Question 1

A pediatric patient with multiple myeloma who is receiving chemotherapy has a body temperature that has risen three degrees during the six-hour period and is now 102.2 °F. The nurse should:

Accepted Answer

The nurse should administer antipyretic as prescribed and notify the physician. An elevated body temperature increases metabolic demands and the pyrexia must be treated immediately; the physician must be notified because the patient is immunocompromised, from both the disease and the chemotherapy.

Question 2

Julie is a newly promoted pediatric intensive care unit manager. She is leading the unit in accordance with her immediate supervisor who demonstrated passion for serving her staff rather than being served. She took the time to listen and preferred to be a teacher first before being a leader. Her immediate supervisor is a leader described as:

Accepted Answer

Her immediate supervisor is a leader described as servant leader. Servant leaders are open-minded, listen deeply, and try to fully understand others and not being judgmental.

Question 3

A nurse is caring for a twelve-year-old patient whose parents are known Jehovah's Witnesses. The physician ordered two "u" of PRBC properly typed and cross matched. The nurse should:

Accepted Answer

The nurse should talk to the parents with full information and reasons for transfusion. Jehovah's Witnesses have traditionally shunned transfusions and blood products as part of their religious beliefs. It's important to approach the family with full information and reasons for the transfusion or blood components without being judgmental, allowing the parents to express their feelings. In fact, studies show that while adults often refuse transfusions for themselves, they frequently allow their children to receive blood products, so one should never assume that an individual will refuse blood products based on their religion alone.

Question 4

A nurse is caring for a fourteen-year-old patient with a diagnosis of leukemia. The nurse learns that the patient's parents and grandparents belong to Hmong populations and these people are always at the bedside. When caring for this type of patient, the nurse should observe all of the following except:

Accepted Answer

When caring for this type of patient, the nurse should observe all of the listed items except to give information related to care solely to the patient or parents. Hmong population cling tightly to their traditions and that includes that the eldest male in the family should be the one to make decisions; nurses should ask who should receive information about the patient.
Additionally, it was mentioned that the grandparents are present at the bedside. They consider direct eye contact to be rude. Respect is shown by bowing their heads and presenting things with both hands. It is okay to question them about the usage of herbs and be sure to explain that some medications already contain herbal treatment and that the patient could receive too much.

Question 5

A nurse is caring for a sixteen-year-old patient with a diagnosis of lung cancer. The nurse is aware that the patient has a Cuban mother and a Mexican father. When caring for this patient, the nurse needs to know all but one of the following:

Accepted Answer

When caring for this patient, the nurse needs to that patients do not need pampering, as they consider it infantile. Hispanics who are ill expect some degree of pampering as parents reacts strongly to news about their child, so extra attention to the child may alleviate some of their anxiety. They encourage outward expressions of emotions.

Question 6

A nurse is aware that parents who are Jehovah's Witnesses may allow their child to undergo blood transfusion of blood products, but a thorough explanation may be required. Which of the following is considered unacceptable to them?

Accepted Answer

Whole blood: plasma is considered to be unacceptable to Jehovah's Witnesses. It is important to know that parents who are Jehovah's Witnesses may allow their child to undergo blood transfusion, but typically only with fractionated blood cells, thus allowing haemoglobin-based blood substitute.

Question 7

Joker is a pediatric unit manager. He is aware that regardless of the size of a work group, enough staff must be available at all times to accomplish certain purposes. Which of these purposes is not included?

Accepted Answer

The purpose that is not included is providing a pair of hands to other units as needed. Providing a pair of hands for other units is not a purpose in doing an effective staffing process. This is a function of a staffing coordinator at a centralized model.

Question 8

After caring for a severely ill patient for several weeks, the nurse becomes increasingly aware of a need to get away from this assignment. The nurse's best primary action is to:

Accepted Answer

The nurse's best primary action is to seek support from colleagues on the unit. Talking with colleagues who face or who have faced the same problems may provide constructive help with the situation.

Question 9

A nurse is working double shifts to pay for a new house. These are stopped when frequent headaches and fatigue ensue. The nurse manager notices that the care the nurse is providing is barely adequate, even when staying extra hours every day. The nurse manager should handle this situation by stating:

Accepted Answer

The nurse manager should handle this situation by stating, "I've noticed that you've been staying late every night." An understanding and supportive approach to a colleague with burnout allows the individual to identify the problem; this intervention points out behavior.

Question 10

The nurse manager in the pediatric department who is helping a nurse with burnout should facilitate confrontation of the problem by urging the nurse to:

Accepted Answer

The nurse manager in the pediatric department who is helping a nurse with burnout should facilitate confrontation of the problem by urging the nurse to identify personal responses to daily work stresses. To confront burnout, the individual must first identify the stressors, coping strategies used, and effectiveness of these strategies.

