Chapter 4: Communicating with Children and Families(FREE) My Nursing Test Banks

Chapter 4: Communicating with Children and Families

Test Bank

MULTIPLE CHOICE

1. Which information should the nurse include when preparing a 5-year-old child for a cardiac catheterization?

a.

A detailed explanation of the procedure

b.

A description of what the child will feel and see during procedure

c.

An explanation about the dye that will go directly into his vein

d.

An assurance to the child that he and the nurse can talk about the procedure when it is over

ANS: B

Feedback

A

Explaining the procedure in detail is probably more than the 5-year-old child can comprehend, and it will likely produce anxiety.

B

For a preschooler, the provision of sensory information about what to expect during the procedure will enhance the childs ability to cope with the events of the procedure and will decrease anxiety.

C

Using the word dye with a preschooler can be frightening for the child.

D

The child needs information before the procedure.

PTS: 1 DIF: Cognitive Level: Application REF: p. 61 | Table 4-3

OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance

2. An important consideration for the nurse who is communicating with a very young child is to

a.

Speak loudly, clearly, and directly.

b.

Use transition objects, such as a puppet.

c.

Disguise own feelings, attitudes, and anxiety.

d.

Initiate contact with child when parent is not present.

ANS: B

Feedback

A

Speaking in this manner will tend to increase anxiety in very young children.

B

Using a transition object, such as a puppet or doll, allows the young child an opportunity to evaluate an unfamiliar person (the nurse). This will facilitate communication with a child of this age.

C

The nurse must be honest with the child. Attempts at deception will lead to a lack of trust.

D

Whenever possible, the parent should be present for interactions with young children.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 60 | Table 4-3

OBJ: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity

3. An effective technique for communicating with toddlers is to

a.

Have the toddler make up a story from a picture.

b.

Involve the toddler in dramatic play with dress-up clothing.

c.

Use picture books.

d.

Ask the toddler to draw pictures of his fears.

ANS: C

Feedback

A

Most toddlers do not have the vocabulary to make up stories.

B

Dramatic play is associated with older children.

C

Activities and procedures should be described as they are about to be done. Use picture books and play for demonstration. Toddlers experience the world through their senses.

D

Toddlers probably are not capable of drawing or verbally articulating their fears.

PTS: 1 DIF: Cognitive Level: Application REF: p. 60 | Table 4-3

OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance

4. What is the most important consideration for effectively communicating with a child?

a.

The childs chronologic age

b.

The parent-child interaction

c.

The childs receptiveness

d.

The childs developmental level

ANS: D

Feedback

A

The childs age may not correspond with the childs developmental level; therefore it is not the most important consideration for communicating with children.

B

Parent-child interaction is useful in planning communication with children, but it is not the primary factor in establishing effective communication.

C

The childs receptiveness is a consideration in evaluating the effectiveness of communication.

D

The childs developmental level is the basis for selecting the terminology and structure of the message most likely to be understood by the child.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 60

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

5. Which behavior is most likely to encourage open communication?

a.

Avoiding eye contact

b.

Folding arms across chest

c.

Standing with head bowed

d.

Soft stance with arms loose at the side

ANS: D

Feedback

A

Avoiding eye contact does not facilitate communication.

B

Folding arms across the chest is a closed body posture, which does not facilitate communication.

C

Standing with head bowed is a closed body posture, which does not facilitate communication.

D

An open body stance and positioning such as loose arms at the side invite communication and interaction.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 56 | Table 4-1

OBJ: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity

6. Which strategy is most likely to encourage a child to express his feelings about the hospital experience?

a.

Avoiding periods of silence

b.

Asking direct questions

c.

Sharing personal experiences

d.

Using open-ended questions

ANS: D

Feedback

A

Periods of silence can serve to facilitate communication.

B

Direct questions can threaten and block communication.

C

Talking about yourself shifts the focus of the conversation away from the child.

D

Open-ended questions encourage conversation.

PTS: 1 DIF: Cognitive Level: Application REF: p. 55

OBJ: Nursing Process: Planning MSC: Client Needs: Psychosocial Integrity

7. Which is the most appropriate question to ask when interviewing an adolescent to encourage conversation?

a.

Are you in school?

b.

Are you doing well in school?

c.

How is school going for you?

d.

How do your parents feel about your grades?

ANS: C

Feedback

A

Direct questions with yes or no answers do not encourage conversation.

B

Direct questions that can be interpreted as judgmental do not enhance communication.

C

Open-ended questions encourage communication.

D

Asking adolescents about their parents feelings may block communication.

PTS: 1 DIF: Cognitive Level: Application REF: p. 61 | Table 4-3

OBJ: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity

8. What is the most appropriate response for the nurse to make to the parent of a 3-year-old child found in a bed with the side rails down?

a.

