Chapter 33 - Maternity and Pediatric Nursing - Third Edition PDF

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Maternity and Pediatric Nursing - Third Edition...

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Maternity and Pediatric Nursing - Third Edition Chapter 33 Caring for Children in Diverse Settings 1. The nurse working in the emergency room monitors the admission of children. Statistically, for which one of the following disorders would children younger than 5 years most commonly be admitted? A) Mental health problems B)

Injuries

C)

Respiratory disorders

D) Gastrointestinal disorders

2. The nurse is caring for a 7-year-old girl hospitalized in isolation. The nurse notices that she has begun sucking her thumb and changing her speech patterns to those of a toddler. What condition is the girl manifesting? A) Regression B)

Suppression

C)

Repression

D) Denial

3. The nurse is caring for an 8-year-old boy hospitalized for a bone marrow transplant. His parents are in and out of his room throughout the day. Which of the following behaviors of the child would alert the nurse that he is in the second stage of separation anxiety? A) He ignores his parents when they return to his room. B)

He cries uncontrollably whenever they leave.

C)

He forms superficial relationships with his caregivers.

D) He sits quietly and is uninterested in playing and eating.

4. The nurse is caring for a 4-year-old girl who has been hospitalized for over a week with severe burns. Which of the following would be a priority intervention to help satisfy this preschool child's basic needs? A) Encourage friends to visit as often as possible. B)

Suggest that a family member be present with her 24 hours a day.

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C)

Explain necessary procedures in simple language that she will understand.

D) Allow her to make choices about her meals and activities as much as permitted.

5. The nurse is caring for a hospitalized 13-year-old girl, who is questioning everything the medical staff is doing and is resistant to treatment. How should the nurse respond? A) “Let's work together to plan your day along with your treatments.” B)

“The sooner you cooperate, the sooner you are going to leave.”

C)

“If you are more cooperative, perhaps we can arrange a visit from friends.”

D) “Please don't make me call your parents about this.”

6. The nurse is caring for a 10-year-old boy who is in traction. The boy has a nursing diagnosis of deficient diversional activity related to confinement in bed that is evidenced by verbalization of boredom and lack of participation in play, reading, and schoolwork. Which of the following would be the best intervention? A) Offer the child reading materials. B)

Enlist the aid of a child life specialist.

C)

Encourage the child to complete his homework.

D) Ask for the parents' assistance.

7. The nurse is caring for a 13-year-old girl hospitalized for complications from type 1 diabetes. The girl has a nursing diagnosis of powerlessness related to lack of control of multiple demands associated with hospitalization, procedures, treatments, and changes in usual routine. How can the nurse help promote control? A) Ask the child to identify her areas of concern. B)

Encourage participation of parents in care activities.

C)

Offer the girl as many choices as possible.

D) Enlist the family's assistance in creating a time schedule.

8. The nurse is caring for an 8-year-old girl who requires numerous venipunctures and injections daily. The nurse understands that the child is exhibiting signs of sensory overload and enlists the assistance of the child life specialist. What should the therapeutic play involve to best deal with the child's stressors? A) Puppets and dolls B)

Drawing paper and crayons

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C)

Wooden hammer and pegs

D) Sewing puppets with needles

9. After teaching a group of students about therapeutic play, the instructor determines that additional teaching is needed when the students identify which of the following as a characteristic? A) Focus on coping B)

Use of a highly structured format

C)

Dramatization of emotions

D) Expression of feelings

10. The mother of a hospitalized child reports that her daughter, who is having some difficulty eating, just had a 4-ounce cup of ice chips. The nurse documents this on the child's intake flow sheet as which of the following? A) 2 ounces B)

4 ounces

C)

6 ounces

D) 8 ounces

11. The nurse is preparing a nursing care plan for a child hospitalized for cardiac surgery. Which of the following are examples of interventions that nurses perform in the "building a trusting relationship" stage? Select all answers that apply. A) Gathering information about the child using the child's own toys B)

Preparing the child for a procedure by playing games

C)

Explaining in simple terms what will happen during surgery

D) Allowing the child to devise an exercise plan following surgery E)

Praising the child for how well he is doing following instructions

F)

Giving the child a favorite toy to cuddle following a painful procedure

12. The nurse is preparing a hospitalized 7-year-old girl for a lumbar puncture. Which of the following actions would help reduce her stress related to the procedure? Select all answers that apply. A) Pretend to perform the procedure on her doll.

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B)

Explain the procedure to her in medical terms.

C)

Do not allow her to see or touch the equipment.

D) Teach her the steps of the procedure. E)

Tell her not to pay attention to any sounds she might hear.

F)

Introduce her to the health care personnel.

13. The nurse is performing an admission of a 10-year-old boy. Which of the following actions will help the nurse establish a trusting and caring relationship with the child and his family? Select all answers that apply. A) The nurse should not minimize the child's fears by smiling. B)

The nurse should initiate introductions.

C)

The nurse should not use formal titles at the introduction.

D) The nurse should maintain eye contact at the appropriate level. E) F)

The nurse should start communication with the child first and then move on to the family. The nurse should use age-appropriate communication with the child.

14. The nurse is caring for an 11-year-old girl preparing to undergo a magnetic resonance imaging (MRI) scan. Which of the following statements would best help prepare the girl for the test and decrease anxiety? A) “You won't hear a sound if you wear your headphones.” B)

“The machine makes a very loud rattle; however, headphones will help.”

C)

“There are a variety of loud sounds you will hear.”

D) “The MRI scanner sounds like a machine gun.”

15. The nurse is caring for a 10-year-old girl who is in an isolation room. Which of the following interventions would be a priority intervention for this child? A) Reduce noise as much as possible. B)

Provide age-appropriate toys and games.

