TEST BANKFOR PEDIATRIC PRIMARY CARE: PRACTICE GUI
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DELINES FOR NURSES: PRACTICE GUIDELINES FOR NURSES
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5TH EDITION BY BETH RICHARDSON A+
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Chapterj1jObtainingjanjInitialjHistory
MULTIPLEjCHOICE
1. Thejnursejisjseeingjanjadolescent jand jthejparentsjinjthejclinicjforjthejfirst jtime.jWhichjshoul
d jthejnursejdojfirst?
a. Introducejhim-jorjherself.
b. Makejthejfamilyjcomfortable.
c. Givejassurancejof jprivacy.
d. Explainjthejpurposejof jthejinterview.jANS:jA
Thejfirst jthingjthat jnursesjmust jdojisjtojintroducejthemselvesjtojthejpatient jand jfamily.jParentsjand joth
erjadultsjshould jbejaddressed jwithjappropriatejtitlesjunlessjtheyjspecifyjajpreferred jname.jClarificatio
njof jthejpurposejof jthejinterview jand jthejnursesjrolejisjthejsecond jthingjthatjshould jbejdone.jDuringjtheji
nitialjpart jof jthejinterview,jthejnursejshould jincludejgeneraljconversationjtojhelpjmakejthejfamilyjfeelj
at jease.jThejinterview jalsojshould jtakejplacejinjanjenvironment jasjfreejof jdistractionjasjpossible.jInjad
dition,jthejnursejshould jclarifyjwhichjinformationjwilljbejshared jwithjotherjmembersjof jthejhealthjcar
ejteamjand janyjlimitsjtojthejconfidentiality.
2. Whichjisjconsidered jajblockjtojeffectivejcommunication?
a. Usingjsilence
b. Usingjclichs
c. Directingjthejfocus
d. DefiningjthejproblemjANS:jB
Usingjstereotyped jcommentsjorjclichsjcanjblockjeffectivejcommunication.jAfterjthejnursejusesjsuchj
tritejphrases,jparentsjoftenjdojnot jrespond.jSilencejcanjbejanjeffectivejinterviewingjtool.jSilencejper
mitsjthejintervieweejtojsort jout jthoughtsjand jfeelingsjand jsearchjforjresponsesjtojquestions.jTojbejeff
ective,jthejnursejmust jbejablejtojdirect jthejfocusjof jthejinterview jwhilejallowingjmaximumjfreedomjo
f jexpression.jByjusingjopen-
ended jquestionsjand jguidingjquestions,jthejnursejcanjobtainjthejnecessaryjinformationjand jmaintainj
ajrelationshipjwithjthe
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family.jThejnursejand jparent jmust jcollaboratejand jdefinejthejproblemjthat jwilljbejthejfocusjof jthejnurs
ingjintervention.
3. Whichjisjthejsinglejmost jimportant jfactorjtojconsiderjwhenjcommunicatingjwithjchil
dren?
a. Presencejof jthejchildsjparent
b. Childsjphysicaljcondition
c. Childsjdevelopmentaljlevel
d. ChildsjnonverbaljbehaviorsjANS:jC
Thejnursejmust jbejawarejof jthejchildsjdevelopmentaljstagejtojengagejinjeffectivejcommunication.jTh
ejusejof jbothjverbaljand jnonverbaljcommunicationjshould jbejappropriatejtojthejdevelopmentaljlevel.j
Nonverbaljbehaviorsjvaryjinjimportancejbased jonjthejchildsjdevelopmentaljleveljand jphysicaljcondit
ion.jAlthoughjthejchildsjphysicaljconditionjisjajconsideration,jdevelopmentaljleveljisjmuchjmorejimp
ortant.jThejpresencejof jparentsjisjimportant jwhenjcommunicatingjwithjyoungjchildrenjbut jmayjbejdet
rimentaljwhenjspeakingjwithjadolescents.
4. Becausejchildrenjyoungerjthanj5jyearsjarejegocentric,jthejnursejshould jdojwhichjwhenjcom
municatingjwithjthem?
a. Focusjcommunicationjonjthejchild.
b. Usejeasyjanalogiesjwhenjpossible.
c. Explainjexperiencesjof jothersjtojthejchild.
d. Assurejthejchild jthat jcommunicationjisjprivate.jANS:jA
Becausejchildrenjof jthisjagejarejablejtojseejthingsjonlyjinjtermsjof jthemselves,jthejbest japproachjisjtojfo
cusjcommunicationjdirectlyjonjthem.jChildrenjshould jbejprovided jwithjinformationjabout jwhat jtheyjc
anjdojand jhow jtheyjwilljfeel.jWithjchildrenjwhojarejegocentric,janalogies,jexperiences,jand jassurance
sjthat jcommunicationjisjprivatejwilljnot jbejeffectivejbecausejthejchild jisjnot jcapablejof junderstanding.
5. Thejnursesjapproachjwhenjintroducingjhospitaljequipment jtojajpreschoolerjwhojseemsjafra
id jshould jbejbased jonjwhichjprinciple?
a. Thejchild jmayjthinkjthejequipment jisjalive.
b. Explainingjthejequipment jwilljonlyjincreasejthejchildsjfear.
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c. Onejbrief jexplanationjwilljbejenoughjtojreducejthejchildsjfear.
d. Thejchild jisjtoojyoungjtojunderstand jwhat jthejequipment jdoes.jANS:jA
Youngjchildrenjattributejhumanjcharacteristicsjtojinanimatejobjects.jTheyjoftenjfearjthat jthejobjectsj
mayjjump,jbite,jcut,jorjpinchjalljbyjthemselvesjwithout jhumanjdirection.jEquipment jshould jbejkept jou
t jof jsight juntiljneeded.jSimple,jconcretejexplanationsjabout jwhat jthejequipment jdoesjandjhow jit jwilljfe
eljwilljhelpjalleviatejthejchildsjfear.jPreschoolersjneed jrepeated jexplanationsjasjreassurance.
