Test Bank For Pediatric Nursing : The Critical Components of Nursing Care, 2nd Edition

Chapter 2 Standards of Practice and Ethical Considerations Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. Which of the following behaviors serves as an example of the nurse directly upholding the American Nurses Association’s (ANA’s) Code of Ethics for Nurses? 1. The nursing union develops a safe patient-to-nurse ratio. 2. The nurse joins a professional specialty organization. 3. The nurse maintains sterile technique during procedures. 4. The nurse develops a plan of care for a community-wide illness. ____ 2. Which of the following behaviors serves as an example of the nurse directly upholding the ANA Code of Ethics for Nurses? 1. The nursing union develops a safe patient-to-nurse ratio. 2. The nurse joins a professional specialty organization. 3. The nurse maintains sterile technique during procedures. 4. The nurse develops a plan of care for a community-wide illness. ____ 3. The emergency department nurse is providing care to a 5-year-old child with a repeated exacerbation of otitis media. When it becomes apparent that the parents smoke and refuse to prevent the child’s exposure to secondhand smoke, the nurse voices frustration to the family that they are causing the child’s otitis media. Which of the provisions of the ANA Code of Ethics for Nurses has the nurse failed to follow? 1. The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient. 2. The nurse practices with compassion and respect for dignity, unrestricted by the nature of health problems. 3. The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient. 4. The patient’s right to self-determination must be upheld, justified only when justified by law. ____ 4. The nurse is providing discharge teaching to the family of a hospitalized 9-year-old patient, recently diagnosed with asthma. The family states that they feel overwhelmed with the treatment plans and cannot perform the necessary nebulizer treatments. Which nursing intervention best reflects the professional performance aspect of pediatric nursing standards? 1. The nurse arranges for a home care respiratory therapy consultation to teach the family proper techniques in the home setting. 2. The nurse contacts the physician to delay the patient’s discharge from the hospital until the family is able to perform treatments. 3. The nurse collects comprehensive data pertinent to the patient’s situation by reviewing the home situation. 4. The nurse evaluates progress toward the attainment of outcomes by having the family perform return demonstrations. Copyright © 2019 F. A. Davis Company ____ 5. The nurse recognizes that the American Nurses Association characterizes which fundamental nursing practice within the Pediatric Nursing Standards of Practice and Professional Performance for Nurses? 1. Nursing utilizes evidence-based practice for the rationale of interventions. 2. Nursing complies with the physician orders to maintain scope of practice. 3. Nursing maintains the institutional review boards that monitor care. 4. Nursing facilitates the rules of laws within the health-care continuum. ____ 6. The nurse understands that the nursing profession has standards of care that promote the covenant between patient and nurse. Which of the following is an example of this covenant? 1. The nurse adheres to strict guidelines regarding medication administration and procedures. 2. The nurse develops a care plan with mutually developed goals and interventions with the patient. 3. The nurse attends continuing education courses to maintain competency in skills. 4. The nurse considers each patient’s cultural practices without bias or judgment. ____ 7. The home care nurse is assessing the home environment for the pediatric patient. The nurse notes that the family is unable to perform some of the physical therapy exercises safely. What is the most appropriate initial nursing action? 1. Consult with the physical therapist to arrange more educational sessions. 2. Consult with the health-care provider for admission to a rehabilitation center. 3. Assess the exercises per the worksheet provided by the physical therapist. 4. Assess the family’s understanding of a safe of the physical therapy exercises. ____ 8. The nurse is providing care to an adolescent patient with cystic fibrosis in the acute care setting. The patient tells the nurse, “You are my favorite because you always listen to me, not like the other nurse who hates me.” Which response by the nurse is most appropriate? 1. “I will report the other nurse immediately, and you won’t have to see her again.” 2. “If you have any concerns, I can ask the charge nurse to talk to you, but we all work as a team.” 3. “That’s nice of you to say. I will try hard to keep you happy while here as my patient.” 