TEST BANK
FOR
PEDIATRIC
PRIMARY
CARE 4TH
EDITION
RICHARDSON
, Pediatric Primary Care 4th Edition Richardson
Testbank/StudyGuide
Chapterh1hObtaininghanhInitialhHistory
MULTIPLEhCHOICE
1. Thehnursehishseeinghanhadolescenthandhthehparentshinhthehclinichforhthehfirsthtime.hWhichhsh
ouldhthehnursehdohfirst?
a. Introducehhim-horhherself.
b. Makehthehfamilyhcomfortable.
c. Givehassurancehofhprivacy.
d. Explainhthehpurposehofhthehintervie
w.hANS:hA
Thehfirsththinghthathnurseshmusthdohishtohintroducehthemselveshtohthehpatienthandhfamily.hParents
andhotherhadultshshouldhbehaddressedhwithhappropriatehtitleshunlesshtheyhspecifyhahpreferredhna
me.hClarificationhofhthehpurposehofhthehinterviewhandhthehnurseshrolehishthehsecondhthinghthathsh
ouldhbehdone.hDuringhthehinitialhparthofhthehinterview,hthehnursehshouldhincludehgeneralhconvers
ationhtohhelphmakehthehfamilyhfeelhathease.hThehinterviewhalsohshouldhtakehplacehinhanhenviron
menthashfreehofhdistractionhashpossible.hInhaddition,hthehnursehshouldhclarifyhwhichhinformationh
willhbehsharedhwithhotherhmembersh ofhthehhealthhcarehteamhandhanyhlimitshtohthehconfidentiality
.
2. Whichhishconsideredhahblockhtoheffectivehcommunication?
a. Usinghsilence
b. Usinghclichs
c. Directinghthehfocus
d. Defininghthehproble
mhANS:hB
Usinghstereotypedhcommentshorhclichshcanhblockheffectivehcommunication.hAfterhthehnursehuses
suchhtritehphrases,hparentshoftenhdohnothrespond.hSilencehcanhbehanheffectivehinterviewinghto
ol.hSilencehpermitshthehintervieweehtohsorthouththoughtshandhfeelingshandhsearchhforhrespons
eshtohquestions.hTohbeheffective,hthehnursehmusthbehablehtohdirecththehfocushofhthehinterviewh
whilehallowinghmaximumhfreedomhofhexpression.hByhusinghopen-
endedhquestionshandhguidinghquestions,hthehnursehcanhobtainhthehnecessaryhinformationhandh
maintainhahrelationshiphwithhthehfamily.hThehnursehandhparenthmusthcollaboratehandhdefineht
hehproblemhthathwillhbehthehfocushofhthehnursinghintervention.
3. Whichhishthehsinglehmosthimportanthfactorhtohconsiderhwhenhcommunicatinghwithhchildren?
a. Presencehofhthehchildshparent
b. Childshphysicalhcondition
c. Childshdevelopmentalhlevel
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, d. Childshnonverbalhbehavior
shANS:hC
Thehnursehmusthbehawarehofhthehchildshdevelopmentalhstagehtohengagehinheffective
communication.hThehusehofhbothhverbalhandhnonverbalhcommunicationhshouldhbehappropriateht
ohthehdevelopmentalhlevel.hNonverbalhbehaviorshvaryhinhimportancehbasedhonhthehchildshdevelo
pmentalhlevelhandhphysicalhcondition.hAlthoughhthehchildshphysicalhconditionhishahconsideratio
n,hdevelopmentalhlevelhishmuchhmorehimportant.hThehpresencehofhparentshishimportanthwhenhco
mmunicatinghwithhyounghchildrenhbuthmayhbehdetrimentalhwhenhspeakinghwithhadolescents.
4. Becausehchildrenhyoungerhthanh5hyearsharehegocentric,hthehnursehshouldhdohwhichhw
henhcommunicatinghwithhthem?
a. Focushcommunicationhonhthehchild.
b. Useheasyhanalogieshwhenhpossible.
c. Explainhexperienceshofhothershtohthehchild.
d. Assurehthehchildhthathcommunicationhishprivat
e.hANS:hA
Becausehchildrenhofhthishageharehablehtohseehthingshonlyhinhtermshofhthemselves,hthehbesthapproach
ishtohfocushcommunicationhdirectlyhonhthem.hChildrenhshouldhbehprovidedhwithhinformationhab
outhwhaththeyhcanhdohandhhowhtheyhwillhfeel.hWithhchildrenhwhoharehegocentric,hanalogies,hexp
eriences,handhassuranceshthathcommunicationhishprivatehwillhnothbeheffectivehbecausehthehchildhi
shnothcapablehofhunderstanding.
