CHAPTER 16: CARE OF CHILDREN WHO ARE HOSPITALIZED My Nursing Test Banks

CHAPTER 16: CARE OF CHILDREN WHO ARE HOSPITALIZED

MULTIPLE CHOICE

1.Prior to the late 1950s governing parents visiting their hospitalized child were:

a.

very liberal, allowing unlimited visitation and rooming-in

b.

limited to the waking hours only

c.

very restrictive and often limited to only weekly visits or visits of a few hours each day

d.

limited to one parent only, allowing that parent unlimited visiting

ANS: C

Feedback

A

Incorrect. Prior to the late 1950s, visitation was strictly limited, not very liberal.

B

Incorrect. Prior to the late 1950s, the rules were restrictive, more concerned about the intense physical and emotional reactions to separation at the time of leave-taking than the time of day.

C

Correct. Prior to the publication of the Platt report in England, 1959, hospital rules governing parents visiting their hospitalized child were very restrictive and often limited to only weekly visits or visits of a few hours each day.

D

Incorrect. Prior to the late 1950s, the rules were restrictive, more concerned about the intense physical and emotional reactions to separation at the time of leave-taking than limiting the number of visitors.

PTS: 1 REF: p. 509 History and Trends In Pediatrics and Pediatric Nursing

OBJ: Cognitive Level: Comprehension

2.Which of the following documents described polices and practices in the care of hospitalized children and how detrimental were these to child development and recovery? (This document brought about change in visiting rules for parents visiting their hospitalized child.)

a.

Platt Report of 1959

c.

Lysaught report of 1970

b.

Brown Report of 1948

d.

Patients Bill of Rights

ANS: A

Feedback

A

Correct. The issuance of the Platt Report in England in 1959 was historic in describing existing policies and practices in the care of hospitalized children, how these practices adversely affected child development and recovery, and the kinds of changes necessary for child-centered pediatric care and education.

B

Incorrect. The Brown Report of 1948 has no connection with the policies and practices in the care of hospitalized children.

C

Incorrect. The Lysaught report of 1970 has no connection with the policies and practices in the care of hospitalized children.

D

Incorrect. The Patients Bill of Rights has no connection with the policies and practices in the care of hospitalized children.

PTS: 1 REF: p. 509 History and Trends In Pediatrics and Pediatric Nursing

OBJ: Cognitive Level: Knowledge

3.Which of the following nurses was the first to systematically study how children and parents cope with hospitalization and to document the effectiveness of nursing in allaying and managing the fears and concerns of children?

a.

Florence Erickson

c.

Gladys Sellew

b.

Dorothy Marlow

d.

Florence G. Blake

ANS: D

Feedback

A

Incorrect. Florence Erickson is remembered as an educator and researcher in the field of nursing and child development who emphasized the therapeutic use of play in the hospital (1914-2002).

B

Incorrect. Dorothy Marlow is remembered for her Textbook in Pediatric Nursing which uniquely arranged the content of child care by age groups alongside concepts of growth and development (1921-1992).

C

Incorrect. Gladys Sellew pioneered nursing work in the tenements, ghettos, and settlements of Cincinnati, Cleveland, Chicago and Washington, D.C. Her thesis was the first nursing research to be based upon an original investigation that used as its methodology participant observation (1887-1977).

D

Correct. Florence G. Blake was the first nurse to systematically study how children and parents cope with hospitalization and to document the effectiveness of nursing in allaying and managing the fears and concerns of children (1907-1982).

PTS: 1 REF: p. 509 History and Trends In Pediatrics and Pediatric Nursing

OBJ: Cognitive Level: Knowledge

4.Which of the following is the predominant goal of nurses caring for children?

a.

Find out what is wrong with a child, and fix it as efficiently as is possible.

b.

Identify the strengths of children, and enhance their growth in the midst of stress and intrusions.

c.

Get the child and family well enough to go to the least-restrictive environment.

d.

Spare the family as much trauma and psychological distress as is humanly possible.

ANS: B

Feedback

A

Incorrect. Nursing care for children is more complex than repairing a car.

B

Correct. The predominant goal of nurses caring for children is: to identify and preserve the strengths of children while trying to enhance their growth in the midst of stress and intrusions into their bodies, their space, and their very being.

C

Incorrect. A goal of returning home is important, but not the most important.

D

Incorrect. Reduction of trauma and psychological distress for the child is as important as it is for the family, maybe more so.

PTS:1REF:p. 543 Home Care

OBJ: Cognitive Level: Application

5.Which of the following do nurses need to do first then preparing for nursing care of children in a clinical setting?

a.

memorize Eriksons life tasks

b.

study Piagets theories of growth and development

c.

examine their own thoughts and feelings about caring for children and families in the hospital and the roles and responsibilities of nurses in pediatric nursing

d.

find out the physicians protocols, and familiarize themselves with these protocols as well as with the policy and procedure manuals of the hospital and unit

ANS: C

Feedback

A

Incorrect. In the preparatory phase, after coming to terms with the beliefs that underlie practice, review and comprehend Eriksons life tasks.

B

Incorrect. In the preparatory phase, after coming to terms with the beliefs that underlie practice, study Piagets theories of growth and development.

C

Correct. Articulating a personal philosophy about the care of children in hospitals provides a foundation of beliefs that underlie practice. First, examine your own thoughts and feelings about caring for children and families in the hospital and the roles and responsibilities of nurses in pediatric nursing

D

Incorrect. After the more general reviews, the pediatric nurse would be well served to find out the physicians protocols, and familiarize themselves with these protocols as well as with the policy and procedure manuals of the hospital and unit.

PTS:1REF:p. 543 Home Care

OBJ: Cognitive Level: Application

6.The nurse, working on a pediatric unit of a hospital, is assigned to care for several children with varying needs. One child was admitted solely for tests, another for management of diabetes, one for heart surgery, and one with a terminal illness. In planning time and attention to the children, the nurse makes it a priority to take into consideration which of the following factors?

a.

severity of the reason for hospitalization

b.

age and intelligence of the child

c.

perceptions and interpretations of the experience by the child

d.

parents emotional, physical, and financial needs

ANS: C

Feedback

A

Incorrect. Severity of the reason for hospitalization is important in planning time and attention to the children, but after thinking about their developmental level.

B

Incorrect. Looking at age and intelligence of the child establishes a notion of their developmental level, but is not as important as thinking about their perceptions and how they might interpret what is happening.

C

Correct. The developmental level of children and their perceptions and interpretations of experiences are more important than the actual events.

D

Incorrect. The parents emotional, physical, and financial needs can dramatically effect the childs status, but first think about the perceptions and interpretations of the experience by the child.

PTS: 1 REF: p. 511 Experiences of Children in Hospitals and Their Responses

OBJ: Cognitive Level: Application

7.Which of the following statements best describes stress-point nursing?

a.

The nurse uses a chart and a pointer to go through the steps of the procedure.

b.

All procedures and treatments are reduced to 10 steps or points to help explain them to the child undergoing them.

c.

Each step of a procedure fits into a star-shaped diagram with the steps outlined on the points of the star.

d.

The treatment or procedure is described in a sequential manner, exploring how it might feel, and the procedure or treatment is rehearsed.

