Deck 40: Nursing Considerations for the Hospitalized Child

Question 1

The nurse is caring for a client in the pediatric intensive care unit. The parents have expressed anger over the nursing care their child is receiving. The nursing intervention most appropriate for these parents would be to:

A)Explain to the parents that their anger is affecting their child, and they will not be allowed to visit the child until they calm down.
B)Ask the physician to talk with the family.
C)Acknowledge the parents' concerns and collaborate with them regarding the care of their child.
D)Call the chaplain to sit with the family.

Answer 1

Acknowledge the parents' concerns and collaborate with them regarding the care of their child.

Question 2

A child has a planned hospitalization in a few weeks, and the patient and family appear very stressed. What is the best way to minimize the stress for the patient and family?

A)Tell the patient and family that everything will be fine.
B)Explain to the patient and family how the child will benefit from the surgery.
C)Tell the patient and family that the surgeon is very good.
D)Give a tour of the hospital unit or surgical area.

Answer 2

Give a tour of the hospital unit or surgical area.

Question 3

When a parent asks to be present during a procedure, the nurse should understand that:

A)The parent wants to support his child before, during, and immediately after the procedure.
B)The parent wants to ensure that nothing goes wrong with the child.
C)The parent is interested because he is also in the medical field.
D)The parent wants to ensure that the correct medication is being used.

Answer 3

The parent wants to support his child before, during, and immediately after the procedure.

Question 4

A five-year-old child is admitted to the pediatric unit for surgery. The parents request to stay with their child. Which is the best response by the nurse?

A)Tell the parents they can stay in the hospital but not on the unit.
B)Read the rules and regulations of rooming in with the child.
C)Let the parents know they are allowed to stay with the child.
D)Explain to the parents why they cannot stay with the child.

Question 5

The nurse must perform a procedure on a toddler. The technique most appropriate when performing the procedure is to:

A)Allow the child to cry or scream.
B)Perform the procedure in the child's hospital bed.
C)Ask the child if it is okay to start the procedure.
D)Ask the mother to restrain the child during the procedure.

Question 6

A child is being prepared for surgery. The parent requests to be present during anesthesia induction. How should the nurse respond?

A)The nurse should tell the parent the names of all the medications the child will receive.
B)The nurse should explain what the parent will see and hear when present during induction.
C)The nurse should tell the parent he will be upset to see his child under anesthesia.
D)The nurse should ignore the request and focus on the child.

Question 7

A preschooler is hospitalized following an injury. The mother has been staying with the child but now must leave to care for the other children. The mother asks the nurse what is the best way to leave. The nurse's response will include:

A)Leave the child after he falls asleep so he won't know you are going.
B)Tell the child you are leaving and identify when you will return by the child's schedule (e.g., after you eat supper).
C)Have the mother leave an article of clothing behind.
D)Tell the nurse when she is leaving so the nurse can stay with the child while the parents are absent.
E)Plan to leave when the child is having procedures performed as the child will be busy and less aware of the parents' absence.

Question 8

A six-year-old child is hospitalized for a surgical procedure. The parents ask if the child's four siblings can visit. The best response by the nurse would be:

A)"Let's plan their visit for a time when the child has received pain medication."
B)"Only those siblings over 16 will be allowed to visit."
C)"I don't think the other children should visit because it might scare them to see their sibling so sick."
D)"Very young children shouldn't visit as they may carry germs."

Question 9

A child is being discharged from the hospital after a three-week stay following a motor vehicle collision. The mother expresses concern about caring for the child's wounds at home. She has demonstrated appropriate technique with medication administration and wound care. What is the priority nursing diagnosis?

A)Parental anxiety related to care of the child at home
B)Family processes, altered related to hospitalization
C)Infection, risk for related to presence of healing wounds
D)Knowledge deficient home care

Question 10

A child has been hospitalized for an extended time period and is being discharged home. This child requires complex, long-term care and will have a home health nurse visit daily. In addition to a central line, the child is on oxygen by nasal cannula. What should the nurse teach the family members?

A)How to insert an IV line
B)Nothing, the family is familiar with the care.
C)Instruction on oxygen administration
D)How to remove a central line

Question 11

The charge nurse on a hospital unit is developing plans of care related to separation anxiety. The charge nurse recognizes that the hospitalized child who is at greatest risk for experiencing separation anxiety when parents cannot stay is the:

A)Six-month-old.
B)18-month-old.
C)Four-year-old.
D)Six-year-old.

