CHAPTER 13: CHILD AND FAMILY COMMUNICATION My Nursing Test Banks

CHAPTER 13: CHILD AND FAMILY COMMUNICATION

MULTIPLE CHOICE

1.Which of the following factors is most important in determining the success of relationships used in delivering care?

a.

transference and countertransference

c.

personality of the participants

b.

effective communication

d.

type of illness of the client

ANS: B

Feedback

A

Incorrect. Transference and countertransference can block effective communication.

B

Correct. The ability to communicate effectively is a basic and the central component in delivering care to children and their caregivers.

C

Incorrect. Personality of the participants is important, but is not the most important determinant factor.

D

Incorrect. Type of illness of the client requires consideration, but is not the most important determinant factor.

PTS:1REF:p. 410 Child and Family Communication

OBJ: Cognitive Level: Comprehension

2.The major components of the communication process are:

a.

message, sender, channel, receiver, and feedback

b.

facial expression, tone of voice, and gestures

c.

verbal, written, and nonverbal

d.

speaker, listener, and reply

ANS: A

Feedback

A

Correct. The sender, message, channel, receiver, and feedback are major components of the communication process.

B

Incorrect. Facial expression, tone of voice, and gestures are characteristics of the sender, but are not major components of the communication process.

C

Incorrect. Verbal, written, and nonverbal characterize the message, but are but are not major components of the communication process.

D

Incorrect. Speaker, listener and reply are but are not major components of the communication process.

PTS:1REF:p. 410 Child and Family Communication

OBJ: Cognitive Level: Comprehension

3.Barriers to communication include:

a.

open-ended questions

c.

encouragement

b.

preconceived ideas

d.

selective reflection

ANS: B

Feedback

A

Incorrect. Open-ended questions can stimulate open communication, not raise a barrier.

B

Correct. Preconceived ideas and allowing feelings to influence behavior, opinions, or beliefs become barriers to communication.

C

Incorrect. Encouragement is not a barrier to communication.

D

Incorrect. Selective reflection is not a barrier to communication.

PTS:1REF:p. 410 Child and Family Communication

OBJ: Cognitive Level: Comprehension

4.In order to make verbal communication more effective, the nurse will:

a.

be brief, clear, and relevant in speech

c.

avoid speaking slowly

b.

use a consistent tone, never varying it

d.

use medical terms

ANS: A

Feedback

A

Correct. Verbal communication is most effective if it is clear, brief, effectively toned, paced appropriately, relevant, and well timed.

B

Incorrect. Use of consistent tone without variance is not a means of making verbal communication most effective.

C

Incorrect. Avoidance of slow speaking is not a means of making verbal communication most effective.

D

Incorrect. The use of medical terms might be the opposite of effective communication.

PTS:1REF:p. 410 Child and Family Communication

OBJ: Cognitive Level: Comprehension

5.The tone and pitch of the voice, volume, inflection, speed, grunts, and other vocalizations are referred to by which of the following terms?

a.

third element

c.

paraverbal clues

b.

ancillary speech

d.

enhancements

ANS: C

Feedback

A

Incorrect. Third element does not refer to the tone and pitch of the voice, volume, inflection, speed, grunts, and other vocalizations.

B

Incorrect. Ancillary speech does not refer to the tone and pitch of the voice, volume, inflection, speed, grunts, and other vocalizations.

C

Correct. Paraverbal cues, also part of verbal communication, include the tone and pitch of the voice; volume, inflection and speed; and grunts or other vocalizations not considered language.

D

Incorrect. An enhancement does not refer to the tone and pitch of the voice, volume, inflection, speed, grunts, and other vocalizations.

PTS:1REF:p. 410 Child and Family Communication

OBJ: Cognitive Level: Comprehension

6.Informal communication takes place then individuals talk and is best described by saying the participants:

a.

are relaxed

b.

are involved in a preexisting informal relationship

c.

have no particular agenda or protocol

d.

talk with slang words

ANS: C

Feedback

A

Incorrect. Informal communication requires participants to be relaxed, but relaxation does not define the term.

B

Incorrect. Informal communication takes place then individuals talk and is not best described by saying the participants are involved in a preexisting informal relationship.

C

Correct. Informal communication occurs then individuals talk using no particular agenda or protocol.

D

Incorrect. Informal communication takes place then individuals talk and is not best described by saying the participants talk with slang words.

PTS:1REF:p. 410 Child and Family Communication

OBJ: Cognitive Level: Comprehension

7.Touch is one of the most important communicative behaviors that nurses use; however, nurses must keep in mind which of the following facts before using touch?

a.

Everyone likes to be touched, but most prefer a light touch on the upper body.

b.

Touch can have many different meanings to different children and their families.

c.

Touch needs to be used very sparingly and only then necessary and asked for.

d.

The opposite gender almost always interprets touch as having a sexual meaning.

ANS: B

Feedback

A

Incorrect. Before employing touch, the nurse does not need to keep uppermost in their mind that everyone likes to be touched, but most prefer a light touch on the upper body.

B

Correct. Touch may have special meanings to children and their families depending upon their gender or ethnic background.

C

Incorrect. Before employing touch, the nurse does not need to keep uppermost in their mind that touch needs to be used very sparingly and only then necessary and asked for.

D

Incorrect. Before employing touch, the nurse does not need to keep uppermost in their mind that the opposite gender almost always interprets touch as having a sexual meaning.

