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
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MULTIPLE CHOICE 2p


1. The nurse is seeing an adolescent and the parents in the clinic for the first time. Which sho
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uld the nurse do first?
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a. Introduce him- or herself. 2p 2p 2p



b. Make the family comfortable. 2p 2p 2p



c. Give assurance of privacy.
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d. Explain the purpose of the interview 2p 2p 2p 2p 2p



. ANS: A
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The first thing that nurses must do is to introduce themselves to the patient and family. Parent
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s and other adults should be addressed with appropriate titles unless they specify a preferred n
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ame. Clarification of the purpose of the interview and the nurses role is the second thing that s
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hould be done. During the initial part of the interview, the nurse should include general conve
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rsation to help make the family feel at ease. The interview also should take place in an enviro
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nment as free of distraction as possible. In addition, the nurse should clarify which informatio
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n will be shared with other members of the health care team and any limits to the confidential
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ity.
2. Which is considered a block to effective communication?
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a. Using silence 2p




b. Using clichs 2p



c. Directing the focus 2p 2p



d. Defining the problem 2p 2p



2pANS: B 2p


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 too
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l. Silence permits the interviewee to sort out thoughts and feelings and search for responses
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pto questions. To be effective, the nurse must be able to direct the focus of the interview wh
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ile 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
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maintain a relationship with the family. The nurse and parent must collaborate and define th
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e problem 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 2p 2p 2p 2p




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,b. Childs physical condition
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c. Childs developmental level
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d. Childs nonverbal behaviors 2p 2p



ANS: C
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The nurse must be aware of the childs developmental stage to engage in effective communicat
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ion. The use of both verbal and nonverbal communication should be appropriate to the develo
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pmental level. Nonverbal behaviors vary in importance based on the childs developmental lev
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el and physical condition. Although the childs physical condition is a consideration, developm
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ental level is much more important. The presence of parents is important when communicating
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with 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 wh
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en communicating with them?
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a. Focus communication on the child. 2p 2p 2p 2p



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 2p 2p 2p 2p 2p 2p



. 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 abo
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ut what they can do and how they will feel. With children who are egocentric, analogies, exp
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eriences, and assurances that communication is private will not be effective because the child i
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s not capable of understanding.
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5. The nurses approach when introducing hospital equipment to a preschooler who seems afra
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id should be based on which principle?
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a. The child may think the equipment is alive. 2p 2p 2p 2p 2p 2p 2p



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 doe
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s. 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 s
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hould be kept out of sight until needed. Simple, concrete explanations about what the equipmen
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t does and how it will feel will help alleviate the childs fear. Preschoolers need repeated expla
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nations as reassurance. 2p 2p


6. When the nurse interviews an adolescent, which is especially important?
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a. Focus the discussion on the peer group. 2p 2p 2p 2p 2p 2p



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 2p 2p 2p 2p 2p 2p



. 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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