Chapter 35 Communication PrepU

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? coloring games dolls demonstration

dolls

A nursing student is learning about teaching and how to evaluate is effectiveness. Which of the following statements made by the student identifies a need for further instruction? "Evaluation is done throughout the teaching process and as the final step." "Evaluation is done as a final step of teaching only." "Evaluation assesses whether the teaching has been effective." "Evaluation helps both the teacher and learner."

"Evaluation is done as a final step of teaching only."

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 good to sit, not stand when listening." "It is good to lean forward when listening." "It is best to stoop to a child's level when listening." "It is best to stand when listening to a child to demonstrate knowledge."

"It is best to stand when listening to a child to demonstrate knowledge."

The parents of a 2-month-old infant have learned that their infant has hemophilia. The parents are visibly upset and ask how this could have happened to them. What is the nurse's best response? "Please do not be upset; it is not your fault. Things like this happen sometimes." "There is no need to worry. We will teach you how to take care of your child." "I understand how you feel. Let's talk about where you go from here." "News like this is difficult to hear. Let's talk about what this means for your child."

"News like this is difficult to hear. Let's talk about what this means for your child."

A nurse is interviewing a 10-year-old client who is saying "My stomach has been hurting for several days and is worse when I drink milk." To clarify understanding of what the child is saying, which question will the nurse ask? "Can you tell me how much milk you drink at a time?" "Is milk a drink that you prefer to have with your meals?" "When did you begin to have difficulty with stomach aches after drinking milk?" "So do you think the stomach ache is worse after you drink milk?"

"So do you think the stomach ache is worse after you drink milk?"

Which statement by the nurse best encourages therapeutic communication from a school-aged child scheduled for surgery? "Are you worried about the surgical procedure?" "Tell me what you are worried about." "Talking with a nurse is helpful to answer your questions." "Is it the pain that concerns you the most?"

"Tell me what you are worried about."

Which statement by the nurse is most appropriate when preparing a 6-year-old child for a surgical procedure under general anesthesia? "There will be a special health care worker who will put you to sleep." "When given anesthesia, you will go to sleep just like you do every night." "When special medicine is given, it will cause a very good and different type of sleep." "Anesthesia will help you feel no pain during the appendectomy, which will make you feel better."

"When special medicine is given, it will cause a very good and different type of sleep."

A 13-year-old adolescent client begins to shout and uses profane language when the nurse enters the room to administer medications. Which is the best nursing action in response to the client's behavior? Gather the equipment and medication and leave until the behavior is appropriate. Follow through with medication administration without responding to the behavior. Acknowledge the anger in the language and set limits on the behavior. Notify the parents of the client's behavior and ask the parents to be present at all times.

Acknowledge the anger in the language and set limits on the behavior.

A nursing student learning pediatrics and the development of language correctly identifies the age when children are able to put together two-word (noun-verb) sentences to be: 9 months. 1 year. 2 years. 3 years.

2 years.

A nurse is preparing discharge instructions to the parent of a child diagnosed with beta thalassemia. The child will need to take subcutaneous deferoxamine. As the nurse begins the instruction, the parent says "This is all so overwhelming. Can we do this another time?" How should the nurse respond? Tell the parent that the teaching needs to be done now. Ask the parent what is concerning him or her. Convey understanding of the parent's feelings. Agree to come back later and discuss the parent's concerns.

Agree to come back later and discuss the parent's concerns.

The nurse notes a 2-year-old toddler with pneumonia is breathing shallow. Which method is best for the nurse to use to teach the toddler how to perform deep breathing exercises? Permit the toddler to run around in the playroom Tell the toddler he or she can have a treat if he or she breathes deeply Demonstrate to the toddler how to perform deep breathing Allow the toddler to blow bubbles in the room

Allow the toddler to blow bubbles in the room

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? Inform the child of priority problems. Assist the child to control emotions. Provide a plan of action. Assess the perception of the problem.

Assess the perception of the problem.

A nurse is demonstrating dressing changes for a 12-year-old child so that the child will be able to perform the skill when discharged. What is important for the nurse to do prior to demonstration? Write down all the steps so the child can follow along with the procedure. Be sure all necessary equipment is present to demonstrate the technique. Plan to take video of the session for the child to watch as needed later on. Obtain a picture of the wound for the child to see the progress of dressing changes.

