Peds Ch. 30 Prep-U I'm dead on the inside

The nurse is preparing a 4-year-old to go visit his older sibling in the pediatric intensive care unit (PICU). What teaching method would best help in this child's preparation?

dolls

The school-age child with a new colostomy will require teaching by the nurse to learn to care for the ostomy. In order for the nurse to teach the child effectively, what is most important for the nurse to know about the child?

learning style

A shy child acknowledges the nurse's care by nodding the head. To improve the nurse-client relationship, the nurse should use which intervention?

Do not require the child to speak.

When developing the plan of care to promote health for a client and family, what would the nurse focus on first?

Reinforcing family strengths

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."

The nurse suspects poor literacy skills in a child's family member when which statement is made?

"I forgot my glasses, so I'll read this when I get home and let you know if I have questions."

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.

What is the main benefit of effective therapeutic communication for the nurse-client relationship?

Helps develop trust between nurse and the child.

When planning to teach a toddler about coughing and deep breathing, which would be most effective?

Playing a game with coughing and breathing

The nurse is working with an interpreter to meet the health needs of a family with limited skills in the English language. Which action is not recommended?

Talking one-on-one with the interpreter at numerous points throughout the session with the

The nurse is preparing a hospitalized child for a lumbar puncture. The health care provider states the procedure will be performed in the child's hospital room. To advocate for the child, what should the nurse inform the health care provider?

"I will have the procedure prepared in the treatment room, so that the child may view the hospital room as safe and secure."

An adolescent who plays catcher on the baseball team begins shouting at the nurses, slams the doors, and refuses to talk to anyone after being given the news that the right arm will require surgery. Which response by the nurse would be the most appropriate in this situation?

"I understand you are angry, but please don't shout or slam doors."

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 clichés

Which is most likely to encourage parents to talk about their feelings related to the poor prognosis their child has been given?

using open-ended questions

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."

The nurse is explaining a diagnostic procedure to a 7-year-old girl before the procedure begins. Which statement by the nurse best utilizes the principles of atraumatic care?

"You will lie on a special bed that moves in the machine but you can still see out."

The nurse is educating a young child about what to expect during an upcoming procedure. Which statements are appropriate for the nurse to use? Select all that apply.

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

The nurse is providing discharge instructions to 12-year-old child and parents after the application of a fiberglass cast placed to manage a fracture of the humerus. What information should be included in the teaching provided? Select all that apply.

-Elevate the casted arm on a pillow today and tomorrow. -Wiggle the fingers throughout the day and evening. -Report any persistent numbness of the fingers.

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.

The nurse educator is providing a class to the nurses on how to communicate with children who have hearing impairments. What communication techniques should be taught in this class? Select all that apply.

-Face the child -Write out -Provide a sign language interpreter -Use pictures to communicate

The teaching session using pictures for a preschool child did not have an intended outcome. What way could the nurse modify the teaching session to best fit the child's developmental level? Select all that apply.

-Offer rewards as each step is learned. -Active participation by the preschooler.

The child life nurse practitioner has been assigned to assist the hospitalized child and the child's parents. Which interventions are appropriate for the child life specialist to perform? Select all that apply.

-Talking to the family about a scheduled diagnostic test -Showing the child where the pediatric play room is located -Speaking to the physician as the child's advocate

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.

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.

When teaching an adolescent about home care after hospitalization, what is most important for the nurse to do?

Allow opportunity for the adolescent to express feelings.

A nurse is preparing to administer medication to a preschooler. What can the nurse do to ensure communication with the child is effective?

Allow the child to choose between juice, water, or soda to take the medication.

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

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.

A family is anxious for information about the status of their ill infant. The parents do not understand English, but the 14-year-old daughter is competent in spoken and written English. The physician is present, but an interpreter is unavailable. The nurse should:

Coordinate physician and interpreter schedules and arrange an information-sharing session for later in the day.

What should be the first step in developing a teaching plan for a 9-year-old child who needs education about a gluten-free diet for the treatment of celiac disease?

Assessing the child's current level of understanding Explanation:

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

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 consistently the same each time.

An adolescent remarks rather sarcastically that she feels like a "lab rat." What is the priority nursing action?

Ensure information is shared with and decisions about care are made with the teen and not for the teen.

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

Expect parents to perform procedures precisely as taught.