You must never leave the child in the room alone with the side rails down.

b.

I am very concerned about your childs safety when you leave the side rails down. The hospital has guidelines stating that side rails need to be up if the child is in the bed.

c.

It is hospital policy that side rails need to be up if the child is in bed.

d.

When parents leave side rails down, they might be considered as uncaring.

ANS: B

Feedback

A

Framing the communication in the negative does not facilitate effective communication.

B

To express concern and then choose words that convey a policy is appropriate.

C

Stating a policy to parents conveys the attitude that the hospital has authority over parents in matters concerning their children and may be perceived negatively.

D

This statement conveys blame and judgment to the parent.

PTS: 1 DIF: Cognitive Level: Application REF: p. 58 | Table 4-2

OBJ: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity

9. What is an appropriate preoperative teaching plan for a school-age child?

a.

Begin preoperative teaching the morning of surgery.

b.

Schedule a tour of the hospital a few weeks before surgery.

c.

Show the child books and pictures 4 days before surgery.

d.

Limit teaching to 5 minutes and use simple terminology.

ANS: C

Feedback

A

Preoperative teaching a few hours before surgery is more appropriate for the preschool child. Preoperative materials should be introduced 1 to 5 days in advance for school-age children.

B

Preparation too far in advance of the procedure can be forgotten or cause undue anxiety for an extended period of time.

C

Preparatory material can be introduced to the school-age child several days (1 to 5)in advance of the event. Books, pictures, charts, and videos are appropriate.

D

A very short, simple explanation of the surgery is appropriate for a younger child such as a toddler.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 61 | Table 4-3

OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance

10. When a child broke her favorite doll during a hospitalization, her primary nurse bought the child a new doll and gave it to her the next day. What is the best interpretation of the nurses behavior?

a.

The nurse is displaying signs of overinvolvement.

b.

The nurse is a kind and generous person.

c.

The nurse feels a special closeness to the child.

d.

The nurse wants to make the child happy.

ANS: A

Feedback

A

Buying gifts for individual children is a warning sign of overinvolvement.

B

Nurses are kind and generous people, but buying gifts for individual children is unprofessional.

C

Nurses may feel closer to some patients and families. This does not make giving gifts to children or families acceptable from a professional standpoint.

D

Replacing lost items is not the nurses responsibility. Becoming overly involved with a child can inhibit a healthy relationship.

PTS: 1 DIF: Cognitive Level: Analysis REF: p. 59 | Box 4-2

OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity

11. When meeting a toddler for the first time, the nurse initiates contact by

a.

Calling the toddler by name and picking the toddler up

b.

Asking the toddler for her first name

c.

Kneeling in front of the toddler and speaking softly to the child

d.

Telling the toddler that you are her nurse

ANS: C

Feedback

A

Picking a toddler up at an initial meeting is a threatening action and will more likely result in a negative response from the child.

B

Toddlers are unlikely to respond to direct questions at a first meeting.

C

More positive interactions occur when the toddler perceives the meeting in a nonthreatening way. Placing yourself at the toddlers level and speaking softly can be less threatening for the child.

D

Telling the toddler you are the nurse is not likely to facilitate or encourage cooperation. The toddler perceives you as a stranger and will find the action threatening.

PTS: 1 DIF: Cognitive Level: Application REF: p. 54

OBJ: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity

12. An 8-year-old girl asks the nurse how the blood pressure apparatus works. The most appropriate nursing action is to

a.

Ask her why she wants to know.

b.

Determine why she is so anxious.

c.

Explain in simple terms how it works.

d.

Tell her she will see how it works as it is used.

ANS: C

Feedback

A

The nurse should respond positively for requests for information about procedures and health information. By not responding, the nurse may be limiting communication with the child.

B

The child is not exhibiting anxiety, just requesting clarification of what will be occurring.

C

School-age children require explanations and reasons for everything. They are interested in the functional aspect of all procedures, objects, and activities. It is appropriate for the nurse to explain how equipment works and what will happen to the child.

D

The nurse must explain how the blood pressure cuff works so that the child can then observe during the procedure.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 61 | Table 4-3

OBJ: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance

13. Communication entails much more than words going from one persons mouth to another persons ears. A positive, supportive technique that is effective from birth throughout adulthood is

a.

Listening

b.

Physical proximity

c.

Environment

d.

Touch

ANS: D

Feedback

A

Listening is an essential component of the communication process. By practicing active listening skills, nurses can be effective listeners. Listening is a component of verbal communication.

B

Individuals have different comfort zones for physical distance. The nurse should be aware of these differences and move cautiously when meeting new children and families.