C)

Discourage visits from family members.

D) Put on mask prior to entering the room.

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16. An adolescent is scheduled for outpatient arthroscopic surgery on his knee next week. As part of preparing him for the procedure, which action would be most appropriate? A) Discussing the events with the adolescent and his mother upon arrival the morning of the procedure B) Providing detailed explanations of the procedure at least a week in advance of the procedure C) Encouraging the parent to stay with the adolescent as much as possible before the procedure D) Answering the adolescent's questions with simple answers, encouraging him to ask the surgeon

17. The nurse is providing developmentally appropriate care for a toddler hospitalized for observation following a fall down the steps. Which of the following measures might the nurse consider when caring for this child? Select all answers that apply. A) Use the en face position when holding the toddler. B)

Use a bed for toddlers who have an adult present.

C)

Avoid leaving small objects that can be swallowed in the bed.

D) Explain activities in concrete, simple terms. E)

Allow the child to select meals and activities.

F)

Encourage parents to stay to prevent separation anxiety.

18. The nurse is ordered to apply restraints to a toddler who keeps pulling at the tubes in his arm. Which of the following criteria must occur to ensure proper use of these restraints? Select all answers that apply. A) The nurse must check the restraints every 15 minutes while they are in place. B)

Secure the restraints with ties to the side rails, not the bed or crib frame.

C)

Assess the temperature of the affected extremities, pulses, and capillary refill every 15 minutes after placement. D) Use a clove-hitch type of knot to secure the restraints with ties. E)

Remove the restraint every 2 hours to allow for range of motion and repositioning.

F)

Encourage parent participation, providing continuous explanations about the reasons and time frame for restraints.

19. The nurse is enlisting the parents' assistance for therapeutic hugging prior to an otoscopic examination. What should the nurse emphasize to the parents? A) “You will need to keep his hands down and his head still.” B)

“If this does not work, we will have to apply restraints.”

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C)

“If you are not capable of this, let me know so I can get some assistance.”

D) “I may need you to leave the room if your son will not remain still.”

20. The nurse is caring for a 7-year-old boy who needs his left leg immobilized. What is the priority nursing intervention? A) Enlist the assistance of a child life specialist. B)

Explain to the boy that he must keep his leg very still.

C)

Apply a clove-hitch restraint to the boy's left leg.

D) Explain that a restraint will be applied if he cannot hold still.

21. The nurse is transporting a 6-month-old with a suspected blood disorder to the nursery. What is the most appropriate method of transporting the child by the nurse? A) A wagon with rails B)

Cradle hold

C)

Football hold

D) Over the shoulder

22. The nurse is caring for an immunosuppressed 3-year-old girl and is providing teaching to the mother about proper oral hygiene. Which of the following responses from the mother indicates a need for further teaching? A) “I really need to carefully check for skin breakdown.” B)

“I must really scrub her teeth and gums well.”

C)

“I must use a soft toothbrush.”

D) “I can use a soft gauze sponge to care for her gums.”

23. When preparing to apply a restraint to a child, which of the following would be most important for the nurse to do? A) Expect to keep the restraint on for at least 8 hours. B)

Explain that safety, not punishment, is the reason for the restraint.

C)

Plan to use a square knot to secure the restraint to the side rails.

D) Use a limb restraint rather than a jacket restraint for most issues.

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24. The nurse is providing discharge planning for a 12-year-old boy with multiple medical conditions. Which of the following would be the best teaching method for this child and his family? A) Demonstrate the care and ask for a return demonstration. B)

Provide and review educational booklets and materials.

C)

Provide a written schedule for the child's care.

D) Provide a trial period of home care.

25. Community-based nursing provides opportunities that are quite different from acute care nursing. Which of the following job characteristics is unique to home care nursing? A) Experiencing a greater amount of independence B)

Building a close relationship with the family

C)

Coordinating therapy services and reimbursements

D) Focusing teaching on child independence

26. The nurse is working as a community health care nurse. What would be the nurse's focus when providing care of the child? A) Providing care to the individual and family in acute care settings B)

Providing care to the indigent in family care settings

C)

Providing care in geographically and culturally diverse settings

D) Providing care for particular age groups or particular diagnoses

27. The nurse working in community nursing uses epidemiology as a tool. What information can be obtained using this process? A) Health needs of a population B)

Cultural needs of a population

C)

Income levels of a population

D) Mortality rates of a population

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28. When speaking to a group of parents at a local elementary school, the nurse describes school nursing as a specialized practice of nursing based on the fact that a healthy child has a better chance to succeed in school. Which of the following best describes the strategy school nurses use to achieve student success? A) They coordinate all school health programs. B)

They link community health services.

C)

They work to minimize health-related barriers to learning.

D) They promote student health and safety.

29. The nurse referring a child to home care discusses the advantages and disadvantages with the child's family. Which of the following are disadvantages of this method of health care? Select all answers that apply. A) The nurse is performing care of the child in the family's home. B)

The home care nurse is not always equipped to perform technical care.

C)

The out-of-pocket cost of home care is more expensive.

D) The technical procedures may be overwhelming for the family. E)

The financial burden may cause more stress for the family.

F)

The child does not receive continuity of care provided in the hospital setting.

30. The nurse working with children in a hospital setting notes that they are being discharged earlier and earlier. Which of the following is a primary reason for this trend? A) Nursing shortages B)

Increased funding for home care

C)

National health care initiatives

D) Cost containment

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Answer Key 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30.

C A D C A B C D B A B, C A, D, F B, D, F B B B C, F D, E, F A B D B B D A C A C A, C, D, E D

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