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Quiz Session - Attempts With Random Questions

PNCB CPN Exam Questions

Page 7 of 20

121.

A nurse is explaining a new diagnosis to a 5-year-old child. What technique should the nurse use to enhance the child's understanding?

  • Use simple, age-appropriate language and visual aids

  • Provide detailed explanations using medical terminology and answer any questions thoroughly

  • Direct all communication toward the parents and encourage them to explain it to the child later

  • Offer written materials for the child to take home

Correct answer: Use simple, age-appropriate language and visual aids

Using simple language and visual aids engages the child at their level of understanding, making it easier for them to grasp the concepts related to their diagnosis. 

Providing detailed explanations using medical terminology can confuse and overwhelm a 5-year-old, reducing their ability to understand their health condition. Directing all communication to the parents might exclude the child from understanding their health, which is important for fostering autonomy and compliance with treatment. Offering written materials for the child to take home is not effective for a 5-year-old who likely cannot read complex information and needs more interactive and understandable formats.

122.

A parent is concerned about their overweight 10-year-old. What dietary modification should the nurse suggest?

  • Incorporate more fruits, vegetables, and whole grains into meals.

  • Strictly limit meal portion sizes to avoid weight increase.

  • Switch entirely to low-fat foods to reduce caloric intake.

  • Eliminate carbohydrates from the diet.

Correct answer: Incorporate more fruits, vegetables, and whole grains into meals.

Incorporating more fruits, vegetables, and whole grains increases dietary fiber and essential nutrients, which can help manage weight by promoting satiety and improving overall nutrition.

Strictly limiting meal portions might lead to inadequate nutrient intake and could adversely affect growth and development in a child. Switching entirely to low-fat foods does not necessarily reduce caloric intake and can lead to compensatory intake of other high-calorie foods. Eliminating all carbohydrates is unsustainable and unhealthy for a growing child, as carbohydrates are a primary energy source.

123.

A pediatric nurse is planning care for an 8-year-old child with chronic headaches. Which integrative approach could the nurse suggest for inclusion in the child’s care plan to help manage symptoms?

  • Biofeedback

  • Distraction techniques using screen time

  • Restrictive dieting

  • Avoiding physical activity that cause exertion

Correct answer: Biofeedback

Biofeedback is a technique that teaches the child to control bodily processes that are typically involuntary, like muscle tension, which can help manage chronic headaches.

Distraction techniques can be helpful but do not address the physiological aspects of chronic headaches as biofeedback does. The use of screens should also typically be avoided by those with headaches. Restrictive dieting without specific indications can be harmful and is not directly related to managing headache symptoms. Avoiding physical activity can reduce overall health and does not specifically contribute to managing headache symptoms unless activities are identified as direct triggers.

124.

During a home visit, a nurse notices a family has multiple firearms. What safety advice is best to provide?

  • Keep firearms in a locked cabinet with ammunition stored separately.

  • Store all firearms unloaded in an out-of-the-way place like a closet.

  • Remove all firearms from the house.

  • Teach children to handle firearms to demystify them.

Correct answer: Keep firearms in a locked cabinet with ammunition stored separately.

Storing firearms in a locked cabinet with the ammunition stored separately is a critical safety measure to prevent accidental discharges and unauthorized access, especially by children.

Storing all firearms unloaded does not prevent children from accessing them or potentially loading them if they find ammunition. While removing all firearms from the house increases safety, it may not be a practical or accepted option for all families. Teaching children to handle firearms does not prevent unintentional misuse or accidents among young children who may not fully understand the risks or be able to handle firearms safely.

125.

A nurse manager notices an increase in sick calls among the staff following several high-stress weeks on the pediatric ward. What proactive measure should a nurse recommend to the nurse manager to help enhance staff resilience?