PTS:1REF:p. 412 The Communication Process

OBJ: Cognitive Level: Comprehension

8.Most communication is:

a.

verbal

c.

nonverbal

b.

spatial

d.

ineffective

ANS: C

Feedback

A

Incorrect. Most communication is not verbal.

B

Incorrect. Most communication is not spatial.

C

Correct. Most communication is nonverbal.

D

Incorrect. Most communication is not ineffective.

PTS:1REF:p. 412 The Communication Process

OBJ: Cognitive Level: Knowledge

9.You are the nurse preparing to meet with a client for the first time. You realize that before effective communication can take place, you must:

a.

share personal information about yourself

b.

develop trust and rapport with the client

c.

set some rules of communication with the client

d.

clarify your purpose in talking with the client

ANS: B

Feedback

A

Incorrect. The establishment of professional boundaries precludes sharing personal information about yourself.

B

Correct. Before communication can be effective, several key elements must be addressed, including establishing rapport, building trust, showing respect, conveying empathy, listening actively, providing appropriate feedback, managing conflict, and establishing professional boundaries.

C

Incorrect. Before communication can be effective it is not necessary to set some rules of communication with the client.

D

Incorrect. Before communication can be effective it is not necessary to clarify your purpose in talking with the client.

PTS:1REF:p. 412 The Communication Process

OBJ: Cognitive Level: Comprehension

10.You are the nurse trying to get a child to take his medication. The child refuses to take the medicine, saying, I hate this medicine because it tastes yucky. Your best response is:

a.

Your daddy and mommy will be upset if you dont take this medicine. Your health care practitioner will be upset with you too.

b.

You will not get well if you dont take this medicine. It is good for you and will make you well again.

c.

Good boys and girls always take their medicine. If you are a good little child, you will take your medicine and Santa will bring you a present.

d.

I understand that the medicine does not taste good and you dont want to take it, but I am so proud of you then you take it and you can be proud of yourself.

ANS: D

Feedback

A

Incorrect. When a child refuses to take their medicine, your best response is not to suggest that caregivers will be upset.

B

Incorrect. When a child refuses to take their medicine, your best response is not to suggest threaten the child with continued or greater illness.

C

Incorrect. When a child refuses to take their medicine, your best response is not suggest that they are not good or that they are bad.

D

Correct. When a child refuses to take their medicine, it is best to express empathy and understanding, emphasizing feelings and expressing ownership, I am pleased you want to help yourself feel better by taking it even though it does taste yucky.

PTS: 1 REF: p. 413 Nurse, Child, and Family Communication

OBJ: Cognitive Level: Application

11.You are working with a child and the childs family. Which of the following actions on your part would most help to establish trust?

a.

Call caregivers at least 24 hours before canceling appointments.

b.

Explain procedures in a way that you feel comfortable with.

c.

Dont make promises you cannot keep, and keep all the ones you make.

d.

Maintain client confidentiality for information that would upset the client if disclosed.

ANS: C

Feedback

A

Incorrect. To establish trust, a nurse must keep appointments, not reschedule or cancel them.

B

Incorrect. To establish trust, a nurse must explain procedures in a way that is acceptable to the family, not in a way that you feel comfortable with.

C

Correct. To establish trust, a nurse must follow through on promises, keep appointments, respect client confidentiality, and carefully explain procedures in a way that is acceptable to the family.

D

Incorrect. Client confidentiality includes all information, not just information that would upset the client if disclosed.

PTS: 1 REF: p. 413 Nurse, Child, and Family Communication

OBJ: Cognitive Level: Application

12.You are working with a family that has nicknames for all the members. Mother is called Mimi and Father is called Papa. The children are called Bubby and Sissy. After introductions, you would:

a.

call the children Bubby and Sissy and refer to the caregivers as Mother and Dad

b.

address the caregivers as Mimi and Papa and the children as Bubby and Sissy

c.

ask each family member what he or she would prefer to be called

d.

call the children Miss and Mr. and the caregivers Mr. and Mrs.

ANS: C

Feedback

A

Incorrect. The nurse will use nicknames only after receiving permission from the caregivers.

B

Incorrect. The nurse will use nicknames only after receiving permission from the caregivers.

C

Correct. To establish respect, the nurse should address the child by first name (the formal name unless given permission to use a nickname) and the caregivers by Mr., Ms. or Mrs. and then the last name.

D

Incorrect. It is permissible to address the children by their given first names and the caregivers by Mr. and Mrs. plus their last names.

PTS: 1 REF: p. 413 Nurse, Child, and Family Communication

OBJ: Cognitive Level: Application

13.To encourage caregivers to share their concerns and ask questions, a nurse would:

a.

let the family know that the nurses time is limited

b.

periodically advise the family of the amount of time left

c.

let the family know that the nurse has time to spend with them

d.

socialize with the family and child so they feel comfortable with the nurse

ANS: C

Feedback

A

Incorrect. To encourage caregivers to share their concerns and ask questions, a nurse would not let the family know that the nurses time is limited.

B

Incorrect. To encourage caregivers to share their concerns and ask questions, a nurse would not periodically advise the family of the amount of time left.

C

Correct. Nurses need to convey they have time to spend with the child and the family. This will allow the family to share thoughts and concerns and ask questions.

