children is:
1. ;nintentional in:ury.A
2. *nfectious disease.A
3. Congenital ano$alies.A
4. Cancer.A
Corret !ns"er: +
#ationale 1: The $ost co$$on cause of death for children between + and +B years of age is unintentional in:ury,
which includes $otor #ehicle crashes, drowning, fire, burns, firear$s, and suffocation.
#ationale 2: *nfectious disease is not the cause of $ost deaths in children.
#ationale 3: The leading cause of death in children is unintentional in:uries, not congenital ano$alies.
#ationale 4: Cancer is not the leading cause of child $ortality.
$lo%al #ationale:
Client Need:
Client Need (u%:
Nursing/)ntegrated Conepts: (ursing &rocess: 1#aluation
Question /
Type: MCSA
5ith regard to child $ortality statistics, which nursing inter#ention would be $ost effecti#e in decreasing
$ortality fro$ unintentional in:ury7
1. Teaching children about dangers of contact sports
2. 1ncouraging parents to obtain genetic counseling
3. 1ducating parents about the benefits of i$$uni)ations
4. Teaching parents about proper use of #ehicle restraint seats
Corret !ns"er: 4
#ationale 1: Teaching about the dangers of contact sports will not decrease $ortality fro$ unintentional in:uries,
such as burns, $otor #ehicle crashes, and suffocation.
#ationale 2: <btaining genetic counseling will not decrease $ortality fro$ unintentional in:uries.
#ationale 3: Since the $ost co$$on cause of $ortality in children is unintentional in:ury, educating about
i$$uni)ations will not be $ost effecti#e.
#ationale 4: The $ost co$$on cause of death for children between + and +B years of age is unintentional in:ury.
The $a:or causes of death fro$ unintentional in:ury in childhood include $otor #ehicle crashes, drowning, fires
and burns, firear$s, and suffocation.
$lo%al #ationale:
Client Need:
Client Need (u%:
Question 0
Type: MCSA
5ith regard to infant $ortality statistics, which nursing inter#ention would be $ost effecti#e in decreasing post"
neonatal $ortality7
1. Teaching parents about Ababy"proofingA their ho$e
2. 1ducating parents on acceptable feeding techniques
3. &ro#iding support for first"ti$e $others
4. 1ducating parents on the i$portance of positioning the baby on his back whene#er sleeping
Corret !ns"er: 4
#ationale 1: Baby"proofing ho$es will not decrease post"neonatal $ortality.
#ationale 2: Teaching acceptable feeding techniques is not the $ost effecti#e inter#ention to decrease post"
neonatal $ortality.
#ationale 3: &ro#iding support for first"ti$e $others will not decrease post"neonatal $ortality.
#ationale 4: Sudden infant death syndro$e accounts for nearly ?C of deaths to infants and usually occurs during
the post"neonatal period .between + and +2 $onths of age/. &ositioning babies on their backs to sleep has
significantly reduced the incidence of sudden infant death syndro$e.
$lo%al #ationale:
Client Need:
Client Need (u%:
Question 11
Type: MCSA
espite the a#ailability of the Children,s -ealth *nsurance &rogra$ .C-*&/, fa$ilies often fail to obtain co#erage
for eligible children because:
1. They do not see the i$portance of insurance co#erage.
2. 6a$ilies do not ha#e adequate ti$e to co$plete the enroll$ent process.
3. They do not know their child is eligible.
4. &arents do not #alue $edical inter#entions for their children.
Corret !ns"er: '
#ationale 1: Most fa$ilies do #alue insurance co#erage, so this is not the reason for failing to obtain SC-*&
co#erage.
#ationale 2: 6a$ilies ha#e adequate ti$e to co$plete the enroll$ent process, but so$e do not belie#e they will
qualify and therefore do not try to enroll.
#ationale 3: espite a#ailability of C-*&, $any eligible children are not enrolled. Deasons fa$ilies ha#e not
enrolled include not being aware that their child is eligible, #iewing the enroll$ent require$ents and inco$e
#erification tests as barriers, and the $onthly pre$iu$ or co"pay$ent for healthcare #isits that are required in
so$e states.
#ationale 4: &arents do #alue $edical inter#entions for their children, but so$e do not belie#e they can qualify,
belie#ing that their inco$e is too high.
$lo%al #ationale:
Client Need:
Client Need (u%:
Question 11
Type: MCSA
A +2"year"old pediatric client is in need of surgery. The health care $e$ber who is legally responsible for
obtaining infor$ed consent for an in#asi#e procedure is the:
1. (urse.
