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TEST BANK FOR WONG’S ESSENTIALS OF PEDIATRIC NURSING 10TH EDITION HOCKENBERRY
TEST BANK FOR WONG’S ESSENTIALS OF PEDIATRIC NURSING 10TH EDITION HOCKENBERRY
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Chapter 04: Communication and Physical Assessment of theChild MULTIPLE CHOICE
1. The nurse is seeing an adolescent boy and his parents in the clinic for the first time. What
should the nurse do first?
a. Introduce self.
b. Make family comfortable.
c. Explain purpose of interview.
d. Give assurance of privacy.
ANS: A
The first thing that nurses should do is to introduce themselves to the patient and family. Parents
and other adults should be addressed with appropriate titles unless they specify a preferred name.
During the initial part of the interview, the nurse should include general conversation to help make
the family feel at ease. Clarification of the purpose of the interview and the nurses role is the next
thing that should be done. The interview should take place in an environment as free of distraction
as possible. In addition, the nurse should clarify which information will be shared with other
members of the health care team and any limits to the confidentiality.
PTS: 1 DIF: Cognitive Level: Apply REF: 58
TOP:Integrated Process: Communication and Documentation
MSC: Area of Client Needs: Psychosocial Integrity
2. Which is most likely to encourage parents to talk about their feelings related to their
childs illness? a. Be sympathetic.
b. Use direct questions.
c. Use open-ended questions.
d. Avoid periods of silence.
ANS: C
Closed-ended questions should be avoided when attempting to elicit parents feelings. Open-ended
questions require the parent to respond with more than a brief answer. Sympathy is having feelings
or emotions in common with another person rather than understanding those feelings (empathy).
,Sympathy is not therapeutic in helping the relationship. Direct questions may obtain limited
information. In addition, the parent may consider them threatening. Silence can be an effective
interviewing tool. It allows sharing of feelings in which two or more people absorb the emotion in
depth. Silence permits the interviewee to sort out thoughts and feelings and search for responses to
questions.
0
Test Bank - Wong's Essentials of Pediatric Nursing (10th Edition by Hockenberry) 4
PTS: 1 DIF: Cognitive Level: Apply REF: 59
TOP:Integrated Process: Communication and Documentation
MSC: Area of Client Needs: Psychosocial Integrity
3. Which communication technique should the nurse avoid when interviewing children and
their families? a. Using silence
b. Using clichs
c. Directing the focus
d. Defining the problem
ANS: B
Using stereotyped comments or clichs can block effective communication, and this technique should
be avoided. After use of such trite phrases, parents will often not respond. Silence can be an effective
interviewing tool. Silence permits the interviewee to sort out thoughts and feelings and search for
responses to questions. To be effective, the nurse must be able to direct the focus of the interview
while allowing maximal freedom of expression. By using open-ended questions, along with guiding
questions, the nurse can obtain the necessary information and maintain the relationship with the
family. The nurse and parent must collaborate and define the problem that will be the focus of the
nursing intervention.
PTS: 1 DIF: Cognitive Level: Understand REF: 61
TOP:Integrated Process: Communication and Documentation
MSC: Area of Client Needs: Psychosocial Integrity
4. What is the single most important factor to consider when communicating with
children? a. The childs physical condition
b. Presence or absence of the childs parent
c. The childs developmental level
d. The childs nonverbal behaviors
,ANS: C
The nurse must be aware of the childs developmental stage to engage in effective communication.
The use of both verbal and nonverbal communication should be appropriate to the developmental
level. Although the childs physical condition is a consideration, developmental level is much more
important. The parents presence is important when communicating with young children but may be
detrimental when speaking with adolescents. Nonverbal behaviors will vary in importance, based on
the childs developmental level.
PTS: 1 DIF: Cognitive Level: Understand REF: 62
TOP:Integrated Process: Communication and Documentation
1
Test Bank - Wong's Essentials of Pediatric Nursing (10th Edition by Hockenberry) 4
MSC: Area of Client Needs: Psychosocial Integrity
5. Which approach would be best to use to ensure a positive response from
a toddler? a. Assume an eye-level position and talk quietly.
b. Call the toddlers name while picking him or her up.
c. Call the toddlers name and say, Im your nurse.
d. Stand by the toddler, addressing him or her by name.
ANS: A
It is important that the nurse assume a position at the childs level when communicating with the
child. By speaking quietly and focusing on the child, the nurse should be able to obtain a positive
response. The nurse should engage the child and inform the toddler what is going to occur. If the
nurse picks up the child without explanation, the child is most likely going to become upset. The
toddler may not understand the meaning of the phrase, Im your nurse. If a positive response is
desired, the nurse should assume the childs level when speaking if possible.