Question 12

In addition to separation anxiety, infants between six and 18 months of age also might display:

A)Fear of disfigurement.
B)Fear of death.
C)Stranger anxiety.
D)Fear of bodily injury.

Question 13

A five-year-old is in the playroom when the respiratory therapist arrives on the pediatric unit to give the child a scheduled breathing treatment. The nurse should:

A)Escort the child to his room and ask the child life specialist to bring toys to the bedside.
B)Reschedule the treatment for a later time.
C)Assist the child back to his room for the treatment but reassure him that he may return when the procedure is completed.
D)Show the respiratory therapist to the playroom so the treatment can be performed.

Question 14

Hospitalization is a stressor for all children. Parents often have other responsibilities that prevent them from staying with their child during hospitalization. Which age groups can best tolerate separation from parents during hospitalization?

A)Infants birth to five months
B)Infants five months to one year
C)Toddlers and preschoolers
D)School-age children
E)Adolescents

Question 15

The nurse is taking care of a child in the ICU. The parent appears very angry and tells the nurse no one is giving her information about her child. How should the nurse respond?

A)Inform the parent she will be asked to leave if she continues this behavior.
B)Apologize for the parent's perception and assure the parent that the staff will keep her informed.Inform the parent of any change in the child's condition as soon as possible.
C)Offer to ask the doctor to come and talk with her.
D)Tell the parent her behavior will upset the child.

Question 16

Prior to discharging the child from the hospital, what routine discharge instructions should the nurse discuss with the family?

A)Monitoring signs and symptoms specific to condition
B)Instruction on performing a medical exam on the child
C)No instructions are needed; the family is familiar with the child.
D)A list of all diagnostic tests obtained during the hospitalization and their results

Question 17

A four-year-old is seen in the clinic for a sore throat. In the child's mind, the most likely causative agent is that the child:

A)Was exposed to someone else with a sore throat.
B)Yelled at his brother.
C)Did not eat the right foods.
D)Did not take his vitamins.

Question 18

The parents have requested to be present during their child's procedure. How should the nurse plan for this request?

A)Explain in detail, using medical terms, what will occur.
B)Explain to the family that it is not permitted for family members to be present.
C)Prepare family members for what they should anticipate and what is expected of them.
D)Prepare the family to speak with the physician.

Question 19

A group of children on one hospital unit are all suffering separation anxiety. When determining the stages of separation anxiety, the nurse recognizes that the child in the "despair" phase is the child who:

A)Lies quietly in bed.
B)Does not cry if his parents return and leave again.
C)Appears to be happy and content with staff.
D)Screams and cries when his parents leave.

Question 20

The parents of a child who is critically injured wish to stay in the room while the child is receiving emergency care. The nurse should:

A)Ask the physician if the parents can stay with the child.
B)Allow the parents to stay with the child.
C)Escort the parents to the waiting room and assure them that they can see their child soon.
D)Tell the parents that they do not need to stay with the child.

Question 21

The physician has ordered the toddler to receive an oral medication. The toddler has fought medication administration in the past. Strategies the nurse will use to administer the medication would include:

A)Request the medication in liquid form and draw the medication in an oral syringe.
B)Put the medication in a favorite drink in the child's sippy cup.
C)Allow the mother to administer the medication to the child.
D)Notify the physician to change the route to intravenous.
E)Hold the child down and squirt the medication in the corner of his mouth.

Question 22

The pediatric unit manager is making changes to the unit to reduce the stress of the hospitalized children. Which changes have been shown to reduce stress for the children?

A)Having only female nurses on the unit
B)Assigning nurses one-on-one with patients
C)Allowing the nurses to wear colored scrubs in place of white uniforms
D)Having the nurses avoid entering the patient room unless a procedure is to be performed

Question 23

An adolescent tells the nurse that the new diagnosis of diabetes has him "stressed out." The nurse will encourage stress reduction activities, including:

A)Daily exercise, such as walking.
B)Learning more about his illness.
C)Practicing deep breathing and other relaxation techniques.
D)Not thinking about his diagnosis.
E)Allowing the parents control of his disease.

Question 24

The four-year-old child is undergoing cardiac surgery. To reduce the child's stress in the pre-operative period, the nurses will:

A)Explain the procedure to the child in simple terms of what the child will see, hear, and feel while awake.
B)Explain to the child that the surgery will fix her "broken" heart.
C)Allow the parents to accompany the child to the surgical holding room and wait with the child.
D)Allow the child to hold onto their special "teddy bear" while awake.
E)Wait until the child is in the holding room to insert the Foley catheter.