4. “I understand. She has been reported by the other staff members for playing favorites.” ____ 9. The nurse is providing care to a child in the home care setting. The nurse often provides the mother with advice that varies from how to perform the child’s medical care to marital advice. The nurse has stated that this is her favorite patient and has made this child’s home the last stop of her shift to use her free time for visits. What is the relationship status between the nurse and family? 1. This is a therapeutic relationship based on family-centered care, with a focus on empathy. 2. This is not a therapeutic relationship, as the nurse has become enmeshed within the family. 3. This is a therapeutic relationship, with the nurse focusing on the well-being of the whole family. 4. This is not a therapeutic relationship, as the nurse has not included the whole family in the care. Copyright © 2019 F. A. Davis Company ____ 10. The nurse is assessing an adolescent patient in the emergency department after she was attacked at a party. The patient refuses to give her parent’s contact information and states, “They will kill me when they find out that I went to the party.” What is the nurse’s best response? 1. “They will understand. Let me call them to at least get the insurance information.” 2. “Since you are a minor, we need their consent to legally treat you.” 3. “We will treat you, and your parents do not have to know that you are here.” 4. “I need to contact the social worker, as we have a duty to report this attack to your family and the authorities.” ____ 11. The nurse is assessing an adolescent patient in the emergency department with a suspected intentional overdose. After given treatment, the patient refuses to give her parent’s contact information and states, “It is none of their business.” What is the nurse’s best response? 1. “Now that you are safe, let me help you develop a plan to prevent a recurrence.” 2. “I’m sorry, but I’m obligated to tell them. Let me help you develop a plan for their possible responses.” 3. “Although most of your health care is confidential, we are obligated to notify them.” 4. “I think you should tell them, but we will honor your confidentiality and not disclose the reason for your visit.” ____ 12. The nurse is preparing a 13-year-old patient for a full physical examination by the primary care provider (PCP). The patient asks that her mother leave the room because of the sensitive nature of the examination. What is the best course of action to be taken by the nurse to protect the interested parties? 1. Ask the mother to leave the room, and allow the patient to discuss her concerns privately with the PCP. 2. Allow the mother to stay in the room, and explain that she has the right to witness any care provided by the PCP. 3. Act as a chaperone and remain with the patient and mother in the room during the full examination. 4. Reassure the mother that the nurse will remain as a chaperone while she leaves the room. ____ 13. The nurse is providing care to the mechanically ventilated 4-year-old patient who is believed to be the victim of abuse from the parents. The parents refuse to permit removal of the ventilator. The nurse believes this is because the parents are afraid that they will be charged with murder if the child dies. What is the recourse for the health-care team in this ethical dilemma? 1. Provide the treatment even in the face of undue burden of resources. 2. Provide the parents with their financial burden of this care. 3. Provide information to the courts for legal involvement. 4. Provide support to the parents even if the team would choose differently. ____ 14. The nurse is preparing an 8-year-old patient for a cancer protocol that has a significant amount of risk. The parents have provided informed consent for this trial, but the patient has refused to partake in this research. What is the most appropriate course of action for this situation? 1. Treatment is carried forth, despite the patient’s dissent. 2. Treatment must be delayed until the parents and patient agree. Copyright © 2019 F. A. Davis Company 3. Treatment is delayed for review by the ethics committee. 4. Treatment is canceled until the patient assents. ____ 15. The nurse is providing care to a hospitalized 1-year-old patient. The nurse locks the exits per protocol to prevent the removal of the child from the unit. The grandparents become angry about this, because they want to take the infant outside for “some fresh air.” What is the appropriate measure that the staff take to promote patient safety at this time? 1. Explain that the child is not to leave the floor without express permission from the parents. 2. Explain to the grandparents that this is a measure to prevent abduction of the patient. 