,Pediatric Primary Care: Practice Guidelines for Nurses, 5th Edition
Pediatric Primary Care: Practice Guidelines for
Nurses, 5th Edition – Richardson (2022)
Chapter 1 Obtaining an Initial History
WELL ELABORATED QUESTIONS AND ANSWERS
MULTIPLE CHOICE
1. The nurse is seeing an adolescent and the parents in the clinic for the first time. Which
should the nurse do first?
a. Introduce him- or herself.
b. Make the family comfortable.
c. Give assurance of privacy.
d. Explain the purpose of the interview.
ANS: A
The first thing that nurses must 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. Clarification of the purpose of the interview and the nurses role is the second thing that
should be done. During the initial part of the interview, the nurse should include general
conversation to help make the family feel at ease. The interview also 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.
2. Which is considered a block to effective communication?
a. Using silence
b. Using clichs
c. Directing the focus
d. Defining the problem
ANS: B
Using stereotyped comments or clichs can block effective communication. After the nurse uses
such trite phrases, parents often do 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 maximum freedom of expression. By using open-ended questions and guiding
questions, the nurse can obtain the necessary information and maintain a relationship with the
family. The nurse and parent must collaborate and define the problem that will be the focus of
the nursing intervention.
3. Which is the single most important factor to consider when communicating with
children?
2
,Pediatric Primary Care: Practice Guidelines for Nurses, 5th Edition
a. Presence of the child’s parent
b. Childs physical condition
c. Childs developmental level
d. Childs 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. Nonverbal behaviors vary in importance based on the child’s
developmental level and physical condition. Although the child’s physical condition is a
consideration, developmental level is much more important. The presence of parents is
important when communicating with young children but may be detrimental when speaking
with adolescents.
4. Because children younger than 5 years are egocentric, the nurse should do which when
communicating with them?
a. Focus communication on the child.
b. Use easy analogies when possible.
c. Explain experiences of others to the child.
d. Assure the 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, analogies,
experiences, and assurances that communication is private will not be effective because the
child is not capable of understanding.
5. The nurses approach when introducing hospital equipment to a preschooler who seems
afraid should be based on which principle?
a. The child may think the equipment is alive.
b. Explaining the equipment will only increase the child’s fear.
c. One brief explanation will be enough to reduce the child’s fear.
d. The child is too young to understand what the equipment does.
ANS: A
Young children attribute human characteristics to inanimate objects. They often fear that the
objects may jump, bite, cut, or pinch all by themselves without human direction. Equipment
should be kept out of sight until needed. Simple, concrete explanations about what the
equipment does and how it will feel will help alleviate the child’s fear. Preschoolers need
repeated explanations as reassurance.
6. When the nurse interviews an adolescent, which is especially important?
3
, Pediatric Primary Care: Practice Guidelines for Nurses, 5th Edition
a. Focus the discussion on the peer group.
b. Allow an opportunity to express feelings.
c. Use the same type of language as the adolescent.
d. Emphasize that confidentiality will always be maintained.
ANS: B
Adolescents, like all children, need opportunities to express their feelings. Often they interject
feelings into their words. The nurse must be alert to the words and feelings expressed. The
nurse
should maintain a professional relationship with adolescents. To avoid misunderstanding or
misinterpretation of words and phrases used, the nurse should clarify the terms used, what
information will be shared with other members of the health care team, and any limits to
confidentiality. Although the peer group is important to this age group, the interview should
focus on the adolescent.
7. The nurse is preparing to assess a 10-month-old infant. He is sitting on his father’s lap
and appears to be afraid of the nurse and of what might happen next. Which initial actions by
the nurse should be most appropriate?
a. Initiate a game of peek-a-boo.
b. Ask the infants father to place the infant on the examination table.
c. Talk softly to the infant while taking him from his father.
d. Undress the infant while he is still sitting on his father’s lap.
ANS: A
Peek-a-boo is an excellent means of initiating communication with infants while maintaining a
safe, nonthreatening distance. The child will most likely become upset if separated from his
father. As much of the assessment as possible should be done with the child on the father’s lap.
The nurse should have the father undress the child as needed during the examination.
8. An 8-year-old girl asks the nurse how the blood pressure apparatus works. The most
appropriate nursing action is which?
a. Ask her why she wants to know.
b. Determine why she is so anxious.
c. Explain in simple terms how it works.
d. Tell her she will see how it works as it is used.
