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, TEST BANK FOR PEDIATRIC PRIMARY CARE 5th
EDITION RICHARDSON
Chaptere1eObtainingeaneInitialeHistory
MULTIPLEeCHOICE
1. Theenurseeiseseeingeaneadolescenteandetheeparentseinetheecliniceforetheefirstetime.eWhicheshou
ldetheenurseedoefirst?
a. Introduceehim-eoreherself.
b. Makeetheefamilyecomfortable.
c. Giveeassuranceeofeprivacy.
d. Explainetheepurposeeofetheeinterview.
ANS:eA
Theefirstethingethatenursesemustedoeisetoeintroduceethemselvesetoetheepatienteandefamily.eParentse
andeothereadultseshouldebeeaddressedewitheappropriateetitleseunlessetheyespecifyeaepreferredenam
e.eClarificationeofetheepurposeeofetheeintervieweandetheenurseseroleeisetheesecondethingethateshoul
debeedone.eDuringetheeinitialeparteofetheeinterview,etheenurseeshouldeincludeegeneraleconversatio
netoehelpemakeetheefamilyefeeleateease.eTheeinterviewealsoeshouldetakeeplaceeineaneenvironmente
asefreeeofedistractioneasepossible.eIneaddition,etheenurseeshouldeclarifyewhicheinformationewillebe
esharedewitheotherememberseofetheehealthecareeteameandeanyelimitsetoetheeconfidentiality.
2. Whicheiseconsideredeaeblocketoeeffectiveecommunication?
a. Usingesilence
b. Usingeclichs
c. Directingetheefocus
d. Definingetheeproblem
ANS:eB
Usingestereotypedecommentseoreclichsecaneblockeeffectiveecommunication.eAfteretheenurseeuses
esuchetriteephrases,eparentseoftenedoenoterespond.eSilenceecanebeeaneeffectiveeinterviewingetool.e
Silenceepermitsetheeintervieweeetoesorteoutethoughtseandefeelingseandesearcheforeresponsesetoeq
uestions.eToebeeeffective,etheenurseemustebeeableetoedirectetheefocuseofetheeinterviewewhileeallo
wingemaximumefreedomeofeexpression.eByeusingeopen-
endedequestionseandeguidingequestions,etheenurseecaneobtainetheenecessaryeinformationeandemai
ntaineaerelationshipewithetheefamily.eTheenurseeandeparentemustecollaborateeandedefineetheeprob
lemethatewillebeetheefocuseofetheenursingeintervention.
3. Whicheisetheesingleemosteimportantefactoretoeconsiderewhenecommunicatingewithechildren?
a. Presenceeofetheechildseparent
b. Childsephysicalecondition
c. Childsedevelopmentalelevel
d. Childsenonverbalebehaviors
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,ANS:eC
Theenurseemustebeeawareeofetheechildsedevelopmentalestageetoeengageeineeffectiveecommunicati
on.eTheeuseeofebotheverbaleandenonverbalecommunicationeshouldebeeappropriateetoetheedevelop
mentalelevel.eNonverbalebehaviorsevaryeineimportanceebasedeonetheechildsedevelopmentalelevele
andephysicalecondition.eAlthoughetheechildsephysicaleconditioneiseaeconsideration,edevelopment
aleleveleisemuchemoreeimportant.eTheepresenceeofeparentseiseimportantewhenecommunicatingewit
heyoungechildrenebutemayebeedetrimentalewhenespeakingewitheadolescents.
4. Becauseechildreneyoungerethane5eyearseareeegocentric,etheenurseeshouldedoewhichewhe
necommunicatingewithethem?
a. Focusecommunicationeonetheechild.
b. Useeeasyeanalogiesewhenepossible.
c. Explaineexperienceseofeothersetoetheechild.
d. Assureetheechildethatecommunicationeiseprivate.
ANS:eA
Becauseechildreneofethiseageeareeableetoeseeethingseonlyeinetermseofethemselves,etheebesteapproac
heisetoefocusecommunicationedirectlyeonethem.eChildreneshouldebeeprovidedewitheinformationeab
outewhatetheyecanedoeandehowetheyewillefeel.eWithechildrenewhoeareeegocentric,eanalogies,eexpe
riences,eandeassurancesethatecommunicationeiseprivateewillenotebeeeffectiveebecauseetheechildeise
notecapableeofeunderstanding.
5. Theenurseseapproachewheneintroducingehospitaleequipmentetoeaepreschoolerewhoeseemseafrai
deshouldebeebasedeonewhicheprinciple?
a. Theechildemayethinketheeequipmenteisealive.
b. Explainingetheeequipmentewilleonlyeincreaseetheechildsefear.
c. Oneebriefeexplanationewillebeeenoughetoereduceetheechildsefear.
d. Theechildeisetooeyoungetoeunderstandewhatetheeequipmentedoes.
