Table of Contents
Chapter 1 Nurse's Role in Care of the Child: Hospital, Community, and Home ....................................................... 1
Chapter 2 Family-Centered Care and Cultural Considerations.....................................................................................13
Chapter 3 Genetic and Genomic Influences ...................................................................................................................26
Chapter 4 Growth and Development ...............................................................................................................................36
Chapter 5 Pediatric Assessment .........................................................................................................................................48
Chapter 6 Introduction to Health Promotion and Maintenance ..................................................................................60
Chapter 7 Health Promotion and Maintenance for the Newborn and Infant ...........................................................73
Chapter 8 Health Promotion and Maintenance for the Toddler and Preschooler ....................................................85
Chapter 9 Health Promotion and Maintenance for the School-Age Child and Adolescent ....................................99
Chapter 10 Nursing Considerations for the Child in the Community ...................................................................... 114
Chapter 11 Nursing Considerations for the Hospitalized Child ............................................................................... 125
Chapter 12 The Child with a Chronic Condition......................................................................................................... 137
Chapter 13 The Child with a Life-Threatening Condition and End-of-Life Care ................................................. 149
Chapter 14 Infant, Child, and Adolescent Nutrition ................................................................................................... 162
Chapter 15 Pain Assessment and Management in Children ...................................................................................... 175
Chapter 16 Immunizations and Communicable Diseases .......................................................................................... 187
Chapter 17 Social and Environmental Influences on the Child ................................................................................ 201
Chapter 18 Alterations in Fluid, Electrolyte, and Acid-Base Balance ....................................................................... 217
Chapter 19 Alterations in Eye, Ear, Nose, and Throat Function .............................................................................. 228
Chapter 20 Alterations in Respiratory Function .......................................................................................................... 239
Chapter 21 Alterations in Cardiovascular Function .................................................................................................... 252
Chapter 22 Alterations in Immune Function ............................................................................................................... 265
Chapter 23 Alterations in Hematologic Function ........................................................................................................ 276
Chapter 24 The Child with Cancer ................................................................................................................................. 289
Chapter 25 Alterations in Gastrointestinal Function .................................................................................................. 302
Chapter 26 Alterations in Genitourinary Function...................................................................................................... 314
Chapter 27 Alterations in Neurologic Function........................................................................................................... 326
Chapter 28 Alterations in Mental Health and Cognitive Function ........................................................................... 338
Chapter 29 Alterations in Musculoskeletal Function .................................................................................................. 349
Chapter 30 Alterations in Endocrine Function ............................................................................................................ 359
Chapter 31 Alterations in Skin Integrity ........................................................................................................................ 372
Chapter 1 Nurse's Role in Care of the Child: Hospital, Community, and Home
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, 1) Which nursing role is not directly involved when providing family-centered approach to the pediatric
population?
1. Advocacy
2. Case management
3. Patient education
4. Researcher
Answer: 4
Explanation: 1. A researcher is not involved in the family-centered approach to patient care of children and
their families. Advocacy, case management, and patient education are all roles directly involved in the care of
children and their families.
2. A researcher is not involved in the family-centered approach to patient care of children and their families.
Advocacy, case management, and patient education are all roles directly involved in the care of children and
their families.
3. A researcher is not involved in the family-centered approach to patient care of children and their families.
Advocacy, case management, and patient education are all roles directly involved in the care of children and
their families.
4. A researcher is not involved in the family-centered approach to patient care of children and their families.
Advocacy, case management, and patient education are all roles directly involved in the care of children and
their families.
Page Ref: 4
Cognitive Level: Analyzing
Client Need &Sub: Safe and Effective Care Environment: Management of Care Standards: QSEN
Competencies: Patient-centered care | AACN Essential Competencies:
Essential II: Basic organizational and systems leadership for quality care and patient safety | NLN
Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process:
Assessment/Coordination of care
Learning Outcome: LO 1.2 Compare the roles of nurses in child healthcare. MNL LO:
Family-centered care
2) A nurse is working with pediatric clients in a research facility. The nurse recognizes that federal
guidelines are in place that delineate which pediatrics clients must give assent for participation in
research trials. Based upon the client's age, the nurse would seek assent from which children?
Select all that apply.
1. The precocious 4-year-old commencing as a cystic fibrosis research-study participant.
2. The 7-year-old leukemia client electing to receive a newly developed medication, now being researched.
3. The 10-year-old commencing in an investigative study for clients with precocious puberty.
4. The 13-year-old client commencing participation in a research program for Attention Deficit
Hyperactivity Disorder (ADHD) treatments.
Answer: 2, 3, 4
Explanation: 1. Federal guidelines mandate that research participants 7 years old and older must receive
developmentally appropriate information about healthcare procedures and treatments and give assent.
2. Federal guidelines mandate that research participants 7 years old and older must receive
developmentally appropriate information about healthcare procedures and treatments and give assent.
3. Federal guidelines mandate that research participants 7 years old and older must receive
developmentally appropriate information about healthcare procedures and treatments and give assent.
4. Federal guidelines mandate that research participants 7 years old and older must receive
developmentally appropriate information about healthcare procedures and treatments and give assent.
Page Ref: 11, 12
Cognitive Level: Applying
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, Client Need &Sub: Psychosocial Integrity
Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential V:
Healthcare policy, finance, and regulatory environments | NLN Competencies: Nursing judgement |
Nursing/Integrated Concepts: Nursing Process: Planning/Coordination of care
Learning Outcome: LO 1.6 Examine three unique pediatric legal and ethical issues in pediatric nursing practice.
MNL LO: Developmentally appropriate care
3) The nurse in a pediatric acute care unit is assigned the following tasks. Which task is not
appropriate for the nurse to complete?
