Chapter 8. Ambulatory / Office Pediatrics
1. In which situation should the nurse address anxiety as a priority problem in planning care
for the child and family?
a. Twenty-four hour
observation b. Emergency
hospitalization
c. Outpatient admission
d. Rehabilitation admission
ANS: B
Emergency hospitalization involves (1) limited time for preparation both for the child and
family, (2) situations that cause fear for the family that the child may die or be permanently
disabled, and (3) a high level of activity, which can foster further anxiety. Although
preparation time may be limited with a 24-hour observation, this situation does not usually
involve the acuteness of the situation and the high levels of anxiety associated with
emergency admission. Outpatient admission generally involves preparation time for the
family and child. Because of the lower level of acuteness in these settings, anxiety levels are
not as high. Rehabilitation admission follows a serious illness or disease. This type of unit
may resemble a home environment, which decreases the childs and familys anxiety.
2. 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 the family
ANS: C
Outpatient and day facility care do not provide extended care; therefore, a child requiring
extended care would have to be transferred to the hospital, causing increased stress to the
child
, and parents. Outpatient and day facility care decreases cost, decreases the risk of infection,
and minimizes separation of the child from the family.
3. In planning care, the nurse recognizes that which child should have the most difficulty
with separation from family during hospitalization?
a. A 5-month-old infant
b. A 15-month-old
toddler c. A 4-year-old
child
d. A 7-year-old child
ANS: B
Separation is the major stressor for children hospitalized between the ages of 6 and 30 months.
Infants younger than 6 months of age will generally adapt to hospitalization if their basic needs
for food, warmth, and comfort are met. Although separation anxiety occurs in hospitalized
preschoolers, it is usually less obvious and less serious than that experienced by the toddler.
The school-age child is accustomed to separation from parents. Although hospitalization is a
stressor, the 7-year-old child will have less separation anxiety than a 15-month-old toddler.
4. A 2-year-old child has been hospitalized for 4 days. The nurse notes the child is quiet
and withdrawn. Which is the best explanation for this behavior?
a. The child is protesting because of separation from
caregivers. b. The child has adjusted to the hospitalization.
c. The child is experiencing the despair stage of
separation. d. The child has reached the stage of
detachment.
ANS: C
In the despair stage of separation, the child exhibits signs of hopelessness and becomes quiet,
withdrawn, and apathetic. The detachment stage occurs after prolonged separation. During
this phase, the child becomes interested in the environment and begins to play. In the protest
stage,
1. In which situation should the nurse address anxiety as a priority problem in planning care
for the child and family?
a. Twenty-four hour
observation b. Emergency
hospitalization
c. Outpatient admission
d. Rehabilitation admission
ANS: B
Emergency hospitalization involves (1) limited time for preparation both for the child and
family, (2) situations that cause fear for the family that the child may die or be permanently
disabled, and (3) a high level of activity, which can foster further anxiety. Although
preparation time may be limited with a 24-hour observation, this situation does not usually
involve the acuteness of the situation and the high levels of anxiety associated with
emergency admission. Outpatient admission generally involves preparation time for the
family and child. Because of the lower level of acuteness in these settings, anxiety levels are
not as high. Rehabilitation admission follows a serious illness or disease. This type of unit
may resemble a home environment, which decreases the childs and familys anxiety.
2. 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 the family
ANS: C
Outpatient and day facility care do not provide extended care; therefore, a child requiring
extended care would have to be transferred to the hospital, causing increased stress to the
child
, and parents. Outpatient and day facility care decreases cost, decreases the risk of infection,
and minimizes separation of the child from the family.
3. In planning care, the nurse recognizes that which child should have the most difficulty
with separation from family during hospitalization?
a. A 5-month-old infant
b. A 15-month-old
toddler c. A 4-year-old
child
d. A 7-year-old child
ANS: B
Separation is the major stressor for children hospitalized between the ages of 6 and 30 months.
Infants younger than 6 months of age will generally adapt to hospitalization if their basic needs
for food, warmth, and comfort are met. Although separation anxiety occurs in hospitalized
preschoolers, it is usually less obvious and less serious than that experienced by the toddler.
The school-age child is accustomed to separation from parents. Although hospitalization is a
stressor, the 7-year-old child will have less separation anxiety than a 15-month-old toddler.
4. A 2-year-old child has been hospitalized for 4 days. The nurse notes the child is quiet
and withdrawn. Which is the best explanation for this behavior?
a. The child is protesting because of separation from
caregivers. b. The child has adjusted to the hospitalization.
c. The child is experiencing the despair stage of
separation. d. The child has reached the stage of
detachment.
ANS: C
In the despair stage of separation, the child exhibits signs of hopelessness and becomes quiet,
withdrawn, and apathetic. The detachment stage occurs after prolonged separation. During
this phase, the child becomes interested in the environment and begins to play. In the protest
stage,
