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Quiz Session - Attempts With Random Questions

PNCB CPN Exam Questions

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1.

A teenager with cystic fibrosis is resistant to following a new treatment protocol. What approach should the pediatric nurse take to advocate for the patient's care?

  • Work with the patient to address concerns and modify the treatment plan as needed

  • Inform the patient about the potential risks of not following the treatment protocol

  • Request a consolation with a psychologist to support the patient’s adjustment

  • Recognize the need for patient autonomy, providing advice but accepting their decision

Correct answer: Work with the patient to address concerns and modify the treatment plan as needed

Working with the patient to address concerns and modify the treatment plan as needed respects the teenager’s autonomy and acknowledges their input, which can increase adherence to the treatment protocol. This approach fosters a partnership between the nurse and patient, enhancing personalized care.

Merely informing the patient about the potential risks of not following the treatment protocol does not address any underlying reasons for resistance and may not be persuasive enough to change behavior. Requesting a consultation with a psychologist could be beneficial but should follow initial efforts to engage directly with the patient about their concerns, rather than as a first step. Recognizing the need for patient autonomy and providing advice while accepting their decision does not actively engage in resolving the issue or exploring why the patient is resistant, which is necessary for effective advocacy and care.

2.

A 5-year-old child is post-operative from an appendectomy and is reluctant to participate in necessary ambulation due to pain. Which non-pharmacologic intervention should the nurse prioritize to encourage mobility?

  • Offer a favorite toy as a focus during ambulation

  • Explain how to avoid thinking about pain during ambulation

  • Allow the child to rest more before trying to walk

  • Apply a warm compress on the incision site before walking

Correct answer: Offer a favorite toy as a focus during ambulation

Offering a favorite toy provides a positive distraction that can reduce fear and pain perception during ambulation, encouraging movement, which is essential for recovery post-surgery.

Explaining how to avoid thinking about pain is unlikely to be effective for a 5-year-old and does not provide immediate relief or motivation. Allowing more rest might delay necessary movement, potentially slowing recovery. Applying a warm compress may not be safe or effective on an incision site and could lead to complications like infection.

3.

A 7-year-old boy with cerebral palsy is transitioning from a specialized educational facility to a mainstream public school. What should a pediatric nurse prioritize when assessing the new school environment?

  • Availability of tailored educational support

  • Proximity to the child’s residence

  • Number of students in the classroom

  • School's extracurricular activities 

Correct answer: Availability of tailored educational support

Ensuring the availability of tailored educational support is essential for a child with cerebral palsy transitioning to a mainstream school, as it addresses both educational adaptations and physical accommodations needed for optimal learning and integration.

Proximity to the child's residence, while convenient, is less critical than the need for specific educational supports that address the child's unique learning and mobility needs. The number of students in the classroom, although impacting the learning environment, does not specifically address the specialized needs of a child with cerebral palsy as tailored educational support does. While extracurricular activities are important for social development, they do not address the immediate educational and physical accommodations necessary for the child's daily school life.

4.

A 17-year-old female is assessed for readiness to transition to adult health care. The nurse discusses strategies to mitigate risk-taking behaviors. What is the most important topic to cover?

  • Strategies for safe driving

  • Choosing a future career path

  • Having routine mammograms

  • Selecting health insurance plans

Correct answer: Strategies for safe driving

Discussing strategies for safe driving is critical for a 17-year-old about to transition to more independence, as motor vehicle accidents are a leading cause of injury and death among teenagers. This topic directly addresses a common risk-taking behavior and provides practical skills for safety.

Choosing a future career path is important for overall development but does not directly address immediate safety concerns or risk-taking behaviors typical of teenagers. Routine mammograms are not typically relevant for a 17-year-old and do not relate to mitigating common risk-taking behaviors in this age group. While important for long-term health management, selecting health insurance plans does not address the immediate risks associated with typical teenage behaviors like unsafe driving.

5.

During a clinic visit, a nurse learns that a child’s family prefers to use traditional remedies from their cultural background. Which approach is most appropriate for the nurse to take?

  • Discuss integrating safe traditional remedies with medical treatment

  • Advise the family to strictly follow medical advice to provide their children with the best care possible

  • Explain that traditional practices can not be used unless they have been studied and published in a reputable journal

  • Allow them to replace pharmaceutical treatments with alternative traditional remedies

Correct answer: Discuss integrating safe traditional remedies with medical treatment

Discussing the integration of safe traditional remedies with medical treatment respects the family's cultural practices while ensuring that the child receives effective and safe health care, fostering trust and cooperation.

Advising the family to follow medical advice strictly, without consideration of their traditional practices, may lead to resistance or non-compliance; it is important to show respect and willingness to incorporate their beliefs where possible. Demanding that traditional practices be validated through scientific study before use is impractical and may alienate the family, reducing their engagement with healthcare services. Allowing them to replace pharmaceutical treatments with traditional remedies without evaluation risks the child's health and is not a responsible medical practice.