3. Permit the grandparents to take the child after they sign a waiver for any possible injuries incurred off the unit. 4. Permit the grandparents a limited amount of time off the unit, due to treatment schedules. ____ 16. The nurse is providing care to a hospitalized pediatric patient, and the patient is refusing all pain medication despite signs of obvious distress. The patient tells the nurse, “All you nurses lied, and the shots hurt.” What is the most appropriate nursing measure at this time? 1. Provide the medication in a cup of juice. 2. Have the parents administer the medication. 3. Explain not all medications are shots. 4. Admit to the patient that the shots hurt but explain they help. Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 17. Which of the following nursing actions is an example of a function of the Code of Ethics for Nurses directly relating to the health-care environment? Select all that apply. 1. The nurse cowrote a policy on nurse:patient ratio for the unit. 2. The nurse includes the extended family in discharge instructions. 3. The nurse joined a local professional organization that shapes community policy. 4. The nurse enrolled in a basic American Sign Language course. 5. The nurse joins the safety and infection control committees. ____ 18. Which of the following are examples of a nurse adhering to the pediatric standards of practice? Select all that apply. 1. The nurse educates the parents on how to administer insulin to their 9-year-old child. 2. The nurse asks the 3-year-old child to describe their level of pain with a Faces or Oucher scale. 3. The nurse refuses to divulge medical information to the parents of a pregnant adolescent. 4. The nurse provides extra free supplies to the family of an underinsured ill child. 5. The nurse uses evidence-based practice to maintain competency of new practices. Copyright © 2019 F. A. Davis Company ____ 19. The nurse is providing care to a toddler recently diagnosed with asthma. The parents have become verbally aggressive with staff and have challenged many of the unit rules. Which of the following may have contributed to the family’s challenging behavior? Select all that apply. 1. The parents are both working professionals in leadership roles and fear loss of control. 2. The family has researched asthma on the Internet and does not agree with the treatment protocol. 3. The staff members have maintained therapeutic communication with the patient and family. 4. The nurse has developed a mutual set of goals and interventions with the family. 5. The staff members have provided a medically trained translator to promote understanding in care. ____ 20. Which of the following interventions are examples of a family-focused strategy? Select all that apply. 1. Coordinating care with other departments to lessen sleep disruptions 2. Providing storage and prep of meals from home for family members 3. Stipulating unilateral visiting rules for all patients and their families 4. Involving the parents in nursing change of shift reports and care plans 5. Providing dedicated family space with basic needs for rooming in parents Copyright © 2019 F. A. Davis Company Chapter 2 Standards of Practice and Ethical Considerations Answer Section MULTIPLE CHOICE 1. ANS: 1 Chapter: Chapter 2 Standards of Practice and Ethical Considerations Chapter Learning Objective: 1. Identify and describe sources of standards of practice relevant to the day-to-day practice of pediatric nurses Page: 13 Heading: Box 2-1: The Nine Provisions of the ANA Code of Ethics for Nurses Integrated Processes: Caring Client Need: Safe and Effective Care Environment Cognitive Level: Analysis [Analyzing] Concept: Ethics Difficulty: Moderate 1 2 3 4 Feedback This is correct. Provisions 5 and 6 of the ANA code describe how the nurse establishes and improves health-care environments and conditions of employment conducive to quality of health care. This is incorrect. Although this may facilitate duties to self and others, it is not a direct effect from the Code of Ethics for Nurses. This is incorrect. This is a fundamental nursing skill. It is not a direct effect from the Code of Ethics for Nurses. This is incorrect. Although the nurse practice involves developing plans of care, it may not involve a Code of Ethics for Nurses stance. PTS: 1 CON: Ethics 2. ANS: 1 Chapter: Chapter 2 Standards of Practice and Ethical Considerations Chapter Learning Objective: 1. Identify and describe sources of standards of practice relevant to the day-to-day practice of pediatric nurses Page: 13 Heading: Box 2-1: The Nine Provisions of the ANA Code of Ethics for Nurses Integrated Processes: Caring Client Need: Safe and Effective Care Environment Cognitive Level: Analysis [Analyzing] Concept: Ethics Difficulty: Moderate 1 Feedback This is correct. Provisions 5 and 6 of the ANA code describe how the nurse establishes and improves health-care environments and conditions of employment conducive to quality of health care. Copyright © 2019 F. A. Davis Company 2 3 4 This is incorrect. Although this may facilitate duties to self and others, it is not a direct effect from the Code of Ethics for Nurses. This is incorrect. This is a fundamental nursing skill. It is not a direct effect from the Code of Ethics for Nurses. This is incorrect. Although the nurse practice involves developing plans of care, it may not involve a Code of Ethics for Nurses stance. PTS: 1 CON: Ethics 3. ANS: 2 Chapter: Chapter 2 Standards of Practice and Ethical Considerations Chapter Learning Objective: 5. Identify the nine provisions of the Code of Ethics for Nurses and relate them to practical situations encountered in the day-to-day practice of pediatric nursing. Page: 13 Heading: Box 2-1: The Nine Provisions of the ANA Code of Ethics for Nurses Integrated Processes: Communication and Documentation Client Need: Health Promotion and Maintenance Cognitive Level: Application [Applying] Concept: Family Dynamics Difficulty: Moderate 1 2 3 4 Feedback This is incorrect. Although the nurse realizes that the secondhand smoke may be a contributing factor to the child’s otitis media, the nurse did not fail to comply to this code of ethics at this time. This is correct. The nurse failed to practice with compassion and respect for the dignity of the patient (and family). This is incorrect. The nurse attempted to maintain the overall health of the patient (and family) regarding the smoking. This is incorrect. This is not an issue at the time, as this is a minor child. PTS: 1 CON: Family Dynamics 4. ANS: 1 Chapter: Chapter 2 Standards of Practice and Ethical Considerations Chapter Learning Objective: 1. Identify and describe standards of practice relevant to the day-to-day practice of pediatric nurses. Page: 14 Heading: Box 2-2: Pediatric Nursing Standards: Professional Performance Integrated Processes: Caring Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Ethics Difficulty: Moderate 1 Feedback This is correct. This would involve communication with the family regarding Copyright © 2019 F. A. Davis Company 2 3 4 their concerns. The nurse will collaborate with the respiratory therapist to arrange a home visit for further teaching. The nurse considers the overall safety of the patient and family by using available resources to deliver home care. The nurse is being an active advocate for the patient and family by providing more resources and coordinating help at home. This is incorrect. Although the nurse is being an advocate, there are no data to support delaying the child’s discharge (standard #17). This is incorrect. This is a component of practice and should be ongoing. It may facilitate better understanding of the family’s fears or concerns, but it is not defined as a professional performance component of the standards (standard #1). This is incorrect. This is a component of practice and should be ongoing. It may facilitate better understanding of the family’s fears or concerns but is not defined as a professional performance component of the standards (standard #6). PTS: 1 CON: Ethics 5. ANS: 1 Chapter: Chapter 2 Standards of Practice and Ethical Considerations Chapter Learning Objective: 3. List the six standards of practice and 11 standards of professional performance highlighted in Pediatric Nursing: Scope and Standards of Practice and discuss associated measurement criteria. Page: 14 Heading: Box 2-2: Pediatric Nursing Standards of Practice and Professional Performance Integrated Processes: Teaching and Learning Client Need: Safe and Effective Care Environment Cognitive Level: Application [Applying] Concept: Ethics Difficulty: Difficult 1 2 3 4 Feedback This is correct. This is an example of the recognition of the Pediatric Nursing Standards of Practice and Professional Performance as a living document that changes with scientific knowledge. Standard 5 states, “The nurse owes the same duties to self as to others, including the responsibility to preserve integrity and safety, to maintain competence, and to continue person and professional growth.” Additionally, standard 7 states, “The nurse participates in the advancement of the profession through contributions to practice, education, administration, and knowledge development.” This is incorrect. The nurse will comply with physician orders as an advocate for both the patient and nursing profession. This is not based on the Pediatric Nursing Standards of Practice and Professional Performance. This is incorrect. The institutional review board is a source