Deck 35: The Ill Child in the Hospital and Other Care Settings

Question 1

A 3 1/2-year-old child who is toilet trained has had several "accidents" since hospital admission.What is the nurse's best action in this situation?

A) Find out how long the child has been toilet trained at home.
B) Encourage the parents to scold the child.
C) Explain how to use a bedpan and place it close to the child.
D) Follow home routines of elimination.

Answer 1

Follow home routines of elimination.

Question 2

In which age-group does the child's active imagination during unfamiliar experiences increase the stress of hospitalization?

A) Toddlers
B) Preschoolers
C) School-age children
D) Adolescents

Answer 2

Preschoolers

Question 3

How should the nurse advise parents whose preschooler used to sleep through the night and now awakens at intervals after a short hospitalization?

A) Regressive behavior after a hospitalization is normal and usually short term.
B) The child is probably expressing anger.
C) Egocentric behavior often manifests itself when the child is left alone to sleep.
D) The child is probably feeling pain and needs further evaluation.

Answer 3

Regressive behavior after a hospitalization is normal and usually short term.

Question 4

Which question most likely elicits information about how a family is coping with a child's hospitalization?

A) "Was this admission an emergency?"
B) "How has your child's hospitalization affected your family?"
C) "Who is taking care of your other children while you are here?"
D) "Is this the child's first hospitalization?"

Question 5

What is the best explanation for a 2-year-old child who is quiet and withdrawn on the fourth day of a hospital admission?

A) The child is protesting her separation from her caregivers.
B) The child has adjusted to the hospitalization.
C) The child is experiencing the despair stage of separation.
D) The child has reached the stage of detachment.

Question 6

What is the best action for the nurse to take when a 5-year-old child who requires another 2 days of IV antibiotics cries,screams,and resists having the IV restarted?

A) Exit the room and leave the child alone until he or she stops crying.
B) Tell the child big boys and girls "don't cry."
C) Let the child decide which color arm board to use with the IV.
D) Administer an opioid analgesic for pain to quiet the child.

Question 7

Why is observation for 24 hours in an acute-care setting often appropriate for children?

A) Longer hospital stays are more costly.
B) Children become ill quickly and recover quickly.
C) Children feel less separation anxiety when hospitalized for 24 hours.
D) Families experience less disruption during short hospital stays.

Question 8

Which situation poses the greatest challenge to the nurse working with a child and family?

A) Twenty-four-hour observation
B) Emergency hospitalization
C) Outpatient admission
D) Rehabilitation admission

Question 9

Which is an appropriate nursing intervention for the hospitalized neonate?

A) Assign the neonate to a room with other neonates.
B) Provide play activities in the hospital room.
C) Offer the neonate a pacifier between feedings.
D) Request that parents bring a security object from home.

Question 10

A 3-year-old child cries,kicks,and clings to the father when the parents try to leave the hospital room.What is the nurse's best response to the parents about this behavior?

A) "Your child is showing a normal response to the stress of hospitalization."
B) "Your child is not coping effectively with hospitalization."
C) "Parents should stay with children during hospitalization."
D) "You can avoid this if you leave after your child falls asleep."

Question 11

The nurse is discussing toddler development with the mother of a 2 1/2-year-old child.Which statement by the mother indicates she has an understanding of how to help her daughter succeed in a developmental task while hospitalized?

A) "I always help my daughter complete tasks to help her achieve a sense of accomplishment."
B) "I provide many opportunities for my daughter to play with other children her age."
C) "I consistently stress the difference between right and wrong to my daughter."
D) "I encourage my daughter to do things for herself when she can."

Question 12

Based on concepts related to the normal growth and development of children,which child would have the most difficulty with separation from family during hospitalization?

A) A 5-month-old infant
B) A 15-month-old toddler
C) A 4-year-old child
D) A 7-year-old child

Question 13

What should the nurse advise the mother of a 4-year-old child to bring with her child to the outpatient surgery center on the day of surgery?

A) Snacks
B) Fruit juice boxes
C) All of the child's medications
D) One of the child's favorite toys

Question 14

A preschool-aged child tells the nurse "I was bad,that's why I got sick." What is the best rationale for this child's statement?

A) The child has a fear that mutilation will lead to death.
B) The child's imagination is very active, and he may believe the illness is a result of something he did.
C) The child has a general understanding of body integrity at this age.
D) The child will not have fear related to an IV catheter initiation but will have fear of an impending surgery.

