Maternity and Pediatric Nursing 4th Edition Test Bank

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Which of the following settings is most therapeutic for an agitated head-injured patient?

  • A. A day room with family visitors and variety of caregivers
  • B. A semiprivate room with one or two consistent caregivers
  • C. A ward with other head-injured patients and volunteers to assist with needs
  • D. A hallway near the nurse's station with adequate sensory stimulation
Correct Answer: B

Rationale: For an agitated head-injured patient, the most therapeutic setting would be a semiprivate room with one or two consistent caregivers. Consistency and familiarity can help reduce agitation and promote a sense of security for the patient. A quieter environment with fewer stimuli can also help in managing agitation and promoting a sense of calmness. By having consistent caregivers, the patient can build trust and feel more comfortable, which can contribute to their overall well-being and recovery. It is essential to minimize external factors that could contribute to further agitation, making a semiprivate room with consistent caregivers the most optimal setting for an agitated head-injured patient.

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In neuroblastoma, metastatic spread can occur via local invasion or distant hematogenous/lymphatic routes. The LEAST common site of metastases in neuroblastoma is

  • A. long bone
  • B. bone marrow
  • C. lung
  • D. skin
Correct Answer: D

Rationale: Skin metastases are rare in neuroblastoma compared to bone, bone marrow, and lung involvement.

These facts are true regarding the developmental stage of preschool children EXCEPT

  • A. handedness is achieved by 3 years of age
  • B. boys are usually later than girls in achieving bladder control
  • C. knowing gender by 4 years
  • D. egocentric thinking
Correct Answer: D

Rationale: Egocentric thinking is characteristic of preschool-age children.

The nurse is caring for a newborn whose mother is diabetic. Which clinical manifestations should the nurse expect to see?

  • A. Hypoglycemic, large for gestational age
  • B. Hyperglycemic, large for gestational age
  • C. Hypoglycemic, small for gestational age
  • D. Hyperglycemic, small for gestational age
Correct Answer: C

Rationale: Infants born to mothers with diabetes, especially uncontrolled diabetes, are at risk for hypoglycemia due to exposure to high glucose levels in utero. The infant's pancreas may have been producing high levels of insulin in response to the mother's high blood glucose levels, leading to hypoglycemia after birth. Additionally, these infants are typically smaller for gestational age (SGA) due to the effects of high blood sugar levels on fetal growth. Therefore, the nurse should expect the newborn of a mother with diabetes to exhibit signs of hypoglycemia and be small for gestational age.

A client with hyperglycemia, which assessment finding best supports a nursing diagnosis of Deficient fluid volume?

  • A. Cool, clammy skin
  • B. Increased urine osmolarity
  • C. Distended neck veins
  • D. serum sodium level
Correct Answer: B

Rationale: Increased urine osmolarity would best support the nursing diagnosis of Deficient fluid volume in a client with hyperglycemia. Hyperglycemia can lead to osmotic diuresis, where the body excretes excessive amounts of water to help eliminate glucose. This results in concentrated urine with a higher osmolarity. A high urine osmolarity indicates that the kidneys are conserving water due to decreased fluid volume in the body, supporting the diagnosis of Deficient fluid volume. The other assessment findings (cool, clammy skin, distended neck veins, serum sodium level) are not specific to the diagnosis of Deficient fluid volume in this context.

The pediatric nurse advises a parent how to best convey the circumstances surrounding the sudden death of an 18-month-old patient to a four-year-old sibling. The nurse anticipates that the sibling:

  • A. may feel guilty about the patient's death.
  • B. may mistrust the parent.
  • C. understands the permanence of death.
  • D. will role-play the patient's death.
Correct Answer: A

Rationale: Young children often struggle with understanding death and may internalize feelings of guilt, believing they had a role in the event.

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