ANS: D

Feedback

A

Incorrect. Stress-point nursing is not best described by the nurse using a chart and pointer without providing sensory information also.

B

Incorrect. Stress-point nursing is not best described by reducing all procedures and treatments into 10 steps.

C

Incorrect. Stress-point nursing is not best described by fitting procedures into star-shaped diagrams.

D

Correct. Stress-point nursing helps children cope by using both procedural information (description of the treatment and sequence of the steps) and sensory information (how might this feel).

PTS: 1 REF: p. 513 Alleviating the Anxieties of Children

OBJ: Cognitive Level: Comprehension

8.The nurse places a unique cartoon character on the outside and inside of a childs door. The hospital has a picture of a different animal for each floor of the hospital, and these pictures are posted in the elevators. Each section of the pediatric unit has a different theme and walls of a different color. These actions on the part of the nurse and the hospital are designed to:

a.

reduce anxiety and help children and others feel secure that they will not get lost and that they have a place of their own

b.

remind everyone that this is a pediatric unit for children who have special needs and is not a unit for adults

c.

cheer the children up and help them laugh to reduce tension in their lives

d.

help establish a personality for the hospital, the floors, the unit, and the room of the child who is hospitalized

ANS: A

Feedback

A

Correct. Children may fear situations that appear minor to an adult, may fear that they may become lost then being transported around the hospital. Anticipating this would prompt the nurse to put a sign on the door, so the child could be found.

B

Incorrect. Placing a unique cartoon character on the outside and inside of a childs door is not to remind everyone that this is a pediatric unit for children who have special needs and is not a unit for adults.

C

Incorrect. Placing a unique cartoon character on the outside and inside of a childs door is not to cheer the children up and help them laugh to reduce tension in their lives.

D

Incorrect. Placing a unique cartoon character on the outside and inside of a childs door is not to help establish a personality for the hospital, the floors, the unit, and the room of the child who is hospitalized.

PTS: 1 REF: p. 513 Alleviating the Anxieties of Children

OBJ: Cognitive Level: Application

9.Nurses caring for a pediatric client can most strengthen a childs sense of security by:

a.

providing a unit and hospital handbook of rules and posting the dos and donts on the walls there children can see them

b.

letting the children know then they will be leaving, who will be caring for them, and then they will be back, and saying good-bye then they leave

c.

giving the children enough toys, games, and stuffed animals to play with

d.

telling the children then meals will be and what the menu will be for each meal as well as then they will have nothing by mouth (NPO) and for how long

ANS: B

Feedback

A

Incorrect. Nurses caring for a pediatric client will not most strengthen a childs sense of security by providing a unit and hospital handbook of rules and posting the dos and donts on the walls there children can see them.

B

Correct. To strengthen childrens sense of feeling secure, it is important for nurses to let them know then they will be leaving, who will be caring for them, and then they will be back, and saying good-bye then they leave.

C

Incorrect. Nurses caring for a pediatric client will not most strengthen a childs sense of security by giving the children enough toys, games, and stuffed animals to play with.

D

Incorrect. Nurses caring for a pediatric client will not most strengthen a childs sense of security by telling the children then meals will be and what the menu will be for each meal as well as then they will have nothing by mouth (NPO) and for how long.

PTS: 1 REF: p. 513 Alleviating the Anxieties of Children

OBJ: Cognitive Level: Application

10.The pediatric nurse in the hospital finds one of her clients crying because Daddy just left. Which of the following actions by the nurse would most help the child to feel more secure?

a.

holding the child, talking about then Dad will return, and looking at Dads picture

b.

looking at the clock, talking about the amount of time before Dad returns, and drawing a clock with that time

c.

distracting the child by playing a game that requires a lot of concentration

d.

giving the child a cuddly blanket and a cuddly stuffed animal to hold until Dad returns

ANS: A

Feedback

A

Correct. Finding one of her clients crying because Daddy just left, the pediatric nurse would most help the child to feel more secure by holding the child, talking about then Dad will return, and looking at Dads picture.

B

Incorrect. Finding one of her clients crying because Daddy just left, the pediatric nurse would not most help the child to feel more secure by looking at the clock, talking about the amount of time before Dad returns, and drawing a clock with that time.

C

Incorrect. Finding one of her clients crying because Daddy just left, the pediatric nurse would not most help the child to feel more secure by distracting the child by playing a game that requires a lot of concentration.

D

Incorrect. Finding one of her clients crying because Daddy just left, the pediatric nurse would not most help the child to feel more secure by giving the child a cuddly blanket and a cuddly stuffed animal to hold until Dad returns.

PTS: 1 REF: p. 513 Alleviating the Anxieties of Children

OBJ: Cognitive Level: Application

11.The nurse notices that a hospitalized, seriously ill child has a talent for drawing and writing poetry. The nurse will encourage this talent mainly for the purpose of getting the child to

a.

express and deal with feelings and thoughts in coping with the illness and hospitalization

b.

earn money to help the parents pay the hospital bill and for college tuition later

c.

entertain himself and stay distracted from pain and discouragement

d.

interact with other people on the unit who may have the same interests or hobbies

ANS: A

Feedback

A

Correct. Childrens talents also help in coping. For example, through drawing, writing prose or poetry, and other creative activities, children not only express their thoughts and feelings, but also use these media to cope.

B

Incorrect. The nurse will not encourage the seriously ill child who has a talent for drawing and writing poetry to earn money to help the parents pay the hospital bill and for college tuition later.

C

Incorrect. The nurse will not encourage this talent for drawing and writing poetry mainly for the purpose of getting the child to entertain himself and stay distracted from pain and discouragement.

D

Incorrect. The nurse will not encourage this talent for drawing and writing poetry mainly for the purpose of getting the child to interact with other people on the unit who may have the same interests or hobbies.

PTS: 1 REF: p. 513 Alleviating the Anxieties of Children

OBJ: Cognitive Level: Application

12.Which of the following is most critical to the nurse in identifying and meeting the needs of acutely ill children?

a.

what was learned in class about pediatrics

b.

all the nurses physiological and psychological senses

c.

journal articles with up-to-date information

d.

the verbal communication of the child

ANS: B

Feedback

A

Incorrect. What was learned in class about pediatrics is not the most critical to the identification and to meeting the needs of acutely ill children.

B

Correct. All the nurses physiological and psychological senses are critical in identifying and meeting the needs of acutely ill children.

C

Incorrect. Journal articles with up-to-date information are not the most critical to the identification and to meeting the needs of acutely ill children.

D

Incorrect. The verbal communication of the child is not the most critical to the identification and to meeting the needs of acutely ill children.

PTS:1

REF: p. 515 Major Factors in Support of Coping During Illness and Hospitalization

OBJ: Cognitive Level: Comprehension

13.The most skilled pediatric nurse will be committed to attending to each child and family in:

a.

exactly the same way

b.

a manner similar to one in the textbook

c.

unique ways designed for that child and family

d.

the same way as every other nurse on the unit

ANS: C

Feedback

A

Incorrect. The most skilled pediatric nurse will not be committed to attending to each child and family in exactly the same way, everyone is different.