2. Social worker.
3. ;nit secretary.
4. &hysician.
Corret !ns"er: 4
#ationale 1: A nurse cannot legally obtain infor$ed consent for a procedure but can witness the signature on the
consent for$.
#ationale 2: A social worker is not responsible for obtaining infor$ed consent for an in#asi#e procedure.
#ationale 3: The unit secretary cannot obtain or sign as a witness for an infor$ed consent docu$ent.
#ationale 4: *nfor$ed consent is legal preauthori)ation for an in#asi#e procedure. *t is the physician,s legal
responsibility to obtain this because it consists of an e!planation about the $edical condition, a detailed
description of treat$ent plans, the e!pected benefits and risks related to the proposed treat$ent plan, alternati#e
treat$ent options, the client,s questions, and the guardian,s right to refuse treat$ent.
$lo%al #ationale:
Client Need:
Client Need (u%:
Question 12
Type: MCSA
A child is being prepared for an in#asi#e procedure in the presence of the child,s babysitter. The single $other of
the child has legal custody but is not present. After details of the procedure are e!plained, the legal infor$ed
consent for treat$ent on behalf of a $inor child will be obtained fro$:
1. The di#orced parent without custody.
2. The babysitter with written pro!y consent.
3. A grandparent who li#es in the ho$e with the child.
4. The cohabitating un$arried boyfriend of the child,s $other.
Corret !ns"er: 2
#ationale 1: State laws #ary. *n the case of di#orced parents, the parent with custody $ay be the only parent
allowed to gi#e infor$ed consent.
#ationale 2: A parent $ay grant pro!y consent in writing to another adult so that children are not denied
necessary health care.
#ationale 3: Desidence in the sa$e household with a child does not authori)e an adult to sign consent for
treat$ent.
#ationale 4: Desidence in the sa$e household with a child does not authori)e an adult to sign consent for
treat$ent.
$lo%al #ationale:
Client Need:
Client Need (u%:
Question 13
Type: MCSA
A +2"year"old child is being ad$itted to the unit for a surgical procedure. The child is acco$panied by two
parents and a younger sibling. The le#el of in#ol#e$ent in treat$ent decision $aking for this child is:
1. That of a $ature $inor.
2. That of an e$ancipated $inor.
3. That of assent.
4. (one.
Corret !ns"er: '
#ationale 1: A $ature $inor is a +4" or +E"year"old who$ the state law designates as being able to understand
$edical risks and who is thus per$itted to gi#e infor$ed consent for treat$ent.
#ationale 2: An e$ancipated $inor is a self"supporting adolescent who is not sub:ect to the control of a parent or
guardian.
#ationale 3: Assent requires the ability to generally understand what procedure and treat$ents are planned, to
understand what participation is required, and to $ake a state$ent of agree$ent or disagree$ent with the plan.
;sually, in &iaget,s stage of for$al operations, ++" to +'"year"olds should be able to proble$"sol#e using abstract
concepts and are able to gi#e #alid assent when parents sign the infor$ed consent.
#ationale 4: The child has so$e in#ol#e$ent at age +2, so this answer is not correct.
$lo%al #ationale:
Client Need:
Client Need (u%:
Question 14
Type: MCSA
All of the following adolescents are in the e$ergency roo$ for treat$ent. 5hich adolescent would be an
e$ancipated $inor7
1. The +E"year"old adolescent who disagrees with the parents in regard to the $edical plan of care
2. The +4"year"old adolescent who understands the risks and benefits of treat$ent
3. The +9"year"old adolescent who is self"supporting and $aintains her own apart$ent
4. The +@"year"old adolescent who ran away fro$ ho$e and is li#ing with a friend
Corret !ns"er: '
#ationale 1: 1$ancipated $inors are not designated only when the parents and child ha#e a disagree$ent but
when the $inor beco$es solely responsible for all aspects of her life.
#ationale 2: 1$ancipated $inors ha#e $ore knowledge than :ust understanding. They are solely responsible for
the$sel#es and can gi#e infor$ed consent.
#ationale 3: 1$ancipated $inors are econo$ically self"supporting adolescents under +? years of age, no longer
li#ing at ho$e, and not sub:ect to parental control. They can legally gi#e infor$ed consent for the$sel#es.
#ationale 4: 1$ancipated $inors are not declared as such only when there is a conflict of interest between the
child and parents. 1$ancipated $inors ha#e sole responsibility for all aspects of their life.