5. Thehnurseshapproachhwhenhintroducinghhospitalhequipmenthtohahpreschoolerhwhohseemshafr
aidhshouldhbehbasedhonhwhichhprinciple?
a. Thehchildhmayhthinkhthehequipmenthishalive.
b. Explaininghthehequipmenthwillhonlyhincreasehthehchildshfear.
c. Onehbriefhexplanationhwillhbehenoughhtohreducehthehchildshfear.
d. Thehchildhishtoohyounghtohunderstandhwhaththehequipmenthdo
es.hANS:hA
Younghchildrenhattributehhumanhcharacteristicshtohinanimatehobjects.hTheyhoftenhfearhthaththe
objectshmayhjump,hbite,hcut,horhpinchhallhbyhthemselveshwithouthhumanhdirection.hEquipmenths
houldhbehkepthouthofhsighthuntilhneeded.hSimple,hconcretehexplanationshabouthwhaththehequipme
nthdoeshandhhowhithwillhfeelhwillhhelphalleviatehthehchildshfear.hPreschoolershneedhrepeatedhexpl
anationshashreassurance.
6. Whenhthehnursehinterviewshanhadolescent,hwhichhishespeciallyhimportant?
a. Focushthehdiscussionhonhthehpeerhgroup.
b. Allowhanhopportunityhtohexpresshfeelings.
c. Usehthehsamehtypehofhlanguagehashthehadolescent.
d. Emphasizehthathconfidentialityhwillhalwayshbehmaintaine
d.hANS:hB
Adolescents,hlikehallhchildren,hneedhopportunitieshtohexpresshtheirhfeelings.hOftenhtheyhinterject
feelingshintohtheirhwords.hThehnursehmusthbehalerthtohthehwordshandhfeelingshexpressed.hThehnurse
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, shouldhmaintainhahprofessionalhrelationshiphwithhadolescents.hTohavoidhmisunderstandingh
orhmisinterpretationhofhwordshandhphraseshused,hthehnursehshouldhclarifyhthehtermshused,hw
hathinformationhwillhbehsharedhwithhotherhmembershofhthehhealthhcarehteam,handhanyhlimit
shtohconfidentiality.hAlthoughhthehpeerhgrouphishimportanthtohthishagehgroup,hthehinterview
hshouldhfocush onhthehadolescent.
7. Thehnursehishpreparinghtohassesshah10-month-
oldhinfant.hHehishsittinghonhhishfathershlaphandhappearshtohbehafraidhofhthehnursehandhofhwh
athmighthhappenhnext.hWhichhinitialhactionshbyhthehnursehshouldhbehmosthappropriate?
a. Initiatehahgamehofhpeek-a-boo.
b. Askhthehinfantshfatherhtohplacehthehinfanthonhthehexaminationhtable.
c. Talkhsoftlyhtohthehinfanthwhilehtakinghhimhfromhhishfather.
d. Undresshthehinfanthwhilehhehishstillhsittinghonhhishfathershl
ap.hANS:hA
Peek-a-boohishanhexcellenthmeanshofhinitiatinghcommunicationhwithhinfantshwhilehmaintainingha
safe,hnonthreateninghdistance.hThehchildhwillhmosthlikelyhbecomehupsethifhseparatedhfromhhis
hfather.hAshmuchhofhthehassessmenthashpossiblehshouldhbehdonehwithhthehchildhonhthehfathers
hlap.hThehnursehshouldh havehthehfatherhundresshthehchildhash neededhduringhthehexamination.
8. Anh8-year-
oldhgirlhaskshthehnursehhowhthehbloodhpressurehapparatushworks.hThehmosthappropriat
ehnursinghactionhishwhich?
a. Askhherhwhyhshehwantshtohknow.
b. Determinehwhyhshehishsohanxious.
c. Explainhinhsimplehtermshhowhithworks.
d. Tellhherhshehwillhseehhowhithworkshashithishus
ed.hANS:hC
School-agehchildrenhrequirehexplanationshandhreasonshforheverything.hTheyharehinterestedhinhthe
functionalhaspecthofhallhprocedures,hobjects,handhactivities.hIthishappropriatehforhthehnursehtohe
xplainhhowhequipmenthworkshandhwhathwillhhappenhtohthehchildhsohthaththehchildhcanhthenho
bservehduringhthehprocedure.hThehnursehshouldhrespondhpositivelyhforhrequestshforhinformatio
nhabouthprocedureshandhhealthhinformation.hByhnothresponding,hthehnursehmayhbehlimitinghco
mmunicationhwithhthehchild.hThehchildhishnothexhibitinghanxietyhinhaskinghhowhthehbloodhpre
ssurehapparatushworks,hjusthrequestinghclarificationhofhwhathwillhoccur.
9. Thehnursehishhavinghdifficultyhcommunicatinghwithhahhospitalizedh6-year-
oldhchild.hWhichhtechniquehshouldhbehmosthhelpful?
a. Recommendhthaththehchildhkeephahdiary.
b. Providehsupplieshforhthehchildhtohdrawhahpicture.
c. Suggesththaththehparenthreadhfairyhtaleshtohthehchild.
d. Askhthehparenthifhthehchildhishalwayshuncommunicativ
e.hANS:hB
Drawinghishonehofhthehmosthvaluablehformshofhcommunication.hChildrenshdrawingshtellhahgreat
dealhabouththemhbecausehtheyharehprojectionshofhthehchildrenshinnerhself.hAhdiaryhshouldhbehdi
fficulthforhah6-year-
oldhchild,hwhohishmosthlikelyhlearninghtohread.hThehparenthreadinghfairyhtaleshtohthehchildhishahp
assivehactivityhinvolvinghthehparenthandhchild;hithshouldhnothfacilitate
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