The community health nurse is assessing a new client who reports he has recently moved to the area and is living with an aunt and her parents. The nurse determines this client resides in which type of family structure?

Extended

The nurse is providing tertiary care to a young, uninsured family who has a child with frequent seizures. Which action by the nurse would demonstrate tertiary care?

Finding a company to provide a helmet for the child to wear daily.

The nurse is teaching a 15-year-old boy with diabetes mellitus 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

A 7-year-old child who has recently immigrated with his family is brought to the school nurse because he refuses to eat lunch. Which response should the nurse prioritize?

Investigate for potential cultural issues.

The nurse is caring for a 14-year-old boy, and his parents, 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

The nurse is caring for a young pregnant couple who are members of an extended family. The nurse anticipates the greatest challenge for this family will involve which factor?

Limited amount of available resources

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 high-school nurse has noticed a trend in the reading ability of the freshman class. This high school is located in a poor, urban area where there is a high proportion of single mothers raising their children with minimal financial support. Young children many times do not have adult supervision with homework. The local school nurses discuss issues within the school area. Which suggestion by a high school nurse would be a realistic solution to the problem described in this scenario?

Organize a group of local high school students to begin a reading program in the grade school to increase interest in reading.

A school-aged child learns how to do range-of-motion exercises but has been unable to perform them the same from day to day. Which approach is best for the nurse to take to encourage compliance by the client?

Praise the client when noted performing the range-of-motion exercies

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 parent 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 all 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.

The nurse has worked diligently with an adolescent to meet his teaching-learning needs and make adaptations for managing his illness to suit his preferences and lifestyle. Even so, there is evidence of noncompliance. The nurse's interpretation is:

Some noncompliance should be expected due to the teen's desire for independence, expression of his personal values, and peer acceptance.

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.

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."

An urgent care nurse is cleaning a forehead laceration on a 7-year-old. The mother is present. The child is crying and screaming. The nurse should:

Tell the child, "It's OK to cry, but I need you to hold still."

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 may be insecure or afraid.

The nurse is teaching injection techniques to a school-aged child newly diagnosed with type 1 diabetes. Which observation would be the best evaluation that learning was successful?

The child needs occasional cuing during return demonstration of the injection technique.

An 5-year-old adoptive child has been injured on the playground and will require orthopedic surgery. The nurses encourage the parents to stay with the child as much as possible while the child is in the hospital based on which potential reason?

They may be afraid they are going to be given back to the foster-care system.

A nurse is preparing to start an intravenous (IV) line in a child with severe pneumonia. The nervous child asks the nurse to wait until later to do the procedure. What is the best option for the nurse?

Use a firm, positive, confident approach when starting the IV.

During assessment for a child with cystic fibrosis who is new to the practice, the nurse notes that the father keeps asking about costs and if there is a "cheaper" way of providing the care that the child needs without compromising health. For example, insteading of buying prepackaged normal saline for breathing treatments, he asks if they can boil water (and containers with lids) and add the salt to the water in proper portions. When documenting this assessment, the nurse would identify the father as playing which role in the family based on the aforementioned questions?

allocation of resources

A mother rooming-in with her 10-month-old infant appears upset following the visit of a consultant physician. The mother has questions but states, "The doctor is always so busy." The nurse will:

assist the mother in preparing a list of questions for the physician's next visit.

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

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

During a home visit from a "Parents as Teachers" leader, the leader notes the mom is enforcing "time out" when the preschool child breaks a rule. The mother is responsible for establishing rules and work assignments based on the child's age. When documenting the family assessment visit, the leader would identify the mother as fulfilling which family role?

maintenance of order

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

A couple is arguing and bickering all the time. This couple has not told the children yet that they are planning to get a divorce. When the couple discusses this with the school nurse, the nurse shares that at this early phase, children likely experience what type of feelings?

take blame for their parents quarreling and try to behave better

A mother of a 9-year-old child newly diagnosed with diabetes is struggling to comes to terms with all the blood monitoring and medications the child will need to maintain a normal quality of life. The mother works full-time and is the primary wage earner for the family. Which interventions suggested by the nurse can possibly help this family? Select all that apply.

-Explore how other family members can help with a portion of the responsibility for medication administration. -Suggest that a nearby grandparent help with healthy meal preparation while the mother is at work. -Provide education for the child in regards to testing blood glucose levels.