$lo%al #ationale:
Client Need:
Client Need (u%:
Question 1,
Type: MCMA
A nurse is working with pediatric clients in a research facility. The nurse recogni)es that federal guidelines are in
place to delineate which pediatrics clients $ust gi#e assent for participation in research trials. Based upon the
client,s age, the nurse would seek assent fro$ which children7
(tandard Te2t: Select all that apply.
1. The +'"year"old client beginning participation in a research progra$ for A- treat$ents
2. The precocious four"year"old starting as a cystic fibrosis research study participant
3. The +3"year"old starting in an in#estigati#e study for clients with precocious puberty
4. The se#en"year"old leuke$ia client electing to recei#e a newly de#eloped $edication being researched
Corret !ns"er: +,',4
#ationale 1: 6ederal guidelines $andate that research participants se#en years old and older $ust recei#e
de#elop$entally appropriate infor$ation about healthcare procedures and treat$ents and gi#e assent.
#ationale 2: A four"year"old is not old enough to understand any of the benefits and risks of the research trial and
is not required to assent.
de#elop$entally appropriate infor$ation about healthcare procedures and treat$ents and gi#e assent.
de#elop$entally appropriate infor$ation about health care procedures and treat$ents and gi#e assent.
$lo%al #ationale:
Client Need:
Client Need (u%:
'earning *uto+e: +"E
Question 1-
Type: MCSA
A super#isor is re#iewing the docu$entation of the nurses in the unit. The docu$entation that $ost accurately and
correctly contains all the required parts for a narrati#e entry is the entry that reads:
1. A+@'3 catheteri)ed using an ? 6rench catheter, 4E $l clear yellow urine obtained, speci$en sent to lab,
squir$ed and cried softly during insertion of catheter. Fuiet in $other,s ar$s following catheter re$o#al. M. May
D(A
2. A+0B03E 2 p.$. g"tube accessed, positi#e air gurgle o#er sto$ach: E $l air in:ected, +3 $l residual sto$ach
contents returned to sto$ach, &ediaSure for$ula hung on Gangaroo pu$p infusing at @3 $l0hr for + hour. Child
grunting inter$ittently throughout procedure. G. 1arnst D(A
3. A6eb. ,3E &ortacath assessed with -uber needle. Blood return present. 6lushed with (aCl sol., *H ga$$a
globulins hung and infusing at '3 $l0hr. Child s$iling and playful throughout the procedure. &. &otter, D(A
4. A4:33 Trach dressing re$o#ed with di$e"si)e stain of dry serous e!udate. Site cleansed with nor$al saline.
ried with sterile gau)e. (ew sterile trach sponge and trach ties applied. 6. %uck D(A
Corret !ns"er: 2
#ationale 1: 5hile the description of the procedure is appropriate, this docu$entation does not include the date
the note was written.
#ationale 2: The client record should include the date and ti$e of entry, nursing care pro#ided, assess$ents, an
ob:ecti#e report of the client,s physiologic response, e!act quotes if applicable, and the nurse,s signature and title.
#ationale 3: This note does not specify the e!act date and ti$e at which the portacath was accessed. *t also does
not include the si)e of the -uber needle that was used.
#ationale 4: This option appropriately describes the procedure but neglects to include the date and how the client
tolerated it.
$lo%al #ationale:
Client Need:
Client Need (u%:
Question 1.
Type: MCSA
The pediatric nurse,s best defense against an accusation of $alpractice or negligence is that the nurse:
1. *s a nurse practitioner or clinical nurse specialist.
2. Met the Society of &ediatric (urses standards of practice.
3. 5as acting on the ad#ice of the nurse $anager.
4. 6ollowed the physician,s written orders.
Corret !ns"er: 2
#ationale 1: Being a clinical nurse specialist or nurse practitioner does not defend the nurse against these
accusations if he does not follow the Society of &ediatric (urses standards of practice.
#ationale 2: Meeting the Society of &ediatric (urses standards of practice would co#er the pediatric nurse against
an accusation of $alpractice or negligence because the standards are rigorous and co#er all bases of e!cellent
nursing practice.
#ationale 3: Acting on the ad#ice of the nurse $anager is not enough to defend the nurse fro$ accusations
because the ad#ice could be wrong or unethical.
#ationale 4: 6ollowing the physician,s written orders is not enough to defend the nurse fro$ accusations because
the orders could be wrong or unethical.