of standards that monitors and regulates research. However, this is not directly based on the Pediatric Nursing Standards of Practice and Professional Performance. This is incorrect. This relates to nursing standards and scope of practice, but it is not the Pediatric Nursing Standards of Practice and Professional Performance. Copyright © 2019 F. A. Davis Company PTS: 1 CON: Ethics 6. ANS: 2 Chapter: Chapter 2 Standards of Practice and Ethical Considerations Chapter Learning Objective: 2. Identify and elaborate on the key themes related to pediatric nursing standards of practice. Page: 14 Heading: Pediatric Nursing Scope and Standards of Practice > Role of Therapeutic Relationships Integrated Processes: Caring Client Need: Safe and Effective Care Environment Cognitive Level: Application [Applying] Concept: Ethics Difficulty: Moderate 1 2 3 4 Feedback This is incorrect. This is safe nursing practice and may promote trust between the nurse and patient, but it does not directly promote the covenant. This is correct. This develops a level of trust and empathy between the patient and nurse. Key word: mutual goal and interventions. This is incorrect. although this may increase the nurse’s competence it does not directly affect the trust between the patient and nurse. This is incorrect. Although this may facilitate respect from the nurse, it may not promote trust between the nurse and patient. PTS: 1 CON: Ethics 7. ANS: 4 Chapter: Chapter 2 Standards of Practice and Ethical Considerations Chapter Learning Objective: 6. Identify ethics controversies commonly encountered in the practice of pediatric nursing and discuss relevant principles, duties, rights, and virtues. Page: 14 Heading: Box 2-2: Pediatric Nursing Standards of Practice and Professional Performance Integrated Processes: Teaching and Learning Client Need: Safe and Effective Care Environment: Coordinated Care Cognitive Level: Analysis [Analyzing] Concept: Collaboration; Culture Difficulty: Moderate Feedback 1 2 3 4 This is incorrect. This intervention may be appropriate if the patient’s family needed more education and therapy sessions, but it is not appropriate in this situation. This is incorrect. Although this may be an appropriate intervention if the patient’s family is unable to perform the home exercise program as set by the therapist, it is not an appropriate initial nursing intervention in this situation. This is incorrect. Although it would be an appropriate intervention for further assessment, this is not appropriate in this situation. This is correct. The appropriate initial nursing intervention is to assess the Copyright © 2019 F. A. Davis Company family’s understanding of the problem. PTS: 1 CON: Collaboration | Culture 8. ANS: 2 Chapter: Chapter 2 Standards of Practice and Ethical Considerations Chapter Learning Objective: 2. Identify and elaborate on the key themes related to pediatric nursing standards of practice. Page: 15 Heading: Safe and Effective Nursing Care: Clinical Pearl Integrated Processes: Nursing Process Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Patient-Centered Care Difficulty: Moderate Feedback 1 2 3 4 This is incorrect. This is unprofessional and facilitates splitting of the staff. The patient is chronically ill and may have repeated hospital admissions. This is correct. Acknowledgment of the patient’s statement and referring the matter to a neutral party may prevent splitting of the staff members. This can avert adversarial responses from the patient. This is incorrect. This is not therapeutic and strengthens the patient’s splitting behavior. This is incorrect. This is not therapeutic, strengthens the patient’s splitting behavior, and is not proper to discuss other staff members to patients. PTS: 1 CON: Patient-Centered Care 9. ANS: 2 Chapter: Chapter 2 Standards of Practice and Ethical Considerations Chapter Learning Objective: 6. Identify ethics controversies commonly encountered in the practice of pediatric nursing and discuss relevant principles, duties, rights, and virtues. Page: 16 Heading: Safe and Effective Nursing Care: Clinical Pearl Integrated Processes: Caring Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Ethics Difficulty: Moderate 1 2 3 Feedback This is incorrect. There may be some empathy, but the nurse has become enmeshed with the care and is neither goal directed nor family focused. This is correct. This nurse has become enmeshed with the family without regard for professional boundaries. This is incorrect. Although the pediatric nursing model is family centered, this Copyright © 2019 F. A. Davis Company 4 appears more nurse centered than family centered. This is incorrect. Although this is not a therapeutic relationship, the rationale is not correct. PTS: 1 CON: Ethics 10. ANS: 