HR II EXAM 1: ch 30

The father of a child hospitalized after a fire questions the use of therapeutic play. He reports he does not understand the purpose. What information can be provided to him?

This type of play gives the child an outlet to deal with stress.

The nurse is educating an 8-year-old client newly diagnosed with type 1 diabetes on how to administer insulin. Which finding best indicates the nurse's education was successful?

The child demonstrates good technique in self-injection of insulin.

The nurse is having trouble communicating with a hospitalized child. Which communication technique would be the most beneficial for the nurse to offer the child?

drawing pictures

The nurse is teaching a 15-year-old boy with type 2 diabetes and his parents how to monitor glucose levels. Which communication technique is least effective?

ignoring the adolescent's tirade about his therapy

The nurse is caring for a 14-year-old girl with terminal cancer and her family. Which intervention provides the best therapeutic communication?

informing the child in terms she can understand

The nurse is preparing to reduce a young parent's anxiety about a child needing hospitalization. Which action should the nurse prioritize?

Include the parent in the medical decision-making.

A parent wants to wait outside the room while a procedure is completed on his young child, saying, "I don't think I can stand to see you do this!" The nurse's best response is:

"Certainly. I will stay with your child during the procedure."

Nursing students are learning about the importance of therapeutic communication in their pediatric course. The nursing instructor identifies a need for further teaching when a student makes which statement?

"It is best to stand when listening to a child to demonstrate knowledge." Good listening is not passive but active. Posture reveals greatly whether one is listening. Sitting, not standing, means the nurse is actively listening and interested in what the child has to say. Leaning forward, not backward, displays interest in the child and conveys an openness. The nurse can convey good listening habits by pulling up a chair to the bedside or to a table when the child is sitting and engaging with the child at the same level.

A nurse is providing teaching on safety to a group of parents whose children are diagnosed with hemophilia. Which statement made by a parent requires follow-up by the nurse?

"Our child always wears a helmet and body padding when playing football."

The nurse is caring for a 7-year-old child scheduled for a tonsillectomy the next day. The client states, "I really wish I was not having surgery tomorrow. I am not excited about this. Maybe I will be better by tomorrow." Which response by the nurse is most appropriate?

"You sound worried. Let's talk about tomorrow."

The nurse is educating a 4-year-old child about what to expect during an upcoming procedure. Which statement(s) is appropriate for the nurse to use? Select all that apply.

-"This little tube will go in your nose and down into your belly." -"When they come to get you, you will get on a special rolling bed." -"They are going to give you some special medicine to help the doctor see what is happening inside your belly."

A 4-year-old adopted child has begun to ask questions about when she was born. Which suggestions by the clinic nurse would be considered the most appropriate answer for this child related to her birth? Select all that apply.

-Explain to the child that she grew inside another woman, but after the birth she was given to her adoptive mom and dad to raise. -Avoid criticizing the biological parents but reinforce how much the adoptive mom and dad love them.

During the change of shift report, the nurse reports concerns about the parents of a hospitalized child understanding the written literature provided concerning the child's plan of treatment. Which observations would provide support to this concern? Select all that apply.

-The child's mother provides little responses to information provided. -The child's medical record contains information indicating the family frequently misses appointments. -The child's mother asks the nurse to complete paperwork for her.

A child is hospitalized with complications related to hemophilia. The health care provider has discussed the child's plan of care with the parents, but they continue to ask questions. What action will the nurse take?

Answer the parents' questions as completely as possible.

A parent brings a toddler to the clinic for treatment of a possible ear infection. How will the nurse communicate effectively with this child?

Approach the toddler while the toddler is being held by the parent.

The nurse is caring for a hospitalized child who is from another country who is well spoken in the dominant language. What is the best means for the nurse to determine any unique cultural needs of the family during the child's hospitalization?

Ask the child and family about preferences.

The nurse is caring for a child who appears fearful and is reluctant to talk. The nurse uses therapeutic communication skills to interact with the child. What initial goal does the nurse accomplish when using these skills to communicate with the child?

Assess the perception of the problem.

The nurse is caring for a parent of a 10-month-old infant. The parent is upset and states, "I have so many questions, but the doctor seems too busy to answer my questions." What is the best action by the nurse?

Assist the parent in preparing a list of questions for the health care provider's next visit.

The nurse is explaining the differences of language development in children. Which example would be appropriate for the nurse to include in the explanation?

Boys raised with older sisters are slower to develop language skills than their siblings.

A 6-year-old reports pain in the stomach upon eating. The nurse replies, "Let me see if I have this right. Every time you eat anything, you get a pain in your tummy?" The nurse is using which technique of therapeutic communication?

Clarifying

The nurse is preparing to teach a 9-year-old child how to do active range-of-motion exercises. Which technique would be most appropriate to use?

Demonstrate the technique by performing it the same way each time.

A 6-year-old child who does not speak the dominant language is in the hospital for an appendectomy. It is late at night when the nurse needs to catheterize the child for a distended bladder. Which action by the nurse would be most helpful in relaying this information?

Draw a picture of the procedure using an anatomically correct figure.

The nurse is providing care for a 2-year-old girl with a chronic respiratory disease present since birth. Which of the following would be of least help in working effectively with the parents?

Expect parents to perform procedures precisely as taught. Parents often modify procedures to better suit the child/family situation and routine. Parents are not new to this child's care—they have been managing it since birth. However, it is essential that safe physical and psychosocial conditions are maintained. Parents often devise creative approaches to the child's care from which nurses can learn. The other strategies are sound and support a good nurse-family-child working relationship.