$lo%al #ationale:
Client Need:
Client Need (u%:
Question 1/
Type: MCSA
6ollowing a trau$atic birth, an infant is ad$itted to the neonatal intensi#e care unit. 5hen the grandparents arri#e
at the hospital, they question the nurse caring for the baby about its condition and plan of care. The nurse who
pro#ides this infor$ation without per$ission fro$ the parents would be co$$itting:
1. (egligence
2. A breach of pri#acy
3. Malpractice
4. A breach of ethics
Corret !ns"er: 2
#ationale 1: (egligence occurs when the nurse does so$ething or fails to do so$ething that a reasonably prudent
nurse would not do or would not ha#e done
#ationale 2: A breach of pri#acy would ha#e been co$$itted in this situation because it #iolates the right to
pri#acy of this fa$ily. The right to pri#acy is the right of a person to keep his person and property free fro$ public
scrutiny .e#en by other fa$ily $e$bers/.
#ationale 3: A nurse charged with $alpractice $ay face a lawsuit for engaging in nursing practice that caused
har$ to a patient.
#ationale 4: 1thics is a syste$ of $oral principles that guides nursing beha#ior. This situation does not describe
an ethical issue.
$lo%al #ationale:
Client Need:
Client Need (u%:
Question 10
Type: MCSA
5hile changing the diaper on a newborn in the presence of the $other, the nurse notes a belly binder wrapped
around the u$bilical cord. 5hen questioned, the $other states this is the way the u$bilical area is cared for in her
culture. The nurse should:
1. Accept this practice as a cultural #ariation and allow the $other to care for the u$bilicus.
2. 1!plain to the $other the risks associated with belly binders and encourage her to re$o#e it.
3. De$o#e the belly binder and discard it.
4. Deplace the belly binder with a coin as a safer cultural practice.
Corret !ns"er: 2
#ationale 1: A belly binder pre#ents the cord fro$ drying and $ay pro$ote infection in the area. Cultural
practices that are har$ful should be discouraged through education of those in#ol#ed.
#ationale 2: *n this case, the belly binder is a cultural practice. 5hile not accepting the practice as safe, the nurse
recogni)es the practice as a cultural #ariation and will work with the $other to pro#ide for the needs of her infant.
#ationale 3: 5hile the use of a belly binder #aries fro$ traditional A$erican practice, the nurse should a#oid
offending the fa$ily and creating a barrier to accepted $edical practice.
#ationale 4: This response does not show cultural acceptance and $ay negati#ely i$pact the therapeutic
relationship.
$lo%al #ationale:
Client Need:
Client Need (u%:
Question 21
Type: MCSA
The nursing super#isor is obser#ing the staff on the pediatric unit. 5hich nurse is pro#iding fa$ily"centered care7
1. The nurse who delays $orning care until after the fa$ily has #isited the child
2. The nurse who suggests the $other take a break and get breakfast while the nurse changes the child8s dressings
3. 5hile ad$itting a new client, the nurse e!plains the #isitation rules of the unit to the parents and grandparents.
4. uring discharge planning, the nurse recogni)es the $other is unable to perfor$ wound care on the client, so
the nurse works with the fa$ily to deter$ine which fa$ily $e$ber will be a#ailable to $eet this child8s health
care needs.
Corret !ns"er: 4
#ationale 1: This obser#ation does not in#ol#e the nurse partnering with the fa$ily to $eet the health care needs
of the child.
#ationale 2: 5hile encouraging the $other to $aintain her own health, this obser#ation does not pro$ote nurse"
fa$ily interaction to i$pro#e the health of the child.
#ationale 3: There is no e#idence of fa$ily"centered care in this interaction.
#ationale 4: Assisting the fa$ily in planning for the health care needs of the child is an e!a$ple of fa$ily"
centered care. The nurse accepts the li$itations of the $other while proble$ sol#ing with the fa$ily to find a
solution.
$lo%al #ationale:
Client Need:
Client Need (u%:
Question 21
Type: MCMA
A registered nurse has been asked to :oin the ethics co$$ittee of the hospital. *n considering this appoint$ent, the
nurse would recogni)e that the co$$ittee $ight be considering ethical situations including:
(tandard Te2t: Select all that apply.
1. *ssuance of a Io (ot DesuscitateJ .allow natural death/ order on a child who has been deter$ined brain dead
against the wishes of the parents.
2. eter$ining if a $inor child who disagrees with the parents about the treat$ent plan can $ake an infor$ed
decision.
