Chapter 44: Pediatric Variations of Nursing Interventions
MULTIPLE CHOICE
1. What should the nurse consider when having consent forms signed for surgery and procedures on
children?
a. Only a parent or legal guardian can
give consent.
b. The person giving consent must be at
least 18 years old.
c. The risks and benefits of a procedure
, are part of the consent process.
d. A mental age of 7 years or older is
required for a consent to be
considered “informed.”
ANS: C
The informed consent must include the nature of the procedure, benefits and risks, and
alternatives to the procedure. In special circumstances such as emancipated minors, consent
can be given by someone younger than 18 years without the parent or legal guardian. A mental
age of 7 years is too young for consent to be informed.
DIF: Cognitive Level: Comprehension REF: p. 1279 OBJ: Nursing
Process: Planning
2. The nurse is planning how to prepare a 4-year-old child for some diagnostic procedures.
Which guideline should be included to prepare this preschooler?
a. Plan for a short teaching session of
about 30 minutes.
b. Tell the child that procedures are
never a form of punishment.
c. Keep equipment out of the child’s
view.
d. Use correct scientific and medical
terminology in explanations.
ANS: B
Preschoolers may view illness and hospitalization as punishment, so it is important to always
state directly that procedures are never a form of punishment. Teaching sessions for this age
group should be 10 to 15 minutes in length. Use of equipment should be demonstrated, and
the child should be allowed to play with miniature or actual equipment. The nurse should
explain the procedure in simple terms as well as how it affects the child.
DIF: Cognitive Level: Application REF: p. 1282 | Box 44-1 OBJ:
Nursing Process: Implementation
3. A 4-year-old is admitted to outpatient surgery for the removal of a cyst on her foot. Her
mother puts the hospital gown on her, but the child is crying because she wants to leave her
underpants on. What is the most appropriate nursing action?
, a. Allow the child to wear her
underpants.
b. Discuss with her mother why this is
important to the child.
c. Ask her mother to explain to her why
she cannot wear them.
d. Explain in a kind, matter-of-fact
manner that removing all clothing is
hospital policy.
ANS: A
In this case, it is appropriate for the child to leave her underpants on. This allows her some
measure of control during the foot surgery. The mother should not be required to make the
child more upset. The child is too young to understand what hospital policy means, so this
explanation would not help her.
DIF: Cognitive Level: Application REF: p. 1282 | Box 44-1 OBJ:
Nursing Process: Implementation
4. From a child development perspective, what is the best approach to prepare a toddler for a
procedure?
a. Avoid asking the child to make
choices.
b. Demonstrate the procedure on a doll.
c. Plan for the teaching session to last
about 20 minutes.
d. Show the necessary equipment
without allowing the child to handle it.
ANS: B
Toddlers are best prepared for procedures by using play. The nurse can demonstrate the
procedure on a doll but should avoid using the child’s favourite doll, because the toddler may
think the doll is really “feeling” the procedure. In preparing a toddler for a procedure, the child
should be allowed to participate in care and help whenever possible. Teaching sessions for
a. Grant her request.
b. Explain why this is not possible.
MULTIPLE CHOICE
1. What should the nurse consider when having consent forms signed for surgery and procedures on
children?
a. Only a parent or legal guardian can
give consent.
b. The person giving consent must be at
least 18 years old.
c. The risks and benefits of a procedure
, are part of the consent process.
d. A mental age of 7 years or older is
required for a consent to be
considered “informed.”
ANS: C
The informed consent must include the nature of the procedure, benefits and risks, and
alternatives to the procedure. In special circumstances such as emancipated minors, consent
can be given by someone younger than 18 years without the parent or legal guardian. A mental
age of 7 years is too young for consent to be informed.
DIF: Cognitive Level: Comprehension REF: p. 1279 OBJ: Nursing
Process: Planning
2. The nurse is planning how to prepare a 4-year-old child for some diagnostic procedures.
Which guideline should be included to prepare this preschooler?
a. Plan for a short teaching session of
about 30 minutes.
b. Tell the child that procedures are
never a form of punishment.
c. Keep equipment out of the child’s
view.
d. Use correct scientific and medical
terminology in explanations.
ANS: B
Preschoolers may view illness and hospitalization as punishment, so it is important to always
state directly that procedures are never a form of punishment. Teaching sessions for this age
group should be 10 to 15 minutes in length. Use of equipment should be demonstrated, and
the child should be allowed to play with miniature or actual equipment. The nurse should
explain the procedure in simple terms as well as how it affects the child.
DIF: Cognitive Level: Application REF: p. 1282 | Box 44-1 OBJ:
Nursing Process: Implementation
3. A 4-year-old is admitted to outpatient surgery for the removal of a cyst on her foot. Her
mother puts the hospital gown on her, but the child is crying because she wants to leave her
underpants on. What is the most appropriate nursing action?
, a. Allow the child to wear her
underpants.
b. Discuss with her mother why this is
important to the child.
c. Ask her mother to explain to her why
she cannot wear them.
d. Explain in a kind, matter-of-fact
manner that removing all clothing is
hospital policy.
ANS: A
In this case, it is appropriate for the child to leave her underpants on. This allows her some
measure of control during the foot surgery. The mother should not be required to make the
child more upset. The child is too young to understand what hospital policy means, so this
explanation would not help her.
DIF: Cognitive Level: Application REF: p. 1282 | Box 44-1 OBJ:
Nursing Process: Implementation
4. From a child development perspective, what is the best approach to prepare a toddler for a
procedure?
a. Avoid asking the child to make
choices.
b. Demonstrate the procedure on a doll.
c. Plan for the teaching session to last
about 20 minutes.
d. Show the necessary equipment
without allowing the child to handle it.
ANS: B
Toddlers are best prepared for procedures by using play. The nurse can demonstrate the
procedure on a doll but should avoid using the child’s favourite doll, because the toddler may
think the doll is really “feeling” the procedure. In preparing a toddler for a procedure, the child
should be allowed to participate in care and help whenever possible. Teaching sessions for
a. Grant her request.
b. Explain why this is not possible.