D

Incorrect. To encourage caregivers to share their concerns and ask questions, a nurse would not socialize with the family and child so they feel comfortable with the nurse.

PTS: 1 REF: p. 414 Nurse, Child, and Family Communication

OBJ: Cognitive Level: Application

14.When working with a child in isolation, the nurse knows that smiling while wearing a mask:

a.

is unnecessary, as the child cannot see the smile

b.

can be seen in the actions of the eyes and the area around the eyes

c.

makes the nurse feel better even if the child cannot tell

d.

is not good, as it allows germs to escape from the open mouth

ANS: B

Feedback

A

Incorrect. A child in isolation will look for any encouragement, and even though the child cannot see the smile through the mask, they will see the smile in the actions of the eyes and the area around the eyes, even in the sound of the voice.

B

Correct. Smiling is important; although a child cannot see a smile from the nurses mouth, since it is covered by a mask, the child will see it in the nurses eyes.

C

Incorrect. A child in isolation will look for any encouragement, it is not about making the nurse feel better.

D

Incorrect. The mask protects the escape of germs.

PTS: 1 REF: p. 413 Nurse, Child, and Family Communication

OBJ: Cognitive Level: Comprehension

15.Empathy is best described in which of the following situations?

a.

The nurse gets down on the floor to see the world as a toddler sees it.

b.

Condolences are offered by a nurse then the caregivers lose a child.

c.

Working with a dying child, the nurse feels sorry for the child and his family.

d.

The nurse is subjective in interactions with the child and caregivers.

ANS: A

Feedback

A

Correct. Empathy refers to the ability to put ones self in the other persons shoesto feel as well as to intellectually know what the other person is experiencing.

B

Incorrect. Sympathy and empathy are not the same.

C

Incorrect. Sympathy is not the same as empathy.

D

Incorrect. The subjectivity of interactions with the child and caregivers has nothing to do with empathy.

PTS: 1 REF: p. 413 Nurse, Child, and Family Communication

OBJ: Cognitive Level: Application

16.In conflict management, the win-win approach occurs then:

a.

both parties involved are committed to solving the conflict

b.

there are two conflicts and the parties agree to each win one

c.

each party gives in on 50% of the disagreements making up the conflict

d.

the conflict is settled out of court so the legal system and the parties win

ANS: A

Feedback

A

Correct. The win-win approach occurs then both parties are committed to solving the conflict.

B

Incorrect. The win-win approach is not best described then there are two conflicts and the parties agree to each win one.

C

Incorrect. The win-win approach is not best described then each party gives in on 50% of the disagreements making up the conflict.

D

Incorrect. The win-win approach is not best described then the conflict is settled out of court so the legal system and the parties win.

PTS: 1 REF: p. 414 Nurse, Child, and Family Communication

OBJ: Cognitive Level: Comprehension

17.When one person allows the conflict to be resolved at his or her own expense, this is referred to in conflict management as:

a.

winning while losing

c.

the win-lose approach

b.

the lose-win approach

d.

losing

ANS: B

Feedback

A

Incorrect. When one person allows the conflict to be resolved at his or her own expense, this is not referred to in conflict management as winning while losing.

B

Correct. The lose-win situation occurs then one person allows a resolution at his or her own expense.

C

Incorrect. When one person allows the conflict to be resolved at his or her own expense, this is not referred to in conflict management as the win-lose approach.

D

Incorrect. When one person allows the conflict to be resolved at his or her own expense, this is not referred to in conflict management as losing.

PTS: 1 REF: p. 415 Nurse, Child, and Family Communication

OBJ: Cognitive Level: Comprehension

18.In maintaining professional boundaries in therapeutic relationships, the nurse must commit to which of the following behaviors?

a.

accepting and giving gifts

c.

doing all the care for the child

b.

becoming emotionally involved

d.

being a nurse and not a social friend

ANS: D

Feedback

A

Incorrect. To maintain professional boundaries in therapeutic relationships, the nurse must commit to not accepting and giving gifts.

B

Incorrect. To maintain professional boundaries in therapeutic relationships, the nurse must commit to not becoming emotionally involved.

C

Incorrect. To maintain professional boundaries in therapeutic relationships, the nurse must commit to not doing all the care for the child.

D

Correct. Nurses should avoid personal behaviors that signal over-involvement such as socializing with the child or their family.

PTS: 1 REF: p. 415 Nurse, Child, and Family Communication

OBJ: Cognitive Level: Comprehension

19.When the nurse is assigned to a child and his or her family, shares personal information such as home addresses and telephone numbers, or socializes with the family, this behavior on the part of the nurse:

a.

is helpful in developing trust and rapport

b.

signals over-involvement on the part of the nurse

c.

keeps the nurse from becoming burned out

d.

makes the nurse feel like part of the family

ANS: B

Feedback

A

Incorrect. When the nurse shares personal information such as home addresses and telephone numbers, or socializes with the family, this behavior on the part of the nurse ignores professional boundaries and is not helpful in developing trust and rapport.

B

Correct. When the nurse shares personal information such as home addresses and telephone numbers, or socializes with the family, this behavior on the part of the nurse signals over-involvement.

C

Incorrect. When the nurse shares personal information such as home addresses and telephone numbers, or socializes with the family, this behavior on the part of the nurse ignores professional boundaries and will lead to the nurse becoming burned out.