ANS:eA
Youngechildreneattributeehumanecharacteristicsetoeinanimateeobjects.eTheyeoftenefearethatetheeob
jectsemayejump,ebite,ecut,eorepincheallebyethemselvesewithoutehumanedirection.eEquipmenteshoul
debeekepteouteofesighteuntileneeded.eSimple,econcreteeexplanationseaboutewhatetheeequipmentedo
eseandehoweitewillefeelewillehelpealleviateetheechildsefear.ePreschoolerseneederepeatedeexplanatio
nseasereassurance.
6. Whenetheenurseeinterviewseaneadolescent,ewhicheiseespeciallyeimportant?
a. Focusetheediscussioneonetheepeeregroup.
b. Alloweaneopportunityetoeexpressefeelings.
c. Useetheesameetypeeofelanguageeasetheeadolescent.
d. Emphasizeethateconfidentialityewillealwaysebeemaintained.
ANS:eB
Adolescents,elikeeallechildren,eneedeopportunitiesetoeexpressetheirefeelings.eOftenetheyeinterjectef
eelingseintoetheirewords.eTheenurseemustebeealertetoetheewordseandefeelingseexpressed.eTheenurse
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, shouldemaintaineaeprofessionalerelationshipewitheadolescents.eToeavoidemisunderstandingeoremi
sinterpretationeofewordseandephraseseused,etheenurseeshouldeclarifyetheetermseused,ewhateinform
ationewillebeesharedewitheotherememberseofetheehealthecareeteam,eandeanyelimitsetoeconfidential
ity.eAlthoughetheepeeregroupeiseimportantetoethiseageegroup,etheeintervieweshouldefocuseonetheea
dolescent.
7. Theenurseeisepreparingetoeassesseae10-month-
oldeinfant.eHeeisesittingeonehisefatherselapeandeappearsetoebeeafraideofetheenurseeandeofewhat
emightehappenenext.eWhicheinitialeactionsebyetheenurseeshouldebeemosteappropriate?
a. Initiateeaegameeofepeek-a-boo.
b. Asketheeinfantsefatheretoeplaceetheeinfanteonetheeexaminationetable.
c. Talkesoftlyetoetheeinfantewhileetakingehimefromehisefather.
d. Undressetheeinfantewhileeheeisestillesittingeonehisefatherselap.
ANS:eA
Peek-a-
booeiseaneexcellentemeanseofeinitiatingecommunicationewitheinfantsewhileemaintainingeaesafe,eno
nthreateningedistance.eTheechildewillemostelikelyebecomeeupseteifeseparatedefromehisefather.eAse
mucheofetheeassessmenteasepossibleeshouldebeedoneewithetheechildeonetheefatherselap.eTheenursee
shouldehaveetheefathereundressetheechildeaseneedededuringetheeexamination.
8. Ane8-year-
oldegirleasksetheenurseehowetheebloodepressureeapparatuseworks.eTheemosteappropriate
enursingeactioneisewhich?
a. Askeherewhyesheewantsetoeknow.
b. Determineewhyesheeisesoeanxious.
c. Explaineinesimpleetermsehoweiteworks.
d. Telleheresheewilleseeehoweiteworkseaseiteiseused.
ANS:eC
School-
ageechildrenerequireeexplanationseandereasonseforeeverything.eTheyeareeinterestedeinetheefunctio
naleaspecteofealleprocedures,eobjects,eandeactivities.eIteiseappropriateeforetheenurseetoeexplaineho
weequipmenteworkseandewhatewillehappenetoetheechildesoethatetheechildecanetheneobserveedurin
getheeprocedure.eTheenurseeshoulderespondepositivelyeforerequestseforeinformationeabouteproced
ureseandehealtheinformation.eByenoteresponding,etheenurseemayebeelimitingecommunicationewit
hetheechild.eTheechildeisenoteexhibitingeanxietyeineaskingehowetheebloodepressureeapparatusewor
ks,ejusterequestingeclarificationeofewhatewilleoccur.
9. Theenurseeisehavingedifficultyecommunicatingewitheaehospitalizede6-year-
oldechild.eWhichetechniqueeshouldebeemostehelpful?
a. Recommendethatetheechildekeepeaediary.
b. Provideesupplieseforetheechildetoedraweaepicture.
c. Suggestethatetheeparentereadefairyetalesetoetheechild.
d. Asketheeparenteifetheechildeisealwayseuncommunicative.
