UMB ABSN NU 435 EXAM 1 QUESTIONS WITH
ACCURATE ANSWERS
1. A nurse is caring for four patients; three are toddlers and one is a preschooler. Which
represents the major stressor of hospitalization for these four patients?
a. Separation anxiety
b. Loss of control
c. Fear of bodily injury
d. Fear of pain - ANSWER ANS: A
The major stressor for children from infancy through the preschool years is separation
anxiety, also called anaclitic depression. This is a major stressor of hospitalization. Loss
of control, fear of bodily injury, and fear of pain are all stressors associated with
hospitalization. However, separation from family is a primary stressor in this age group.
2. During the first 4 days of hospitalization, Eric, age 18 months, cried inconsolably
when his parents left him, and he refused the staff's attention. Now the nurse observes
that Eric appears to be "settled in" and unconcerned about seeing his parents. The
nurse should interpret this as which statement?
a. He has successfully adjusted to the hospital environment.
b. He has transferred his trust to the nursing staff.
c. He may be experiencing detachment, which is the third stage of separation anxiety.
d. Because he is "at home" in the hospital now, seeing his mother frequently will only
start the cycle again. - ANSWER ANS: C
Detachment is a behavior manifestation of separation anxiety. Superficially it appears
that the child has adjusted to the loss. Detachment is a sign of resignation, not
contentment. Parents should be encouraged to be with their child. If parents restrict
visits, they may begin a pattern of misunderstanding the child's cues and not meeting
his needs.
3. When a preschool child is hospitalized without adequate preparation, how does the
child often react to the hospitalization?
a. Sees it as a punishment
b. A threat to child's self-image
,c. An opportunity for regression
d. Loss of companionship with friends - ANSWER ANS: A
If a toddler is not prepared for hospitalization, a typical preschooler fantasy is to
attribute the hospitalization to punishment for real or imagined misdeeds. Attributing
the hospitalization to punishment for real or imagined misdeeds is a reaction typical of
toddler and school-age children when threatened with loss of control.
4. Which age group should the pediatric nurse recognize as being vulnerable to events
that lessen their feeling of control and power?
a. Infants
b. Toddlers
c. Preschoolers
d. School-age children - ANSWER 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 usurp 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 to
different extents by loss of power, are not as significantly affected as are school-age
children.
5. 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." The nurse should recognize this
as which description?
a. This is normal behavior for a school-age child.
b. The behavior is 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. - ANSWER ANS: A
The 10-year-old girl is attempting to maintain control. The nurse should provide the girl
with structured choices about when the IV will be inserted. Telling the nurse "Wait a
minute" and "I'm not ready" can be characteristic behavior when an individual needs to
maintain some control over a situation.
6. What is a common initial reaction of parents to illness or injury and hospitalization in
their child?
a. Anger
,b. Fear
c. Depression
d. Helplessness - ANSWER ANS: D
Recent research has identified common themes among parents whose children were
hospitalized, including feeling an overall sense of helplessness, questioning the skills of
staff, accepting the reality of hospitalization, needing to have information explained in
simple language, dealing with fear, coping with uncertainty, and seeking reassurance
from caregivers. Anger or guilt is usually the second reaction stage. Fear, anxiety, and
frustrations also are common feelings. Parents may finally react with some form of
depression related to the physical and emotional exhaustion associated with a
hospitalized child.
7. 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 neighbors." Which is the nurse's best assessment of this
situation?
a. The siblings are immature and probably spoiled.
b. Jealousy and resentment are common reactions to the illness or hospitalization of a
sibling.
c. Family has ineffective coping mechanisms to deal with chronic illness.
d. The siblings need to better understand their sister's illness and needs. - ANSWER
ANS: B
Siblings experience loneliness, fear, and worry, as well as anger, resentment, jealousy,
and guilt. The siblings experience stress equal to that of the hospitalized child. There is
no evidence that the family has maladaptive coping mechanisms.
