Test Bank for Pediatric Primary Care: Practice Guidelines for Nurses: Practice Guidelines for Nurses 5th Edition (Richardson, 2022), All Chapters | Complete Guide A+

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Chapter 1 Obtaining an Initial History
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WELL poELABORATED poQUESTIONS poAND poANSWERS

MULTIPLE CHOICE po


1. The nurse is seeing an adolescent and the parents in the clinic for the first time. Which
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should the nurse do first?
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a. Introduce him- or herself. po po po



b. Make the family comfortable.
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c. Give assurance of privacy.
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d. Explainthepurposeof theinterview. po



ANS: A
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The first thing that nurses must do is to introduce themselves to the patient and family. Parents
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and other adults should be addressed with appropriate titles unless theyspecify a preferred
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name. Clarification of the purpose of the interview and the nurses role is the second thing
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that should be done. During the initial part of the interview, the nurse should include
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general conversation to help make the family feel at ease. The interview also should take
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place in an environment as free of distraction as possible. In addition, the nurse should
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clarify which information will be shared with other members of the health care team and
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any limits to the confidentiality.
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2. Which is considered a block to effective communication?
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a. Using silence po



b. Usingclichs
c. Directing the focus po po



d. Definingtheproblem
ANS: B
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Usingstereotyped comments or clichs can block effective communication. After the nurse
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uses such trite phrases, parents often do not respond. Silence can be an effective
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interviewing tool. Silence permits the interviewee to sort out thoughts and feelings and
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search for responses to
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questions. To be effective, the nurse must be able to direct the focus of the interview
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while allowing maximum freedom of expression. By using open-ended questions and
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guiding questions, the nurse can obtain the necessaryinformation and maintain a
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relationship with the family. The nurse and parent must collaborate and define the
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problem that will be the focus of the nursing intervention.
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3. Whichis the single most important factor to consider when communicating with children?
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a. Presence of the childs parent po po po po



b. Childs physical condition po po



c. Childs developmental level po po




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d. Childsnonverbalbehaviors
ANS: C
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The nurse must be aware ofthe childs developmental stage to engage in effective
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communication. The use of both verbal and nonverbal communication should be
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appropriate to the developmental level. Nonverbal behaviors vary in importance based on
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the childs developmental level and physical condition. Although the childs physical
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condition is a consideration, developmental level is much more important. The presence of
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parents is important when communicating with young children but may be detrimental
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when speaking with adolescents.
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4. Because children younger than 5 years are egocentric, the nurse should do which
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when communicating with them?
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a. Focus communication on the child. po po po po



b. Use easyanalogies when possible.
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c. Explain experiences of others to the child.
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d. Assurethe child that communication is private. po po po po po



ANS: A
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Because children of this age are able to see things onlyin terms of themselves, the best approach
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is to focus communication directlyon them. Children should be provided with information
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about what they can do and how they will feel. With children who are egocentric,
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analogies, experiences, and assurances that communication is private will not be effective
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because the child is not capable of understanding.
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5. The nurses approach when introducing hospital equipment to a preschooler who seems
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afraid should be based on which principle?
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a. The child maythink the equipment is alive. po po po po p o po



b. Explainingthe equipment will onlyincrease the childs fear. po po po po po po



c. Onebrief explanation will be enough to reduce the childs fear.
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d. Thechild is too youngtounderstand what the equipment po po po po po po



does. ANS: A
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Youngchildren attribute human characteristics to inanimate objects. They often fear that the
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objects may jump, bite, cut, or pinch all by themselves without human direction.
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Equipment should be kept out of sight until needed. Simple, concrete explanations about what
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the equipment does and how it will feel will help alleviate the childs fear. Preschoolers
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need repeated explanations as reassurance.
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6. Whenthe nurse interviews an adolescent, which is especially important?
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a. Focus the discussion on the peer group. po po po po po po



b. Allow an opportunityto express feelings.
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c. Use the same type of language as the adolescent.
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d. Emphasizethat confidentialitywill always be maintained. po po po po



ANS: B
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Adolescents, like all children, need opportunities to express their feelings. Often theyinterject
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feelings into their words. The nurse must be alert tothe words and feelings expressed. The nurse
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should maintain a professional relationship with adolescents. To avoid misunderstanding
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or misinterpretation of words and phrases used, the nurse should clarify the terms used,
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what information will be shared with other members of the health care team, and any
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limits to confidentiality. Although the peer group is important to this age group, the
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interview should focus on the adolescent.
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7. The nurse is preparing to assess a 10-month-old infant. He is sitting on his fathers
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lap and appears to be afraid of the nurse and of what might happen next. Which
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initial actions by the nurse should be most appropriate?
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a. Initiate a game of peek-a-boo. po po po po



b. Askthe infants father to place the infant on the examination table.
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c. Talk softlyto the infant while taking him from his father.
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d. Undress the infant while he is still sittingon his fathers po po po po po po po po po



lap. ANS: A
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Peek-a-boois an excellent means of initiating communication with infants while maintaining a
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safe, nonthreatening distance. The child will most likely become upset if separated from
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his father. As much of the assessment as possible should be done with the child on the
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fathers lap. The nurse should have the father undress the child as needed during the
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examination.
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8. An 8-year-old girl asks the nurse how the blood pressure apparatus works. The
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most appropriate nursing action is which?
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a. Ask her whyshe wants to know. po po po po po



b. Determine whyshe is so anxious. po po po po



c. Explain in simple terms how it works. po po po po po po



d. Tell her she will see how it works as it is po po po po po po po po po po



used. ANS: C
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School-age children require explanations and reasons for everything. Theyare interested in the
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functional aspect of all procedures, objects, and activities. It is appropriate for the nurse
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poto explain how equipment works and what will happen to the child so that the child
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pocan then observe during the procedure. The nurse should respond positivelyfor requests for
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information about procedures and health information. By not responding, the nurse may
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pobe limiting communication with the child. The child is not exhibiting anxiety in asking
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pohow the blood pressure apparatus works, just requesting clarification of what will
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pooccur.
9. The nurse is having difficultycommunicating with a hospitalized 6-year-old child.
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Which technique should be most helpful?
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a. Recommend that the child keep a diary. po po po po po po



b. Provide supplies for the child to draw a picture.
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c. Suggest that the parent read fairytales to the child.
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d. Asktheparent if thechild is always po po po po



uncommunicative. ANS: B
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Drawing is one of the most valuable forms of communication. Childrens drawings tell a great
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deal about them because they are projections of the childrens inner self. A diary should be
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podifficult for a 6-year-old child, who is most likely learning to read. The parent reading
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fairytales to the child is a passive activity involving the parent and child; it should not
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pofacilitate
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