B

Incorrect. The most skilled pediatric nurse will not be committed to attending to each child and family in a manner similar to one in the textbook.

C

Correct. The most skilled pediatric nurse will be committed to attending to each child and family in unique ways designed for that child and family. The experienced nurse may also be described as a nurse-artist because of the sensitivity exemplified in grasping the meaning of behavior in light of past and evolving events and the creative, skillful actions that reflect depth of understanding, and commitment to attending to each child and family in unique ways.

D

Incorrect. The most skilled pediatric nurse will not be committed to attending to each child and family in the same way as every other nurse on the unit, as every nurse is unique.

PTS:1

REF: p. 515 Major Factors in Support of Coping During Illness and Hospitalization

OBJ: Cognitive Level: Application

14.You are the nurse admitting a 5-year-old child to the pediatric unit. The mother says that she feels certain the child will be all right with the parents taking turns being at the hospital in the evenings only. The mother mentions that the child has been attending day care for several years. Which of the following is the nurses best response?

a.

Hospitalization can be very stressful to a child without a familiar person. If you can arrange to be here more, it will help your child.

b.

Some children who have been in day care do fine with just the nurse.

c.

I will personally take care of your child whenever I am here, so you wont have to worry about the care at all.

d.

Perhaps you could hire a private duty nurses aide or a nurse for part of the day.

ANS: A

Feedback

A

Correct. The critical importance of caregiver presence in the hospital may need to be explained to families because young children are often cared for by others during the day, and the impact of separation in a strange environment may not be fully understood.

B

Incorrect. Upon hearing a mother of an admitted 5-year-old child say that she feels certain the child will be all right with the parents taking turns being at the hospital in the evenings only, the nurses best response will not be: Some children who have been in day care do fine with just the nurse.

C

Incorrect. Upon hearing a mother of an admitted 5-year-old child say that she feels certain the child will be all right with the parents taking turns being at the hospital in the evenings only, the nurses best response will not be: I will personally take care of your child whenever I am here, so you wont have to worry about the care at all.

D

Incorrect. Upon hearing a mother of an admitted 5-year-old child say that she feels certain the child will be all right with the parents taking turns being at the hospital in the evenings only, the nurses best response will not be: Perhaps you could hire a private duty nurses aide or a nurse for part of the day.

PTS:1

REF: p. 515 Major Factors in Support of Coping During Illness and Hospitalization

OBJ: Cognitive Level: Application

15.Which of the following arrangements is generally considered to be best for the parents of a hospitalized infant or young child?

a.

day visits and sleeping at home

b.

rooming-in

c.

separate caregiver sleeping room on the unit

d.

staying at a nearby hotel or motel

ANS: B

Feedback

A

Incorrect. Day visits and sleeping at home is not generally considered to be the best arrangements for the parents of a hospitalized infant or young child.

B

Correct. The selection of arrangements is complex, but, whenever possible, rooming-in by the parents is of the highest priority for infants and young children.

C

Incorrect. Separate caregiver sleeping room on the unit is not generally considered to be the best arrangements for the parents of a hospitalized infant or young child.

D

Incorrect. Staying at a nearby hotel or motel is not generally considered to be the best arrangements for the parents of a hospitalized infant or young child.

PTS:1

REF: p. 516 Major Factors in Support of Coping During Illness and Hospitalization

OBJ: Cognitive Level: Comprehension

16.In the nursing mutual participation model of care (NMPMC), the nurse believes that:

a.

caregivers can and will be helpful at times if the nurse provides adequate teaching and training

b.

caregivers can participate in the simple day-to-day care of the child

c.

with enough supervision, caregivers can be good partners with nurses in caring for ill children and can help allay the childrens fears

d.

the presence and support of families is essential for optimal healing, recovery, and prevention of additional trauma to a child

ANS: D

Feedback

A

Incorrect. In the nursing mutual participation model of care (NMPMC), the nurse does believe that caregivers can and will be helpful at all times with or without adequate teaching and training.

B

Incorrect. In the nursing mutual participation model of care (NMPMC), the nurse does believe that caregivers can participate in the simple day-to-day care of the child, and much, much more.

C

Incorrect. In the nursing mutual participation model of care (NMPMC), the nurse does not believe that supervision of caregivers makes them good partners with nurses in caring for ill children and can help allay the childrens fears.

D

Correct. In the nursing mutual participation model of care (NMPMC), the nurse believes that the presence and support of families is essential for optimal healing, recovery, and prevention of additional trauma to a child.

PTS:1

REF: p. 517 Major Factors in Support of Coping During Illness and Hospitalization

OBJ: Cognitive Level: Comprehension

17.Which of the following questions by the nurse would best fit the philosophy of the nursing mutual participation model of care (NMPMC)?

a.

Where have you been all morning?

b.

Have you brushed your childs teeth today?

c.

How does your child look to you today?

d.

Do you think your childs color is worse?

ANS: C

Feedback

A

Incorrect. The following question by the nurse would not best fit the philosophy of the nursing mutual participation model of care (NMPMC): Where have you been all morning? The question is like an interrogation.

B

Incorrect. The following question by the nurse would not best fit the philosophy of the nursing mutual participation model of care (NMPMC): Have you brushed your childs teeth today? The question suggests there is a partition of responsibilities.

C

Correct. The following question by the nurse would best fit the philosophy of the nursing mutual participation model of care (NMPMC): How does your child look to you today? The question indicates equality of the partnership.

D

Incorrect. The following question by the nurse would not best fit the philosophy of the nursing mutual participation model of care (NMPMC): Do you think your childs color is worse?

PTS:1

REF: p. 517 Major Factors in Support of Coping During Illness and Hospitalization

OBJ: Cognitive Level: Application

18.The environment of the pediatric unit most needs to:

a.

be conducive to feelings of safety and security

b.

reflect the latest technology and up-to-date care

c.

reflect a warm working relationship among the staff

d.

be aesthetically pleasing to children and families

ANS: A

Feedback

A

Correct. As a place of healing, the environment of the pediatric unit should be conducive to feelings of safety and security.

B

Incorrect. The latest technology and up-to-date care are not as important as an environment conducive to feelings of safety and security.

C

Incorrect. The environment of the pediatric unit needs to reflect a warm working relationship among the staff, but this is at best secondary, as it contributes to an environment conducive to feelings of safety and security.

D

Incorrect. The environment of the pediatric unit may need to be aesthetically pleasing to children and families, but most important is an environment conducive to feelings of safety and security.

PTS:1

REF: p. 519 Major Factors in Support of Coping During Illness and Hospitalization

OBJ: Cognitive Level: Comprehension

19.The nurse is helping admit a child to the pediatric unit of the hospital. The nurse will help the child:

a.

put her clothing and shoes in the closet or send them home in a bag

b.

store worn blankets and stuffed animals out of sight

c.

place the shoes in plain sight there the child can see them

d.

make the bed up the way the child likes it at home

ANS: C

Feedback

A

Incorrect. While admitting a child to the pediatric unit of the hospital, the nurse will not best help the child by putting her clothing and shoes in the closet or sending them home.

B

Incorrect. While admitting a child to the pediatric unit of the hospital, the nurse will not best help the child by putting away their personal and most prized possessions.