8. What is an appropriate nursing intervention to minimize separation anxiety in a
hospitalized toddler?
a. Provide for privacy
b. Encourage parents to room in
c. Explain procedures and routines
d. Encourage contact with children the same age - ANSWER ANS: B
A toddler experiences separation anxiety secondary to being separated from the
parents. To avoid this, the parents should be encouraged to room in as much as
, possible. Maintaining routines and ensuring privacy are helpful interventions, but they
would not substitute for the parents. Encouraging contact with children the same age
would not substitute for having the parents present.
9. Four-year-old Brian appears to be upset by hospitalization. Which is an appropriate
intervention?
a. Let him know it is all right to cry.
b. Give him time to gain control of himself.
c. Show him how other children are cooperating.
d. Tell him what a big boy he is to be so quiet. - ANSWER ANS: A
Crying is an appropriate behavior for the upset preschooler. The nurse provides
support through physical presence. Giving the child time to gain control is appropriate,
but the child must know that crying is acceptable. The preschooler does not engage in
competitive behaviors.
10. Latasha, age 8 years, is being admitted to the hospital from the emergency
department with an injury from falling off her bicycle. Which will help her most in her
adjustment to the hospital?
a. Explain hospital schedules to her, such as mealtimes.
b. Use terms such as "honey" and "dear" to show a caring attitude.
c. Explain when parents can visit and why siblings cannot come to see her.
d. Orient her parents, because she is young, to her room and hospital facility. - ANSWER
ANS: A
School-age children need to have control of their environment. The nurse should offer
explanations or prepare the child for those experiences that are unavailable. The nurse
should refer to the child by the preferred name. Explaining when parents can visit and
why siblings cannot come to see her is telling the child all of the limitations, not helping
her adjust to the hospital. At the age of 8 years, the child should be oriented to the
environment along with the parents.
11. Samantha, age 5 years, tells the nurse that she "needs a Band-Aid" where she had
an injection. Which is the best nursing action?
a. Apply a Band-Aid.
ACCURATE ANSWERS
1. A nurse is caring for four patients; three are toddlers and one is a preschooler. Which
represents the major stressor of hospitalization for these four patients?
a. Separation anxiety
b. Loss of control
c. Fear of bodily injury
d. Fear of pain - ANSWER ANS: A
The major stressor for children from infancy through the preschool years is separation
anxiety, also called anaclitic depression. This is a major stressor of hospitalization. Loss
of control, fear of bodily injury, and fear of pain are all stressors associated with
hospitalization. However, separation from family is a primary stressor in this age group.
2. During the first 4 days of hospitalization, Eric, age 18 months, cried inconsolably
when his parents left him, and he refused the staff's attention. Now the nurse observes
that Eric appears to be "settled in" and unconcerned about seeing his parents. The
nurse should interpret this as which statement?
a. He has successfully adjusted to the hospital environment.
b. He has transferred his trust to the nursing staff.
c. He may be experiencing detachment, which is the third stage of separation anxiety.
d. Because he is "at home" in the hospital now, seeing his mother frequently will only
start the cycle again. - ANSWER ANS: C
Detachment is a behavior manifestation of separation anxiety. Superficially it appears
that the child has adjusted to the loss. Detachment is a sign of resignation, not
contentment. Parents should be encouraged to be with their child. If parents restrict
visits, they may begin a pattern of misunderstanding the child's cues and not meeting
his needs.
3. When a preschool child is hospitalized without adequate preparation, how does the
child often react to the hospitalization?
a. Sees it as a punishment
b. A threat to child's self-image
,c. An opportunity for regression
d. Loss of companionship with friends - ANSWER ANS: A
If a toddler is not prepared for hospitalization, a typical preschooler fantasy is to
attribute the hospitalization to punishment for real or imagined misdeeds. Attributing
the hospitalization to punishment for real or imagined misdeeds is a reaction typical of
toddler and school-age children when threatened with loss of control.