D

Incorrect. When the nurse shares personal information such as home addresses and telephone numbers, or socializes with the family, this behavior on the part of the nurse may make the nurse feel like part of the family, but it will reduce the therapeutic quality of the nursing relationship.

PTS: 1 REF: p. 415 Nurse, Child, and Family Communication

OBJ: Cognitive Level: Comprehension

20.A nurse coworker, who has been working with a child and his family, asks you for advice about buying a gift for the child and the family. Which of the following would be the best advice you could give this nurse?

a.

Do not buy them a gift unless they buy you one first.

b.

If you buy a gift, be certain that it is a small token only.

c.

Not giving gifts or receiving them is part of being professional.

d.

You should not buy gifts, but it is all right to receive them.

ANS: C

Feedback

A

Incorrect. Professional boundaries insist that you do not give gifts to your clients.

B

Incorrect. Professional boundaries insist that you do not give gifts to your clients.

C

Correct. When a nurse coworker asks you for advice about buying a gift for the child and the family, your best response is that not giving gifts or receiving them is part of being professional.

D

Incorrect. Professional boundaries insist that you do not give gifts to your clients nor expect or receive gifts from your clients.

PTS: 1 REF: p. 415 Nurse, Child, and Family Communication

OBJ: Cognitive Level: Application

21.A nurse is sitting with a family who has just heard some upsetting news about their childs prognosis. The nurse sits with the family in silence. The nurses silence is best interpreted as:

a.

not knowing what to say

b.

fear of saying the wrong thing

c.

respect, concern, and a desire to comfort the caregivers

d.

waiting for the family to speak and tell the nurse what they need

ANS: C

Feedback

A

Incorrect. After receipt of some upsetting news about their childs prognosis, the nurse sitting with the family in silence is not best interpreted as not knowing what to say.

B

Incorrect. After receipt of some upsetting news about their childs prognosis, the nurse sitting with the family in silence is not best interpreted as fear of saying the wrong thing.

C

Correct. Silence may demonstrate comfort, respect, and concern as then a nurse sits with parents after upsetting news is heard.

D

Incorrect. After receipt of some upsetting news about their childs prognosis, the nurse sitting with the family in silence is not best interpreted as the nurse if waiting for the family to speak and tell the nurse what they need.

PTS: 1 REF: p. 416 Nurse, Child, and Family Communication

OBJ: Cognitive Level: Comprehension

22.You are the nurse working with a small child who is in a four-bed ward. You need to do an assessment with the caregivers. Which of the following actions would be best on your part?

a.

Provide the assessment on a written form so caregivers can fill it out in the room.

b.

Ask all the other visitors to step out while you do the assessment with the caregivers.

c.

Talk low so others in the room will not hear.

d.

Take the caregivers to a nearby quiet, private area.

ANS: D

Feedback

A

Incorrect. Providing the assessment on a written form so caregivers can fill it out in the room would not be the best action.

B

Incorrect. Asking all the other visitors to step out while you do the assessment with the caregivers would not be the best action.

C

Incorrect. Talking low so others in the room will not hear would not be the best action.

D

Correct. When sensitive issues or feelings of anxiety need to be discussed and the environment is a four-bed unit there roommates can overhear the conversation, sharing fears and anxieties and asking questions may be difficult. A quiet, private environment should be provided before discussion begins.

PTS: 1 REF: p. 416 Nurse, Child, and Family Communication

OBJ: Cognitive Level: Application

23.Children will experience less stress, irritability, and fatigue in caregiving situations then the nurse and other caregivers:

a.

make the child adhere to the hospital schedule and fit the units needs

b.

give instructions and information about tests the day before they take place

c.

tell the child that he or she has nothing to fear, as lots of kids have experienced this

d.

assist the child to remain in control of physical and personal space whenever possible

ANS: D

Feedback

A

Incorrect. Making the child adhere to the hospital schedule and fit the units needs will not lower the childs stress, irritability, and fatigue, will likely aggravate the same.

B

Incorrect. Giving instructions and information about tests the day before they take place will not lower the childs stress, irritability, and fatigue, will likely aggravate the same.

C

Incorrect. Telling the child that he or she has nothing to fear, as lots of kids have experienced this will not lower the childs stress, irritability, and fatigue, will likely aggravate the same.

D

Correct. Clients in care-giving settings will experience less stress, irritability, and fatigue then they remain in relative control of their physical and personal space.

PTS: 1 REF: p. 416 Nurse, Child, and Family Communication

OBJ: Cognitive Level: Comprehension

24.You are the nurse working with a child who is fearful, has difficulty trusting the staff, and says very little. Which of the following methods would be best for you to try in order to get this child to relax, focus on your message, and respond verbally?

a.

taking turns reading a book

b.

using a puppet or stuffed toy in third-party communication

c.

asking the mother to talk to the child and get the answers you want

d.

asking the health care practitioner for an order to medicate the child with a mild tranquilizer

ANS: B

Feedback

A

Incorrect. Taking turns reading a book would not be a best method for you to try in order to get this child to relax, focus on your message, and respond verbally.

B

Correct. Because play is familiar and a daily form of natural behavior, children do not associate it with stress, anxiety or fear. Using a puppet or stuffed toy in third-party communication would be best for you to try in order to get this child to relax, focus on your message, and respond verbally.

C

Incorrect. Asking the mother to talk to the child and get the answers you want would not be a best method for you to try in order to get this child to relax, focus on your message, and respond verbally.