4 Chapter: Chapter 2 Standards of Practice and Ethical Considerations Chapter Learning Objective: 6. Identify ethics controversies commonly encountered in the practice of pediatric nursing and discuss relevant principles, duties, rights, and virtues. Page: 20 Heading: Developmentally Appropriate Care > Child Development, Privacy, and Confidentiality > Practical Limitations and Legal Exceptions Regarding Confidentiality Integrated Processes: Communication and Documentation Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Safety; Legal Difficulty: Moderate 1 2 3 4 Feedback This is incorrect. This is not therapeutic communication, and it negates the patient’s concerns. This is incorrect. The patient may receive emergency treatment without parental consent. This is incorrect. The parents may receive a bill from the emergency department for the visit. It may not provide information on why the patient was in the emergency department. This is correct. The nurse has an obligation as a mandated reporter to notify the appropriate authorities. Often the social worker will fill a report. The nurse must verify that the patient’s record contains documentation of this report. PTS: 1 CON: Safety | Legal 11. ANS: 2 Chapter: Chapter 2 Standards of Practice and Ethical Considerations Chapter Learning Objective: 6. Identify ethics controversies commonly encountered in the practice of pediatric nursing and discuss relevant principles, duties, rights, and virtues. Page: 20 Heading: Developmentally Appropriate Care > Child Development, Privacy, and Confidentiality > Practical Limitations and Legal Exceptions Regarding Confidentiality Integrated Processes: Communication and Documentation Client Need: Safe and Effective Care Environment Cognitive Level: Application [Applying] Concept: Communication; Legal Difficulty: Moderate Feedback Copyright © 2019 F. A. Davis Company 1 2 3 4 This is incorrect. This does not address the fact that the health-care provider has a mandated obligation to report self-harm to the authorities or parents. This is correct. When health-care professionals have a reasonable concern that a patient may harm himself or herself, they are required by law to break confidentiality. The child should be given the option to participate in telling the parents, but ultimately the health-care provider is mandated to report the patient’s self-harm. This is incorrect. Although the health-care provider is mandated to report self-harm, the best option would be to prepare the patient for the fallout of the disclosure. This is incorrect. This does not address the health-care provider’s mandated obligation to report self-harm. PTS: 1 CON: Communication | Legal 12. ANS: 4 Chapter: Chapter 2 Standards of Practice and Ethical Considerations Chapter Learning Objective: 6. Identify ethics controversies commonly encountered in the practice of pediatric nursing and discuss relevant principles, duties, rights, and virtues. Page: 20 Heading: Developmentally Appropriate Care > Child Development, Privacy, and Confidentiality > Use of Chaperones Integrated Processes: Teaching and Learning Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Patient-Centered Care Difficulty: Moderate 1 2 3 4 Feedback This is incorrect. Due to the sensitive nature of the examination, there should be a qualified chaperone to protect both the patient and practitioner. This is incorrect. Due to the sensitive nature of the examination, the child has the right to privacy. This is incorrect. The patient may be hesitant to discuss sensitive information with the mother present, and the patient has requested privacy at the beginning of the examination. This is correct. Due to the sensitive nature of the examination, there should be a qualified chaperone to protect both the patient and practitioner. PTS: 1 CON: Patient-Centered Care 13. ANS: 3 Chapter: Chapter 2 Standards of Practice and Ethical Considerations Chapter Learning Objective: 6. Identify ethics controversies commonly encountered in the practice of pediatric nursing and discuss relevant principles, duties, rights, and virtues. Page: 21 Heading: Pediatric Decision Making > Best Interest: Who Gets to Decide? Integrated Processes: Communication and Documentation Copyright © 2019 F. A. Davis Company Client Need: Safe and Effective Care Environment Cognitive Level: Application [Applying] Concept: Ethics Difficulty: Moderate 1 2 3 4 Feedback This is incorrect. This would negate the best intent of the child. The parents are making decisions based on the interests of themselves rather than the child and there is an apparent conflict of interest. This is incorrect. This course of action is not in the best intent of the child. When parents are making health-care decisions based on the interests of