Deck 16: Care of Children Who Are Hospitalized

Question 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

Answer 1

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

Question 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
B) Brown Report of 1948
C) Lysaught report of 1970
D) Patient's Bill of Rights

Answer 2

Platt Report of 1959

Question 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
B) Dorothy Marlow
C) Gladys Sellew
D) Florence G. Blake

Answer 3

Florence G. Blake

Question 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.

Question 5

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

A) memorize Erikson's life tasks
B) study Piaget's 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

Question 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

Question 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.

Question 8

The nurse places a unique cartoon character on the outside and inside of a child's 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

Question 9

Nurses caring for a pediatric client can most strengthen a child's sense of security by:

A) providing a unit and hospital handbook of rules and posting the dos and don'ts 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

Question 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 Dad's 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

Question 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

Question 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 nurse's physiological and psychological senses
C) journal articles with up-to-date information
D) the verbal communication of the child

Question 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

Question 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 nurse's 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 won't have to worry about the care at all."
D) "Perhaps you could hire a private duty nurse's aide or a nurse for part of the day."

Question 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

Question 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 children's fears
D) the presence and support of families is essential for optimal healing, recovery, and prevention of additional trauma to a child

Question 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 child's teeth today?"
C) "How does your child look to you today?"
D) "Do you think your child's color is worse?"

Question 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

Question 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

Question 20

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

A) a library
B) television room
C) computer room
D) playroom

Question 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 don't object."

Question 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
B) rational emotive therapy
C) play therapy
D) short-term therapy

Question 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

Question 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 child's 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.

Question 25

A mother asks the pediatric nurse then preparation for her 5-year-old child's upcoming hospital experience should begin. Which of the following is the nurse's 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

Question 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.

Question 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.

Question 28

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

A) child
B) caregivers
C) mother
D) father

Question 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

Question 30

Which of the following actions by the nurse would usually be most productive in gaining an understanding of an adolescent's or a child's 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 child's diary if the parents will provide it.
D) Have the child write a report for the nurse to read.

Question 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

Question 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."

Question 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 child's 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

Question 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."

Question 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) "You're 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."

Question 36

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

A) that kid
B) the diabetic kid
C) the child with diabetes
D) the cute diabetic child

Question 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 nurse's 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.

Question 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

Question 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

Question 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

Question 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

Question 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.

Question 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

Question 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

Question 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

Question 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) "It's time to eat now. Do you want Pooh Bear to eat with you?"
D) "Are you hungry?"

Question 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

Question 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

Question 49

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

A) happiness
B) life
C) hurting
D) joy

Question 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

Question 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
B) someone to supervise their activities
C) an adult to debate life's issues with
D) opportunities to regress without fear

Question 52

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