D

Incorrect. Medicating the child would not be a best method for you to try in order to get this child to relax, focus on your message, and respond verbally.

PTS: 1 REF: p. 417 Nurse, Child, and Family Communication

OBJ: Cognitive Level: Application

25.Which of the following approaches has been recognized as most healing and capable of bridging communication gaps with children and families?

a.

limit setting

c.

humor

b.

authoritarian

d.

direct communication

ANS: C

Feedback

A

Incorrect. The limit setting approach has not been recognized as most healing and capable of bridging communication gaps with children and families.

B

Incorrect. The authoritarian approach has not been recognized as most healing and capable of bridging communication gaps with children and families.

C

Correct. Humor is healing and can bridge communication gaps even then the direct communication is feared or offensive.

D

Incorrect. The direct communication approach has not been recognized as most healing and capable of bridging communication gaps with children and families.

PTS: 1 REF: p. 422 Developmental Factors Affecting Communication

OBJ: Cognitive Level: Comprehension

26.Which of the following is likely to be the most effective method of communicating with older school-age children and adolescents?

a.

direct communication

c.

nonverbal body language

b.

written communication

d.

telephone conversation

ANS: B

Feedback

A

Incorrect. Direct communication is not the most effective method of communicating with older school-age children and adolescents.

B

Correct. An especially effective method of communicating with older, school-age children and adolescents, writing can include keeping a journal or diary, writing a letter that is not delivered.

C

Incorrect. Nonverbal body language is not the most effective method of communicating with older school-age children and adolescents.

D

Incorrect. Telephone conversation is not the most effective method of communicating with older school-age children and adolescents.

PTS: 1 REF: p. 417 Nurse, Child, and Family Communication

OBJ: Cognitive Level: Comprehension

27.You are the nurse working with a preschool child who has just drawn an interesting picture of his family. Your best action is to:

a.

ask the child to tell a story about the picture

b.

ask the child questions to ascertain the meaning of the picture

c.

interpret the picture and give the child a chance to approve or deny your interpretation

d.

get another child to tell you about the picture

ANS: A

Feedback

A

Correct. Evaluating the drawings or having a child tell a story about the drawing allows the nurse a window into the childs inner self.

B

Incorrect. Asking the child questions to ascertain the meaning of the picture is not your best action.

C

Incorrect. Interpreting the picture and giving the child a chance to approve or deny your interpretation is not your best action.

D

Incorrect. Getting another child to tell you about the picture is not your best action.

PTS: 1 REF: p. 417 Nurse, Child, and Family Communication

OBJ: Cognitive Level: Application

28.The nurse is working with a group of older children and adolescents who have diabetes. The nurse wants to explore the feelings of the children and encourage them to wear a MedicAlert bracelet and carry hard candy. The nurse will probably have the greatest success in getting the children to talk about feelings and to comply with the bracelet and candy if the nurse uses which of the following approaches?

a.

Tell the story in the third person, using the case of another girl unknown to the group to get the points across.

b.

Contract with the children in writing what the nurse is expected to do and what the children are expected to do.

c.

Use behavior modification, rewarding the children with candy if they comply and having consequences if they do not.

d.

Have a contest to see who can comply the fastest and the longest in wearing the bracelet and carrying candy.

ANS: A

Feedback

A

Correct. Another third-party approach used with older children and adolescents is to attribute feelings or thoughts to other children.

B

Incorrect. A contract in writing is far too direct, and will not probably have the greatest success in getting the children to talk about feelings and to comply with wearing a MedicAlert bracelet and carrying hard candy

C

Incorrect. Using behavior modification, especially rewarding the children with candy is out of place in teaching about diabetes.

D

Incorrect. Having a contest will not probably have the greatest success in getting the children to talk about feelings and to comply with wearing a MedicAlert bracelet and carrying hard candy.

PTS: 1 REF: p. 418 Nurse, Child, and Family Communication

OBJ: Cognitive Level: Application

29.In working with the caregivers of a child with an acute or chronic illness, the nurse would:

a.

teach care early and allow the caregivers to provide daily care for as many aspects of the childs care as possible

b.

delegate care of the child to a nurses aide and make certain he or she understands the care delegated and completes it

c.

take responsibility for the childs care until the day before the child leaves, and then give caregivers instructions

d.

teach care daily and let the caregivers do a return demonstration just before discharge

ANS: A

Feedback

A

Correct. In working with the caregivers of a child with an acute or chronic illness, the nurse would teach care early and allow the caregivers to provide daily care for as many aspects of the childs care as possible.

B

Incorrect. In working with the caregivers of a child with an acute or chronic illness, the nurse would not best delegate care of the child to a nurses aide and make certain he or she understands the care delegated and completes it.

C

Incorrect. In working with the caregivers of a child with an acute or chronic illness, the nurse would not best take responsibility for the childs care until the day before the child leaves, and then give caregivers instructions.

D

Incorrect. In working with the caregivers of a child with an acute or chronic illness, the nurse would not best teach care daily and let the caregivers do a return demonstration just before discharge.

PTS: 1 REF: p. 420 Developmental Factors Affecting Communication

OBJ: Cognitive Level: Application

30.Which of the following approaches will work best then the nurse is communicating with an infant?

a.

Communicate through the caregivers.

b.

Allow the child time to warm up to the nurse.

c.