A nurse is providing care for a child diagnosed with beta-thalassemia major, and is preparing the family for discharge. The nurse notes that the family is overwhelmed with the challenges of their child's diagnosis. What is the best way for the nurse to ensure that the family is supported after discharge?

Have the case manager meet with the family prior to discharge.

A 10-year-old child with sickle-cell anemia is frequently in the pediatric center of a hospital. What intervention can the nurse provide that will allow the child the sense of control that meets the goals promotes atraumatic care?

Maintain the child's home routine related to activities of daily living.

A home care nurse is teaching a parent how to administer a clotting factor infusion to their child. How can the nurse best evaluate the effectiveness of the teaching?

Observe the parent set up and administer the infusion.

A 9-year-old child with rheumatoid arthritis has difficulty moving the hands as well as other joints due to pain. The child refuses to participate in the prescribed physical therapy. What would be the best way for the nurse to make sure the child continues to exercise the joints?

Play a game like "Simon Says" to introduce exercises.

The nurse is teaching the parents of a newborn with a metabolic problem about the disorder and its treatment. What is the least effective teaching technique?

Provide literature for the parents to read and then have them ask questions.

A nursing instructor is teaching a class about the basic functions of families. The instructor determines the class is successful when the students correctly choose which statement as a basic function of the family?

Reproduction remains an important function of many families.

A nurse is assigned to care for a 6-month-old infant hospitalized with diarrhea and dehydration. Because the infant does not have developed speech, what can the nurse do to communicate with the infant?

Sing to the infant.

A nurse is talking with a school-age child with asthma who expresses concerns that peers will not want to be friends because of the disease. What therapeutic communication technique would be beneficial for the nurse to use?

Sit at the child's level and allow the child time for self-expression.

A 15-year-old client with type 1 diabetes has been noncompliant with the dietary regimen. When educating the adolescent, what is the most important thing the nurse can do to allow the adolescent to be in control and involved in the decision-making process?

Speak directly to the adolescent and consider the client's input in the decisions about care and education.

An 8-year-old child is scheduled to have a tonsillectomy and adenoidectomy in 2 weeks. What intervention can the nurse provide to help the child and family adjust to the hospitalization?

Take the child on a tour of the facility and surgical suite and explain what to expect preoperatively and postoperatively. Nurses can help children cope with the experience by using age-appropriate and child-specific interventions. Preparation can help children and their families to adjust to illness and hospitalization. Preparing the child reduces stress and fear. As much as possible, the nurse or child life specialist can show the child the areas where the child will have surgery, play with age-appropriate dolls to learn such things as IV insertion, and answer all the child's questions. Telling the child the parents will not be able to see him or her increases fear and anxiety. Being able to have a popsicle after surgery is the truth, but it is not the entire truth nor does it prepare the child for unknown places. The purpose of prehospital preparation is not to interview the child but to prepare the child.

A nurse is teaching a 6-year-old child and parents about an outpatient surgical procedure the child will have the next day. The child is "shy" and does not maintain eye contact with the nurse. What is the best way for the nurse to approach the child?

Talk to the parents first to give the child a chance to "warm up."

The nurse is assessing the teaching needs of the parents of an 8-year-old boy with leukemia. Which assessment should the nurse explore as a potential issue with the parent's health literacy?

The parents missed the last scheduled appointment.

A recently licensed nurse asked the charge nurse what it means to provide atraumatic care to hospitalized children. Which response by the charge nurse would be accurate?

The underlying premise refers to the concept of "do no harm."

The nurse is educating the family of a 2-year-old boy with bronchiolitis about the disorder and its treatment. The family parents speak only Chinese. Which action, involving an interpreter, can jeopardize the family's trust?

asking the interpreter questions not meant for the family

A nurse is caring for a small child with leukemia who will be hospitalized frequently for chemotherapy. What type of referral can the nurse make that will help the child and family through this time?

child life specialist

A nurse is preparing to teach an 8-year-old child recently diagnosed with diabetes how to give an insulin injection. Which is the best technique for the nurse to use?

demonstration

A preschool child fell off a tricycle and broke an arm that will require surgical repair. The nurse wants to prepare the child for surgery. Which is the best technique the nurse could use to teach the child about what to expect?

dolls Teaching preschool children about what to expect from a hospital experience is often taught using a series of puppets or dolls to represent different hospital personnel such as the surgeon, a nurse, and a nurse's assistant. Preschool children are particularly receptive to puppets and dolls because, with their imagination at its peak, they believe the puppet or doll is actually talking to them. Children can practice giving the doll "shots" or submitting it to procedures they will experience. Coloring, games, and demonstration can be helpful in many situations, but dolls allow the child to have a hands-on learning experience.

The nurse is caring for a 14-year-old boy who has just been diagnosed with a malignant tumor on his liver. Which intervention is most important to this child and family?

involving the child and family in decision-making Since the child has just been diagnosed, concerns about postoperative home care would be least important. Arranging an additional meeting with the specialist and discussing treatment options may be necessary at some point, but involving the child and family in decision-making is always a goal and is a part of family-centered care.

A 9-year-old child is newly diagnosed with asthma. The nurse plans to teach the child about triggers related to the diagnosis. What would be the best approach for this child?

play an allergy trivia game with the child Learning through play is a valuable tool at this age. School-age children like to participate in their learning. Watching a video is more passive rather than active. It does not give the child the chance to ask questions or get explanations about things in the video that were not understood. Giving the child a list of what he or she cannot have is a negative approach. Using a negative approach generally causes rejection, so the child will not follow through. Educating clients and their families is a large role of nursing.

A 5-year-old is obviously relieved yet angry following a procedure he resisted and needed to be restrained to complete. Which nursing action may be most helpful to this kindergartner?

providing Play-Doh for him to manipulate