Chapter 43: Reaction to Illness and Hospitalization
MULTIPLE CHOICE
1. Which is a major stressor when children from middle infancy through the preschool
years are hospitalized?
a. Separation anxiety
b. Loss of control
c. Fear of bodily injury
d. Fear of pain
ANS: A
The major stress caused by hospitalization for children from infancy through the
preschool years is separation anxiety, also called anaclitic depression. Loss of control,
fear of bodily injury, and fear of pain are all stressors associated with hospitalization as
well. However, separation from the family is a primary stressor for this age group.
DIF: Cognitive Level: Comprehension REF: p. 1255
OBJ: Nursing Process: Assessment
2. Because they strive for independence and productivity, which age group of children is
particularly vulnerable to events that may lessen their feelings of control and power?
a. Infants
b. Toddlers
c. Preschoolers
d. School-age children
ANS: D
When a child is hospitalized, the altered family role, physical disability, loss of peer
acceptance, lack of productivity, and inability to cope with stress usurps individual
power and identity. This is especially detrimental to school-age children, who are
striving for independence and productivity and are now experiencing events that
lessen their control and power. Infants, toddlers, and preschoolers, although affected
by loss of power, are not as significantly affected as school-age children.
DIF: Cognitive Level: Analysis REF: p. 1257
OBJ: Nursing Process: Diagnosis
, 3. A 10-year-old girl needs to have another intravenous (IV) line started. She keeps
telling the nurse, “Wait a minute,” and, “I’m not ready.” What should the nurse
recognize about this behaviour?
a.
child.
b. This behaviour is usually not seen past the
preschool years.
c. The child thinks the nurse is punishing
her.
d. The child has successfully
manipulated the nurse in the past.
This is normal behaviour for a school-age
ANS: A
This school-age child is attempting to maintain control. The nurse should provide the
girl with structured choices about when the IV will be inserted. This is characteristic
behaviour when an individual needs to maintain some control over a situation. The
child is trying to have some control in the hospital experience.
DIF: Cognitive Level: Analysis REF: p. 1257
OBJ: Nursing Process: Implementation
4. Amy, age 6 years, needs to be hospitalized again because of a chronic illness. The
clinic nurse overhears her school-age siblings tell her, “We are sick of Mom always
sitting with you in the hospital and playing with you. It isn’t fair that you get
everything and we have to stay with the neighbours.” What is the nurse’s best
assessment of this situation?
a.
spoiled.
b. Jealousy and resentment are common
reactions to the illness or hospitalization
of a sibling.
c. The family has ineffective coping
mechanisms to deal with chronic illness.
d. The siblings need to better understand
their sister’s illness and needs.
The siblings are immature and probably
ANS: B
Siblings of a child with a chronic illness experience loneliness, fear, worry, anger,
resentment, jealousy, and guilt. The siblings experience stress equal to that of the
MULTIPLE CHOICE
1. Which is a major stressor when children from middle infancy through the preschool
years are hospitalized?
a. Separation anxiety
b. Loss of control
c. Fear of bodily injury
d. Fear of pain
ANS: A
The major stress caused by hospitalization for children from infancy through the
preschool years is separation anxiety, also called anaclitic depression. Loss of control,
fear of bodily injury, and fear of pain are all stressors associated with hospitalization as
well. However, separation from the family is a primary stressor for this age group.
DIF: Cognitive Level: Comprehension REF: p. 1255
OBJ: Nursing Process: Assessment
2. Because they strive for independence and productivity, which age group of children is
particularly vulnerable to events that may lessen their feelings of control and power?
a. Infants
b. Toddlers
c. Preschoolers
d. School-age children
ANS: D
When a child is hospitalized, the altered family role, physical disability, loss of peer
acceptance, lack of productivity, and inability to cope with stress usurps individual
power and identity. This is especially detrimental to school-age children, who are
striving for independence and productivity and are now experiencing events that
lessen their control and power. Infants, toddlers, and preschoolers, although affected
by loss of power, are not as significantly affected as school-age children.
DIF: Cognitive Level: Analysis REF: p. 1257
OBJ: Nursing Process: Diagnosis
, 3. A 10-year-old girl needs to have another intravenous (IV) line started. She keeps
telling the nurse, “Wait a minute,” and, “I’m not ready.” What should the nurse
recognize about this behaviour?
a.
child.
b. This behaviour is usually not seen past the
preschool years.
c. The child thinks the nurse is punishing
her.
d. The child has successfully
manipulated the nurse in the past.
This is normal behaviour for a school-age
ANS: A
This school-age child is attempting to maintain control. The nurse should provide the
girl with structured choices about when the IV will be inserted. This is characteristic
behaviour when an individual needs to maintain some control over a situation. The
child is trying to have some control in the hospital experience.
DIF: Cognitive Level: Analysis REF: p. 1257
OBJ: Nursing Process: Implementation
4. Amy, age 6 years, needs to be hospitalized again because of a chronic illness. The
clinic nurse overhears her school-age siblings tell her, “We are sick of Mom always
sitting with you in the hospital and playing with you. It isn’t fair that you get
everything and we have to stay with the neighbours.” What is the nurse’s best
assessment of this situation?
a.
spoiled.
b. Jealousy and resentment are common
reactions to the illness or hospitalization
of a sibling.
c. The family has ineffective coping
mechanisms to deal with chronic illness.
d. The siblings need to better understand
their sister’s illness and needs.
The siblings are immature and probably
ANS: B
Siblings of a child with a chronic illness experience loneliness, fear, worry, anger,
resentment, jealousy, and guilt. The siblings experience stress equal to that of the