Respond only after the child cries for a little while.

d.

Use an adult voice just as you would for anyone.

ANS: B

Feedback

A

Incorrect. Communication principles based on developmental level suggests the best outcome for communicating with an infant will not depend upon communicating through the caregivers, instead requires talking to the infant directly.

B

Correct. Communication principles based on developmental level suggests the best outcome for communicating with an infant will depend upon allowing the infant time to warm up to the nurse.

C

Incorrect. Communication principles based on developmental level suggests the best outcome for communicating with an infant will not depend upon responding only after the child cries for a little while, instead requires responding to the infants cries in a timely manner.

D

Incorrect. Communication principles based on developmental level suggests the best outcome for communicating with an infant will not depend upon using an adult voice just as you would for anyone, use motherese, and a soothing and calm voice.

PTS: 1 REF: p. 420 Developmental Factors Affecting Communication

OBJ: Cognitive Level: Application

31.Which of the following statements best describes motherese?

a.

being oversolicitous to a child

b.

patting a child and touching frequently

c.

a type of speech using short, simple sentences in a high-pitched voice

d.

the way that mothers always seem to know what their babies need and want

ANS: C

Feedback

A

Incorrect. Motherese is not best described as being oversolicitous to a child.

B

Incorrect. Motherese is not best described as patting a child and touching frequently.

C

Correct. Motherese is best described as child-directed speech, using simple, short sentences, spoken slowly in high-pitched voice.

D

Incorrect. Motherese is not best described as the way that mothers always seem to know what their babies need and want.

PTS: 1 REF: p. 420 Developmental Factors Affecting Communication

OBJ: Cognitive Level: Application

32.Which of the following best describes a difference in communicating with school-age children versus toddlers?

a.

The number of words is more then communicating with a toddler than it is with a school-aged child.

b.

For toddlers, preparation for procedures is just before the procedure and much earlier for school-aged children.

c.

Toddlers require more empathy and more touching and holding.

d.

Caregivers need less information then care involves a school-aged child.

ANS: B

Feedback

A

Incorrect. The best description of the difference in communicating with school-age children versus toddlers has nothing to do with the number of words.

B

Correct. The best description of the difference in communicating with school-age children versus toddlers is: for toddlers, preparation for procedures is just before the procedure and much earlier (several days in advance) for school-aged children.

C

Incorrect. The best description of the difference in communicating with school-age children versus toddlers is the timing of the communication, not empathy or touching and holding involved.

D

Incorrect. The best description of the difference in communicating with school-age children versus toddlers involves the children, not the caregivers.

PTS: 1 REF: p. 420 Developmental Factors Affecting Communication

OBJ: Cognitive Level: Application

33.When the nurse is caring for an infant who is experiencing stranger anxiety, the nurse tries to get the caregiver involved in the care. If the caregiver is not able to be involved, the nurse needs to:

a.

hold the infant so the caregiver is in view

b.

swaddle the baby and hold the baby so he or she cannot see the caregiver

c.

keep the caregiver away so the baby will not fuss

d.

feed the baby, as babies bond with whoever feeds them

ANS: A

Feedback

A

Correct. After the onset of stranger anxiety, incorporating the caregiver into the health care procedures reduces the infants discomfort. Whenever the nurse needs to hold or give an infant care, caregivers should be involved. If this is not possible, the nurse should hold the infant so the caregiver is in view.

B

Incorrect. Holding the baby so he or she cannot see the caregiver is the exact opposite of the expected and best action.

C

Incorrect. Keeping the caregiver away so the baby will not fuss is the exact opposite of the expected and best action.

D

Incorrect. Feeding the baby is appropriate prior to the development of stranger anxiety, but is the exact opposite of the expected and best action after the development of stranger anxiety.

PTS: 1 REF: p. 420 Developmental Factors Affecting Communication

OBJ: Cognitive Level: Application

34.Which of the following skills does the toddler master?

a.

ability to take responsibility for his or her own actions

b.

mastery of spatial, temporal, and numerical concepts and serialization

c.

capacity to do abstract thinking some of the time

d.

ability to participate in turn-taking rules of social communication

ANS: D

Feedback

A

Incorrect. The ability to take responsibility for his or her own actions occurs later than the toddler stage.

B

Incorrect. The mastery of spatial, temporal, and numerical concepts and serialization occurs later than the toddler stage.

C

Incorrect. The capacity to do abstract thinking some of the time occurs later than the toddler stage.

D

Correct. Language in the form of two-word combinations emerges for the toddler as well as the ability to participate in turn-taking rules of social communication.

PTS: 1 REF: p. 421 Developmental Factors Affecting Communication

OBJ: Cognitive Level: Comprehension

35.Two-word utterances by a child become common around which of the following ages?

a.

12 months

c.

2 years

b.

16 months

d.

3 years

ANS: C

Feedback

A

Incorrect. Two-word utterances are not common for a child at 12 months.

B

Incorrect. Two-word utterances are not common for a child at 16 months.

C

Correct. Two-word utterances are common for a child at 2 years.

D

Incorrect. Complete sentences are common for a child at 3 years.

PTS: 1 REF: p. 421 Developmental Factors Affecting Communication

OBJ: Cognitive Level: Comprehension

36.The nurse is preparing to give a preschool child some oral medicine. Which of the following statements by the nurse would be most helpful to the childs development?

a.

