Deck 38: Family-Centered Care of the Child During Illness and Hospitalization

Question 1

A nurse is preparing to complete an admission assessment on a 2-year-old child who is sitting on the parent's lap.Which technique should the nurse implement to complete the physical examination?

A) Ask the parent to place the child in the hospital crib.
B) Take the child and parent to the examination room.
C) Perform the examination while the child is on the parent's lap.
D) Ask the child to stand by the parent while completing the examination.

Answer 1

Perform the examination while the child is on the parent's lap.

Question 2

The nurse is caring for an adolescent hospitalized after a bicycle accident.Which statement by the adolescent would be expected about separation anxiety?

A) "I wish my parents could spend the night with me while I am in the hospital."
B) "I think I would like for my siblings to visit me but not my friends."
C) "I hope my friends don't forget about visiting me."
D) "I will be embarrassed if my friends come to the hospital to visit."

Answer 2

"I hope my friends don't forget about visiting me."

Question 3

Latasha,age 8 years,is being admitted to the hospital from the emergency department with an injury from falling off her bicycle.What intervention will help an 8 year old most in adjusting to a hospital admission?

A) Explain hospital schedules such as mealtimes.
B) Use terms such as "honey" and "dear" to show a caring attitude.
C) Explain when parents can visit and why siblings cannot come to see her.
D) Orient her parents, because she is young, to her room and hospital facility.

Answer 3

Explain hospital schedules such as mealtimes.

Question 4

A school-age child,admitted for intravenous antibiotic therapy for osteomyelitis,reports difficulty in going to sleep at night.Which intervention should the nurse implement to assist the child in going to sleep at bedtime?

A) Request a prescription for a sleeping pill.
B) Allow the child to stay up late and sleep late in the morning.
C) Create a schedule similar to the one the child follows at home.
D) Plan passive activities in the morning and interactive activities right before bedtime.

Question 5

What intervention should the nurse implement when a 5 year old tells the nurse,"I need a Band-Aid" after having an injection.

A) Apply a Band-Aid.
B) Ask why he/she wants a Band-Aid.
C) Explain why a Band-Aid is not needed.
D) Show he/her that the bleeding has already stopped.

Question 6

What is an appropriate nursing intervention to minimize separation anxiety in a hospitalized toddler?

A) Provide for privacy
B) Encourage parents to room in
C) Explain procedures and routines
D) Encourage contact with children the same age

Question 7

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 8

Emma,age 3 years,is being admitted for about 1 week of hospitalization.The parents of a 3 year old being admitted tell the nurse that they are going to buy their child "a lot of new toys to help during the hospital." The nurse's reply should be based on an understanding of comfort measures for that age-group?

A) New toys do make hospitalization easier.
B) New toys are usually better than older ones for children of this age.
C) At this age children often need the comfort and reassurance of familiar toys from home.
D) Buying new toys for a hospitalized child is a maladaptive way to cope with parental guilt.

Question 9

The nurse needs to take a blood pressure on the child playing in the playroom.Which is the appropriate procedure for obtaining the blood pressure?

A) Take the blood pressure in the playroom.
B) Ask the child to come to the exam room to obtain the blood pressure.
C) Ask the child to return to his or her room for the blood pressure, then escort the child back to the playroom.
D) Document that the blood pressure was not obtained because the child was in the playroom.

Question 10

A 6 year old,hospitalized again because of a chronic illness,is told by school-age siblings that,"We are sick of Mom always sitting with you in the hospital and playing with you.It is not fair that you get everything and we have to stay with the neighbors." What is the nurse's best assessment of the cause of the siblings' resentment?

A) The siblings are immature and probably spoiled.
B) Jealousy and resentment are common reactions to the illness or hospitalization of a sibling.
C) The family has ineffective coping mechanisms to deal with chronic illness.
D) The siblings need to better understand the patient's illness and needs.

Question 11

When a preschool child is hospitalized without adequate preparation,what is the child may likely see hospitalization as?