PTS: 1 DIF: Cognitive Level: Apply REF: 62
TOP:Integrated Process: Communication and Documentation
MSC: Area of Client Needs: Psychosocial Integrity
6. What is an important consideration for the nurse who is communicating with a very
young child? a. Speak loudly, clearly, and directly.
b. Use transition objects, such as a doll.
c. Disguise own feelings, attitudes, and anxiety.
d. Initiate contact with child when parent is not present.
,ANS: B
Using a transition object allows the young child an opportunity to evaluate an unfamiliar person
(the nurse). This will facilitate communication with a child this age. Speaking in this manner will
tend to increase anxiety in very young children. 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.
PTS: 1 DIF: Cognitive Level: Understand REF: 61
TOP:Integrated Process: Nursing Process: Planning
MSC: Area of Client Needs: Psychosocial Integrity
7. A nurse is preparing to assess a 3-year-old child. What communication technique should the
nurse use for this child?
2
Test Bank - Wong's Essentials of Pediatric Nursing (10th Edition by Hockenberry) 4
a. Focus communication on child.
b. Explain experiences of others to child.
c. Use easy analogies when possible.
d. Assure child that communication is private.
ANS: A
Because children of this age are able to see things only in terms of themselves, the best approach is
to focus communication directly on them. Children should be provided with information about what
they can do and how they will feel. With children who are egocentric, experiences of others,
analogies, and assurances that the communication is private will not be effective because the child is
not capable of understanding.
PTS: 1 DIF: Cognitive Level: Apply REF: 62
TOP:Integrated Process: Communication and Documentation
MSC: Area of Client Needs: Psychosocial Integrity
8. The nurses approach when introducing hospital equipment to a preschooler should be based
on which principle?
a. The child may think the equipment is alive.
b. The child is too young to understand what the equipment does.
c. Explaining the equipment will only increase the childs fear.
d. One brief explanation will be enough to reduce the childs fear.
,ANS: A
Young children attribute human characteristics to inanimate objects. They often fear that the objects
may jump, bite, cut, or pinch all by themselves without human direction. Equipment should be kept
out of sight until needed. The child should be given simple concrete explanations about what the
equipment does and how it will feel to the child. Simple, concrete explanations will help alleviate
the childs fear. The preschooler will need repeated explanations as reassurance.
PTS: 1 DIF: Cognitive Level: Analyze REF: 62
TOP:Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Psychosocial Integrity
9. A nurse is assigned to four children of different ages. In which age group should the nurse
understand that body integrity is a concern?
a. Toddler
b. Preschooler
3
Test Bank - Wong's Essentials of Pediatric Nursing (10th Edition by Hockenberry) 4
c. School-age child
d. Adolescent
ANS: C
School-age children have a heightened concern about body integrity. They place importance and
value on their bodies and are oversensitive to anything that constitutes a threat or suggestion of
injury. Body integrity is not as important a concern to toddlers, preschoolers, or adolescents.
PTS: 1 DIF: Cognitive Level: Understand REF: 63
TOP:Integrated Process: Nursing Process: Planning
MSC:Area of Client Needs: Health Promotion and Maintenance
10. An 8-year-old girl asks the nurse how the blood pressure apparatus works. The most
appropriate nursing action is to:
a. ask her why she wants to know.
b. determine why she is so anxious.
c. explain in simple terms how it works.
d. tell her she will see how it works as it is used.
ANS: C
, 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. A 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.
PTS: 1 DIF: Cognitive Level: Apply REF: 62
TOP:Integrated Process: Teaching/Learning
MSC:Area of Client Needs: Health Promotion and Maintenance
11. When the nurse interviews an adolescent, which is especially important?
a. Focus the discussion on the peer group.
b. Allow an opportunity to express feelings.
c. Emphasize that confidentiality will always be maintained.
d. Use the same type of language as the adolescent.
4
Test Bank - Wong's Essentials of Pediatric Nursing (10th Edition by Hockenberry) 4
ANS: B
Adolescents, like all children, need an opportunity to express their feelings. Often they will
interject feelings into their words. The nurse must be alert to the words and feelings expressed.
Although the peer group is important to this age group, the focus of the interview should be on the
adolescent. The nurse should clarify which information will be shared with other members of the
health care team and any limits to confidentiality. The nurse should maintain a professional
relationship with adolescents. To avoid misinterpretation of words and phrases that the adolescent
may use, the nurse should clarify terms frequently.
PTS: 1 DIF: Cognitive Level: Understand REF: 63
TOP:Integrated Process: Communication and Documentation
MSC: Area of Client Needs: Psychosocial Integrity
12. The nurse is having difficulty communicating with a hospitalized 6-year-old child. What
technique might be most helpful?
a. Suggest that the child keep a diary.
b. Suggest that the parent read fairy tales to the child.
c. Ask the parent if the child is always uncommunicative.
d. Ask the child to draw a picture.
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