ANS:eB
Drawingeiseoneeofetheemostevaluableeformseofecommunication.eChildrensedrawingsetelleaegreated
ealeaboutethemebecauseetheyeareeprojectionseofetheechildrenseinnereself.eAediaryeshouldebeediffic
ulteforeae6-year-
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, TEST BANK FOR PEDIATRIC PRIMARY CARE 5th
EDITION RICHARDSON
Chaptere1eObtainingeaneInitialeHistory
MULTIPLEeCHOICE
1. Theenurseeiseseeingeaneadolescenteandetheeparentseinetheecliniceforetheefirstetime.eWhicheshou
ldetheenurseedoefirst?
a. Introduceehim-eoreherself.
b. Makeetheefamilyecomfortable.
c. Giveeassuranceeofeprivacy.
d. Explainetheepurposeeofetheeinterview.
ANS:eA
Theefirstethingethatenursesemustedoeisetoeintroduceethemselvesetoetheepatienteandefamily.eParentse
andeothereadultseshouldebeeaddressedewitheappropriateetitleseunlessetheyespecifyeaepreferredenam
e.eClarificationeofetheepurposeeofetheeintervieweandetheenurseseroleeisetheesecondethingethateshoul
debeedone.eDuringetheeinitialeparteofetheeinterview,etheenurseeshouldeincludeegeneraleconversatio
netoehelpemakeetheefamilyefeeleateease.eTheeinterviewealsoeshouldetakeeplaceeineaneenvironmente
asefreeeofedistractioneasepossible.eIneaddition,etheenurseeshouldeclarifyewhicheinformationewillebe
esharedewitheotherememberseofetheehealthecareeteameandeanyelimitsetoetheeconfidentiality.
2. Whicheiseconsideredeaeblocketoeeffectiveecommunication?
a. Usingesilence
b. Usingeclichs
c. Directingetheefocus
d. Definingetheeproblem
ANS:eB
Usingestereotypedecommentseoreclichsecaneblockeeffectiveecommunication.eAfteretheenurseeuses
esuchetriteephrases,eparentseoftenedoenoterespond.eSilenceecanebeeaneeffectiveeinterviewingetool.e
Silenceepermitsetheeintervieweeetoesorteoutethoughtseandefeelingseandesearcheforeresponsesetoeq
uestions.eToebeeeffective,etheenurseemustebeeableetoedirectetheefocuseofetheeinterviewewhileeallo
wingemaximumefreedomeofeexpression.eByeusingeopen-
endedequestionseandeguidingequestions,etheenurseecaneobtainetheenecessaryeinformationeandemai
ntaineaerelationshipewithetheefamily.eTheenurseeandeparentemustecollaborateeandedefineetheeprob
lemethatewillebeetheefocuseofetheenursingeintervention.
3. Whicheisetheesingleemosteimportantefactoretoeconsiderewhenecommunicatingewithechildren?
a. Presenceeofetheechildseparent
b. Childsephysicalecondition
c. Childsedevelopmentalelevel
d. Childsenonverbalebehaviors
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,ANS:eC
Theenurseemustebeeawareeofetheechildsedevelopmentalestageetoeengageeineeffectiveecommunicati
on.eTheeuseeofebotheverbaleandenonverbalecommunicationeshouldebeeappropriateetoetheedevelop
mentalelevel.eNonverbalebehaviorsevaryeineimportanceebasedeonetheechildsedevelopmentalelevele
andephysicalecondition.eAlthoughetheechildsephysicaleconditioneiseaeconsideration,edevelopment
aleleveleisemuchemoreeimportant.eTheepresenceeofeparentseiseimportantewhenecommunicatingewit
heyoungechildrenebutemayebeedetrimentalewhenespeakingewitheadolescents.
4. Becauseechildreneyoungerethane5eyearseareeegocentric,etheenurseeshouldedoewhichewhe
necommunicatingewithethem?
a. Focusecommunicationeonetheechild.
b. Useeeasyeanalogiesewhenepossible.
c. Explaineexperienceseofeothersetoetheechild.
d. Assureetheechildethatecommunicationeiseprivate.
ANS:eA
Becauseechildreneofethiseageeareeableetoeseeethingseonlyeinetermseofethemselves,etheebesteapproac
heisetoefocusecommunicationedirectlyeonethem.eChildreneshouldebeeprovidedewitheinformationeab
outewhatetheyecanedoeandehowetheyewillefeel.eWithechildrenewhoeareeegocentric,eanalogies,eexpe
riences,eandeassurancesethatecommunicationeiseprivateewillenotebeeeffectiveebecauseetheechildeise
notecapableeofeunderstanding.
5. Theenurseseapproachewheneintroducingehospitaleequipmentetoeaepreschoolerewhoeseemseafrai
deshouldebeebasedeonewhicheprinciple?
a. Theechildemayethinketheeequipmenteisealive.
b. Explainingetheeequipmentewilleonlyeincreaseetheechildsefear.
c. Oneebriefeexplanationewillebeeenoughetoereduceetheechildsefear.
d. Theechildeisetooeyoungetoeunderstandewhatetheeequipmentedoes.
