Deck 3: Family Dynamics and Communicating With Children and Families

Question 1

The nurse is assessing a pediatric patient in the emergency room for injuries sustained from a fall. The nurse asks the parents how the child was injured. Which response by the parent uses the most productive communication pattern?

A)"My wife forgot to check the baby gate like I had asked her to."
B)"I am the only one who checks the baby gate all the time."
C)"Typical man; he just doesn't follow directions."
D)"I forgot the check the baby gate when I came home."

Answer 1

"I forgot the check the baby gate when I came home."

Question 2

The nurse is assessing a newborn who has been brought to the family clinic for her first well-child visit. The nurse accidentally drops a metal pan on the floor near the child. The child is startled, but the mother does not react. What is the most appropriate intervention at this time?

A)Speak loudly and clearly to mother to enhance comprehension.
B)Read the infant's chart to verify how to communicate.
C)Continue with the assessment and document the findings.
D)Ask the mother if she needs an interpreter to communicate.

Answer 2

Ask the mother if she needs an interpreter to communicate.

Question 3

The nurse is providing discharge instructions to the family of a 14-year-old patient who was treated for an exacerbation of a chronic illness. The nurse recognizes that this will add stress to the family unit and has developed a plan of care based on the family-centered care model. Which intervention best addresses the crisis experienced by the family unit at this time?

A)Encourage the patient to contact friends from school for visits.
B)Discuss treatment options and alternatives with the family.
C)Provide privacy to discuss their options independently of staff.
D)Request clergy to counsel the family prior to discharge.

Answer 3

Discuss treatment options and alternatives with the family.

Question 4

The nurse is providing care to a 17-year-old patient in the family practice clinic. The patient reports concern for the parents, as she is the last one of the four children to leave the home. She is concerned that her parents may "fall apart" when she leaves for college in the fall. What is the best response from the nurse based on the family systems theory?

A)"Although changes that occur in one family member's life affects the entire family, keep in mind that your family is dynamic."
B)"Each member of the family has to differentiate themselves, whether good or bad, to influence family relationships."
C)"Although this may put a strain on their relationship, a healthy family recognizes the need love and growth."
D)"Although the family is growing apart, this is a time for your parents to refocus on extended family relationships."

Question 5

The nurse is performing a functional family assessment of a chronically ill pediatric patient. In what way can the nurse enhance communication with the family?

A)Identify the leader of the family and provide options for respite care.
B)Assess for abuse and report suspected abuse to the authorities.
C)Complete a family APGAR questionnaire and share the results.
D)Educate the family on resources in the community to help with care.

Question 6

The emergency department nurse is providing care to a 3-year-old child who has suffered a major accident. The parents ask the nurse, "Is our child going to be okay?" What is the most effective communication response at this time?

A)"Your child has suffered a severe laceration to the spinal cord and may have terminal paralysis."
B)"Your child is being assessed at this time. I am confident the physician will resolve the problem."
C)"Your child has suffered a major injury; let me give you some privacy. May I call the chaplain just to be with you?"
D)"Your child has suffered a major injury. Please wait here while we finish assessing the injuries."

Question 7

The nurse is providing care to a 10-year-old patient hospitalized for multiple injuries from a motor vehicle crash. Which nursing intervention is appropriate for communication with this child?

A)Include the child in some decisions regarding care, such as choosing food from the hospital menu.
B)Offer the child a chance to play with the medical instruments when possible.
C)Communicate primarily to the parents regarding treatments and the child's progress.
D)Recognize that behavior may fluctuate between adult and childlike during hospitalization.

Question 8

Identify one or more choices that best complete the statement or answer the question.
The nurse is providing care to an 11-month-old child who is hospitalized with pneumonia. Which nursing interventions are appropriate for this child? Select all that apply.

A)Communicate primarily with parents regarding treatment.
B)Allow the child to tour the facility before treatments.
C)Use simple terminology when talking to the child.
D)Use a singsong wide-eyed approach to interact.
E)Promote a sense of security with use of gentle touch.

Question 9

In an acute care setting, the pediatric nurse is providing care to a 4-year-old patient with an exacerbation of cystic fibrosis. The nurse notes that there is little interaction between the patient and the older siblings when they visit. The siblings often seek to divert the staff's attention during their visits. What is the most appropriate nursing intervention at this time?

A)Ask the parents to leave the siblings at home to avoid disruptions.
B)Interact with the siblings and show them the playroom during visits.
C)Encourage the siblings to visit and bring familiar objects to the hospital.
D)Develop a plan to include the siblings in age-appropriate care of the patient.

Question 10

The nurse is assessing the family of a pediatric patient in the home-care setting. Which of the following family APGAR findings best correlates with the nursing diagnosis of caregiver role strain?

A)They have recently moved to the area and have not been able to form relationships within the community.
B)They show affection to each other and are able to devote time to other family members.
C)They have formed a partnership to carry forth the usual household responsibilities and support each other.
D)The mother provides primary care of the ill child and household while the father works two jobs to provide financial support.