6.

During a clinic visit, a pediatric nurse learns that a 12-year-old patient with epilepsy has missed several doses of medication over the past month. To assess barriers to adherence, what should the nurse do first?

  • Ask about the child’s and family’s daily schedule and routines around medication times

  • Report the non-adherence to the physician to facilitate interdisciplinary monitoring

  • Ask the physician to change the medication to one that requires less frequent dosing

  • Explain to the child and family the importance of medication adherence

Correct answer: Ask about the child’s and family’s daily schedule and routines around medication times

Asking about the daily schedule and routines around medication times directly addresses potential practical barriers to medication adherence, such as an inconsistent schedule. This approach helps tailor interventions to improve adherence.

Reporting non-adherence to the physician without understanding the underlying reasons does not contribute to solving the problem and may increase stress for the family. Changing the medication without first understanding the reasons for missed doses could lead to further adherence issues if the underlying causes are not addressed. While explaining the importance of medication adherence is crucial, understanding the barriers to adherence should come first to provide relevant and effective education.

7.

A school nurse is assessing pain in a 4-year-old child who has fallen and scraped their knee. Which tool is most appropriate for evaluating the child's pain level?

  • FACES Pain Scale - Revised

  • Numeric rating scale

  • Visual analog scale

  • Adult nonverbal pain scale

Correct answer: FACES Pain Scale - Revised

The FACES Pain Scale - Revised is appropriate for a 4-year-old as it uses facial expressions to help children articulate their pain level. This aligns well with their developmental ability to recognize and use visual cues to communicate discomfort.

A numeric rating scale is generally not suitable for children this young as they may not reliably understand or use numbers to represent pain intensity. A visual analog scale requires a level of abstract thinking and fine motor skills that a 4-year-old may not yet possess, making it less suitable for assessing pain in this age group. The adult nonverbal pain scale is designed for adults, especially those unable to communicate verbally, and is not tailored to the expression and behavior typical of young children.

8.

A 12-year-old child recently witnessed a violent crime in their neighborhood. During the assessment, the nurse should prioritize evaluating which of the following?

  • Signs of post-traumatic stress disorder

  • Encouraging the expression of thoughts and feelings

  • Distracting the child and making them laugh

  • Having the child recount the incident to help them process the traumatic experience

Correct answer: Signs of post-traumatic stress disorder

Evaluating signs of post-traumatic stress disorder (PTSD) is crucial for a child who witnessed a violent crime, as early detection can allow for early interventions that mitigate the severity of potential future mental health disorders and their sequela.

While encouraging expression is beneficial, it does not address the direct assessment for PTSD, which is essential for identifying specific symptoms and initiating appropriate interventions. Distracting the child and making them laugh might temporarily ease discomfort, but it does not address the underlying trauma or assist in a clinical assessment of the child’s psychological needs following the incident. Having the child explain the incident could inadvertently retraumatize them and should be handled with professional guidance specifically trained in trauma-informed care, not as an initial nursing action.

9.

During a consultation, a 16-year-old patient expresses concerns about contraception. What should the nurse include in the plan of care?

  • Ask the patient if they are currently using any contraceptives

  • Explain how to use every type of available contraceptives

  • Offer to help them get a prescription for emergency contraception

  • Refer the patient to a specialist to continue the discussion

Correct answer: Ask the patient if they are currently using any contraceptives

Asking the patient if they are currently using any contraceptives is fundamental to understanding their current contraceptive methods and guiding further advice. This initial inquiry allows the nurse to provide specific information and guidance based on the patient’s current practices.

While explaining how to use every type of available contraceptive might be informative, it can overwhelm the patient with too much information at once, especially if it includes methods that are not relevant to their situation or preferences. Offering to help them get a prescription for emergency contraception might imply urgency or risk that is not present. The nurse should instead assess their current contraceptive use and immediate needs. Referring the patient to a specialist at this stage may be unnecessary if the nurse can address the patient’s concerns directly. Referral should be considered if the patient’s needs exceed the nurse’s scope of practice or if there are complications.

10.

A pediatric nurse is planning care for a 4-year-old child with cerebral palsy who has severe motor impairments and is non-verbal. What is an essential element to integrate into the child's care plan?

  • Implementing an augmentative and alternative communication device

  • Providing weekly cognitive assessments

  • Reducing physical therapy to limit fatigue

  • Focusing primarily on nutritional needs

Correct answer: Implementing an augmentative and alternative communication device

For a non-verbal child with severe motor impairments, an augmentative and alternative communication device is essential to facilitate communication and improve quality of life.

