Test Bank for Primary Care A Collaborative Practice 5th Edition By Terry Mahan Buttaro & JoAnn Trybulski

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TEST BANK FOR PEDIATRIC PRIMARY CARE: PRACTICE GU
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IDELINES FOR NURSES: PRACTICE GUIDELINES FOR NURSE
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S 5TH EDITION BY BETH RICHARDSON A+
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Chaptern1nObtainingnannInitialnHistory
MULTIPLEnCHOICE
1. Thennursenisnseeingnannadolescentnandnthenparentsninnthenclinicnfornthenfirstntime.nWhichns
houldnthennursendonfirst?
a. Introducenhim-nornherself.
b. Makenthenfamilyncomfortable.
c. Givenassurancenofnprivacy.
d. Explainnthenpurposenofntheninterview.nANS:nA
Thenfirstnthingnthatnnursesnmustndonisntonintroducenthemselvesntonthenpatientnandnfamily.nParentsnand
n othernadultsnshouldnbenaddressednwithnappropriatentitlesnunlessntheynspecifynanpreferrednname.nClari
ficationnofnthenpurposenofntheninterviewnandnthennursesnrolenisnthensecondnthingnthatnshouldnbendone.n
Duringntheninitialnpartnofntheninterview,nthennursenshouldnincludengeneralnconversationntonhelpnmake
n thenfamilynfeelnatnease.nTheninterviewnalsonshouldntakenplaceninnannenvironmentnasnfreenofndistractio
nnasnpossible.nInnaddition,nthennursenshouldnclarifynwhichninformationnwillnbensharednwithnothernme
mbersnofnthenhealthncarenteamnandnanynlimitsntonthenconfidentiality.
2. Whichnisnconsiderednanblockntoneffectivencommunication?
a. Usingnsilence
b. Usingnclichs
c. Directingnthenfocus
d. DefiningnthenproblemnANS:nB
Usingnstereotypedncommentsnornclichsncannblockneffectivencommunication.nAfternthennursenusesnsu
chntritenphrases,nparentsnoftenndonnotnrespond.nSilencencannbenanneffectiveninterviewingntool.nSilen
cenpermitsnthenintervieweentonsortnoutnthoughtsnandnfeelingsnandnsearchnfornresponsesntonquestions.
n Tonbeneffective,nthennursenmustnbenablentondirectnthenfocusnofntheninterviewnwhilenallowingnmaxim
umnfreedomnofnexpression.nBynusingnopen-
endednquestionsnandnguidingnquestions,nthennursencannobtainnthennecessaryninformationnandnmaint
ainnanrelationshipnwithnthe


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family.nThennursenandnparentnmustncollaboratenandndefinenthenproblemnthatnwillnbenthenfocusnofnthen
nursingnintervention.
3. Whichnisnthensinglenmostnimportantnfactorntonconsidernwhenncommunicatingnwithnc
hildren?
a. Presencenofnthenchildsnparent
b. Childsnphysicalncondition
c. Childsndevelopmentalnlevel


d. ChildsnnonverbalnbehaviorsnANS:nC
Thennursenmustnbenawarenofnthenchildsndevelopmentalnstagentonengageninneffectivencommunication.n
Thenusenofnbothnverbalnandnnonverbalncommunicationnshouldnbenappropriatentonthendevelopmentaln
level.nNonverbalnbehaviorsnvaryninnimportancenbasednonnthenchildsndevelopmentalnlevelnandnphysic
alncondition.nAlthoughnthenchildsnphysicalnconditionnisnanconsideration,ndevelopmentalnlevelnisnmuc
hnmorenimportant.nThenpresencenofnparentsnisnimportantnwhenncommunicatingnwithnyoungnchildrenn
butnmaynbendetrimentalnwhennspeakingnwithnadolescents.
4. Becausenchildrennyoungernthann5nyearsnarenegocentric,nthennursenshouldndonwhichnwhennc
ommunicatingnwithnthem?
a. Focusncommunicationnonnthenchild.
b. Useneasynanalogiesnwhennpossible.
c. Explainnexperiencesnofnothersntonthenchild.
d. Assurenthenchildnthatncommunicationnisnprivate.nANS:nA
Becausenchildrennofnthisnagenarenablentonseenthingsnonlyninntermsnofnthemselves,nthenbestnapproachnis
tonfocusncommunicationndirectlynonnthem.nChildrennshouldnbenprovidednwithninformationnaboutnwh
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atntheyncanndonandnhowntheynwillnfeel.nWithnchildrennwhonarenegocentric,nanalogies,nexperiences,na
ndnassurancesnthatncommunicationnisnprivatenwillnnotnbeneffectivenbecausenthenchildnisnnotncapableno
fnunderstanding.
5. Thennursesnapproachnwhennintroducingnhospitalnequipmentntonanpreschoolernwhonseemsna
fraidnshouldnbenbasednonnwhichnprinciple?
a. Thenchildnmaynthinknthenequipmentnisnalive.
b. Explainingnthenequipmentnwillnonlynincreasenthenchildsnfear.