  • Organize regular stress management sessions

  • Begin enforcing penalties for unapproved absences

  • Increase the number of scheduled shifts to cover absences

  • Implement a policy of decreasing the stress associated with work

Correct answer: Organize regular stress management sessions

Organizing regular stress management sessions provides a proactive and supportive approach to enhancing staff resilience. These sessions can offer practical skills and strategies for managing stress, benefiting both the staff’s well-being and their ability to provide patient care.

Beginning to enforce penalties for unapproved absences might address attendance issues but does not address the underlying causes of increased sick calls, such as stress and burnout, and may exacerbate the issue. Increasing the number of scheduled shifts to cover absences without addressing the causes of high stress can exacerbate the problem by adding to the workload of already stressed staff. Implementing a policy of decreasing the stress associated with work is too vague an intervention and does not provide specific actions or strategies to effectively manage and reduce stress.

126.

A nurse is caring for a terminally ill child whose family's spiritual beliefs emphasize prayer over medical intervention. The family wishes to have a prayer session before any medical procedure. What is the best response by the nurse?

  • Schedule the medical procedures with flexibility to include prayer times

  • Refer them to the hospital’s chaplain

  • Allow quick prayers that do not interfere with the schedule

  • Encourage the family to focus on medical interventions rather than spiritual practices

Correct answer: Schedule the medical procedures with flexibility to include prayer times

Scheduling medical procedures to accommodate prayer times shows respect for the family's spiritual beliefs, potentially improving their comfort and compliance with necessary medical interventions.

Referring them to the hospital’s chaplain is supportive but should not replace accommodating their wishes for prayer times in relation to medical procedures. Allowing only quick prayers that do not interfere with the schedule may seem dismissive of the family's spiritual needs, potentially leading to feelings of being undervalued. Encouraging the family to focus only on medical interventions disregards their spiritual needs and beliefs.

127.

A 10-year-old child diagnosed with asthma experiences an increase in asthma attacks. During an appointment, the nurse observes the child becoming distressed when discussing symptoms. How should the nurse assess the child’s adjustment to their condition?

  • Ask the child to describe what triggers the asthma and how they feel during an attack

  • Tell the child to be brave and not fear asthma attacks

  • Advise the parents to keep asthma medication out of the child’s sight to reduce anxiety

  • Recommend the child be homeschooled to avoid triggers

Correct answer: Ask the child to describe what triggers the asthma and how they feel during an attack

Asking the child to describe triggers and their feelings during an attack helps identify specific environmental or emotional factors that need to be addressed. This also engages the child in their care, making them feel heard and involved in managing their condition. It may help empower the child, decreasing their anxiety by helping them to feel more in control of their disease process.

Telling the child to be brave does not address their fears or the real impact of asthma on their life, and it may discourage open communication about their symptoms. It may also encourage the child to underappreciate the importance of recognizing and avoiding triggers. Keeping medication out of sight does not solve the problem of distress during attacks and can make emergency access to asthma medication more difficult. Homeschooling does not address the triggers of asthma directly and may unnecessarily isolate the child from their peers and normal activities.

128.

Which of the following statements by a parent indicates understanding regarding the sleeping environment of a newborn?

  • “I should place the baby on their back to sleep on a firm, flat surface.”

  • “I can allow the baby to sleep with only one soft toy to provide comfort.”

  • “It's safe for the baby to sleep on a soft mattress.”

  • “The baby can sleep in bed with me only for the first month.”

Correct answer: “I should place the baby on their back to sleep on a firm, flat surface.”

Placing the baby on their back to sleep on a firm, flat surface is the safest practice to reduce the risk of SIDS (sudden infant death syndrome) and is widely recommended by pediatric health experts.

Allowing the baby to sleep with even one soft toy can increase the risk of suffocation and is not recommended in the safest sleep environments for infants. A soft mattress poses a risk of suffocation and is not recommended for infant sleep safety; a firm mattress is the safer choice. Unsafe bed-sharing increases the risk of SIDS and accidental suffocation; infants should sleep in their crib or bassinet.