A) Punishment
B) Threat to child's self-image
C) An opportunity for regression
D) Loss of companionship with friends

Question 12

During the first 4 days of hospitalization,an 18 month old cried inconsolably when his/her parents left and he/she refused the staff's attention.Now the nurse observes that the child appears to be "settled in" and unconcerned about seeing his/her parents.How should the nurse interpret this change in behavior?

A) The child has successfully adjusted to the hospital environment.
B) The child has transferred their trust to the nursing staff.
C) The child may be experiencing detachment, which is the third stage of separation anxiety.
D) Because the child is "at home" in the hospital now, seeing his mother frequently will only start the cycle again.

Question 13

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

A) Exit the room and leave the child alone until he 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 a narcotic analgesic for pain to quiet the child.

Question 14

What represents the major stressor of hospitalization for children from middle infancy throughout the preschool years?

A) Separation anxiety
B) Loss of control
C) Fear of bodily injury
D) Fear of pain

Question 15

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 16

A 14-year-old boy is being admitted to the hospital for an appendectomy.Which roommate should the nurse assign with this patient?

A) A 4-year-old boy who is first day postappendectomy surgery.
B) A 6-year-old boy with pneumonia.
C) A 15-year-old boy admitted with a vaso-occlusive sickle cell crisis.
D) A 12-year-old boy with cellulitis.

Question 17

The nurse is doing a prehospitalization orientation for a 7 year old,who is scheduled for cardiac surgery.As part of the preparation,the nurse explains that he/she will not be able to talk until the endotracheal tube is removed.What is the assessment of this explanation?

A) It is unnecessary.
B) It is the surgeon's responsibility.
C) It is too stressful for a young child.
D) It is an appropriate part of the child's preparation.

Question 18

A previously "potty-trained" 30-month-old child has reverted to wearing diapers while hospitalized.The nurse should reassure the parents based on what knowledge concerning regressive behaviors?

A) Regression is seen during hospitalization.
B) Developmental delays occur because of the hospitalization.
C) The child is experiencing urinary urgency because of hospitalization.
D) The child was too young to be "potty-trained."

Question 19

Because of their striving for independence and productivity,which age-group of children is particularly vulnerable to events that may lessen their feeling of control and power?

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

Question 20

A 10 year old,who needs to have another intravenous (IV)line started,keeps telling the nurse,"Wait a minute," and,"I'm not ready." How should the nurse interpret these requests?

A) This is normal behavior for a school-age child.
B) This behavior is usually not seen past the preschool years.
C) The child thinks the nurse is punishing her.
D) The child has successfully manipulated the nurse in the past.

Question 21

A nurse in the emergency department is assessing a 5-year-old child with symptoms of pneumonia and a fever of 102° F.Which intervention can the nurse implement to promote a sense of control for the child?

A) None, this is an emergency and the child should not participate in care.
B) Allow the child to hold the digital thermometer while taking the child's blood pressure.
C) Ask the child if it is OK to take a temperature in the ear.
D) Have parents wait in the waiting room.

Question 22

What is an age-appropriate nursing intervention to facilitate psychologic 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 23

A child is being discharged from an ambulatory care center after an inguinal hernia repair.Which discharge interventions should the nurse implement? (Select all that apply.)

A) Discuss dietary restrictions.
B) Hold any analgesic medications until the child is home.
C) Send a pain scale home with the family.
D) Suggest the parents fill the prescriptions on the way home.
E) Discuss complications that may occur.

Question 24

A nurse plans therapeutic play time for a hospitalized child.Which are the benefits of therapeutic play? (Select all that apply.)

A) Serves as method to assist disturbed children
B) Allows the child to express feelings
C) The nurse can gain insight into the child's feelings
D) The child can deal with concerns and feelings
E) Gives the child a structured play environment

Question 25

A child has just been unexpectedly admitted to the intensive care unit after abdominal surgery.The nursing staff has completed the admission process,and the child's condition is beginning to stabilize.When speaking with the parents,the nurses should expect which stressors to be evident? (Select all that apply.)

A) Unfamiliar environment
B) Usual day-night routine
C) Strange smells
D) Provision of privacy
E) Inadequate knowledge of condition and routine