Be sure all necessary equipment is present to demonstrate the technique.

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? Open-ended questions Reflecting Clarifying Perception checking

Clarifying

A 5-year-old girl tenses up when the nurse approaches to examine her. "Are you afraid?" the nurse asks her. The girl shakes her head in denial. As the nurse lifts the stethoscope to auscultate the girl's chest, however, the nurse notices that the girl tenses up again and grips the edge of the examination table tightly. "Oh—you are afraid of the stethoscope, aren't you?" the nurse replies. "It's okay—it doesn't hurt; see—reach out and touch it." Which communication technique is the nurse demonstrating here? Empathy Genuineness Warmth Attentive listening

Empathy

An emergency department nurse is caring for an 8-year-old client with a hearing impairment. The child is scared and having pain from a forearm burn. What is the best way for the nurse to communicate with the child? Stand at a slight elevation over the child and have the child look up at the nurse's face. Face directly in front of the child when speaking to allow following of lip movement. Be sure to touch the child to gain attention prior to speaking and use common gestures. Speak slowly and use exaggerated lip movements when speaking with the child.

Face directly in front of the child when speaking to allow following of lip movement.

The nurse is educating an adolescent, newly diagnosed with diabetes, on how to follow a diabetic diet. Which approach would be most effective? Give the client preplanned meals and have the client choose which one to try. Give choices and then allow the client to plan meals for the next couple days. Quiz the client on the sugar amount and nutritional value of foods. Encourage the client to obtain information from an interactive website for clients with diabetes.

Give choices and then allow the client to plan meals for the next couple days.

The nurse is trying to understand how a 10-year-old child feels about the treatment plan. Which nursing technique may be most beneficial? Have the child draw a picture. Get the child to write a song. Ask the parent to ask the child. Listen while the child is talking to a sibling.

Have the child draw a picture.

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? Ask the parent to repeat the instructions step-by-step. Make time for questions at the end of the teaching session. Give cues as needed while the parent sets up the infusion. Observe the parent set up and administer the infusion.

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? Give the client a coloring book about arthritis. Show a video about exercising. Play a game like "Simon Says" to introduce exercises. Give the client a pamphlet about the importance of exercise.

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

A 6-year-old child is learning how to draw insulin into a syringe and becomes frustrated, throwing themselves on the floor. What is the best action by the nurse? Provide positive reinforcement for steps achieved, ignoring the temper tantrum. Encourage the child to come back and provide written directions for guidance. Have the child re-demonstrate the skill to show that it can be done with practice. Teach the child ways to control frustrations and give a time-out for 6 minutes.

Provide positive reinforcement for steps achieved, ignoring the temper tantrum.

A nurse is providing teaching on the medication regimen for beta-thalassemia to an adolescent. What is the best way for the nurse to determine if the teaching was successful? Provide written materials to reinforce teaching. Ask the adolescent if the teaching was understood. Request that the adolescent teach the information to the nurse. Provide an opportunity for the adolescent to ask questions.

Request that the adolescent teach the information to the nurse.

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 child lists five foods to ingest when determining that blood glucose levels are too low. The parents of the child demonstrate good technique in administering insulin to their child. The child is able to draw the correct amount of insulin up in the syringe.

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

A nurse is caring for a 12-year-old child who is very demanding. Within 4 hours, the child has pressed a call light 12 times for multiple reasons. What does the nurse understand may be the reason for this child's demanding behavior? The child is spoiled at home and is continuing this behavior in the hospital. The child wants to be sure the nurse is doing what he or she is supposed to be doing. The child may be insecure or afraid. The child is expecting quality care from the nurse.

The child may be insecure or afraid.

The nurse is caring for a hospitalized preschool child and needs to hang IV fluids by the infusion pump. The nurse introduces the infusion pump to the child based on what developmental principle? The child may think the equipment causes the pain. The child is too young to for an explanation of the equipment. Explaining the equipment will only increase the child's fear. One explanation will be enough to reduce the child's fear.

The child may think the equipment causes the pain.