Question 15

Having explanations for all procedures and selecting their own meals from hospital menus is an important coping mechanism for which age-group?

A) Toddlers
B) Preschoolers
C) School-age children
D) Adolescents

Question 16

What is the best nursing response to the mother of a 4-year-old child who asks what she can do to help the child cope with a sibling's repeated hospitalizations?

A) Recommend that the child be sent to visit the grandmother until the sibling returns home.
B) Inform the parent that the child is too young to visit the hospital.
C) Assume the child understands that the sibling will soon be discharged because the child asks no questions.
D) Help the mother give the child a simple explanation of the treatment, and encourage the mother to have the child visit the hospitalized sibling.

Question 17

Which intervention helps a hospitalized toddler feel a sense of control?

A) Assign the same nurses to care for the child.
B) Put a cover over the child's crib.
C) Require parents to stay with the child.
D) Follow the child's usual routines for feeding and bedtime.

Question 18

Which therapeutic approach will best help a 7-year-old child cope with a lengthy course of intravenous antibiotic therapy?

A) Arrange for the child to go to the playroom daily.
B) Ask the child to draw you a picture of himself or herself.
C) Allow the child to participate in injection play.
D) Give the child stickers for cooperative behavior.

Question 19

What is the primary disadvantage associated with outpatient and day facility care?

A) Increased cost
B) Increased risk of infection
C) Lack of physical connection to the hospital
D) Longer separation of the child from family

Question 20

Which is the most developmentally appropriate intervention when working with the hospitalized adolescent?

A) Encourage peers to call and visit when the adolescent's condition allows.
B) Encourage the adolescent's friends to continue with their daily activities; the adolescent has concrete thinking and will understand.
C) Discourage questions and concerns about the effects of the illness on the adolescent's appearance.
D) Ask the parents how the adolescent usually copes in new situations.

Question 21

What are age-appropriate nursing interventions to facilitate psychological adjustment for an adolescent expected to have a prolonged hospitalization? (Select all that apply.)

A) Encourage parents to bring in homework and schedule study times.
B) Allow the adolescent to wear street clothes.
C) Involve the parents in care.
D) Follow home routines.
E) Encourage parents to bring in favorite foods.

Question 22

The nurse is working with a child in the intensive care unit.The family is from out of town.There are two siblings,both of whom are acting out at home.What suggestions does the nurse provide the family? (Select all that apply.)

A) Let the siblings call the ill child at scheduled times.
B) Take photographs of the sick child to show the siblings.
C) Suggest the parents take the siblings to counseling.
D) Reassure the siblings that they will not get ill themselves.
E) Stay at home with the siblings until their behavior improves.

Question 23

Which play activity should the nurse implement to enhance deep breathing exercises for a toddler?

A) Blowing bubbles
B) Throwing a Nerf ball
C) Using a spirometer
D) Keeping a chart of deep breathing

Question 24

The home health nurse outlines short- and long-term goals for a 10-year-old child with many complex health problems.Who should agree on these goals?

A) Family and nurse
B) Child, family, and nurse
C) All professionals involved
D) Child, family, and all professionals involved

Question 25

The traditional areas of school health nursing that are still prevalent in many school systems include which of the following? (Select all that apply.)

A) Health screening
B) Emergency care
C) Intensive care
D) Communicable disease management
E) Health care advice

Question 26

A child with a serious,chronic illness is hospitalized frequently.The parents are worried about the child's growth and development.What action by the nurse is best?

A) Tell parents developmental delays are likely in this case.
B) Make a referral to the play therapist for therapeutic play.
C) Encourage the child to perform age-appropriate activities.
D) Ask the parents if they want a child psychology referral.

Question 27

Home care is being considered for a young child who is ventilator dependent.Which factor is most important in deciding whether home care is appropriate?

A) Level of parents' education
B) Presence of two parents in the home
C) Preparation and training of family
D) Family's ability to assume all health care costs

Question 28

A nurse is working with a child who has a sudden,serious illness.To best support the parents,what action by the nurse is best?

A) Assess the parents' usual coping methods.
B) Give them information about the unit protocols.
C) Tell them to stay with the child as much as desired.
D) Reassure them about how common this illness is.