129.

A 16-year-old reveals during a clinic visit that she is experiencing stress due to her parents' high academic expectations. What response by the nurse is best?

  • “Talk with your parents and be open about your feelings.”

  • “Ignore your parents' expectations and focus on setting your own expectations.”

  • “How can you achieve higher grades to meet their expectations?”

  • “What extracurricular activities can you eliminate to focus on studying?”

Correct answer: “Talk with your parents and be open about your feelings.”

Open communication with parents about stress and expectations can lead to mutual understanding and adjustment of expectations, which may alleviate stress. While, depending on the teen’s family dynamics, it may not always be an effective solution, starting with encouraging open communication with the teen's family is the best approach.

Ignoring parental expectations does not resolve the underlying stress and can lead to further conflict or internal conflict within the teenager. It also misses an opportunity for the family to adjust dynamics and expectations. Asking how to achieve higher grades does not address the stress caused by high expectations and could exacerbate it by reinforcing the idea that the only solution is improved performance. Suggesting the elimination of extracurricular activities to focus on studying can reduce the teenager's quality of life and social opportunities, potentially increasing stress rather than decreasing it. It also does not address the root cause of the stress.

130.

A 6-year-old child with mild cerebral palsy attends a local public school. Which of the following school environment adaptations would most likely support their educational and physical needs?

  • A classroom on the first floor

  • Homework assignments in extra large font

  • Prevention of participation in any physical education activities

  • A classroom able to accommodate a wheelchair

Correct answer: A classroom on the first floor

Positioning a classroom on the first floor is crucial for a child with mild cerebral palsy, as it facilitates easier access, reduces the need for navigating stairs, and enhances safety and independence.

While using an extra large font for homework assignments may assist children with visual impairments, it does not specifically address the typical needs of a child with cerebral palsy, whose primary challenges are physical rather than visual. Preventing participation in physical education activities would not support the child's need for physical activity and social inclusion; instead, adaptations should be made to enable safe participation when possible. Although having a classroom that can accommodate a wheelchair is important, the child has mild cerebral palsy, which may not necessarily require a wheelchair. This makes first-floor classroom access a more universally beneficial adaptation.

131.

A nurse is taking the health history of a 10-year-old child who has a severe peanut allergy. To assess for potential risk factors in the child’s environment, which of the following questions should the nurse ask?

  • "Are there any known allergens in your child's school environment?”

  • “Does your child know that they are allergic to peanuts?”

  • "How often does your child participate in physical education classes?”

  • “Do any of your child's close friends have peanut allergies?”

Correct answer: "Are there any known allergens in your child's school environment?”

Asking about known allergens in the school environment directly relates to managing and mitigating risks associated with the child’s severe peanut allergy in everyday settings.

While it’s important for the child to be aware of their allergy, this does not directly assess environmental risk factors. It instead assesses the child’s ability to recognize risk factors that are present. The frequency of physical education classes does not provide information on environmental risks related to the child's peanut allergy. Whether the child’s friends have peanut allergies does not directly affect environmental risk factors for the child.

132.

Which immunization is primarily recommended for children at their 11-year-old check-up visit?

  • Tdap vaccine

  • Rotavirus vaccine

  • Hepatitis A vaccine

  • Varicella vaccine

Correct answer: Tdap vaccine

The Tdap vaccine is recommended for children at 11 years old to protect against tetanus, diphtheria, and pertussis (whooping cough). All of these are serious diseases that can be prevented through vaccination.

The rotavirus vaccine is typically given to infants to prevent rotavirus, which causes severe diarrhea in young children. The hepatitis A vaccine is generally administered to younger children, with the first doses often given between the ages of 1 and 2 years. The varicella vaccine, which protects against chickenpox, is typically given at a much younger age, with the first dose recommended at 12-15 months and a second dose at 4-6 years.

133.

During a routine visit, a pediatric nurse finds that a child’s immunizations are not up to date due to the parents' concerns about vaccine safety. What is the best initial response?