Question 11

The nurse is providing care to a 4-year-old child who is recovering from an orthopedic injury in the hospital. The nurse notes there are two siblings who are ages 6 years and 1 year. The father is the primary caregiver, and the mother is the primary wage earner. During the assessment, the nurse notes that the 6-year-old seems to be the primary nurturer of the 1-year-old, while the father tends to the 4-year-old, and the mother talks on her cell phone. Which nursing diagnosis is appropriate for this family?

A)Compromised family coping r/t insufficient reciprocal support between the parents as evidenced by family behavior during hospital visits.
B)Risk for delayed development r/t lack of parental involvement as evidenced by family behavior, mother and siblings not interacting.
C)Ineffective family health management r/t family conflict as evidenced by mother's inability to interact with the child during hospitalization.
D)Interrupted family processes r/t hospitalized child as evidenced by lack of full family interactions during hospitalization.

Question 12

The nurse is assessing an infant during a well-baby visit in the family practice clinic. During this assessment, the nurse asks the mother several routine questions regarding the infant's progress and notes that the mother nods her head but is looking at her cell phone. Which response by the nurse is most appropriate in this situation?

A)Continue the assessment and note the mother's disinterest in the infant's chart.
B)Continue to ask the questions repeatedly until an acceptable answer is provided.
C)Ask the mother if she could please put the phone down and discuss her infant's progress.
D)Contact the facility's social worker for a referral to child protective services for an in-home visit.

Question 13

The nurse assesses a toddler with an apparent ear infection in the emergency department. During the assessment, the nurse finds that the child is not up to date on immunizations or well-baby checkups. Upon further investigation, the nurse discovers that the family is uninsured and undocumented immigrants. What are the most likely barriers to effective communication at this time?

A)The insurance status affects many health-care practices such as immunizations.
B)The possible language issue may affect the family's comprehension of instructions.
C)The family may have barriers to transportation, employment, or knowledge.
D)The family may not have a primary care provider and relies upon emergency

Question 14

The nurse is providing care to a 6-year-old child who is recovering from an infection after a round of chemotherapy in the hospital. The parents appear overwhelmed with the situation of wanting "quality time" and voice guilt over missing the healthy children's school functions when at the hospital. Which is an appropriate nursing goal for this family?

A)The family will demonstrate knowledge of the regimen and prevent further infections.
B)The family will meet and seek counseling for each family member prior to the patient's discharge to home.
C)The family will acknowledge the range of emotions during the child's hospitalization.
D)The family will meet with the social worker to coordinate community resources to facilitate the transition to home.

Question 15

The nurse is providing care to a pediatric patient in the mental health facility. The nurse asks the patient to draw a picture of her family. What is the function of this activity?

A)This drawing depicts the child's perspective of the family unit.
B)This drawing provides an outlet from the therapy sessions.
C)This activity is a tool to facilitate communication via play.
D)This activity develops problem-solving skills for the child.

Question 16

The nurse is assessing preschool twins during a well-child visit in the family clinic. Which of the following statements by the parents would indicate a healthy transition for the family per Duvall's family development theory?

A)The parents state that they have maintained scheduled play dates to help the children socialize.
B)The parents have maintained the children's well-child examinations and immunizations.
C)The parents have compiled a list of goals and request suggested interventions.
D)The parents and children appear to interact well and display nurturing and affection.

Question 17

The nurse is providing care to a 5-year-old child who is recovering from a tonsillectomy in the hospital. The nurse notes that the 9-year-old sibling is tending to the psychosocial needs of the patient, while the parents discuss their marital conflicts in front of the children. Which nursing diagnosis is appropriate for this family?

A)Dysfunctional family processes
B)Risk for parent-child attachment
C)Spiritual distress
D)Risk for impaired parenting

Question 18

The nurse is attempting to provide education to the family of a newborn in the home-care setting. Which nursing intervention will assess comprehension of the communication with the family?

A)The nurse identifies the primary caregiver of the infant for instructions and asks for privacy with the individual.
B)The nurse provides both written and verbal instructions at an age-appropriate level and asks for a return demonstration.
C)The nurse provides descriptions of signs and symptoms to report to the primary care provider.
D)The nurse requests to see their calendar with approximate dates for immunizations.

Question 19

A nurse is providing care to an adolescent patient. Which statement by the nurse is most likely to enhance communication with the patient?

A)"Are you participating in any risky behaviors?"
B)"What concerns do you have about your health?"
C)"Are you taking your medication as prescribed?"
D)"Is there a reason why you waited so long to come in?"

Question 20

The nurse is assessing the psychosocial needs of a family that has a chronically ill child. During the interview process, the nurse notes that the grandmother answers for all the family members. What nursing intervention is most appropriate at this time?

A)Ask the grandmother if a medical translator is necessary.
B)Continue with the interview and document the findings.
C)Identify the grandmother as the primary source of information.
D)Ask the grandmother to leave the room for privacy.