C

It is important to create a supportive and friendly environment for children including the use of child-sized furniture, posters, developmentally appropriate toys, and art displayed at a childs eye level.

D

Touch can convey warmth, comfort, reassurance, security, caring, and support. In infancy, messages of security and comfort are conveyed when they are being held. Toddlers and preschoolers find it soothing and comforting to be held and rocked. School-aged children and adolescents appreciate receiving a hug or pat on the back (with permission).

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 53

OBJ: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance

MULTIPLE RESPONSE

1. In planning care for a preschool-age child, the nurse knows that which open body postures encourage positive communication? Select all that apply.

a.

Leaning away from the preschooler

b.

Frequent eye contact

c.

Hands on hips

d.

Conversing at eye level

e.

Asking the parents to stay in the room

ANS: B, D

Feedback

Correct

Frequent eye contact and conversing at eye level are both open body postures that encourage positive communication.

Incorrect

Leaning away from the child and placing your hands on your hips are both closed body postures that do not facilitate effective communication. Asking the parents to stay in the room while the nurse is talking to the child is helpful but is not an open body posture.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 56 | Table 4-1

OBJ: Nursing Process: Planning MSC: Client Needs: Psychosocial Integrity

2. Trust is important in establishing and maintaining a therapeutic relationship. Maintaining the balance between appropriate involvement and professional separation is quite challenging. Which behaviors may indicate professional separation or underinvolvement? Select all that apply.

a.

Avoiding the child or his or her family

b.

Revealing personal information

c.

Calling in sick

d.

Spending less time with a particular child

e.

Asking to trade assignments

ANS: A, C, D, E

Feedback

Correct

Whether nurses become too emotionally involved or find themselves at the other end of the spectrumbeing underinvolvedthey lose effectiveness as objective professional resources. These are all indications of the nurse who is underinvolved in a childs care.

Incorrect

Revealing personal information to a patient or his or her family is an indication of overinvolvement.

PTS: 1 DIF: Cognitive Level: Analysis REF: p. 59 | Box 4-3

OBJ: Nursing Process: Implementation

MSC: Client Needs: Safe and Effective Care Environment

3. While developing a care plan for a school-age child with a visual impairment, the nurse knows that which of the following actions are important in working with this special needs child? Select all that apply.

a.

Obtain a thorough assessment of the childs self-care abilities.

b.

Orient the child to various sounds in the environment.

c.

Mandate that the childs parents stay continuously with their child during hospitalization.

d.

Allow the child to handle equipment as procedures are explained.

e.

Encourage the child to use a dry erase board to write his needs.

ANS: A, B, D

Feedback

Correct

These are correct responses that can be used for a school-age child with a visual impairment.

Incorrect

Mandating that the childs parents stay continuously with their child may not be possible and is not usually necessary if the school-age child is at the expected level of growth and development. Encouraging a child to write his needs on a dry erase board would be an appropriate intervention for a child who is aphonic, not for a child with a visual deficit.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 65

OBJ: Nursing Process: Planning MSC: Client Needs: Psychosocial Integrity

4. A preschool age child is being admitted for some diagnostic tests and possible surgery. The nurse planning care should use which phrases when explaining procedures to the child? Select all that apply.

a.

Fluids will be given through tubing connected to a small tiny tube inserted into your arm.

b.

After surgery we will be doing dressing changes.

c.

You will get a shot before surgery.

d.

The doctor will give you medicine that will help you go into a deep sleep.

e.

We will take you to surgery on a bed on wheels.

ANS: A, D, E

Feedback

Correct

A preschool child needs simple concrete explanations that cannot be misinterpreted. An IV should be explained as fluids going into a tube connected to a small tube in your hand; anesthesia can be explained as a medicine that will help you go into a deep sleep (put to sleep should be avoided); and a stretcher can be described as riding on a bed with wheels.

Incorrect

The term dressing changes is ambiguous and will not be understood by a preschooler. The term get a shot should not be used. A preschooler or young child is likely to misinterpret this information.

PTS: 1 DIF: Cognitive Level: Application REF: p. 63 | Table 4-4

OBJ: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity

TRUE/FALSE

1. For the child who speaks another language, the nurse must identify an interpreter who is proficient in both languages. The patients 12-year-old brother has accompanied him to the hospital and would be an ideal candidate to interpret before any treatment or surgical procedure. Is this statement true or false?

ANS: F

Other children should not be used as interpreters under any circumstances. An adult family member, a friend of the family, or an interpreter service should be used whenever possible. This is necessary in order to explain procedures, teach new skills, and assess patient needs.

PTS: 1 DIF: Cognitive Level: Application REF: p. 59

OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance

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