This medicine is good for you. Take it, or your mother will be upset.

b.

Would you like water or a mouthful of flavored gelatin after your medicine?

c.

The health care practitioner has ordered this medicine especially for you.

d.

Do you want to take this medicine? Id like for you to take it.

ANS: B

Feedback

A

Incorrect. The choice offered is to upset or not upset the mother, which is not the most the most helpful to the childs development.

B

Correct. Since the preschooler is striving for independence, it is important to allow the child to initiate activities and make choices if possible. For example, let the child decide whether to have water or Jell-O after your medicine.

C

Incorrect. Authoritarian statements are not the most helpful to the childs development.

D

Incorrect. Offering a choice to take or not take the medicine would be least helpful to the childs health and development.

PTS: 1 REF: p. 421 Developmental Factors Affecting Communication

OBJ: Cognitive Level: Application

37.Preschoolers are able to see things from which of the following perspectives?

a.

only their own

c.

their own and their caregivers

b.

their own and their mothers

d.

their peers

ANS: A

Feedback

A

Correct. Preschoolers are egocentric, and see things only from their perspective.

B

Incorrect. Preschoolers are egocentric, and are unable to see things from their own and their mothers perspective.

C

Incorrect. Preschoolers are egocentric, and are unable to see things from their own and their caregivers perspective.

D

Incorrect. Preschoolers are egocentric, and are unable to see things from their peers perspective.

PTS: 1 REF: p. 421 Developmental Factors Affecting Communication

OBJ: Cognitive Level: Comprehension

38.When the nurse communicates with a preschool child, he or she should communicate with:

a.

fantasy and abstract language

c.

honesty and concrete language

b.

magical language

d.

stories about a hypothetical child

ANS: C

Feedback

A

Incorrect. The use of fantasy and abstract language is the exact opposite of what is best.

B

Incorrect. Magical language is the exact opposite of what is best.

C

Correct. When preschoolers lack information or do not understand something, they fill in the gaps with their imagination. Since an avid imagination can be far worse than reality, it is better to communicate with honesty, in simple sentences using concrete language.

D

Incorrect. Telling stories about a hypothetical child is the exact opposite of what is best.

PTS: 1 REF: p. 422 Developmental Factors Affecting Communication

OBJ: Cognitive Level: Comprehension

39.The nurse is preparing to give the child an intramuscular injection. The nurses best approach would be to:

a.

smile and laugh about the injection

b.

say, I am going to give you a little stick.

c.

say, Good little children dont cry.

d.

say, I am going to give you an injection that may hurt a little.

ANS: D

Feedback

A

Incorrect. The nurses best approach would never be to smile and laugh about the injection.

B

Incorrect. The nurses best approach would never be to say, I am going to give you a little stick.

C

Incorrect. The nurses best approach would never be to say, Good little children dont cry.

D

Correct. The nurse should never smile or laugh then giving an injection, say something wont hurt then it will, or use words with double or literal meanings such as a shot or a stick in the arm.

PTS: 1 REF: p. 422 Developmental Factors Affecting Communication

OBJ: Cognitive Level: Application

40.A preschool child asks the nurse if the X-ray will hurt and why he needs an X-ray. The best response by the nurse is:

a.

The X-ray is a picture of your tummy to see what makes it hurt. The X-ray will not hurt.

b.

I will go get a book that describes the special rays involved in X-rays, the different types of X-rays, and how the film is developed to provide a picture.

c.

Let me get someone from X-ray to explain this to you and to take you down to X-ray so you can see all the different equipment.

d.

Your health care practitioner will explain this complicated process to you and your caregivers just before you have the X-ray.

ANS: A

Feedback

A

Correct. Whenever talking to preschoolers, use simple words that answer the question asked. The best response by the nurse: The X-ray is a picture of your tummy to see what makes it hurt. The X-ray will not hurt.

B

Incorrect. The best response by the nurse will not be to go get a book.

C

Incorrect. The best response by the nurse will not be to get someone from X-ray to explain or go see the equipment.

D

Incorrect. The best response by the nurse will not complicate the question or the answer.

PTS: 1 REF: p. 422 Developmental Factors Affecting Communication

OBJ: Cognitive Level: Application

41.Rhymes, chants, and rituals such as knocking on wood serve which of the following purposes for school-aged children?

a.

substitute for aggressive acts toward peers and adults in their environment

b.

door opener for friendships with other children participating in these activities

c.

means of emotional-social control in frightening and confusing contexts

d.

entertainment in an otherwise dull and dreary world run by adults

ANS: C

Feedback

A

Incorrect. Rhymes, chants, and rituals such as knocking on wood do not serve as a substitute for aggressive acts toward peers and adults in their environment.

B

Incorrect. Rhymes, chants, and rituals such as knocking on wood do not serve as a door opener for friendships with other children participating in these activities.

C

Correct. School-aged children teach each other rhymes, chants, and rituals which can serve as a means of emotional-social control in frightening and confusing contexts.

D

Incorrect. Rhymes, chants, and rituals such as knocking on wood do not serve as entertainment in an otherwise dull and dreary world run by adults.

PTS: 1 REF: p. 422 Developmental Factors Affecting Communication

OBJ: Cognitive Level: Comprehension

42.In working with school-aged children, the nurse keeps in mind that the child of this age has which of the following skills mastered?

a.

understanding of words with double meanings

b.

ability to understand philosophical meanings

c.

spatial, temporal, and numerical concepts

d.

interest in and ability to create metaphors

ANS: C

Feedback

A

Incorrect. School-aged children have not mastered the skill of understanding words with double meanings.

