CHAPTER 1: OVERVIEW OF PEDIATRIC NURSING

CHAPTER 1: OVERVIEW OF PEDIATRIC NURSING

MULTIPLE CHOICE

1.Which of the following major problems results from the denial of preventive services (such as prenatal care, dental care, and immunizations) to any given population?a.spiraling costs for emergency medical services b.health maintenance organizations losing money c.extensive waiting lists for clinic health care services d.closing of small community hospitals

ANS: A

Feedback A Correct: By denying preventive services minor health problems are not detected and treated early. Therefore, the problems become more serious, often requiring treatment in acute care and emergency settings, a more expensive approach than prevention.B Incorrect: The rationale for health maintenance organizations (HMOs) is to provide preventive services by a primary care provider to contain costs. If individuals have to be treated in the more costly acute or emergency settings for problems which could have been detected earlier, the HMOs may lose money. However this is not the most important problem resulting from denial of preventive services.C Incorrect: Preventive services are provided in clinic settings. However, if these services are denied, individuals will be utilizing clinics less frequently, thereby, reducing waiting lists.

D Incorrect: Denial of preventive servicdes should not have any effect on small

community hospitals.PTS: 1 REF: p. 5 - Immigrants OBJ: Cognitive Level: Comprehension 2.Poverty rates are highest in which of the following types of families?a.two-parentc.adoptive b.single-parentd.foster

ANS: B

Feedback A Incorrect: Poverty rates in two-parent families are much lower than those in families headed by a single parent. The potential exists for both parents to work which would increase household income.B Correct: Almost half of all poor children live in single-parent (usually women) households. The risk of poverty is high for the following reasons: low wages for women, low educational attainment for single mothers, and low rates and levels of child support from fathers.C Incorrect: When a child is adopted, there usually is adequate income to raise the individual at a decent living standard.D Incorrect: Foster parents are typically compensated and/or receive public benefits by state or federal programs. Poverty is not an issue in these families PTS: 1 REF: p. 6 - Poverty OBJ: Cognitive Level: Knowledge Pediatric Nursing Caring for Children and Their Families 3e Nicki Potts, Barbara Mandleco (Test Bank All Chapters, 100% Original Verified, A+ Grade) 1 / 4

• Which of the following factors most increases the prevalence of illnesses such as asthma and anemia,

as well as respiratory and gastrointestinal infections?

• household smokers c. poverty
• family history of these illnesses d. education

ANS: C

Feedback A Incorrect: Household smokers may increase the prevalence of asthma and respiratory problems. However, second had smoke will not affect the prevalence of anemia or gastrointestional infections.B Incorrect: Heredity plays a role in the etiology of asthma and other respiratory illnesses such as cystic fibrosis because these disorders tend to appear in families. However, a family history of other illnesses such as anemia and gastrointestinal infections does not increase their prevalence.C Correct: Children who live in poverty have diminshed physical health, higher mortality and morbidity, and decreased access to health care than nonpoor children. Therefore, they experience an increased incidence of physical and emotional health problems.D Incorrect: Lack of education and skills are at the root of poverty. So family income has significant effects on the well being of children. Yet, poverty is the major factor that increases the prevalence of illness.

PTS: 1 REF: p. 6 - Poverty OBJ: Cognitive Level: Comprehension

4. The children who are at greatest risk of infant death are born:

• to mothers under age 18 c. to fathers and mothers over age 40
• into families in poverty d. into families with alcohol problems

ANS: B

Feedback A Incorrect: Birth weight is the major determinant of infant mortality rate (IMR).The lower the birth rate, the higher the mortality. Adolescent pregnancy is associated with low birth weight which contributes to infant mortality, but it is not the major factor.B Correct: Racial disparities exist for infant mortality. The IMR for African Americans is twice the rate for whites because of the high rate of low birth weight infants born to minority mothers. Poverty is the most important factor in determining IMR. More nonwhites than whites are poor in the United States. Women who live in poverty are unlikely to be in good health or to have access to prenatal care which are vital during pregnancy.C Incorrect: Infant mortality rate is higher for mothers over the age of 40. However, this does not apply to fathers.D Incorrect: Although substance abuse such as alcohol does affect birth outcomes, it is not the greatest risk factor of infant death.