While cognitive assessments are important, they do not directly address the potential communication needs of a non-verbal child. Reducing physical therapy could lead to deterioration in physical abilities and does not address communication needs. Focusing primarily on nutritional needs overlooks the critical component of communication, which is fundamental for expressing basic needs and desires.

11.

During a home visit, a nurse observes that a child seems anxious and reluctant to speak in the presence of their siblings, who often interrupt to answer on the child’s behalf. Which assessment should the nurse prioritize?

  • The communication patterns among siblings

  • Nutritional status of the children

  • Signs of neglect

  • Preferred methods of parental discipline

Correct answer: The communication patterns among siblings

Prioritizing the assessment of communication patterns among siblings is crucial in this context, as it can reveal dynamics that may contribute to the child's anxiety and reluctance to speak, impacting their ability to express needs and feelings.

Nutritional status is important but does not directly address the immediate concern of why the child is anxious and non-communicative in the presence of siblings. Signs of neglect are important to assess, but the specific scenario presented suggests that the immediate issue may relate more directly to sibling dynamics and communication barriers. Parental discipline methods are important for understanding overall family dynamics but are less directly related to the problem of sibling interference in communication in this situation.

12.

A pediatric nurse is providing guidance to parents on their child's recent diagnosis of anxiety disorder. Which approach should the nurse recommend for supporting their child?

  • Maintain a consistent daily routine and seek professional counseling.

  • Learn how to recognize signs of anxious behavior and discourage it.

  • Try to ignore the symptoms as much as possible so they can diminish on their own.

  • Increase family outings to distract from the anxiety and provide emotional support.

Correct answer: Maintain a consistent daily routine and seek professional counseling.

A consistent daily routine can provide structure and predictability, which can be comforting for a child with anxiety. Professional counseling can provide targeted strategies for managing anxiety effectively. This comprehensive approach supports both daily stability and long-term coping mechanisms.

Recognizing signs of anxious behavior and discouraging it does not provide support or understanding. This approach can make the child feel misunderstood or stigmatized and it may prevent them from expressing their feelings openly. Ignoring the symptoms can lead to a worsening of the anxiety and does not address the underlying issues. Increasing family outings might provide a temporary distraction but does not address the anxiety directly.

13.

Which recommendation should a pediatric nurse make for a child with constipation?

  • Increase intake of high-fiber vegetables and fruits.

  • Limit fluid intake to concentrate digestive juices.

  • Focus on high-protein, low-carbohydrate foods.

  • Increase consumption of processed foods for more fat.

Correct answer: Increase intake of high-fiber vegetables and fruits.

High-fiber vegetables and fruits help increase stool bulk and frequency, which can alleviate constipation. They also provide essential nutrients and promote a healthier digestive system.

Limiting fluid intake is counterproductive for treating constipation, as adequate hydration is crucial to help soften stool and promote regular bowel movements. Focusing solely on high-protein, low-carbohydrate foods can exacerbate constipation, as these foods are typically low in fiber, which is essential for bowel regularity. Increasing consumption of processed foods is detrimental since these often contain low levels of fiber and high levels of fats and sugars, which can worsen constipation.

14.

A 3-year-old is brought to the clinic for a routine checkup. What safety advice should the nurse provide regarding car travel?

  • Use a rear-facing car seat until the child exceeds the height or weight limit for the seat.

  • The child can use a seatbelt without a booster if they are tall for their age.

  • The child should sit in the front seat if there are no other passengers to avoid feeling isolated.

  • Transition to a booster as soon as the child turns 4.

Correct answer: Use a rear-facing car seat until the child exceeds the height or weight limit for the seat.

Keeping the child in a rear-facing car seat until they exceed the height or weight limit is recommended for safety, as it provides better protection for the child's head, neck, and spine in a crash.

Using only a seatbelt without a booster seat may not provide adequate safety for a child who is not tall enough or heavy enough according to safety standards. Children should sit in the back seat, as front seat placement poses higher risks in the event of an accident. The consideration of whether they feel isolated is secondary to safety concerns. Transitioning to a booster based solely on age without considering height or weight limits may compromise safety.

15.

What is the best advice a pediatric nurse can give to parents about bicycle safety for a 7-year-old?

  • Ensure the child wears a properly fitted helmet every time they ride a bicycle.

  • The child must never ride in the street.

  • Knee and elbow pads are sufficient protection for casual riding.

  • Bicycles with training wheels are always safer than regular bikes.

Correct answer: Ensure the child wears a properly fitted helmet every time they ride a bicycle.

Wearing a properly fitted helmet is essential for protecting a child's head during bicycle rides and is one of the most effective ways to reduce the risk of head injuries.

It is impractical to say a child must never ride on a street; rather, children should be taught safe riding practices and supervised as appropriate. While knee and elbow pads provide additional protection, they are not a substitute for a helmet, which protects the most critical and most at-risk part of the body in a fall. Training wheels are not inherently safer than regular bikes; the key safety measure is the use of helmets and appropriate supervision.

