Maternal and Pediatric Nursing Care Clinical Chapter 4 - Wong s Essentials of Pediatric Nursing 10th Edition Hockenberry Rodgers Wilson

Maternal and Pediatric Nursing Care Clinical Chapter 4 - Wong s Essentials of Pediatric Nursing 10th Edition Hockenberry Rodgers Wilson Chapter 04: Communication and Physical Assessment of the Child and Family Hockenberry: Wong’s Essentials of Pediatric Nursing, 10th Edition MULTIPLE CHOICE 1. The nurse is seeing an adolescent boy and his parents in the clinic for the first time. What should the nurse do first? a. Introduce self. b. Make family comfortable. c. Explain purpose of interview. d. Give assurance of privacy. ANS: A The first thing that nurses should do is to introduce themselves to the patient and family. Parents and other adults should be addressed with appropriate titles unless they specify a preferred name. During the initial part of the interview, the nurse should include general conversation to help make the family feel at ease. Clarification of the purpose of the interview and the nurse’s role is the next thing that should be done. The interview should take place in an environment as free of distraction as possible. In addition, the nurse should clarify which information will be shared with other members of the health care team and any limits to the confidentiality. DIF: Cognitive Level: Apply REF: p. 57 TOP: Integrated Process: Communication and Documentation MSC: Area of Client Needs: Psychosocial Integrity 2. Which is most likely to encourage parents to talk about their feelings related to their child’s illness? a. Be sympathetic. b. Use direct questions. c. Use open-ended questions. d. Avoid periods of silence. ANS: C Closed-ended questions should be avoided when attempting to elicit parents’ feelings. Openended questions require the parent to respond with more than a brief answer. Sympathy is having feelings or emotions in common with another person rather than understanding those feelings (empathy). Sympathy is not therapeutic in helping the relationship. Direct questions may obtain limited information. In addition, the parent may consider them threatening. Silence can be an effective interviewing tool. It allows sharing of feelings in which two or more people absorb the emotion in depth. Silence permits the interviewee to sort out thoughts and feelings and search for responses to questions. DIF: Cognitive Level: Apply REF: p. 58 TOP: Integrated Process: Communication and Documentation MSC: Area of Client Needs: Psychosocial Integrity 3. Which communication technique should the nurse avoid when interviewing children and their families? TestBankW Downloaded by oliver jamestec () a. Using silence b. Using clichés c. Directing the focus d. Defining the problem ANS: B Using stereotyped comments or clichés can block effective communication, and this technique should be avoided. After use of such trite phrases, parents will often not respond. Silence can be an effective interviewing tool. Silence permits the interviewee to sort out thoughts and feelings and search for responses to questions. To be effective, the nurse must be able to direct the focus of the interview while allowing maximal freedom of expression. By using openended questions, along with guiding questions, the nurse can obtain the necessary information and maintain the relationship with the family. The nurse and parent must collaborate and define the problem that will be the focus of the nursing intervention. DIF: Cognitive Level: Understand REF: p. 59 TOP: Integrated Process: Communication and Documentation MSC: Area of Client Needs: Psychosocial Integrity 4. What is the single most important factor to consider when communicating with children? a. The child’s physical condition b. Presence or absence of the child’s parent c. The child’s developmental level d. The child’s nonverbal behaviors ANS: C The nurse must be aware of the child’s developmental stage to engage in effective communication. The use of both verbal and nonverbal communication should be appropriate to the developmental level. Although the child’s physical condition is a consideration, developmental level is much more important. The parents’ presence is important when communicating with young children but may be detrimental when speaking with adolescents. Nonverbal behaviors will vary in importance, based on the child’s developmental level. DIF: Cognitive Level: Understand REF: p. 60 TOP: Integrated Process: Communication and Documentation MSC: Area of Client Needs: Psychosocial Integrity 5. Which approach would be best to use to ensure a positive response from a toddler? a. Assume an eye-level position and talk quietly. b. Call the toddler’s name while picking him or her up. c. Call the toddler’s name and say, “I’m your nurse.” d. Stand by the toddler, addressing him or her by name. ANS: A TestBankW It is important that the nurse assume a position at the child’s level when communicating with the child. By speaking quietly and focusing on the child, the nurse should be able to obtain a positive response. The nurse should engage the child and inform the toddler what is going to occur. If the nurse picks up the child without explanation, the child is most likely going to become upset. The toddler may not understand the meaning of the phrase, “I’m your nurse.” If a positive response is desired, the nurse should assume the child’s level when speaking if possible. DIF: Cognitive Level: Apply REF: p. 60 TOP: Integrated Process: Communication and Documentation MSC: Area of Client Needs: Psychosocial Integrity 6. What is an important consideration for the nurse who is communicating with a very young child? a. Speak loudly, clearly, and directly. b. Use transition objects, such as a doll. c. Disguise own feelings, attitudes, and anxiety. d. Initiate contact with child when parent is not present. ANS: B Using a transition object allows the young child an opportunity to evaluate an unfamiliar person (the nurse). This will facilitate communication with a child this age. Speaking in this manner will tend to increase anxiety in very young children. The nurse must be honest with the child. Attempts at deception will lead to a lack of trust. Whenever possible, the parent should be present for interactions with young children. DIF: Cognitive Level: Understand REF: p. 61 TOP: Integrated Process: Nursing Process: Planning MSC: Area of Client Needs: Psychosocial Integrity 7. A nurse is preparing to assess a 3-year-old child. What communication technique should the nurse use for this child? a. Focus communication on child. b. Explain experiences of others to child. c. Use easy analogies when possible. d. Assure child that communication is private. ANS: A Because children of this age are able to see things only in terms of themselves, the best approach is to focus communication directly on them. Children should be provided with information about what they can do and how they will feel. With children who are egocentric, experiences of others, analogies, and assurances that the communication is private will not be effective because the child is not capable of understanding. DIF: Cognitive Level: Apply REF: p. 61 TOP: Integrated Process: Communication and Documentation MSC: Area of Client Needs: Psychosocial Integrity 8. A nurse is assigned to four children of different ages. In which age group should the nurse understand that body integrity is a concern? TestBankW a. Toddler b. Preschooler c. School-age child d. Adolescent ANS: C School-age children have a heightened concern about body integrity. They place importance and value on their bodies and are oversensitive to anything that constitutes a threa