ANS:eA
Youngechildreneattributeehumanecharacteristicsetoeinanimateeobjects.eTheyeoftenefearethatetheeob
jectsemayejump,ebite,ecut,eorepincheallebyethemselvesewithoutehumanedirection.eEquipmenteshoul
debeekepteouteofesighteuntileneeded.eSimple,econcreteeexplanationseaboutewhatetheeequipmentedo
eseandehoweitewillefeelewillehelpealleviateetheechildsefear.ePreschoolerseneederepeatedeexplanatio
nseasereassurance.
6. Whenetheenurseeinterviewseaneadolescent,ewhicheiseespeciallyeimportant?
a. Focusetheediscussioneonetheepeeregroup.
b. Alloweaneopportunityetoeexpressefeelings.
c. Useetheesameetypeeofelanguageeasetheeadolescent.
d. Emphasizeethateconfidentialityewillealwaysebeemaintained.
ANS:eB
Adolescents,elikeeallechildren,eneedeopportunitiesetoeexpressetheirefeelings.eOftenetheyeinterjectef
eelingseintoetheirewords.eTheenurseemustebeealertetoetheewordseandefeelingseexpressed.eTheenurse
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, shouldemaintaineaeprofessionalerelationshipewitheadolescents.eToeavoidemisunderstandingeoremi
sinterpretationeofewordseandephraseseused,etheenurseeshouldeclarifyetheetermseused,ewhateinform
ationewillebeesharedewitheotherememberseofetheehealthecareeteam,eandeanyelimitsetoeconfidential
ity.eAlthoughetheepeeregroupeiseimportantetoethiseageegroup,etheeintervieweshouldefocuseonetheea
dolescent.
7. Theenurseeisepreparingetoeassesseae10-month-
oldeinfant.eHeeisesittingeonehisefatherselapeandeappearsetoebeeafraideofetheenurseeandeofewhat
emightehappenenext.eWhicheinitialeactionsebyetheenurseeshouldebeemosteappropriate?
a. Initiateeaegameeofepeek-a-boo.
b. Asketheeinfantsefatheretoeplaceetheeinfanteonetheeexaminationetable.
c. Talkesoftlyetoetheeinfantewhileetakingehimefromehisefather.
d. Undressetheeinfantewhileeheeisestillesittingeonehisefatherselap.
ANS:eA
Peek-a-
booeiseaneexcellentemeanseofeinitiatingecommunicationewitheinfantsewhileemaintainingeaesafe,eno
nthreateningedistance.eTheechildewillemostelikelyebecomeeupseteifeseparatedefromehisefather.eAse
mucheofetheeassessmenteasepossibleeshouldebeedoneewithetheechildeonetheefatherselap.eTheenursee
shouldehaveetheefathereundressetheechildeaseneedededuringetheeexamination.
8. Ane8-year-
oldegirleasksetheenurseehowetheebloodepressureeapparatuseworks.eTheemosteappropriate
enursingeactioneisewhich?
a. Askeherewhyesheewantsetoeknow.
b. Determineewhyesheeisesoeanxious.
c. Explaineinesimpleetermsehoweiteworks.
d. Telleheresheewilleseeehoweiteworkseaseiteiseused.
ANS:eC
School-
ageechildrenerequireeexplanationseandereasonseforeeverything.eTheyeareeinterestedeinetheefunctio
naleaspecteofealleprocedures,eobjects,eandeactivities.eIteiseappropriateeforetheenurseetoeexplaineho
weequipmenteworkseandewhatewillehappenetoetheechildesoethatetheechildecanetheneobserveedurin
getheeprocedure.eTheenurseeshoulderespondepositivelyeforerequestseforeinformationeabouteproced
ureseandehealtheinformation.eByenoteresponding,etheenurseemayebeelimitingecommunicationewit
hetheechild.eTheechildeisenoteexhibitingeanxietyeineaskingehowetheebloodepressureeapparatusewor
ks,ejusterequestingeclarificationeofewhatewilleoccur.
9. Theenurseeisehavingedifficultyecommunicatingewitheaehospitalizede6-year-
oldechild.eWhichetechniqueeshouldebeemostehelpful?
a. Recommendethatetheechildekeepeaediary.
b. Provideesupplieseforetheechildetoedraweaepicture.
c. Suggestethatetheeparentereadefairyetalesetoetheechild.
d. Asketheeparenteifetheechildeisealwayseuncommunicative.
ANS:eB
Drawingeiseoneeofetheemostevaluableeformseofecommunication.eChildrensedrawingsetelleaegreated
ealeaboutethemebecauseetheyeareeprojectionseofetheechildrenseinnereself.eAediaryeshouldebeediffic
ulteforeae6-year-
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