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 r1 r1 r1 r1 r1




MULTIPLE CHOICE r1


1. The nurse is seeing an adolescent and the parents in the clinic for the first time. Which should
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the nurse do first?
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a. Introduce him- or herself. r1 r1 r1



b. Make the family comfortable. r1 r1 r1



c. Give assurance of privacy. r1 r1 r1



d. Explain the purpose of the interview. r1 r1 r1 r1 r1 r



1ANS: A r1


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 name
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. Clarification of the purpose of the interview and the nurses role is the second thing that should
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be done. During the initial part of the interview, the nurse should include general conversation t
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o help make the family feel at ease. The interview also should take place in an environment as f
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ree of distraction as possible. In addition, the nurse should clarify which information will be sha
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red 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 r1




b. Using clichs r1



c. Directing the focus r1 r1



d. Defining the problem r1 r1 r



1ANS: B r1


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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1Silence permits the interviewee to sort out thoughts and feelings and search for responses to
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questions. To be effective, the nurse must be able to direct the focus of the interview while al
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lowing maximum freedom of expression. By using open-
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ended questions and guiding questions, the nurse can obtain the necessary information and ma
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intain a relationship with the family. The nurse and parent must collaborate and define the pro
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blem 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 r1 r1 r1 r1




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,b. Childs physical condition
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c. Childs developmental level
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d. Childs nonverbal behaviors r1 r1 r



ANS: C
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The nurse must be aware of the childs developmental stage to engage in effective communicatio
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n. The use of both verbal and nonverbal communication should be appropriate to the developme
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ntal level. Nonverbal behaviors vary in importance based on the childs developmental level and
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physical condition. Although the childs physical condition is a consideration, developmental lev
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el is much more important. The presence of parents is important when communicating with youn
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g 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 when
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communicating with them?
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a. Focus communication on the child. r1 r1 r1 r1



b. Use easy analogies when possible.
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c. Explain experiences of others to the child. r1 r1 r1 r1 r1 r1



d. Assure the child that communication is private. r1 r1 r1 r1 r1 r1 r



1ANS: A r1


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, experien
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ces, and assurances that communication is private will not be effective because the child is not ca
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pable of understanding. r1 r1


5. The nurses approach when introducing hospital equipment to a preschooler who seems afraid
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1should be based on which principle? r1 r1 r1 r1 r1



a. The child may think the equipment is alive. r1 r1 r1 r1 r1 r1 r1



b. Explaining the equipment will only increase the childs fear. r1 r1 r1 r1 r1 r1 r1 r1



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.
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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 sho
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uld be kept out of sight until needed. Simple, concrete explanations about what the equipment do
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es and how it will feel will help alleviate the childs fear. Preschoolers need repeated explanatio
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ns as reassurance.
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6. When the nurse interviews an adolescent, which is especially important?
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a. Focus the discussion on the peer group. r1 r1 r1 r1 r1 r1



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. r1 r1 r1 r1 r1 r1 r



1ANS: B r1


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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