Chapter 21: Family-Centered Care of the Child during Illness and Hospitalization Test Bank for Wong's Nursing Care of Infants And Children 11th Edition by Hockenberry

TEST BANK FOR WONG'S NURSING CARE OF INFANTS AND CHILDREN 11TH EDITION BY HOCKENBERRY Chapter 21: Family-Centered Care of the Child during Illness and Hospitalization MULTIPLE CHOICE 1. What behavior should most likely be manifested in an infant experiencing the protest phase of separation anxiety? a. Inactivity b. Depression and sadness c. Inconsolable and crying d. Regression to earlier behavior ANS: C For older infants, being inconsolable and crying is seen during the protest phase of separation anxiety. Inactivity is observed during the stage of despair. The child is much less active and withdraws from others. Depression, sadness, and regression to earlier behaviors are observed during the phase of despair. DIF: Cognitive Level: Understanding TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 2. 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 ANS: D When a child is hospitalized, the altered family role, physical disability, loss of peer acceptance, lack of productivity, and inability to cope with stress usurp individual power and identity. This is especially detrimental to school-age children, who are striving for independence and productivity and are now experiencing events that decrease their control and power. Infants, toddlers, and preschoolers, although affected by loss of power, are not as significantly affected as school-age children. DIF: Cognitive Level: Analyzing TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 3. Cognitive development influences response to pain. What age group is most concerned with the fear of losing control during a painful experience? a. Toddlers b. Preschoolers c. School-age children d. Adolescents ANS: D Adolescents view illness as physiologic (an organ malfunction) and psychophysiologic (psychologic factors that affect health). Adolescents usually approach pain with self-control. They are concerned with remaining composed and feel embarrassed and ashamed of losing control. Toddlers and preschoolers react to pain primarily as a physical, concrete experience. Preschoolers may try to escape a procedure with verbal statements such as go away. Young school-age children may view pain as punishment for wrongdoing. This age group fears bodily harm. DIF: Cognitive Level: Analyzing TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 4. A child, age 4 years, tells the nurse that she needs a Band-Aid where she had an injection. What nursing action should the nurse implement? a. Apply a Band-Aid. b. Ask her why she wants a Band-Aid. c. Explain why a Band-Aid is not needed. d. Show her that the bleeding has already stopped. ANS: A Children in this age group still fear that their insides may leak out at the injection site. The nurse should be prepared to apply a small Band-Aid after the injection. No explanation should be required. DIF: Cognitive Level: Understanding TOP: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance 5. The psychosexual conflicts of preschool children make them extremely vulnerable to which threat? a. Loss of control b. Loss of identity c. Separation anxiety d. Bodily injury and pain ANS: D The psychosexual conflicts of children in this age group make them vulnerable to threats of bodily injury. Intrusive procedures, whether painful or painless, are threatening to preschoolers, whose concept of body integrity is still poorly developed. Loss of control, loss of identity, and separation anxiety are not related to psychosexual conflicts. DIF: Cognitive Level: Understanding TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 6. A spinal tap must be done on a 9-year-old boy. While he is waiting in the treatment room, the nurse observes that he seems composed. When the nurse asks him if he wants his mother to stay with him, he says, I am fine. How should the nurse interpret this situation? a. This child is unusually brave. b. He has learned that support does not help. c. Nine-year-old boys do not usually want a parent present during the procedure. d. Children in this age group often do not request support even though they need and want it. ANS: D The school-age childs visible composure, calmness, and acceptance often mask an inner longing for support. Children of this age have a more passive approach to pain and an indirect request for support. It is especially important to be aware of nonverbal cues such as facial expression, silence, and lack of activity. Usually when someone identifies the unspoken messages, the child will readily accept support. DIF: Cognitive Level: Analyzing TOP: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance 7. The mother of a 7-month-old infant newly diagnosed with cystic fibrosis is rooming in with her infant. She is breastfeeding and provides all the care except for the medication administration. What should the nurse include in the plan of care? a. Ensuring that the mother has time away from the infant b. Making sure the mother is providing all of the infants care c. Determining whether other family members can provide the necessary care so the mother can rest d. Contacting the social worker because of the mothers interference with the nursing care ANS: A The mother needs sufficient rest and nutrition so she can be effective as a caregiver. While the infant is hospitalized, the care is the responsibility of the nursing staff. The mother should be made comfortable with the care the staff provides in her absence. The mother has a right to provide care for the infant. The nursing staff and the mother should agree on the care division. DIF: Cognitive Level: Applying TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity 8. A 10-year-old girl needs to have another intravenous (IV) line started. She keeps telling the nurse, Wait a minute, and, Im not ready. How should the nurse interpret this behavior? a. IV insertions are viewed as punishment. b. This is expected behavior for a school-age child. c. Protesting like this is usually not seen past the preschool years. d. The child has successfully manipulated the nurse in the past.