C

Correct. While admitting a child to the pediatric unit of the hospital, the nurse will help the child place her shoes in plain sight there the child can see them. Shoes are symbols of mobility and reminders of going home, i.e., a symbol of life outside the hospital.

D

Incorrect. While admitting a child to the pediatric unit of the hospital, the nurse will not best help the child by making the bed up the way the child likes it at home.

PTS:1

REF: p. 519 Major Factors in Support of Coping During Illness and Hospitalization

OBJ: Cognitive Level: Application

20.Which of the following areas is most important for a pediatric unit to have for its hospitalized children to use?

a.

a library

c.

computer room

b.

television room

d.

playroom

ANS: D

Feedback

A

Incorrect. A library is not most important for a pediatric unit.

B

Incorrect. A television room is not most important for a pediatric unit.

C

Incorrect. A computer room is not most important for a pediatric unit.

D

Correct. Every pediatric unit needs a playroom as a safe haven there no painful treatments or scenes are encountered; a place there children are empowered to cope with stressful events on a day-to-day basis.

PTS:1

REF: p. 519 Major Factors in Support of Coping During Illness and Hospitalization

OBJ: Cognitive Level: Comprehension

21.The parents ask if blood work can be drawn from their daughter while she is in the playroom and distracted from this procedure. The best answer by the nurse is:

a.

No, definitely not, because it is against hospital rules to draw blood there.

b.

Yes, if you prefer the blood to be drawn there, we will abide by your wishes.

c.

The playroom is a safe haven there no painful treatments or scenes are encountered.

d.

If your child agrees to have the blood drawn in the playroom and other parents dont object.

ANS: C

Feedback

A

Incorrect. Answering a parents question about why you would never draw blood then the child is in the playroom, the best answer by the nurse is not: No, definitely not, because it is against hospital rules to draw blood there.

B

Incorrect. Answering a parents question about why you would never draw blood then the child is in the playroom, the best answer by the nurse is never: Yes, if you prefer the blood to be drawn there, we will abide by your wishes.

C

Correct. Answering a parents question about why you would never draw blood then the child is in the playroom, the best answer by the nurse is: The playroom is a safe haven there no painful treatments or scenes are encountered.

D

Incorrect. Answering a parents question about why you would never draw blood then the child is in the playroom, the best answer by the nurse is never: If your child agrees to have the blood drawn in the playroom and other parents dont object.

PTS:1

REF: p. 519 Major Factors in Support of Coping During Illness and Hospitalization

OBJ: Cognitive Level: Application

22.Which of the following therapies is most often used by psychiatrists, psychologists, and psychiatric nurse clinicians to assess and treat young children who are experiencing anxiety or who have mental health problems?

a.

reality therapy

c.

play therapy

b.

rational emotive therapy

d.

short-term therapy

ANS: C

Feedback

A

Incorrect. Reality therapy would never be used by psychiatrists, psychologists, and psychiatric nurse clinicians to assess and treat young children who are experiencing anxiety or who have mental health problems.

B

Incorrect. Rational emotive therapy would never be used by psychiatrists, psychologists, and psychiatric nurse clinicians to assess and treat young children who are experiencing anxiety or who have mental health problems.

C

Correct. Therapeutic play, or play therapy, is a highly effective, nondirective way of assisting children to use hospital equipment and toys to express reactions to stressful events in the hospital.

D

Incorrect. Short-term therapy is not most often used by psychiatrists, psychologists, and psychiatric nurse clinicians to assess and treat young children who are experiencing anxiety or who have mental health problem.

PTS:1

REF: p. 520 Major Factors in Support of Coping During Illness and Hospitalization

OBJ: Cognitive Level: Comprehension

23.Pediatric nurses realize that allowing a sibling to visit a hospitalized child:

a.

presents a great risk of infection and should not be allowed

b.

will probably tire out the ill child and make him feel worse

c.

will probably be very disruptive to the nursing staff and to the rest of the unit

d.

often is very helpful to not only the hospitalized child but the sibling as well

ANS: D

Feedback

A

Incorrect. Pediatric nurses realize that allowing a sibling to visit a hospitalized child does not present a great risk of infection and should be allowed.

B

Incorrect. Pediatric nurses realize that allowing a sibling to visit a hospitalized child will not probably tire out the ill child and make him feel worse, in fact, both will feel better.

C

Incorrect. Pediatric nurses realize that allowing a sibling to visit a hospitalized child may be disruptive to the nursing staff and to the rest of the unit, but the visit will help both the siblings.

D

Correct. Sibling visitation has become a well-established practice in pediatric units. There are considerable benefits to the child, sibling, and family with minimal risks such as infections. Siblings have fears and fantasies about what is happening as well, and seeing them helps alleviates concerns.

PTS:1

REF: p. 518 Major Factors in Support of Coping During Illness and Hospitalization

OBJ: Cognitive Level: Comprehension

24.You are working as a pediatric nurse on the pediatric unit and assigned to work with a school-aged child who is on bed rest. This child cannot go to the playroom. What is the most helpful thing you can do to reduce stress and anxiety for this child?

a.

Offer extra ice cream and special desserts if allowed on the childs diet.

b.

Get two puppets and have a conversation with the child holding one and you holding the other puppet.

c.

Talk to the child several times during the shift, assuring him that he has nothing to be anxious about.

d.

Give the child a book to read about what it is like for a child to be in the hospital.

ANS: B

Feedback

A

Incorrect. For the school-aged child who is on bed rest and unable to go to the playroom, offering extra ice cream and special desserts will not be the most helpful thing you can do to reduce stress and anxiety for this child.

B

Correct. It is difficult for children to resist play, but if they cannot go to the playroom, observing the play of other children, puppet shows or play at the bedside is appropriate.

C

Incorrect. For the school-aged child who is on bed rest and unable to go to the playroom, talking to the child several times during the shift, assuring him that he has nothing to be anxious about will not be the most helpful thing you can do to reduce stress and anxiety for this child.

D

Incorrect. For the school-aged child who is on bed rest and unable to go to the playroom, giving the child a book to read about what it is like for a child to be in the hospital will not be the most helpful thing you can do to reduce stress and anxiety for this child.

PTS:1

REF: p. 519 Major Factors in Support of Coping During Illness and Hospitalization

OBJ: Cognitive Level: Application

25.A mother asks the pediatric nurse then preparation for her 5-year-old childs upcoming hospital experience should begin. Which of the following is the nurses best response?

a.

a few days before admission

b.

during the admission process on the day of admission

c.

on arrival at the hospital unit

d.

no preparation is needed because it will just create anxiety

ANS: A

Feedback

A

Correct. For planned admissions, the age of the child should be a guide to timing for preparation for hospitalization or surgery. For children aged 4-to-7-year-olds, 4 to 7 days.

B

Incorrect. Answering a mothers question about then she should begin preparation for her 5-year-old childs upcoming hospital experience, the best response would not be during the admission process on the day of admission.

C

Incorrect. Answering a mothers question about then she should begin preparation for her 5-year-old childs upcoming hospital experience, the best response would not be upon arrival at the hospital unit.