1. Diagnose an 8-year-old with acute otitis media and prescribe an antibiotic.
2. Listen to the concerns of an adolescent about being out of school for a lengthy surgical recovery.
3. Provide information to a mother of a newly diagnosed 4-year-old diabetic about local support- group
options.
4. Diagnose a 6-year-old with Diversional Activity Deficit related to placement in isolation. Answer: 1
Explanation: 1. The role of the pediatric nurse includes providing nursing assessment, directing nursing care
interventions, and educating client and family at developmentally appropriate levels; client advocacy, case
management, minimization of distress, and enhancement of coping. Advanced practice nurse practitioners
perform assessment, diagnosis, and management of health conditions.
2. The role of the pediatric nurse includes providing nursing assessment, directing nursing care
interventions, and educating client and family at developmentally appropriate levels; client advocacy, case
management, minimization of distress, and enhancement of coping. Advanced practice nurse practitioners
perform assessment, diagnosis, and management of health conditions.
3. The role of the pediatric nurse includes providing nursing assessment, directing nursing care
interventions, and educating client and family at developmentally appropriate levels; client advocacy, case
management, minimization of distress, and enhancement of coping. Advanced practice nurse practitioners
perform assessment, diagnosis, and management of health conditions.
4. The role of the pediatric nurse includes providing nursing assessment, directing nursing care
interventions, and educating client and family at developmentally appropriate levels; client advocacy, case
management, minimization of distress, and enhancement of coping. Advanced practice nurse practitioners
perform assessment, diagnosis, and management of health conditions.
Page Ref: 2-4
Cognitive Level: Applying
Client Need &Sub: Safe and Effective Care Environment: Management of Care Standards: QSEN
Competencies: Patient-centered care | AACN Essential Competencies:
Essential II: Basic organizational and systems leadership for quality care and patient safety | NLN
Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process:
Implementation/Coordination of care
Learning Outcome: LO 1.2 Compare the roles of nurses in child healthcare. MNL LO:
Pediatric nursing care
4) A 7-year-old child is admitted for acute appendicitis. The parents are questioning the nurse about
expectations during the child's recovery. Which information tool would be most useful in answering a
parent's questions about the timing of key events?
1. Healthy People 2020
2. Clinical pathways
3. Child mortality statistics
4. National clinical practice guidelines
Answer: 2
Explanation: 1. Clinical pathways are interdisciplinary documents provided by a hospital to suggest ideal
sequencing and timing of events and interventions for specific diseases to improve efficiency of care and
enhance recovery. This pathway serves as a model outlining the typical hospital stay for individuals with
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, specified conditions. Healthy People 2020 contains objectives set by the U.S. government to improve the
health and reduce the incidence of death in the
twenty-first century. Child mortality statistics can be compared with those from other decades for the
evaluation of achievement toward health-care goals. National clinical practice guidelines promote uniformity in
care for specific disease conditions by suggesting expected outcomes from specific interventions.
2. Clinical pathways are interdisciplinary documents provided by a hospital to suggest ideal sequencing and
timing of events and interventions for specific diseases to improve efficiency of care and enhance recovery.
This pathway serves as a model outlining the typical hospital stay for individuals with specified conditions.
Healthy People 2020 contains objectives set by the U.S. government to improve the health and reduce the
incidence of death in the twenty-first century. Child mortality statistics can be compared with those from
other decades for the evaluation of achievement toward health-care goals. National clinical practice
guidelines promote uniformity in care for specific disease conditions by suggesting expected outcomes from
specific interventions.
3. Clinical pathways are interdisciplinary documents provided by a hospital to suggest ideal sequencing and
timing of events and interventions for specific diseases to improve efficiency of care and enhance recovery.
This pathway serves as a model outlining the typical hospital stay for individuals with specified conditions.
Healthy People 2020 contains objectives set by the U.S. government to improve the health and reduce the
incidence of death in the twenty-first century. Child mortality statistics can be compared with those from
other decades for the evaluation of achievement toward health-care goals. National clinical practice
guidelines promote uniformity in care for specific disease conditions by suggesting expected outcomes from
specific interventions.
4. Clinical pathways are interdisciplinary documents provided by a hospital to suggest ideal sequencing and
timing of events and interventions for specific diseases to improve efficiency of care and enhance recovery.
This pathway serves as a model outlining the typical hospital stay for individuals with specified conditions.
Healthy People 2020 contains objectives set by the U.S. government to improve the health and reduce the
incidence of death in the twenty-first century. Child mortality statistics can be compared with those from
other decades for the evaluation of achievement toward health-care goals. National clinical practice
guidelines promote uniformity in care for specific disease conditions by suggesting expected outcomes from
specific interventions.
Page Ref: 1, 2
Cognitive Level: Applying
Client Need &Sub: Psychosocial Integrity
Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential II: Basic
organizational and systems leadership for quality care and patient safety |
NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Planning/Health
teaching and health promotion
Learning Outcome: LO 1.1 Describe the continuum of pediatric healthcare. MNL LO:
Family-centered care
5) The nurse recognizes that the pediatric client is from a cultural background different from that of the
hospital staff. Which goal is most appropriate for this client when planning nursing care?
1. Overlook or minimize the differences that exist.
2. Facilitate the family's ability to comply with the care needed.
3. Avoid inadvertently offending the family by imposing the nurse's perspective.
4. Encourage complementary beneficial cultural practices as primary therapies. Answer:
2
Explanation: 1. The incorporation of the family's cultural perspective into the care plan is most likely to
result in the family's ability to accept medical care and comply with the regimen prescribed. Since culture
develops from social learning, attempts to ignore or minimize cultural consideration will result in mistrust,
suspicion, or offenses that can have negative effects upon the health of children by reducing the resources
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