PTS: 1 REF: p. 6 - Poverty OBJ: Cognitive Level: Application

• The chance that a child will have to repeat a grade in school or be placed in special education classes:
• is the same for the general population, regardless of circumstances
• depends mainly on the quality of the schools and the teachers
• increases a small amount for each year the child lives in poverty
• depends mainly on whether the child has moved during the school year
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ANS: C

Feedback A Incorrect: School achievement declines with the time a child spends in poverty, thus increasing the possibility of having to repeat a grade or be placed in special education classes. A child living in poverty does not have the same chance of succeeding in school as a child in the general population.B Incorrect: Poor quality of schools and teachers may adversely affect a child’s performance in school; however, it is not the major predictor of a child having to repeat a grade or be placed in special education.C Correct: The chance a child will be retained in a grade or be placed in special education increses 2% to 3% for every year that the child lives in poverty.D Incorrect: Moving during the school year may affect a child’s performance in school, but it is not the most significant factor.

PTS: 1 REF: p. 6 - Poverty OBJ: Cognitive Level: Comprehension

• The fastest-growing segment of the homeless population consists of which of the following groups?
• alcoholics refusing treatment c. single males
• mentally ill people d. families with children

ANS: D

Feedback A Incorrect: Many individuals become homeless because of substnace abuse, but they are not the fastest growing segment of the homeless population.B Incorrect: Mental illness is one reason for homelesssness, but mentally ill people are not the fastest growing segment of the homeless population.C Incorrect: In the past the homeless population primarily consisted of single males; however, this is not true today.D Correct: Currently the fastest growing segment of the homeless consist of families with children, most commonly single mothers with two or three children.

PTS: 1 REF: p. 7 - Homelessness OBJ: Cognitive Level: Comprehension

• Which of the following groups of people disproportionately represents the homeless population?
• African Americans c. Hispanics
• Caucasians d. Asians

ANS: A

Feedback

A Correct: The homeless population is disproportionately represented by African

Americans. Chronic and peristant multigenerational poverty is the primary driving force resulting in this group’s homelessness.B Incorrect: Caucasian’s poverty rate is the lowest among these racial and ethnic groups.C Incorrect: Hispanics poverty rate at 21.5% as compared to 25.3% to the African American group is the second most likely racial/ethnic group to be affected by homelessness.D Incorrect: Asian population like the Caucasian population is 50% or more lesss likely to be entrapped in a chronic, persistent cycle of poverty.

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PTS: 1 REF: p. 7 - Homelessness OBJ: Cognitive Level: Comprehension

• A teacher confers with the school psychologist and the school nurse about a child who has poor

attention span, aggressive behaviors, delayed speech, and shyness, and who tends to withdraw. This child often falls asleep in class, saying he is not sleeping at night. Which of the following situations or conditions is most likely to cause or contribute to the behavior exhibited by this child?

• sharing a room with a sibling
• attention deficit disorder with hyperactivity
• homelessness
• narcolepsy

ANS: C

Feedback A Incorrect: Sharing a room with a sibling might result in sleep problems but none of the other behaviors.B Incorrect: ADHD is a physical disorder which may result in the poor attention span and aggression but none of the other behaviors.C Correct: A homeless child is a child experiencing traumatic insecurity and will exhibit all cited behaviors and more.D Incorrect: Narcolepsy is a physical disorder causing a child to fall asleep at any time but should not contribute to the other behaviors cited in the situation.

PTS: 1 REF: p. 8 - Homelessness OBJ: Cognitive Level: Comprehension

9. Psychological problems most often identified among homeless children are:

• conduct disorder
• oppositional defiant disorder
• depression, anxiety, and behavioral problems
• personality problems and difficulty with authority figures

ANS: C

Feedback A Incorrect: Conduct disorder is a psychological disorder characterized by irresponsible, delinquent behaviors such as truancy and running away; violations of the rights of others, and overt physical aggression. Conduct disorder is acting out behavior; whereas, depressed and anxious individuals (homeless children) do not tend to display antisocial behavior.B Incorrect: Oppositional defiant disorder (ODD) is characterized by hostile, negativistic, defiant, and disobedient attitudes and behaviors, especially toward authority figures.C Correct: Psychological problems identified most often among homelesss children include anxiety, depresssion, poor attention span, trouble sleeping, delayed speech, shyness, withdrawl, and aggressive behaviors.D Incorrect: Personality problems are manifested in behavior that deviates markedly from the expectations of one’s culture. Difficulty with authority figures is a symptom of ODD.

PTS: 1 REF: p. 8 - Homelessness OBJ: Cognitive Level: Comprehension

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