Question 1

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

Accepted Answer

Open-ended questions encourage conversation.Periods of silence can serve to facilitate communication,but this is not the most effective meAnswer of getting the child to communicate.Yes/no questions are closed ended and do not encourage conversation.Talking about yourself shifts the focus of the conversation away from the child.

Question 2

An effective technique for communicating with toddlers is to

Accepted Answer

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.Most toddlers do not have the vocabulary to make up stories.Dramatic play is associated with older children.Toddlers probably are not capable of drawing or verbally articulating their fears.

Question 3

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

Accepted Answer

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.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.The child is not exhibiting anxiety,just requesting clarification of what will be occurring.The nurse must explain how the blood pressure cuff works so that the child can then observe during the procedure.

Question 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.)

Accepted Answer

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.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.

Question 5

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

Accepted Answer

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.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.Preparation too far in advance of the procedure can be forgotten or cause undue anxiety for an extended period of time.A very short,simple explanation of the surgery is appropriate for a younger child such as a toddler.

Question 6

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

Accepted Answer

For a preschooler,the provision of sensory information about what to expect during the procedure will enhance the child's ability to cope with the events of the procedure and will decrease anxiety.Explaining the procedure in detail is probably more than the 5-year-old child can comprehend,and it will likely produce anxiety.Using the word "dye" with a preschooler can be frightening for the child.The child needs information before the procedure.

Question 7

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

Accepted Answer

More positive interactions occur when the toddler perceives the meeting in a nonthreatening way.Placing yourself at the toddler's level and speaking softly can be less threatening for the child.Picking a toddler up at an initial meeting is a threatening action and will more likely result in a negative response from the child.Toddlers are unlikely to respond to direct questions at a first meeting.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.

Question 8

Which behavior is most likely to encourage open communication?

Accepted Answer

An open body stance and positioning such as loose arms at the side invite communication and interaction.Avoiding eye contact,folding the arms across the chest,and standing with the head bowed,are closed body postures and do not facilitate communication.

Question 9

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

Accepted Answer

The child's developmental level is the basis for selecting the terminology and structure of the message most likely to be understood by the child.The child's age may not correspond with the child's developmental level; therefore it is not the most important consideration for communicating with children.Parent-child interaction is useful in planning communication with children,but it is not the primary factor in establishing effective communication.The child's receptiveness is a consideration in evaluating the effectiveness of communication.

Question 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 nurse's behavior?

Accepted Answer

Buying gifts for individual children is a warning sign of overinvolvement.Nurses are kind and generous people,but buying gifts for individual children is unprofessional.Nurses may feel closer to some patients and families.This does not make giving gifts to children or families acceptable from a professional standpoint.Replacing lost items is not the nurse's responsibility.Becoming overly involved with a child can inhibit a healthy relationship.

Question 11

An important consideration for the nurse who is communicating with a 5-year-old child is to

Accepted Answer

Using objects 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.Speaking in this manner will tend to increase anxiety in very young children as they may interpret this as being yelled at.The nurse must be honest with the child.Attempts at deception will lead to a lack of trust.Whenever possible,the parent should be present for interactions with young children.

Question 12

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

Accepted Answer

Open-ended questions encourage communication.Questions with "yes" or "no" Answerwers do not encourage conversation.Questions that can be interpreted as judgmental do not enhance communication.Asking adolescents about their parents' feelings may block communication.

Question 13

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

Accepted Answer

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

Question 14

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?

Accepted Answer

To express concern and then choose words that convey a policy without appearing to cast blame on improper behavior is appropriate.Framing the communication in the negative does not facilitate effective communication.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.It also does not give information as to why the side rails need to be up.This statement conveys blame and judgment to the parent.

Question 15

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.)

Accepted Answer

Conducting a thorough assessment of the child's self-care abilities,orienting the child to various sounds in the environment,and allowing the child to handle equipment are all ways to enhance communication with a visually impaired child.Mandating that the child's 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 hearing impaired,not for a child with a visual deficit.

Question 16

Which behaviors by the nurse may indicate professional separation or underinvolvement? (Select all that apply.)

Accepted Answer

Whether nurses become too emotionally involved or find themselves at the other end of the spectrum-being underinvolved-they lose effectiveness as objective professional resources.These are all indications of the nurse who is underinvolved in a child's care.Revealing personal information to a patient or his or her family is an indication of overinvolvement.

Question 17

A positive,supportive communication technique that is effective from birth throughout adulthood is

Accepted Answer

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).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.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.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 child's eye level.

Question 18

A nurse is caring for a child who does not speak English.The parents are able to understand and speak only limited English.What action by the nurse is best?

Accepted Answer

A professional interpreter is the best option in this situation.They are trained in medical interpreting and do not allow cultural influences into their work.A child should never be asked to interpret; the child may be too young to understand sophisticated concepts involved in the discussion and the information from the patient may be misconstrued and disturbing to the child.An adult family member may have to do temporarily in an emergency,but the best option is a professional interpreter.

Quiz 4: Communicating with Children and Families