16.

A nurse observes that a 12-year-old with type 1 diabetes has consistently high blood sugar levels despite adherence to the prescribed insulin regimen. What is the appropriate modification to the plan of care?

  • Increase the insulin dosage as per sliding scale

  • Educate the child on dietary management

  • Change the type of insulin used

  • Recommend more frequent glucose monitoring

Correct answer: Increase the insulin dosage as per sliding scale

Increasing the insulin dosage according to a sliding scale allows for adjustments based on current blood glucose levels, which can help manage unexpected high readings effectively. This method specifically responds to changes and can tailor insulin administration in real time to prevent hyperglycemia.

While educating the child on dietary management is crucial for long-term diabetes control, it does not address immediate concerns of consistently high blood sugar levels that are unresponsive to the current insulin regimen. Changing the type of insulin is a significant modification that requires careful consideration and is typically considered when there are issues with the effectiveness of the current insulin type over time. Recommending more frequent glucose monitoring is useful for gathering data on blood sugar patterns but does not directly intervene in lowering high blood sugar levels. It is a diagnostic tool rather than a solution to high glucose levels.

17.

During a routine clinic visit, a pediatric nurse evaluates a 3-year-old with intermittent episodes of otitis media who appears to be in distress. Which of the following is critical for the nurse to relay to the healthcare team?

  • Recent frequency and severity of symptoms

  • Concerns about the frequent use of antibiotics

  • Possible allergic reactions to medication used during previous episodes

  • Recent mild trauma and abrasions to the shins and palms of the hand

Correct answer: Recent frequency and severity of symptoms

Documenting the frequency and severity of otitis media episodes is critical for determining the effectiveness of treatment and guiding future care decisions.

Concerns about antibiotic use are valid but secondary to understanding the actual impact of the condition on the child. The potential of past allergic reactions should be assessed after clarifying the pattern of the disease itself. Trauma and abrasions following a typical pattern for minor childhood fall injuries are unrelated to the primary concern of otitis media and do not directly inform the management of this condition.

18.

A child with a recent amputation appears to be coping well, but her siblings are reluctant to interact with her as before. What is the most appropriate action for the nurse to assess the siblings' coping mechanisms?

  • Organize a family meeting to discuss the amputation openly

  • Encourage the siblings to take part in care activities

  • Refer the siblings to a counselor to encourage their acceptance

  • Advise the parents to treat the child as they did prior to the amputation as much as possible

Correct answer: Organize a family meeting to discuss the amputation openly

Organizing a family meeting to discuss the amputation provides a safe space for all family members to express their feelings and concerns, facilitating open communication and understanding. This helps assess how each member, including the siblings, is coping with the change.

While involving siblings in care is supportive, it doesn't address their initial hesitation or reluctance to interact as before. Referring siblings directly to a counselor may be premature without first attempting to understand their feelings and providing familial support. Advising parents to treat the child as before may ignore the siblings' and the child's emotional and psychological adjustments to the amputation.

19.

A nurse is caring for a 6-year-old child with partial hearing loss who is dependent on a ventilator. Which intervention should the nurse prioritize to enhance communication with the child during care?

  • Using tactile signs when communicating

  • Speaking loudly to ensure the child can hear

  • Using written communication

  • Avoiding direct communication to reduce stress

Correct answer: Using tactile signs when communicating

Tactile signs are effective for children with hearing loss, especially when using a ventilator may impede visual cues, making tactile communication a priority for ensuring understanding.

Speaking loudly is likely to be ineffective. Using written communication assumes the child can read proficiently, which may not be the case at 6 years old, and does not accommodate hearing loss adequately. Avoiding direct communication can lead to feelings of isolation, reducing the quality of care.

20.

A pediatric nurse is discussing the introduction of complementary foods with the parents of a 4-month-old. What is the most appropriate guidance?

  • Wait until the infant is at least 6 months old to start solids.

  • Start introducing pureed fruits and vegetables.

  • Focus solely on non-allergenic foods initially.

  • Offer cereals mixed with formula or breast milk.

Correct answer: Wait until the infant is at least 6 months old to start solids.

Waiting until at least 6 months allows the infant's digestive system to mature adequately, and the infant is more developmentally ready to handle solids. This guidance aligns with current health recommendations.

While introducing pureed foods is part of the process, starting at 4 months may be too early for some infants, potentially leading to feeding difficulties or gastrointestinal discomfort. Focusing solely on non-allergenic foods initially is unnecessary and can delay exposure to potential allergens, which recent studies suggest should be introduced early to prevent allergies. Although offering cereals mixed with formula or breast milk is an option, starting at 4 months may not provide any developmental advantage and could be premature for digestive readiness.

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