themselves rather than the child or have a conflict of interest, their parental decision-making rights may be challenged legally. This is correct. The parents are putting their self-interests ahead of the interests of the child and there is a clear conflict of interest. In this case, the parent’s decision-making rights may be challenged legally. This is incorrect. This would negate the best intent of the child. The parents are making decisions based on the interests of themselves rather than the child and there is an apparent conflict of interest. PTS: 1 CON: Ethics 14. ANS: 4 Chapter: Chapter 2 Standards of Practice and Ethical Considerations Chapter Learning Objective: 7. Differentiate consent, permission, and assent, and discuss how promoting the best interests of children in the issue of consent differs from obtaining informed consent from a competent adult. Page: 23 Heading: Critical Component: Consent, Assent, and Permission Integrated Processes: Teaching and Learning Client Need: Safe and Effective Care Environment, Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Ethics; Legal Difficulty: Moderate 1 2 3 4 Feedback This is correct. Although the patient has refused, the parents have provided permission for the care of the patient. This is incorrect. The treatment may be delayed for further discussion, but ultimately, the parents have given permission to proceed. This is incorrect. Unless the parents do not agree, there is no call for an ethics board review at this time. This is incorrect. Although the patient has refused to assent, the parents have provided informed consent to the treatment. PTS: 1 CON: Ethics | Legal Copyright © 2019 F. A. Davis Company 15. ANS: 2 Chapter: Chapter 2 Standards of Practice and Ethical Considerations Chapter Learning Objective: 1. Identify and describe sources of standards of practice relevant to the day-to-day practice of pediatric nurses. Page: 25 Heading: Safety in the Pediatric Setting > National Patient Safety Goals Integrated Processes: Communication and Documentation Client Need: Safe and Effective Care Environment Cognitive Level: Application [Applying] Concept: Safety Difficulty: Moderate 1 2 3 4 Feedback This is incorrect. This is a safety measure to prevent abduction of the patients by noncustodians. This is correct. This is a standard safety measure to prevent abduction by noncustodians. This is incorrect. Unless the parents have given express permission, the noncustodial grandparents may not take the child off the unit. This is incorrect. Unless the parents have given express permission, the noncustodial grandparents may not take the child off the unit. PTS: 1 CON: Safety 16. ANS: 4 Chapter: Chapter 2 Standards of Practice and Ethical Considerations Chapter Learning Objective: 6. Identify ethics controversies commonly encountered in the practice of pediatric nursing and discuss relevant principles, duties, rights, and virtues. Page: 27 Heading: Truth-Telling Standards and Pediatric Nursing Integrated Processes: Communication and Documentation Client Need: Safe and Effective Care Environment: Safety and Infection Control Cognitive Level: Application [Applying] Concept: Safety Difficulty: Moderate 1 2 3 4 Feedback This is incorrect. The key terms are truth and veracity. This would essentially constitute a lie by masking the medication from the child. This is incorrect. This would provide a chance for the child to distrust the parents. This is incorrect. Although this would help with the administration of a pain medication, it does not address the issue of veracity or truth telling to the patient. This is correct. Telling the truth may help rebuild the lost trust. “In general, children prefer the truth and may develop distrust for health-care providers when just one health care provider deceives them.” Copyright © 2019 F. A. Davis Company PTS: 1 CON: Safety MULTIPLE RESPONSE 17. ANS: 1, 3, 5 Chapter: Chapter 2 Standards of Practice and Ethical Considerations Chapter Learning Objective: 5. Identify the nine provisions of Code of Ethics for Nurses and relate them to practical situations encountered on a day-to-day practice of pediatric nursing. Page: 13 Heading: Box 2-1: The Nine Provisions of the ANA Code of Ethics for Nurses Integrated Processes: Nursing Process Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Patient-Centered Care Difficulty: Moderate 1. 2. 3. 4. 