D

Incorrect. Answering a mothers question about then she should begin preparation for her 5-year-old childs upcoming hospital experience, the best response would not be none needed because it will just create anxiety.

PTS:1

REF: p. 522 Major Factors in Support of Coping During Illness and Hospitalization

OBJ: Cognitive Level: Application

26.An infant is going to be admitted to the hospital in a few days. What is the best approach to prepare the infant for hospitalization?

a.

Have the parents take the infant to the hospital for an hour or so to familiarize the infant with the hospital environment.

b.

Put the infant on a routine that is similar to the routines the infant will encounter in the hospital.

c.

It is better to prepare the caregivers so that they will convey a sense of calmness to the infant.

d.

Have the parents go by the hospital to have the nurses meet the baby ahead of time.

ANS: C

Feedback

A

Incorrect. When preparing for the infant for upcoming hospitalization, the best approach is not to have the parents take the infant to the hospital for an hour or so to familiarize the infant with the hospital environment.

B

Incorrect. When preparing for the infant for upcoming hospitalization, the best approach is not to put the infant on a routine that is similar to the routines the infant will encounter in the hospital.

C

Correct. For infants, the best approach is to prepare the caregivers. By allaying their fears and concerns they will be better able to communicate a sense of calmness and well-being to their infants.

D

Incorrect. When preparing for the infant for upcoming hospitalization, the best approach is not to have the parents go by the hospital to have the nurses meet the baby ahead of time.

PTS:1

REF: p. 522 Major Factors in Support of Coping During Illness and Hospitalization

OBJ: Cognitive Level: Application

27.You are working with the family of a school-aged child who will be admitted in 2 weeks to the pediatric unit for surgery. Which of the following activities would be most helpful to the child?

a.

Have the child spend time with a child or other children who have been clients in this hospital.

b.

Allow the child to tour the hospital, engage in medical play, and handle equipment such as an IV fluid bag, tubing, and blood pressure equipment.

c.

Show the child a movie about the hospital.

d.

Have the child draw pictures of the upcoming hospitalization.

ANS: B

Feedback

A

Incorrect. Having the child spend time with a child or other children who have been clients in this hospital would not be the most helpful activity for the school-aged child.

B

Correct. For planned admissions for children over age 7 years, a few weeks before hospitalization or surgery is fine. Through tours, use of puppets, medical play, childrens literature, and audiovisual media, children learn about the experience and their role in the recovery process. Whenever possible, you will let them handle equipment such as an IV fluid bag, tubing, and blood pressure equipment.

C

Incorrect. Showing the child a movie about the hospital would not be the most helpful activity for the school-aged child.

D

Incorrect. Having the child draw pictures of the upcoming hospitalization would not be the most helpful activity for the school-aged child.

PTS: 1 REF: p. 523 Preparation of Children and Families for Hospitalization

OBJ: Cognitive Level: Application

28.When young children are admitted to the hospital, the nurse should first establish a relationship with the:

a.

child

c.

mother

b.

caregivers

d.

father

ANS: B

Feedback

A

Incorrect. When young children are admitted to the hospital, the nurse should first establish a relationship with the caregivers, not the child

B

Correct. When young children are admitted to the hospital, the nurse should first establish a relationship with the caregivers. As children see their caregivers trust the nurse, it is easier for them to engage in a relationship with the nurse.

C

Incorrect. When young children are admitted to the hospital, the nurse should first establish a relationship with the caregivers, not exclusively the mother.

D

Incorrect. When young children are admitted to the hospital, the nurse should first establish a relationship with the caregivers, not exclusively the father.

PTS: 1 REF: p. 523 Preparation of Children and Families for Hospitalization

OBJ: Cognitive Level: Application

29.Which of the following actions on the part of the nurse would best facilitate positive responses then talking with a hospitalized child?

a.

using terms of endearment such as honey or sugar

b.

promising a special treat such as ice cream or a ride in the wheelchair

c.

getting positioned at eye level and having eye contact with the child

d.

having the child hold some piece of hospital or personal equipment

ANS: C

Feedback

A

Incorrect. Using terms of endearment such as honey or sugar will not best facilitate positive responses then talking with a hospitalized child.

B

Incorrect. Promising a special treat such as ice cream or a ride in the wheelchair will not best facilitate positive responses then talking with a hospitalized child.

C

Correct. Being at eye level and having eye contact while talking to children facilitates positive responses.

D

Incorrect. Having the child hold some piece of hospital or personal equipment will not best facilitate positive responses then talking with a hospitalized child.

PTS: 1 REF: p. 523 Preparation of Children and Families for Hospitalization

OBJ: Cognitive Level: Application

30.Which of the following actions by the nurse would usually be most productive in gaining an understanding of an adolescents or a childs perceptions related to their illness and hospitalization?

a.

Conduct interviews with extended family members.

b.

Interview the child or adolescent alone one-on-one.

c.

Read the childs diary if the parents will provide it.

d.

Have the child write a report for the nurse to read.

ANS: B

Feedback

A

Incorrect. Conducting interviews with extended family members would never be most productive in gaining an understanding of an adolescents or a childs perceptions related to their illness and hospitalization.

B

Correct. It is always helpful to have a separate interview with the child or adolescent in order to understand their perceptions related to illness and hospitalization.

C

Incorrect. Reading the childs diary if the parents will provide it is an invasion of privacy that will never be appropriate, and if discovered by the adolescent, will destroy professional boundaries beyond repair.

D

Incorrect. Having the child write a report for the nurse to read is not the equal for a two-way conversation of an interview one-on-one.

PTS: 1 REF: p. 524 Care of Children During Admission to a Hospital

OBJ: Cognitive Level: Application

31.When children are in an uncomplicated preoperative situation, the need for heavy sedation decreases then

a.

the anesthetist or anesthesiologist is friendly

b.

a nurse gives pain medication liberally the day before surgery

c.

the doctor stops by before surgery to talk to the client

d.

the parents are present during the preoperative situation

ANS: D

Feedback

A

Incorrect. Although having a friendly anesthetist or anesthesiologist may decrease the childs stress, the presence of the parents during the preoperative situation is the most important factor in decreasing the need for heavy sedation.

B

Incorrect. A nurse giving pain medication liberally the day before surgery is not a factor in decreasing the need for heavy sedation for the child

C

Incorrect. Although having the doctor stops by before surgery to talk to the client may provide and reinforce information for children and parents and encourage expression of any fears they may have about surgery, is not the most important factor in decreasing the need for heavy sedation.

D

Correct. When children are in an uncomplicated preoperative situation, the need for heavy sedation decreases then the parents are present during the preoperative situation.Their presence during induction of anesthesia is reassuring to children and minimizes the stress of separation.

PTS: 1 REF: p. 524 Care of Children During Admission to a Hospital

OBJ: Cognitive Level: Comprehension

32.When anesthesia is explained to children, which of the following statements would usually be less frightening?

a.

This medicine will put you to sleep.

b.

We are going to put you down under the anesthesia now.

c.

This will give you a special kind of sleep and you will awake.

d.

You will have a heavenly feeling.

ANS: C

Feedback

A

Incorrect. The statement this medicine will put you to sleep may be frightening for children especially if it has been used in reference to euthanizing a pet.