Question 11

A pediatric patient was hospitalized under an involuntary procedure. The patient's father wants to call his lawyer about matters involving a lawsuit. Which of the following nursing actions is most appropriate?

Accepted Answer

The nursing action that is most appropriate is to allow the phone call without seeking any further information. A patient who is admitted under an involuntary procedure retains all civil rights, including the right to consult a lawyer and the right to sue.

Question 12

Jake, a seven-year-old patient, was admitted to the unit. He was born to parents who speak a foreign language. To facilitate communication, it is best to implement which of the following:

Accepted Answer

To facilitate communication, it is best to implement the use of an interpreter. An interpreter will enable the nurse to better assess the concerns. Other options are also important; however, these are insufficient for assessment of patient's needs.

Question 13

A nurse is observed as routinely responding to patients in an autocratic, controlling manner and with little consideration for their dignity and rights. After attempts to directly acknowledge the situation with the nurse in question, the nurse's colleagues plan to meet with the supervisor to express their concern about this unprofessional conduct. The plan to go to the nurse supervisor is:

Accepted Answer

The plan to go to the nurse supervisor is appropriate, because peer review is a professional activity needed to maintain quality care. Every institution calls for peer review as a mechanism for maintaining quality care. In the above situation, it would be better if a formal peer review system were in place to evaluate the nurse's performance.

Question 14

A nurse has observed that a co-worker came to work drunk at least four times in the past month. Which of the following would the nurse do to ensure patient safety and obtain necessary assistance for the co-worker?

Accepted Answer

What the nurse would most appropriately do to ensure patient safety and obtain necessary assistance for the co-worker is to report the co-worker's behavior to the appropriate supervisor. The nurse is obligated by ethical considerations of patient safety, as well as by nurse practice acts in many nations, to report substance abuse in health care workers.

Question 15

A nursing unit supervisor notes that there is a high rate of absenteeism and minimal participation by staff nurses. Which of the following leadership styles is the supervisor most likely using in this situation?

Accepted Answer

A leadership style that the supervisor would most likely use in this situation is authoritarian. When the leadership style is authoritarian, the group may demonstrate passive-aggressive behavior, such as absenteeism and minimal participation.

Question 16

The nurse manager notes that the unit atmosphere has become negative and some of the nurses are not accepting staff. It would be best for the nurse manager to:

Accepted Answer

It would be best for the nurse manager to share the observation with the entire team. This will facilitate group process by correcting behavior that hinders the team functioning. Other options are avoidance in dealing with an essential issue to team functioning.

Question 17

A nurse accompanies a physician to the patient's room. Upon assessment, the patient has an extremely painful, reddened, and enlarged abscess on the right elbow. The physician proceeds to incise the abscess area without anesthetic and the patient cries out loudly in pain. The most appropriate immediate nursing action is to:

Accepted Answer

The most appropriate immediate nursing action is to attempt to distract the patient during the procedure. The nurse needs to be a protector and patient's advocate. The nurse helps to maintain a safe environment for the patient and takes steps to prevent injury and protect the patient from possible adverse effects of diagnostic or treatment measures.

Question 18

A nurse notices that her colleague is taking frequent breaks, having inaccurate drug counts, and working extra shifts. The nurse would suspect:

Accepted Answer

The nurse would suspect the colleague is abusing a substance. The above mentioned findings are indicative that the nurse's colleague is abusing a substance. The nurse may volunteer for extra shifts in an effort to obtain drugs. Other indicators include irritability, absenteeism, and deteriorating appearance.

Question 19

Julie, a clinical nurse specialist, observes that her co-worker has behavior that suggests chemical impairment. Julie should first:

Accepted Answer

Julie should first report the observed behavior to the unit manager. The nurse needs to report the observed behavior to the unit manager. The unit manager is accountable for maintaining the level of care in the unit. She is also the staff nurses' link to administration. The prevalence of substance abuse among nurses is parallel to that in the general population.

Question 20

When the nurse enters the patient's room, she observes that the patient is vomiting. The nurse had taken a capsule of Vistaril from the stock supply to the patient's bedside for administration. The nurse decides the injectable form of the medication should be used rather that the oral form and calls the physician to change the order. Proper safe disposal of the oral capsule of the medication requires the nurse to:

Accepted Answer

Proper safe disposal of the oral capsule of the medication requires the nurse to crush the tablet and flush it into the sewer system. Medication taken from the stock supply cannot be returned; the safest way is achieved by rendering it unusable and disposing it in the sewer system.

Quiz 3: Pediatrics