5. Feedback This is correct. This is provision #6, which states the nurse participates in improving health-care environments and conditions of employment. This is incorrect. Although this is an example of family-centered care, it is not a component of the Code of Ethics for Nurses. This is correct. This could indirectly influence the workplace environment by shaping social policy. This relates to provision #9. This is incorrect. Although this would facilitate communication and cultural sensitivity, it does not directly influence the workplace environment. This is correct. This relates to provision #8, which states that the nurse will collaborate with other health professionals to meet health needs of the facility and community. An example is how the two patient-identifier practice was started by a group of concerned nurses. PTS: 1 CON: Patient-Centered Care 18. ANS: 1, 2, 3, 5 Chapter: Chapter 2 Standards of Practice and Ethical Considerations Chapter Learning Objective: 3. List the 6 standards of practice and 11 standards of professional performance highlighted in Pediatric Nursing: Scope and Standards of Practice and discuss associated measurement criteria. Page: 14 Heading: Box 2-2: Pediatric Nursing Standards of Practice and Professional Performance Integrated Processes: Nursing Process Client Need: Safe and Effective Care Environment: Safety and Infection Control Cognitive Level: Application [Applying] Concept: Safety; Ethics Difficulty: Moderate Copyright © 2019 F. A. Davis Company 1. 2. 3. 4. 5 Feedback This is correct. Teaching parents how to administer insulin relates to advocacy and empowerment for the patient and family. This is correct. Using these established tools to assess a patient’s pain level is an example of effective communication. This is correct. This action ensures the privacy of the patient. Although the parents may be financially responsible for the adolescent, they are not entitled to her medical information without her express permission. This is incorrect. The criteria for analysis of this situation would involve the just and ethical distribution of resources. Would the facility approve of distribution of these resources, and would the nurse provide the same to all of the patients? This is correct. Per the ANA and pediatric standards of care, the nurse must maintain competency in current standards of care. PTS: 1 CON: Safety | Ethics 19. ANS: 1, 2 Chapter: Chapter 2 Standards of Practice and Ethical Considerations Chapter Learning Objective: 6. Identify ethics controversies commonly encountered in the practice of pediatric nursing, and discuss relevant principles, duties, rights, and virtues. Page: 16 Heading: Box 2-3: Potential Contributing Factors to Challenging Family Behaviors Integrated Processes: Caring Client Need: Safe and Effective Care Environment Cognitive Level: Application [Applying] Concept: Family Dynamics; Communication Difficulty: Moderate 1. 2. 3. 4. 5 Feedback This is correct. Family members who have a background in leadership may fear loss of control over their child and lash out at the staff. This is correct. If the family is in possession of inadequate information or misinformation, they may lash out or challenge the treatment protocol. This is incorrect. Maintaining therapeutic communication may facilitate a covenant between the patient/family and nurse/staff. This is incorrect. This would provide a therapeutic relationship between the nurse and patient/family. This is incorrect. Providing a medically trained translator facilitates better communication between the staff and patient, which may promote better understanding and reliable information. PTS: 1 CON: Family Dynamics | Communication 20. ANS: 2, 4, 5 Chapter: Chapter 2 Standards of Practice and Ethical Considerations Copyright © 2019 F. A. Davis Company Chapter Learning Objective: 1. Identify and describe sources of standards of practice relevant to the day-to-day practice of pediatric nurses; 5. identify the nine provisions of the Code of Ethics for Nurses and relate them to practical situations encountered in the day-to-day practice of pediatric nursing. Page: 16 Heading: Family-Centered Care > Overview of Family-Centered and Family-Focused Strategies Integrated Processes: Communication and Documentation Client Need: Psychosocial Integrity Cognitive Level: Analysis [Analyzing] Concept: Family Dynamics Difficulty: Moderate 1. 2. 3. 4. 5 PTS: Feedback This is incorrect. Although this would facilitate rest for the patient, it is not family focused. This is correct. Meal storage and prep for meals at home will help decrease the discomfort for the family members of the patient. This is a culturally sensitive intervention as well. This is incorrect. Although this would be fair for all, it is not a family-focused set of rules. This is correct. This is family focused, because it involves the parents in the care of the child. This is correct. Providing a dedicated family space for rooming-in parents will ease the discomfort incurred from the hospital stay. There are “Ronald McDonald Family Rooms” in many facilities. 1 CON: Family Dynamics Copyright © 2019 F. A. Davis Company