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c. Onenbriefnexplanationnwillnbenenoughntonreducenthenchildsnfear.
d. Thenchildnisntoonyoungntonunderstandnwhatnthenequipmentndoes.nANS:nA
Youngnchildrennattributenhumanncharacteristicsntoninanimatenobjects.nTheynoftennfearnthatnthenobjec
tsnmaynjump,nbite,ncut,nornpinchnallnbynthemselvesnwithoutnhumanndirection.nEquipmentnshouldnbenk
eptnoutnofnsightnuntilnneeded.nSimple,nconcretenexplanationsnaboutnwhatnthenequipmentndoesnandnho
wnitnwillnfeelnwillnhelpnalleviatenthenchildsnfear.nPreschoolersnneednrepeatednexplanationsnasnreassur
ance.
6. Whennthennurseninterviewsnannadolescent,nwhichnisnespeciallynimportant?
a. Focusnthendiscussionnonnthenpeerngroup.
b. Allownannopportunityntonexpressnfeelings.
c. Usenthensamentypenofnlanguagenasnthenadolescent.
d. Emphasizenthatnconfidentialitynwillnalwaysnbenmaintained.nANS:nB
Adolescents,nlikenallnchildren,nneednopportunitiesntonexpressntheirnfeelings.nOftenntheyninterjectnfee
lingsnintontheirnwords.nThennursenmustnbenalertntonthenwordsnandnfeelingsnexpressed.nThennursensho
uldnmaintainnanprofessionalnrelationshipnwithnadolescents.nTonavoidnmisunderstandingnornmisinter
pretationnofnwordsnandnphrasesnused,nthennursenshouldnclarifynthentermsnused,nwhatninformationnwi
llnbensharednwithnothernmembersnofnthenhealthncarenteam,nandnanynlimitsntonconfidentiality.nAlthou
ghnthenpeerngroupnisnimportantntonthisnagengroup,ntheninterviewnshouldnfocusnonnthenadolescent.
7. Thennursenisnpreparingntonassessnan10-month-
oldninfant.nHenisnsittingnonnhisnfathersnlapnandnappearsntonbenafraidnofnthennursenandnofnwhatnmightnh
appennnext.nWhichninitialnactionsnbynthennursenshouldnbenmostnappropriate?
a. Initiatenangamenofnpeek-a-boo.
b. Askntheninfantsnfatherntonplacentheninfantnonnthenexaminationntable.
c. Talknsoftlyntontheninfantnwhilentakingnhimnfromnhisnfather.
d. Undressntheninfantnwhilenhenisnstillnsittingnonnhisnfathersnlap.nANS:nA
Peek-a-
boonisnannexcellentnmeansnofninitiatingncommunicationnwithninfantsnwhilenmaintainingnansafe,nnonth
reateningndistance.nThenchildnwillnmostnlikelynbecomenupsetnifnseparatednfromnhisnfather.nAsnmuchn
ofnthenassessmentnasnpossiblenshouldnbendonenwithnthenchildnonnthenfathersnlap.nThennursenshouldnha
venthenfathernundressnthenchildnasnneedednduringnthenexamination.



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8. Ann8-year-
oldngirlnasksnthennursenhownthenbloodnpressurenapparatusnworks.nThenmostnappropriatennursing
n actionnisnwhich?
a. Asknhernwhynshenwantsntonknow.
b. Determinenwhynshenisnsonanxious.
c. Explainninnsimplentermsnhownitnworks.
d. Tellnhernshenwillnseenhownitnworksnasnitnisnused.nANS:nC
School-
agenchildrennrequirenexplanationsnandnreasonsnforneverything.nTheynareninterestedninnthenfunctionaln
aspectnofnallnprocedures,nobjects,nandnactivities.nItnisnappropriatenfornthennursentonexplainnhownequip
mentnworksnandnwhatnwillnhappenntonthenchildnsonthatnthenchildncannthennobservenduringnthenprocedu
re.nThennursenshouldnrespondnpositivelynfornrequestsnforninformationnaboutnproceduresnandnhealthnin
formation.nBynnotnresponding,nthennursenmaynbenlimitingncommunicationnwithnthenchild.nThenchildn
isnnotnexhibitingnanxietyninnaskingnhownthenbloodnpressurenapparatusnworks,njustnrequestingnclarific
ationnofnwhatnwillnoccur.
9. Thennursenisnhavingndifficultyncommunicatingnwithnanhospitalizedn6-year-
oldnchild.nWhichntechniquenshouldnbenmostnhelpful?
a. Recommendnthatnthenchildnkeepnandiary.
b. Providensuppliesnfornthenchildntondrawnanpicture.
c. Suggestnthatnthenparentnreadnfairyntalesntonthenchild.
d. Asknthenparentnifnthenchildnisnalwaysnuncommunicative.nANS:nB
Drawingnisnonenofnthenmostnvaluablenformsnofncommunication.nChildrensndrawingsntellnangreatndeal
n aboutnthemnbecausentheynarenprojectionsnofnthenchildrensninnernself.nAndiarynshouldnbendifficultnforn
an6-year-
oldnchild,nwhonisnmostnlikelynlearningntonread.nThenparentnreadingnfairyntalesntonthenchildnisnanpassive
n activityninvolvingnthenparentnandnchild;nitnshouldnnotnfacilitatencommunicationnwithnthennurse.nThen
childnisninnanstressfulnsituationnandnisnprobablynuncomfortablenwithnstrangers,nnotnalwaysnuncommu
nicative.
10. Whichndatanshouldnbenincludedninnanhealthnhistory?
a. Reviewnofnsystems
b. Physicalnassessment
c. Growthnmeasurements
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