Test Bank for Pediatric Primary Care: Practice Guidelines for Nurses 4th Edition by Beth Richardson All 1-36 Chapters Covered ,Latest Edition. BEST COPY

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,Chapter 1 Obtaining an Initial History sx sx sx sx sx




MULTIPLE CHOICE sx


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



b. Make the family comfortable. sx sx sx



c. Give assurance of privacy. sx sx sx



d. Explain the purpose of the interview. sx sx sx sx sx s



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 they specify a preferred nam
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e. Clarification of the purpose of the interview and the nurses role is the second thing that shoul
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d be done. During the initial part of the interview, the nurse should include general conversatio
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n to help make the family feel at ease. The interview also should take place in an environment
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as free of distraction as possible. In addition, the nurse should clarify which information will b
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e shared with other members of the health care team and 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 sx




b. Using clichs sx



c. Directing the focus sx sx



d. Defining the problem sx sx s



xANS: B sx


Using stereotyped comments or clichs can block effective communication. After the nurse uses
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such trite phrases, parents often do not respond. Silence can be an effective interviewing tool
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. Silence permits the interviewee to sort out thoughts and feelings and search for responses t
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o questions. To be effective, the nurse must be able to direct the focus of the interview while
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allowing maximum freedom of expression. By using open-
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ended questions and guiding questions, the nurse can obtain the necessary information and m
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aintain a relationship with the family. The nurse and parent must collaborate and define the pr
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oblem that will be the focus of the nursing intervention.
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3. Which is the single most important factor to consider when communicating with children?
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a. Presence of the childs parent sx sx sx sx




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,b. Childs physical condition
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c. Childs developmental level
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d. Childs nonverbal behaviors sx sx s



xANS: C sx


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



b. Use easy analogies when possible.
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c. Explain experiences of others to the child.
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d. Assure the child that communication is private. sx sx sx sx sx sx



ANS: A
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Because children of this age are able to see things only in terms of themselves, the best approach
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is to focus communication directly on them. Children should be provided with information about
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what they can do and how they will feel. With children who are egocentric, analogies, experie
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nces, and assurances that communication is private will not be effective because the child is not
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capable of understanding. sx sx


5. The nurses approach when introducing hospital equipment to a preschooler who seems afrai
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d should be based on which principle?
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a. The child may think the equipment is alive. sx sx sx sx sx sx sx



b. Explaining the equipment will only increase the childs fear.
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c. One brief explanation will be enough to reduce the childs fear.
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d. The child is too young to understand what the equipment does sx sx sx sx sx sx sx sx sx sx



. ANS: A
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Young children 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. Equipment sh
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ould be kept out of sight until needed. Simple, concrete explanations about what the equipment
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does and how it will feel will help alleviate the childs fear. Preschoolers need repeated explana
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tions as reassurance. sx sx


6. When the nurse interviews an adolescent, which is especially important?
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a. Focus the discussion on the peer group. sx sx sx sx sx sx



b. Allow an opportunity to express feelings.
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c. Use the same type of language as the adolescent.
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d. Emphasize that confidentiality will always be maintained. sx sx sx sx sx sx



ANS: B
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Adolescents, like all children, need opportunities to express their feelings. Often they interject
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feelings into their words. The nurse must be alert to the words and feelings expressed. The nurse
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