3. eter$ining if a non"sal#ageable newborn can be used as an organ donor.
4. *n#estigating a $edication error.
,. Consulting and inter#ening when parents are not in agree$ent on decisions of health care for their child.
Corret !ns"er: +,'
#ationale 1: 1thical issues arise when the health care tea$ $ust $ake decisions regarding potential outco$e for
the child and the beneficence of treat$ent.
#ationale 2: *nfor$ed decisions and the rights of the indi#idual are legal issues, not ethical issues.
#ationale 3: *ssues of organ donations and waiting lists for organs in#ol#e ethical issues that $ight be presented
to the hospital ethics co$$ittee.
#ationale 4: Medication errors do not in#ol#e ethical issues but are syste$ failures that need to be in#estigated.
#ationale ,: Staff nurses $ay work with parents in conflict resolutionK it is not a function of an ethics co$$ittee.
$lo%al #ationale:
Client Need:
Client Need (u%:
Question 22
Type: MCSA
The rationale for nurses utili)ing nursing inter#ention classifications .(*Cs/ when de#eloping a nursing care plan
for a child on the unit is to:
1. *$pro#e co$$unication a$ong nurses working with the child.
2. Assist $edical records in docu$enting care pro#ided for insurance purposes.
3. Aid the nursing super#isor in e#aluating the nursing staff.
4. Coordinate $edical orders with nursing orders.
Corret !ns"er: +
#ationale 1: Standardi)ing the language assists each indi#idual pro#iding care to be consistent in the health care
approach.
#ationale 2: The purpose of the nursing care plan is to i$pro#e care pro#ided to the child and is not related
directly to insurance.
#ationale 3: The nursing care plan is a co$$unication tool for all health care $e$bers caring for the child and is
not related to nursing super#ision.
#ationale 4: 5hile the nursing care plan includes dependent and independent orders, this is not the purpose of
standardi)ed (*Cs.
$lo%al #ationale:
Client Need:
Client Need (u%:
Question 23
Type: MCSA
A +4"$onth"old child is ad$itted to the hospital. uring the ad$ission process, the nurse deter$ines that the
child and fa$ily are #isiting this country fro$ a foreign country. The nurse is unaware of the cultural traditions
and #alues of that country. -ow can the nurse best pro#ide culturally co$petent health care7
1. Dead about that country on the internet.
2. Ask the fa$ily $e$bers how care would be pro#ided in their own country.
3. Ask a nurse who has #isited the child8s ho$e country about life in that country.
4. Ask a coworker who co$es fro$ the sa$e region about custo$s and cultures in their country.
Corret !ns"er: 2
#ationale 1: 5hile this $ay pro#ide so$e infor$ation about culture, this is not the best choice for this particular
child and fa$ily.
#ationale 2: This response pro#ides accurate infor$ation about this fa$ily8s beliefs and culture.
#ationale 3: This choice pro#ides an outsider8s #iew of the country and is not the best response.
#ationale 4: 5hile this $ay be helpful in seeing the full picture, the fa$ily is the $ost direct and co$plete
source of infor$ation.
$lo%al #ationale:
Client Need:
Client Need (u%:
Question 24
Type: MCSA
5hile working on the pediatric unit, the nurse recogni)es a neighbor whose child has been ad$itted to the
hospital pediatric intensi#e care. <ut of curiosity, the nurse #isits the &*C; and re#iews the child8s chart for
infor$ation about the child8s diagnosis. This nurse:
1. -as #iolated -*&AA laws.
2. 5as working within the legal li$itations of his0her :ob.
3. 5as not guilty of #iolating -*&AA laws unless the nurse shares the infor$ation with so$eone outside the
hospital.
4. 5as working as a $e$ber of the health care tea$ to pro#ide fa$ily"centered nursing.
Corret !ns"er: +
#ationale 1: Because the nurse was not in#ol#ed in the child8s care, the nurse had no right to re#iew the chart and
#iolated the fa$ily8s right to pri#acy by re#iewing the chart.
#ationale 2: This nurse was not in#ol#ed in the child8s care and had no legal right to the infor$ation.
#ationale 3: The nurse had no legal right to the infor$ation e#en if the infor$ation was not shared with others.
#ationale 4: Although the nurse was a $e$ber of the health care tea$, this nurse was not on the tea$ assigned to
this patient. *t is a -*&AA #iolation.
$lo%al #ationale:
Client Need:
Client Need (u%:
'earning *uto+e: +"@

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Ball, Child Health Nursing, 3/E

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