ANS: C
School-age children require explanations and reasons for everything. They are interested in the
functional aspect of all procedures, objects, and activities. It is appropriate for the nurse to
explain how equipment works and what will happen to the child so that the child can then
observe during the procedure. The nurse should respond positively for requests for information
4
Pediatric Primary Care: Practice Guidelines for
Nurses, 5th Edition – Richardson (2022)
Chapter 1 Obtaining an Initial History
WELL ELABORATED QUESTIONS AND ANSWERS
MULTIPLE CHOICE
1. The nurse is seeing an adolescent and the parents in the clinic for the first time. Which
should the nurse do first?
a. Introduce him- or herself.
b. Make the family comfortable.
c. Give assurance of privacy.
d. Explain the purpose of the interview.
ANS: A
The first thing that nurses must 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. Clarification of the purpose of the interview and the nurses role is the second thing that
should be done. During the initial part of the interview, the nurse should include general
conversation to help make the family feel at ease. The interview also 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.
2. Which is considered a block to effective communication?
a. Using silence
b. Using clichs
c. Directing the focus
d. Defining the problem
ANS: B
Using stereotyped comments or clichs can block effective communication. After the nurse uses
such trite phrases, parents often do 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 maximum freedom of expression. By using open-ended questions and guiding
questions, the nurse can obtain the necessary information and maintain a relationship with the
family. The nurse and parent must collaborate and define the problem that will be the focus of
the nursing intervention.
3. Which is the single most important factor to consider when communicating with
children?
2
,Pediatric Primary Care: Practice Guidelines for Nurses, 5th Edition
a. Presence of the child’s parent
b. Childs physical condition
c. Childs developmental level
d. Childs 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. Nonverbal behaviors vary in importance based on the child’s
developmental level and physical condition. Although the child’s physical condition is a
consideration, developmental level is much more important. The presence of parents is
important when communicating with young children but may be detrimental when speaking
with adolescents.
4. Because children younger than 5 years are egocentric, the nurse should do which when
communicating with them?
a. Focus communication on the child.
b. Use easy analogies when possible.
c. Explain experiences of others to the child.
d. Assure the 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, analogies,
experiences, and assurances that communication is private will not be effective because the
child is not capable of understanding.
5. The nurses approach when introducing hospital equipment to a preschooler who seems
afraid should be based on which principle?
a. The child may think the equipment is alive.
b. Explaining the equipment will only increase the child’s fear.
c. One brief explanation will be enough to reduce the child’s fear.
d. The child is too young to understand what the equipment does.
ANS: A
Young children attribute human characteristics to inanimate objects. They often fear that the
objects may jump, bite, cut, or pinch all by themselves without human direction. Equipment
should be kept out of sight until needed. Simple, concrete explanations about what the
equipment does and how it will feel will help alleviate the child’s fear. Preschoolers need
repeated explanations as reassurance.
6. When the nurse interviews an adolescent, which is especially important?
3
, Pediatric Primary Care: Practice Guidelines for Nurses, 5th Edition
a. Focus the discussion on the peer group.
b. Allow an opportunity to express feelings.
c. Use the same type of language as the adolescent.
d. Emphasize that confidentiality will always be maintained.
ANS: B
Adolescents, like all children, need opportunities to express their feelings. Often they interject
feelings into their words. The nurse must be alert to the words and feelings expressed. The
nurse
should maintain a professional relationship with adolescents. To avoid misunderstanding or
misinterpretation of words and phrases used, the nurse should clarify the terms used, what
information will be shared with other members of the health care team, and any limits to
confidentiality. Although the peer group is important to this age group, the interview should
focus on the adolescent.
7. The nurse is preparing to assess a 10-month-old infant. He is sitting on his father’s lap
and appears to be afraid of the nurse and of what might happen next. Which initial actions by
the nurse should be most appropriate?
a. Initiate a game of peek-a-boo.
b. Ask the infants father to place the infant on the examination table.
c. Talk softly to the infant while taking him from his father.
d. Undress the infant while he is still sitting on his father’s lap.
ANS: A
Peek-a-boo is an excellent means of initiating communication with infants while maintaining a
safe, nonthreatening distance. The child will most likely become upset if separated from his
father. As much of the assessment as possible should be done with the child on the father’s lap.
The nurse should have the father undress the child as needed during the examination.
8. An 8-year-old girl asks the nurse how the blood pressure apparatus works. The most
appropriate nursing action is which?
a. Ask her why she wants to know.
b. Determine why she is so anxious.
c. Explain in simple terms how it works.
d. Tell her she will see how it works as it is used.
ANS: C
School-age children require explanations and reasons for everything. They are interested in the
functional aspect of all procedures, objects, and activities. It is appropriate for the nurse to
explain how equipment works and what will happen to the child so that the child can then
observe during the procedure. The nurse should respond positively for requests for information
4