6. Whenjthejnursejinterviewsjanjadolescent,jwhichjisjespeciallyjimportant?
a. Focusjthejdiscussionjonjthejpeerjgroup.
b. Allow janjopportunityjtojexpressjfeelings.
c. Usejthejsamejtypejof jlanguagejasjthejadolescent.
d. Emphasizejthat jconfidentialityjwilljalwaysjbejmaintained.jANS:jB
Adolescents,jlikejalljchildren,jneed jopportunitiesjtojexpressjtheirjfeelings.jOftenjtheyjinterject jfeelin
gsjintojtheirjwords.jThejnursejmust jbejalert jtojthejwordsjand jfeelingsjexpressed.jThejnursejshould jmai
ntainjajprofessionaljrelationshipjwithjadolescents.jTojavoid jmisunderstandingjorjmisinterpretationj
of jwordsjand jphrasesjused,jthejnursejshould jclarifyjthejtermsjused,jwhatjinformationjwilljbejshared jw
ithjotherjmembersjof jthejhealthjcarejteam,jand janyjlimitsjtojconfidentiality.jAlthoughjthejpeerjgroupji
sjimportant jtojthisjagejgroup,jthejinterview jshould jfocusjonjthejadolescent.
7. Thejnursejisjpreparingjtojassessjaj10-month-
old jinfant.jHejisjsittingjonjhisjfathersjlapjand jappearsjtojbejafraid jof jthejnursejand jof jwhat jmight jhappe
njnext.jWhichjinitialjactionsjbyjthejnursejshould jbejmost jappropriate?
a. Initiatejajgamejof jpeek-a-boo.
b. Askjthejinfantsjfatherjtojplacejthejinfant jonjthejexaminationjtable.
c. Talkjsoftlyjtojthejinfant jwhilejtakingjhimjfromjhisjfather.
d. Undressjthejinfant jwhilejhejisjstilljsittingjonjhisjfathersjlap.jANS:jA
Peek-a-
boojisjanjexcellent jmeansjof jinitiatingjcommunicationjwithjinfantsjwhilejmaintainingjajsafe,jnonthreat
eningjdistance.jThejchild jwilljmost jlikelyjbecomejupset jif jseparated jfromjhisjfather.jAsjmuchjof jthejas
sessment jasjpossiblejshould jbejdonejwithjthejchild jonjthejfathersjlap.jThejnursejshould jhavejthejfatherj
undressjthejchild jasjneeded jduringjthejexamination.
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8. Anj8-year-
old jgirljasksjthejnursejhow jthejblood jpressurejapparatusjworks.jThejmost jappropriatejnursingjact
ionjisjwhich?
a. Askjherjwhyjshejwantsjtojknow.
b. Determinejwhyjshejisjsojanxious.
c. Explainjinjsimplejtermsjhowjit jworks.
d. Telljherjshejwilljseejhowjit jworksjasjit jisjused.jANS:jC
School-
agejchildrenjrequirejexplanationsjand jreasonsjforjeverything.jTheyjarejinterested jinjthejfunctionaljasp
ect jof jalljprocedures,jobjects,jand jactivities.jIt jisjappropriatejforjthejnursejtojexplainjhow jequipment jw
orksjand jwhat jwilljhappenjtojthejchild jsojthat jthejchild jcanjthenjobservejduringjthejprocedure.jThejnurs
ejshould jrespond jpositivelyjforjrequestsjforjinformationjabout jproceduresjand jhealthjinformation.jByj
not jresponding,jthejnursejmayjbejlimitingjcommunicationjwithjthejchild.jThejchild jisjnot jexhibitingja
nxietyjinjaskingjhow jthejblood jpressurejapparatusjworks,jjust jrequestingjclarificationjof jwhat jwilljocc
ur.
9. Thejnursejisjhavingjdifficultyjcommunicatingjwithjajhospitalized j6-year-
old jchild.jWhichjtechniquejshould jbejmost jhelpful?
a. Recommend jthat jthejchild jkeepjajdiary.
b. Providejsuppliesjforjthejchild jtojdraw jajpicture.
c. Suggest jthat jthejparent jread jfairyjtalesjtojthejchild.
d. Askjthejparent jif jthejchild jisjalwaysjuncommunicative.jANS:jB
Drawingjisjonejof jthejmost jvaluablejformsjof jcommunication.jChildrensjdrawingsjtelljajgreat jdealjabo
ut jthemjbecausejtheyjarejprojectionsjof jthejchildrensjinnerjself.jAjdiaryjshould jbejdifficult jforjaj6-
year-
old jchild,jwhojisjmost jlikelyjlearningjtojread.jThejparent jreadingjfairyjtalesjtojthejchild jisjajpassivejacti
vityjinvolvingjthejparent jand jchild;jit jshould jnot jfacilitatejcommunicationjwithjthejnurse.jThejchild jisji
njajstressfuljsituationjand jisjprobablyjuncomfortablejwithjstrangers,jnot jalwaysjuncommunicative.
10. Whichjdatajshould jbejincluded jinjajhealthjhistory?
a. Review jof jsystems
b. Physicaljassessment
c. Growthjmeasurements
d. Record jof jvitaljsignsjANS:jA
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