  • Provide evidence-based information addressing the safety and benefits of vaccines

  • Accept the parents' decision not to vaccinate their child

  • Explain the legal implications of non-compliance with childhood vaccinations

  • Inform the parents that the practice may choose to stop seeing the patient if non-compliance continues

Correct answer: Provide evidence-based information addressing the safety and benefits of vaccines

Providing evidence-based information addressing the safety and benefits of vaccines can help alleviate concerns and promote informed decision-making. This approach respects the parents' concerns while responsibly addressing potential misinformation or the importance of immunizations.

Accepting the parents' decision without providing additional information does not fulfill the nurse's responsibility to advocate for the child's health and public health. Explaining the legal implications of non-compliance can come across as threatening and is not correct, as a parent do legally have the ability to make medical decisions that they believe are best for their children, including vaccination decisions. Informing the parents about the potential discontinuation of care if non-compliance continues may escalate the situation unnecessarily and is typically considered an extreme, punitive intervention that fails to recognize the inherent right of parents to have autonomy in medical decisions for their children.

134.

A 10-year-old patient on chronic steroid therapy appears to have stunted growth. The nurse suspects that the medication is not being taken as prescribed. To explore adherence issues, what should the nurse consider first?

  • The side effects of long-term steroid use that might concern the parents

  • Whether the child is intentionally skipping doses due to peer influence

  • Ordering a growth hormone test prior to discussing adherence

  • Switching to an alternative medication to avoid stunted growth

Correct answer: The side effects of long-term steroid use that might concern the parents

Considering the side effects of long-term steroid use helps the nurse understand if side effects are influencing non-adherence, which is crucial for managing the child's condition effectively. Addressing these concerns can lead to adjustments in treatment or additional support to improve adherence.

Assuming the child is intentionally skipping doses due to peer influence without evidence could overlook other important factors affecting adherence, such as side effects or misunderstandings about the medication. Ordering a test without discussing adherence issues does not address potential reasons for non-compliance and may lead to unnecessary procedures. Switching medications without first understanding if there are factors that could lead to poor adherence might not resolve the underlying issues and could complicate the treatment plan.

135.

During the holiday season, a pediatric nurse receives a gift card from a patient's family as a token of appreciation. What is the most appropriate action for the nurse to take?

  • Politely decline the gift, citing the hospital’s policy on receiving gifts from patients

  • Accept the gift card to avoid offending the family

  • Accept the gift card but ensure it is shared with the entire healthcare team

  • Report the family to hospital administration for attempting to influence care through gifts

Correct answer: Politely decline the gift, citing the hospital’s policy on receiving gifts from patients

Politely declining the gift ensures that the nurse adheres to ethical standards and hospital policies designed to maintain trust and integrity in the healthcare profession.

Accepting the gift card might create an appearance of impropriety or conflict of interest, which could undermine trust in the nurse's objectivity and professional judgment. Accepting the gift card and sharing it with the team, although well-intentioned, still does not address the fundamental issue of accepting gifts from patients. Reporting the family to hospital administration for a well-meaning gesture is excessive and could harm the relationship between the family and the healthcare team.

136.

A 12-year-old child with autism spectrum disorder and chronic renal failure is undergoing hemodialysis. Which of the following should the nurse incorporate into the care plan to address the child's sensory sensitivities?

  • Provide a quiet and visually calming environment during dialysis

  • Conduct dialysis in a room with bright and varied colors to engage the child

  • Use soft restraints to prevent movement during dialysis

  • Play music to distract from the dialysis process

Correct answer: Provide a quiet and visually calming environment during dialysis

A quiet and visually calming environment addresses the sensory sensitivities common in children with autism, making the dialysis experience less stressful and more tolerable.