4. Which age group should the pediatric nurse recognize as being vulnerable to events
that lessen their feeling of control and power?
a. Infants
b. Toddlers
c. Preschoolers
d. School-age children - ANSWER 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 usurp 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 to
different extents by loss of power, are not as significantly affected as are school-age
children.
5. 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." The nurse should recognize this
as which description?
a. This is normal behavior for a school-age child.
b. The behavior is 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. - ANSWER ANS: A
The 10-year-old girl is attempting to maintain control. The nurse should provide the girl
with structured choices about when the IV will be inserted. Telling the nurse "Wait a
minute" and "I'm not ready" can be characteristic behavior when an individual needs to
maintain some control over a situation.
6. What is a common initial reaction of parents to illness or injury and hospitalization in
their child?
a. Anger
,b. Fear
c. Depression
d. Helplessness - ANSWER ANS: D
Recent research has identified common themes among parents whose children were
hospitalized, including feeling an overall sense of helplessness, questioning the skills of
staff, accepting the reality of hospitalization, needing to have information explained in
simple language, dealing with fear, coping with uncertainty, and seeking reassurance
from caregivers. Anger or guilt is usually the second reaction stage. Fear, anxiety, and
frustrations also are common feelings. Parents may finally react with some form of
depression related to the physical and emotional exhaustion associated with a
hospitalized child.
7. 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 neighbors." Which is the nurse's best assessment of this
situation?
a. The siblings are immature and probably spoiled.
b. Jealousy and resentment are common reactions to the illness or hospitalization of a
sibling.
c. Family has ineffective coping mechanisms to deal with chronic illness.
d. The siblings need to better understand their sister's illness and needs. - ANSWER
ANS: B
Siblings experience loneliness, fear, and worry, as well as anger, resentment, jealousy,
and guilt. The siblings experience stress equal to that of the hospitalized child. There is
no evidence that the family has maladaptive coping mechanisms.
8. What is an appropriate nursing intervention to minimize separation anxiety in a
hospitalized toddler?
a. Provide for privacy
b. Encourage parents to room in
c. Explain procedures and routines
d. Encourage contact with children the same age - ANSWER ANS: B
A toddler experiences separation anxiety secondary to being separated from the
parents. To avoid this, the parents should be encouraged to room in as much as
, possible. Maintaining routines and ensuring privacy are helpful interventions, but they
would not substitute for the parents. Encouraging contact with children the same age
would not substitute for having the parents present.
9. Four-year-old Brian appears to be upset by hospitalization. Which is an appropriate
intervention?
a. Let him know it is all right to cry.
b. Give him time to gain control of himself.
c. Show him how other children are cooperating.
d. Tell him what a big boy he is to be so quiet. - ANSWER ANS: A
Crying is an appropriate behavior for the upset preschooler. The nurse provides
support through physical presence. Giving the child time to gain control is appropriate,
but the child must know that crying is acceptable. The preschooler does not engage in
competitive behaviors.
10. Latasha, age 8 years, is being admitted to the hospital from the emergency
department with an injury from falling off her bicycle. Which will help her most in her
adjustment to the hospital?
a. Explain hospital schedules to her, such as mealtimes.
b. Use terms such as "honey" and "dear" to show a caring attitude.
c. Explain when parents can visit and why siblings cannot come to see her.
d. Orient her parents, because she is young, to her room and hospital facility. - ANSWER
ANS: A
School-age children need to have control of their environment. The nurse should offer
explanations or prepare the child for those experiences that are unavailable. The nurse
should refer to the child by the preferred name. Explaining when parents can visit and
why siblings cannot come to see her is telling the child all of the limitations, not helping
her adjust to the hospital. At the age of 8 years, the child should be oriented to the
environment along with the parents.
11. Samantha, age 5 years, tells the nurse that she "needs a Band-Aid" where she had
an injection. Which is the best nursing action?
a. Apply a Band-Aid.