An adolescent comes to the clinic exploring options for birth control. In addition to instruction on birth control, the nurse provides a pamphlet about sexually transmitted infections (STIs). As the nurse is documenting the interactions of the visit, which documentation best identifies that the teaching has been effective? Birth control is obtained and an STI pamphlet is given; no further questions. The client states an understanding of when to use birth control and STI prevention. The client demonstrates effective use of a condom and names two methods to reduce the risk of STIs. The client states, "I will use birth control, which will decrease the risk of STIs. I am afraid of getting those."

The client demonstrates effective use of a condom and names two methods to reduce the risk of STIs.

The nurse is caring for a 7-year-old client who is newly diagnosed with diabetes. Which teaching strategy will be effective when teaching this client to check blood glucose levels? Use the demonstration/re-demonstration strategy. Provide a thorough lecture on the topic of blood glucose levels. Show the client the procedure by role modeling. Provide resources like books and pamphlets.

Use the demonstration/re-demonstration strategy.

The nurse is preparing a preschool-aged child for a planned hospitalization. Which teaching strategy will be most effective in preparing the child for the experience? a puppet show with doctor and nurse puppets a DVD having the various staff introduce themselves having the child color pictures of hospital staff an easy-to-read pamphlet with pictures of the hospital

a puppet show with doctor and nurse puppets

A nurse is teaching a young client about the importance of good nutrition for wound healing and incorporates a verbal discussion, a coloring sheet with pictures of foods, and an activity where the client arranges foods that would represent a nutritious meal for the client. Following the activity, the client states, "I will eat more protein from eggs and meats and take my vitamins so my wound will heal faster." The statement demonstrates the child has accomplished which type of learning? psychomotor cognitive affective concept-based

cognitive

A nurse is showing a 9-year-old a video about why insulin is needed. The nurse then plans to discuss a booklet with the child on the same topic after the video. Of what type of learning is this an example? cognitive learning psychomotor learning affective learning tactile learning

cognitive learning

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? role modeling video coloring book about diabetes demonstration

demonstration

A nurse is teaching an 11-year-old client how to apply a topical cream to the skin. Which method of teaching would be most appropriate for the nurse to use? demonstration video role-play discussion

demonstration

A nurse is talking to a mother concerned about her 5-year-old son. She informs the nurse that he eats only cereal and peanut butter every day and fears that he is not getting proper nutrition. The nurse reassures the mother that even though he is eating a limited variety of foods, he is likely getting enough nutrition. Which type of teaching is this nurse practicing? formal teaching informal teaching structured teaching systematic teaching

informal teaching

A 4-year-old child is scheduled for major abdominal surgery. Prior to the procedure, which teaching will the nurse provide regarding pain? information on expected pain and ways to alleviate pain use of deep breathing and coughing to relieve pain no instruction at this time, unless the child asks the role of a variety of pain-relieving methods

information on expected pain and ways to alleviate pain

When developing a teaching plan for a child, what must the nurse assess first? level of knowledge, ability to complete task, and motivation to learn motivation to learn, parental understanding, and ability to learn level of knowledge, interest in topic, and understanding of impact peer support, ability to stay focused, and motivation to learn

level of knowledge, ability to complete task, and motivation to learn

A nurse is teaching a 7-year-old what to expect during an upcoming tonsillectomy. In this situation related to teaching, which of the following is the encoder? client nurse information about the tonsillectomy the hospital

nurse

When the nurse is caring for various pediatric clients, which one may benefit the most from the use of drawings to elicit their feelings? preschool-aged child scheduled for surgery infant with a congenital heart defect adolescent suffering from alopecia adolescent who has witnessed a traumatic disaster

preschool-aged child scheduled for surgery

The child states, "I never want to be a nurse or a doctor." The nurse recognizes this statement as reflecting what level of communication? shared personal ideas and judgments cliché conversation fact reporting shared feelings

shared personal ideas and judgments

A 16-year-old girl confides in the nurse that her parents are difficult to deal with and that it stresses her out. The nurse responds by saying, "You think that's stressful, you should see some of the clients I have to deal with in here!" Which barrier to communication is this nurse demonstrating? topping up clichéd advice growing defensive showing disapproval

topping up

The nurse is communicating with a family about their child's illness. Which communication technique would be considered a block to effective communication with the family? using silence using clichés defining the problem clarifying

using clichés

Which is most likely to encourage parents to talk about their feelings related to the poor prognosis their child has been given? being sympathetic using direct questions using open-ended questions avoiding periods of silence

using open-ended questions