Bright and varied colors might be overstimulating for a child with sensory sensitivities, potentially causing discomfort or anxiety during treatments. Using soft restraints is not an appropriate method to manage sensory issues and could lead to increased anxiety and distress. While playing music can sometimes be beneficial, it does not specifically cater to the child's need for a visually calming environment and could be overstimulating, depending on the child's specific sensitivities.

137.

A nurse is preparing a workshop for parents on recognizing signs of depression in children. Which symptom should be highlighted as a key indicator?

  • Disinterest in favorite activities

  • Unexplained increase in energy levels

  • Increased focus on academic performance at the expense of other activities

  • A change in peer group

Correct answer: Disinterest in favorite activities

A loss of interest in previously enjoyed activities is a classic symptom of depression, indicating a change in mood and enjoyment of life. This can be a red flag for deeper emotional issues that require attention.

An unexplained increase in energy levels is not typically associated with depression; it could be more indicative of other conditions like bipolar disorder or drug use, particularly if the energy levels are abnormally high. Increased focus on academic performance is not typically a symptom of depression. A change in peer group could be a result of many factors and is not specifically indicative of depression. While it could be a sign of social issues, it doesn't directly suggest depression.

138.

A 2-year-old toddler is evaluated for developmental progress. Which assessment finding is most indicative of typical developmental achievement?

  • Scribbles spontaneously

  • Can skip on one foot

  • Stacks six blocks

  • Uses a fork and spoon neatly

Correct answer: Scribbles spontaneously

Scribbling spontaneously is a developmental milestone typically achieved around the age of 2 years, indicating normal motor and cognitive development as the child begins to express themselves through drawing.

Skipping on one foot is a skill that usually develops around age 5, and expecting a 2-year-old to perform this physically coordinated task is developmentally inappropriate. Although stacking blocks is a milestone for toddlers, stacking six blocks is generally expected closer to 3 years of age, reflecting more advanced motor skills and problem-solving abilities than typically seen at 2 years. Using a fork and spoon neatly is generally mastered later in toddlerhood, as it requires more refined motor skills and coordination than a 2-year-old typically possesses.

139.

During a busy shift, a nurse notices that a portable oxygen cylinder is left standing unsecured in a pediatric ward corridor. What is the appropriate action?

  • Secure the cylinder immediately in an oxygen cylinder holder

  • Move the cylinder into an unoccupied room until it can be secured

  • Check how full the cylinder is

  • Call respiratory therapy to ensure the cylinder is secured correctly

Correct answer: Secure the cylinder immediately in an oxygen cylinder holder

Securing the cylinder immediately in a holder prevents accidents such as the cylinder falling over, which could cause injury or a hazardous oxygen leak.

Moving the cylinder to an unoccupied room does not secure it properly and still poses a risk of falling and causing harm. Checking how full the cylinder is does not address the immediate safety concern of securing the cylinder. While calling respiratory therapy could be an appropriate step for managing respiratory equipment, the immediate need is to secure the cylinder to prevent accidents.

140.

You are preparing to discharge an 8-year-old who has undergone an appendectomy. Which of the following would indicate that the family is ready for the child's discharge?

  • The parents demonstrate the ability to recognize signs of infection

  • The parents have memorized the post-operative care instructions

  • The procedure was at least 72 hours ago

  • The child has fully recovered from general anesthesia

Correct answer: The parents demonstrate the ability to recognize signs of infection

Recognizing signs of infection is crucial to ensure timely medical intervention and prevent complications following an appendectomy. This directly impacts the child's health and safety post-discharge.

Memorizing post-operative care instructions is helpful, but the practical ability to apply this knowledge, especially in recognizing warning signs, is more critical. The time elapsed since the operation is less important than the parents' understanding and ability to respond to potential health issues. Full recovery from anesthesia is necessary, but the ability to recognize and respond to signs of infection is a more specific and crucial readiness indicator for safe discharge. Full recovery from anesthesia is not typically the facto used to determine readiness for discharge, as this almost always precedes other important discharge planning interventions.

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