B

Incorrect. School-aged children have not mastered the ability to understand philosophical meanings.

C

Correct. School-aged children are interested in learning and have increased attention spans. They learn to master classification, serialization, and spatial, temporal and numerical concepts.

D

Incorrect. School-aged children have not mastered an interest in and ability to create metaphors.

PTS: 1 REF: p. 422 Developmental Factors Affecting Communication

OBJ: Cognitive Level: Comprehension

43.Adolescents most need people to:

a.

talk with them and explain the world to them

b.

honestly tell them then their ideas are wrong

c.

agree with them and give positive reinforcement then they are right

d.

listen to them verbalize what the world should be like

ANS: D

Feedback

A

Incorrect. Adolescents do not most need people to talk with them and explain the world to them.

B

Incorrect. Adolescents do not most need people to honestly tell them then their ideas are wrong.

C

Incorrect. Adolescents do not most need people to agree with them and give positive reinforcement then they are right.

D

Correct. Adolescents most need people to allow them to verbalize what the world should be like in order to analyze their own ideas and come to their position short of the ideal.

PTS: 1 REF: p. 422 Developmental Factors Affecting Communication

OBJ: Cognitive Level: Comprehension

44.When working with clients who are Japanese and who were raised with Japanese customs, you would keep in mind that the Japanese tend to:

a.

use a lot of touch and appreciate touch from health care professionals

b.

speak a lot and view feelings as less important than words

c.

complain then something, such as pain, is bothering them

d.

avoid direct eye contact, as this is seen as a lack of respect

ANS: D

Feedback

A

Incorrect. Touching should be limited with clients who are Japanese and who were raised with Japanese customs.

B

Incorrect. Clients who are Japanese and who were raised with Japanese customs value attitudes, actions and feelings as more important than words.

C

Incorrect. Clients who are Japanese and who were raised with Japanese customs are stoic and do not complain.

D

Correct. Clients who are Japanese and who were raised with Japanese customs avoid direct eye contact, as this is seen as a lack of respect.

PTS: 1 REF: p. 424 Developmental Factors Affecting Communication

OBJ: Cognitive Level: Comprehension

45.When working with clients who are from Mexico or have been raised with Hispanic customs, the nurse would keep in mind that people of these cultural groups tend to:

a.

avoid direct eye contact

b.

use few gestures and tend not to vary voice tone

c.

find discussions of personal topics easier if the nurse is the same gender as the client

d.

get right to the point in any discussion, as they view small talk as a waste of time

ANS: C

Feedback

A

Incorrect. When working with clients who are from Mexico or have been raised with Hispanic customs, the nurse would keep in mind that people of these cultural groups welcome direct eye contact.

B

Incorrect. When working with clients who are from Mexico or have been raised with Hispanic customs, the nurse would keep in mind that people of these cultural groups tend to freely use gestures and tend to vary voice tone.

C

Correct. When working with clients who are from Mexico or have been raised with Hispanic customs, the nurse would keep in mind that people of these cultural groups tend to find discussions of personal topics easier if the nurse is the same gender as the client.

D

Incorrect. When working with clients who are from Mexico or have been raised with Hispanic customs, the nurse would keep in mind that people of these cultural groups tend to view small talk as important before a serious discussion begins.

PTS: 1 REF: p. 424 Developmental Factors Affecting Communication

OBJ: Cognitive Level: Comprehension

MULTIPLE RESPONSE

1.A nurse is providing family education on conflict resolution through communication. Which of the following statements made by the parent indicates that the teaching has been effective? Select all that apply.

a.

I will try to overlook our differences.

b.

Im willing to compromise and accept my spouses solutions to our problems.

c.

I will actively listen to our child.

d.

I am going to take your feelings seriously.

ANS: C, D

Feedback

Correct

When providing family education on conflict resolution, it is important for the family members to identify actively listening and taking one anothers feelings seriously.

When providing family education on conflict resolution, it is important for the family members to identify actively listening and taking one anothers feelings seriously.

Incorrect

Rather than overlooking their differences, it is important for families to clarify points of their differences.

It is important for families to negotiate solutions, rather than compromising.

PTS: 1 REF: p. 414 Nurse, Child, and Family Communication

OBJ: Cognitive Level: Comprehension

2.A nurse is providing education to an adolescent who is planning to have surgery. Which of the following developmentally appropriate strategies should the nurse implement? Select all that apply.

a.

Prepare the adolescent up to 24 hours prior to the procedure.

b.

Include the peer group since the adolescent does not prefer to have privacy.

c.

Use appropriate medical terminology.

d.

Draw a diagram of the surgery to describe the procedure if the adolescent questions how the procedure will be done.

ANS: C, D

Feedback

Correct

When interacting with an adolescent client, it is important for the nurse to use the appropriate medical terminology.

It is appropriate for the nurse to use creative methods to explain procedures, such as drawing a diagram.

Incorrect

The adolescent should be made aware of the procedure up to 1 week prior.

The adolescent values privacy and this should be respected by health care providers.

PTS: 1 REF: p. 419 Developmental Factors Affecting Communication

OBJ: Cognitive Level: Comprehension

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