B

Incorrect. The statement we are going to put you down under the anesthesia now may also be frightening for children. Preschoolers interpret what is said literally and may think they will be put underneath something.

C

Correct. When anesthesia is explained to children, the least frightening statement would be: This will give you a special kind of sleep and you will be awakened then its over and come back here there (person in family) will be waiting for you.

D

Incorrect. Saying you will have a heavenly feeling to a child as a way to explain anesthesia may also frightening. Sometimes words are confusing and cause distress. This statement may evoke fantasies of doom. The child might think he or she could die during surgery and will be going to heaven.

PTS: 1 REF: p. 524 Care of Children During Admission to a Hospital

OBJ: Cognitive Level: Application

33.When having a child role-play a procedure, the nurse would

a.

ask the child to choose the subject of the procedure

b.

select one of the childs dolls or stuffed animals for the procedure

c.

invite the mother to be the subject

d.

volunteer to be the subject on which the procedure is being done

ANS: A

Feedback

A

Correct. When having a child role-play a procedure, the nurse would ask the child to choose the subject of the procedure.

B

Incorrect. Many children do not like to use their favorite doll or stuffed animal then role-playing a procedure.

C

Incorrect. Inviting the mother to be the subject is not appropriate because the child may be afraid that she might be hurt or feel pain.

D

Incorrect. The nurse should allow the child to choose who will be the subject of the procedure. It is not appropriate for the nurse to volunteer to be the subject.

PTS: 1 REF: p. 526 Preparation of Children and Their Families for Surgery

OBJ: Cognitive Level: Application

34.When explaining to a child that you are going to do a dressing change, the best explanation would include which of the following statements?

a.

I am going to rip the bandage off real quick, and it will be all gone.

b.

I will try not to pull all your hair out then I pull this bandage off.

c.

I am going to take off your bandage.

d.

I am going to fix your bandage and make it better.

ANS: D

Feedback

A

Incorrect. This statement is not the best explanation. I am going to rip the bandage off real quick can be threatening to a child.

B

Incorrect. This statement should always be avoided because it is aggressive language and can cause anxiety and distress for the child.

C

Incorrect. This statement is not the best explanation because it uses aggressive language.

D

Correct. When explaining to a child that you are going to do a dressing change, the best explanation would be I am going to fix your bandage and make it better. When preparing children for procedures, use the least aggressive language. This statement is the least aggressive of all the choices.

PTS: 1 REF: p. 526 Preparation of Children and Their Families for Surgery

OBJ: Cognitive Level: Application

35.Which of the following statements by the nurse would be most helpful to a child during a procedure or a treatment?

a.

It is hard to be quiet and lie still during this, but you are doing very well.

b.

Youre a good girl (or a good boy).

c.

This will only hurt for another 10 minutes.

d.

If you are good, I will give you some of your favorite ice cream or a Popsicle.

ANS: A

Feedback

A

Correct. The statement by the nurse It is hard to be quiet and lie still during this, but you are doing very well would be most helpful to a child during a procedure or a treatment. During procedures, the nurse should guide and coach the child using soft, reassuring words and giving praise intermittently for cooperation and following directions

B

Incorrect. It is inadvisable to use phrases like Youre a good girl (or a good boy). Young children may associate the procedure with punishment.

C

Incorrect. This statement is not helpful because it is not possible to know how long a treatment will hurt. At the conclusion of the procedure, offer a simple apology if the child experienced pain, such as Im sorry if I hurt you.

D

Incorrect. This statement is not helpful to a child during a procedure or treatment. If the child cries during the procedure, he or she may feel like a failure. Also, follow up to a procedure should include fun activities or comfort measures agreed on in advance.

PTS: 1 REF: p. 526 Preparation of Children and Their Families for Surgery

OBJ: Cognitive Level: Application

36.Which of the following terms is preferred then referring to a child who has diabetes?

a.

that kid

c.

the child with diabetes

b.

the diabetic kid

d.

the cute diabetic child

ANS: C

Feedback

A

Incorrect. The term that kid should not be used because it minimizes the dignity of children.

B

Incorrect. The term the diabetic kid should not be used. This term identifies the child by the disease, diabetes. As stated in A the term kid is inappropriate.

C

Correct. The term the child with diabetes is preferred then referring to a child who has diabetes. This term emphasizes that he is a child with a health problem. Any other term labels or stereotypes the child and can have detrimental effects.

D

Incorrect. The cute diabetic child is inappropriate because it identifies the child by the disease.

PTS: 1 REF: p. 528 Communicating with Children and Families

OBJ: Cognitive Level: Application

37.The nurse is tube-feeding an infant. In order to reduce future difficulty with the infant accepting oral feedings, which of the following actions will the nurse carry out?

a.

Keep the infant in an upright position and never lose hand contact with the infant.

b.

Have the infant suck on the nurses fingers.

c.

Hold the infant in an en face position, give eye contact, and carry out verbal interaction.

d.

Give the baby a pacifier to use at each feeding.

ANS: C

Feedback

A

Incorrect. Eye contact is key, not touch.

B

Incorrect. Eye contact is key, not touch.

C

Correct. The nurse is tube-feeding an infant. In order to reduce future difficulty with the infant accepting oral feedings, which of the following actions will the nurse carry out

D

Incorrect. Eye contact is key, not an inanimate object such as a pacifier.

PTS: 1 REF: p. 529 Nursing Care and Guidance of Infants

OBJ: Cognitive Level: Application

38.The nurse gives an infant a pacifier to suck on during a tube feeding. The reason for the pacifier is to:

a.

distract the infant so she will not try to pull the feeding tube out in a reflex action

b.

help the infant know the relationship between oral pleasure and a full satiated feeling

c.

keep the child from sucking on her fingers during this time

d.

keep the infant focused so she will not remember the procedure

ANS: B

Feedback

A

Incorrect. The reason for the pacifier is not to distract the infant so she will not try to pull the feeding tube out in a reflex action. The basic source of infant satisfaction is through satiation of oral needs. Tube feeding interferes with the gratification of these needs.

B

Correct. The nurse gives an infant a pacifier to suck on during a tube feeding. The reason for the pacifier is to help the infant know the relationship between oral pleasure and a full satiated feeling.

C

Incorrect. The nurse does not give an infant a pacifier to suck on during a tube feeding to keep the child from sucking on her fingers.

D

Incorrect. The nurse does not give an infant a pacifier to suck on during a tube feeding to keep the infant focused so she will not remember the procedure.

PTS: 1 REF: p. 529 Nursing Care and Guidance of Infants

OBJ: Cognitive Level: Application

39.When an infant undergoes surgery, is vomiting, or has to take medications that taste terrible, these experiences will most often make it difficult for the infant to:

a.

experience pleasure in sucking, swallowing, digesting, and eliminating

b.

relate to the nursing staff and the other members of the health care team

c.

accept cuddling and comforting from the caregivers

d.

communicate basic human needs

ANS: A

Feedback

A

Correct. Nurses should be particularly aware of the effects of situations that interfere with the gratification of oral needs (e.g., oral surgery, vomiting, distasteful medications, withholding food and fluids as well as periods of nonoral feeding). These experiences will most often make it difficult for the infant to experience pleasure in sucking, swallowing, digesting, and eliminating.

B

Incorrect. The infant is sufficiently self-centered that they are never going to be concerned about how they relate to the nursing staff and the other members of the health care team.

C

Incorrect. When oral satisfaction is threatened, the infant will not be satisfied with cuddling and comforting from the caregivers until the more basic need is fulfilled.

D

Incorrect. When oral satisfaction is threatened, the infant has adequate means to communicate their needs without difficulty.

PTS: 1 REF: p. 529 Nursing Care and Guidance of Infants

OBJ: Cognitive Level: Application

40.The nurse is teaching a new mother how to reduce tension in the newborn and infant. Which of the following activities will the nurse recommend?

a.

giving the breast or bottle so that the baby falls asleep with warm milk

b.

talking softly, singing, and gentle stroking

c.

swinging the baby in the air, holding the neck secure

d.

bouncing the child on the knee

ANS: B

Feedback

A

Incorrect. Giving the breast or bottle so that the baby falls asleep with warm milk will lead to caries, and is not the activity the nurse will recommend.

B

Correct. Talking to infants slowly, singing lullabies, moving them gently and carefully, and rocking and cuddling are ways to help infants reduce tension.

C

Incorrect. Swinging the baby in the air, holding the neck secure will not reduce tension, but will induce fear in the newborn and infant; this is definitely not the activity the nurse will recommend.

D

Incorrect. Bouncing the child on the knee if done gently and carefully is not the activity the nurse will recommend, as holding the infant closely and cuddling is preferred.

PTS: 1 REF: p. 529 Nursing Care and Guidance of Infants

OBJ: Cognitive Level: Application

41.Which of the following practices is used by a large number of cultural groups to provide comfort and security to a child?

a.

burying a rock near a large shade tree

b.

taping a coin to the umbilical cord

c.

wrapping the infant snugly in a soft blanket

d.

boiling an egg and keeping it close to the child

ANS: C

Feedback

A

Incorrect. Burying a rock near a large shade tree is not a practice used by a large number of cultural groups to provide comfort and security to a child.

B

Incorrect. Taping a coin to the umbilical cord is not a practice used by a large number of cultural groups to provide comfort and security to a child.

C

Correct. Swaddling, by wrapping the infant snugly in a soft blanket, is a practice used by many cultural groups to promote infant comfort and security.

D

Incorrect. Boiling an egg and keeping it close to the child is not a practice used by a large number of cultural groups to provide comfort and security to an infant.

PTS: 1 REF: p. 529 Nursing Care and Guidance of Infants

OBJ: Cognitive Level: Application

42.The nurse is teaching new mothers about safety in caring for infants. Which of the following actions will the nurse insist the new mothers adhere to in the day-to-day care of the infant?

a.

Put a blanket on the floor around and under the crib.

b.

Have the crib sides at least halfway up at all times.

c.

Have at least one hand on the infant then the crib sides are down.

d.

Leave little toys in the crib so the infant will be entertained.

ANS: C

Feedback

A

Incorrect. In teaching new mothers about safety in caring for infants, the nurse will never insist the new mothers put a blanket on the floor around and under the crib.

B

Incorrect. In teaching new mothers about safety in caring for infants, the nurse will not insist the new mothers have the crib sides at least halfway up at all times, as this will engender a false sense of security.

C

Correct. In teaching new mothers about safety in caring for infants, the nurse will insist the new mothers always have at least one hand on the infant then the crib sides are down.

D

Incorrect. In teaching new mothers about safety in caring for infants, the nurse will never insist the new mothers leave little toys in the crib. In fact, the nurse will insist harmful objects or objects small enough to be swallowed never be left in or near the crib to avoid that danger.

PTS: 1 REF: p. 530 Nursing Care and Guidance of Infants

OBJ: Cognitive Level: Application

43.Which of the following is necessary for the nurse working with hospitalized toddlers to know?

a.

what the individual toddler has mastered and how to maintain mastery

b.

how far behind or ahead this child seems to be compared to the average same-age child

c.

which parent has been present most of the time then skills have been mastered

d.

how many times the child has had to try something before mastering it

ANS: A

Feedback

A

Correct. To preserve developing autonomy and minimize shame and doubt in themselves, it is important to know the accomplishments of individual toddlers and maintain mastery insofar as possible.

B

Incorrect. The nurse working with the hospitalized toddler is focused upon the individual and their accomplishments, and is not concerned with comparison to the average same-age child.

C

Incorrect. The nurse working with the hospitalized toddler is focused upon the individual and their accomplishments, and is not concerned with which parent has been present most of the time then skills have been mastered.

D

Incorrect. The nurse working with the hospitalized toddler is focused upon the individual and their accomplishments, and is not concerned with how many times the child has had to try something before mastering it.

PTS: 1 REF: p. 530 Nursing Care and Guidance of Infants

OBJ: Cognitive Level: Comprehension

44.The nurse working with hospitalized toddlers can best preserve the toddlers sense of autonomy by:

a.

telling the parents to let them have their own way once in a while

b.

letting them throw a tantrum as long as they want without stopping it

c.

finding ways to give them some choices of actions and things

d.

writing their preferences on a bedside list or on a wall chart

ANS: C

Feedback

A

Incorrect. The nurse working with hospitalized toddlers will not best preserve the toddlers sense of autonomy by telling the parents to let them have their own way once in a while, ut by teaching the parents to find ways to give them some choices of actions and things.

B

Incorrect. The nurse working with hospitalized toddlers will not best preserve the toddlers sense of autonomy by letting them throw a tantrum as long as they want without stopping it, but by teaching the parents to find ways to give them some choices of actions and things.

C

Correct. Understanding autonomy in toddlers and the negativism that is part of this task is evident with choices for a toddler. The choices must be age-appropriate and simple.

D

Incorrect. The nurse working with hospitalized toddlers will not best preserve the toddlers sense of autonomy by writing their preferences on a bedside list or on a wall chart.

PTS: 1 REF: p. 530 Nursing Care and Guidance of Infants

OBJ: Cognitive Level: Application

45.When toddlers are separated from parents or caregivers for a long time, they may look away or focus on something else then caregivers return. This behavior is most accurately interpreted as which of the following behaviors?

a.

settling in and accepting that the caregivers have more important things to do

b.

development of some lifelong coping skills to deal with stressful situations

c.

revenge for being abandoned then they needed their parents or caregivers attention

d.

detachment from losing hope for permanent reunion with parents or caregivers

ANS: D

Feedback

A

Incorrect. Due to extended separation from home, the toddler may look away or focus on something else then caregivers return. This does not indicate that the toddler is settling in and accepting that the caregivers have more important things to do, but this behavior is most accurately interpreted as denial.

B

Incorrect. Due to extended separation from home, the toddler may look away or focus on something else then caregivers return. This does not indicate that the toddler is developing some lifelong coping skills to deal with stressful situations.

C

Incorrect. Due to extended separation from home, the toddler may look away or focus on something else then caregivers return. This does not indicate that the toddler is taking revenge for being abandoned then they needed their parents or caregivers attention.

D

Correct. Due to extended separation from home, the toddler may look away or focus on something else then caregivers return. This behavior is most accurately interpreted as denial or detachment, indicating the toddler has lost hope for permanent reunion.

PTS: 1 REF: p. 531 Nursing Care and Guidance of Toddlers

OBJ: Cognitive Level: Application

46.The nurse working with a toddler in the hospital wants the toddler to eat lunch. Which of the following statements by the nurse will likely result in the toddler eating lunch?

a.

Do you want your lunch?

b.

You must eat your lunch now because you have to be done in 30 minutes!

c.

Its time to eat now. Do you want Pooh Bear to eat with you?

d.

Are you hungry?

ANS: C

Feedback

A

Incorrect. Wanting a toddler in the hospital to eat lunch, the nurse will not entice the toddler to eat by offering a choice that is not age-appropriate such as, Do you want your lunch? Such a choice often results in a negative response by the toddler.

B

Incorrect. Wanting a toddler in the hospital to eat lunch, the nurse will not entice the toddler to eat by challenging their autonomy by giving an order with a time limit. Such a statement will result in a negative response by the toddler.

C

Correct. Wanting a toddler in the hospital to eat lunch, the nurse offers an age-appropriate choice, such as: Its time to eat now. Do you want Pooh Bear to eat with you?

D

Incorrect. Wanting a toddler in the hospital to eat lunch, the nurse knows not to ask: Are you hungry? What if the toddler answers, No?

PTS: 1 REF: p. 532 Nursing Care and Guidance of Toddlers

OBJ: Cognitive Level: Application

47.Preschool children have special needs including:

a.

being curious and wanting to know why

b.

wanting someone to do everything for them

c.

fear of failure and needing reassurance

d.

wanting to be bigger and better than others

ANS: A

Feedback

A

Correct. Preschool children are naturally curious, wanting to know why, they have facility with language and other skills and enjoy the beginning of independence, yet are acutely aware of their need for the presence and support of adults in their lives.

B

Incorrect. Preschool children are beginning to establish independence and do not want someone to do everything for them.

C

Incorrect. Preschool children are not best described as fearing failure and needing reassurance.

D

Incorrect. Preschool children are not best described as wanting to be bigger and better than others.

PTS: 1 REF: p. 532 Nursing Care and Guidance of Toddlers

OBJ: Cognitive Level: Comprehension

48.Preschoolers learn best through which of the following methods?

a.

observations and manipulation of objects

b.

abstractions presented by their caregivers

c.

looking at simple picture instructions in a book

d.

being told how to do something by caregivers

ANS: A

Feedback

A

Correct. Preschoolers learn best through observation and manipulation of objects. Abstractions or things not seen are difficult to understand for this age group.

B

Incorrect. Preschoolers do not learn best through abstractions presented by their caregivers, as they are very concrete.

C

Incorrect. Preschoolers do not learn best through looking at simple picture instructions in a book, as these are abstractions.

D

Incorrect. Preschoolers do not learn best through being told how to do something by caregivers, but instead by using objects and observing.

PTS: 1 REF: p. 532 Nursing Care and Guidance of Toddlers

OBJ: Cognitive Level: Comprehension

49.The nurse working with pediatric clients will keep in mind that the meaning of red to children is:

a.

happiness

c.

hurting

b.

life

d.

joy

ANS: C

Feedback

A

Incorrect. The nurse working with pediatric clients knows that the meaning of red to children is not happiness.

B

Incorrect. The nurse working with pediatric clients knows that the meaning of red to children is not life.

C

Correct. Seeing blood or taking blood is frightening because of its symbolic nature. To many children, Red is the color of hurting. Their falls and scrapes and scratches and cuts are present in their minds, blood, red, injury, even the pain of the care after the fall.

D

Incorrect. The nurse working with pediatric clients knows that the meaning of red to children is not joy.

PTS: 1 REF: p. 532 Nursing Care and Guidance of Toddlers

OBJ: Cognitive Level: Comprehension

50.The nurse working with a preschooler finds on assessment early in the shift that this child is not taking adequate fluids. Which of the following actions by the nurse will most likely result in the child taking more fluids?

a.

telling the child he will not get better unless he drinks more

b.

offering the child a reward if he drinks a certain amount each hour

c.

having the doctor talk to the child and the parents

d.

setting up a tea party or playing restaurant

ANS: D

Feedback

A

Incorrect. Sometimes then children are having difficulty taking fluids, the nurse will not most likely tell the child he will not get better unless he drinks more. Threats are rarely effective intervention.

B

Incorrect. Sometimes then children are having difficulty taking fluids, the nurse will not most likely offer the child a reward if he drinks a certain amount each hour. Bribes are not always an effective technique.

C

Incorrect. Sometimes then children are having difficulty taking fluids, the nurse will never most likely have the doctor talk to the child and the parents, as this is the responsibility of the nurse and the nursing staff.

D

Correct. Preschoolers are usually sociable, and group play and activities are often successful. Sometimes then children are having difficulty taking fluids, a tea party, or playing restaurant then drinks are ordered, is more helpful than frequent encouragement to take fluids.

PTS: 1 REF: p. 535 Nursing Care and Guidance of Preschool Children

OBJ: Cognitive Level: Application

51.The nurse assigned to work with school-aged children who have been hospitalized knows that from a developmental viewpoint their special needs include:

a.

opportunities to do and learn well

c.

an adult to debate lifes issues with

b.

someone to supervise their activities

d.

opportunities to regress without fear

ANS: A

Feedback

A

Correct. During hospitalization of school-aged children, every effort needs to be put forth to help those whose primary focus is school-related to continue to learn and maintain their individual strengths.

B

Incorrect. The nurse assigned to work with school-aged children who have been hospitalized knows that from a developmental viewpoint their special needs does not include someone to supervise their activities.

C

Incorrect. The nurse assigned to work with school-aged children who have been hospitalized knows that from a developmental viewpoint their special needs does not include an adult to debate lifes issues with.

D

Incorrect. The nurse assigned to work with school-aged children who have been hospitalized knows that from a developmental viewpoint their special needs does not include opportunities to regress without fear. Instead, they need to maintain their skills and to continue learning.

PTS: 1 REF: p. 535 Nursing Care and Guidance of Preschool Children

OBJ: Cognitive Level: Comprehension

MULTIPLE RESPONSE

1.Hospitalized adolescents do best then which of the following conditions exist? Select all that apply.

a.

then other adolescents are present on the same unit

b.

in a room with another adolescent but on a ward of mixed adolescents and adults there they can view how adults respond to their hospitalizations

c.

mixed with younger children so they can be role models for the younger children

d.

then offered the opportunity to participate in the governance of their space

ANS: A, D

Feedback

Correct

For the hospitalized adolescent, adaptation is facilitated then other adolescents are present on the same unit.

For the hospitalized adolescent, adaptation is facilitated then the adolescent is offered the opportunity to participate in the governance of their space.

Incorrect

Adaptation is not facilitated by being in a mixed unit with adolescents and adults.

Mixing the unit with younger children is also not an indication for adaptation for the hospitalized adolescent.

PTS: 1 REF: p. 530 Nursing Care and Guidance of Infants

OBJ: Cognitive Level: Application

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