Ch. 30: Atraumatic Care Prep U
The nurse is preparing to reduce a young parent's anxiety about a child needing hospitalization. Which action should the nurse prioritize? Schedule time to address the parent's concerns. Tell the parent about the tests being performed. Let the parent know you will relay any messages she has for the doctor. Include the parent in the medical decision-making.
Include the parent in the medical decision-making.
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 his right arm will require surgery. Which response by the nurse would be the most appropriate in this situation? "Stop shouting at the nurses. We're only trying to help you." "I understand you are angry, but please don't shout or slam doors." "I am really sorry about your arm, but surgery is needed to correct the problem." "Once surgery is over you'll be back playing baseball in no time."
"I understand you are angry, but please don't shout or slam doors."
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? Occupational therapist Play therapist Child psychologist Child life specialist
Child life specialist
The nurse is caring for an adolescent with a newly diagnosed disease process. The adolescent refuses to learn about the disease. Which technique should the nurse use to encourage the adolescent to be actively involved in education about this disease? Urge the adolescent to listen attentively to what information the nurse wants to teach. Encourage the adolescent to be educated about the disease to know what to expect concerning treatments. Help the adolescent understand how new information about the disease will improve health status now. Help the adolescent to realize that he or she is different from peers and needs teaching while they do not.
Help the adolescent understand how new information about the disease will improve health status now.
The nurse is preparing to educate the child about a procedure scheduled for the following morning. Which techniques should the nurse use when communicating with this child? Select all that apply. Standing at the foot of the child's bed while teaching the child Being patient with the child Using terms that the child will likely understand Looking for nonverbal cues Requesting that the parents leave the room during the education
Using terms that the child will likely understand Looking for nonverbal cues Being patient with the child
What is the main benefit of effective therapeutic communication for the nurse-client relationship? will cause the child to do what the health care provider requires helps develop trust between nurse and the child improves the child's ability to cope helps the child understand the reason for hospitalization
helps develop trust between nurse and the child
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 lack of support people in a crisis a child developing a chronic illness a parent wishing he or she had more education
limited amount of available resources
A 9-year-old arrives in the clinic for a venipuncture. The child says to the nurse, "You better know what you are doing, because you only get one chance at this!" What is the best response by the nurse? "Why are you so angry?" "I can understand that you are concerned about having your blood drawn. I will try and make this as comfortable as possible." "I am good at what I do, but even I can miss a vein sometimes." "That is a lot of pressure to place on me. Sometimes, it takes a couple of times to get it right."
"I can understand that you are concerned about having your blood drawn. I will try and make this as comfortable as possible."
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? story pictures dolls video
dolls
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? After interviewing the child, give the child a prize for answering the questions. Take the child on a tour of the facility and surgical suite and explain what to expect preoperatively and postoperatively. Tell the child about being able to eat popsicles and ice cream after surgery. Tell the child that the parents will not be able to see him or her until after the child returns to the hospital room.
Take the child on a tour of the facility and surgical suite and explain what to expect preoperatively and postoperatively.
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, instead 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? maintenance of order division of labor problem solver allocation of resources
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. encourage the mother to remain at the infant's bedside so as not to miss any future consultant visits. ask the mother for her questions so that the nurse can relay them to the medical team. explain to the mother the limits on the consultant's time.
assist the mother in preparing a list of questions for the physician's next visit.
What is the main benefit of effective therapeutic communication for the nurse-client relationship? helps develop trust between nurse and the child will cause the child to do what the health care provider requires improves the child's ability to cope helps the child understand the reason for hospitalization
helps develop trust between nurse and the child
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? Tell the child about being able to eat popsicles and ice cream after surgery. Take the child on a tour of the facility and surgical suite and explain what to expect preoperatively and postoperatively. After interviewing the child, give the child a prize for answering the questions. Tell the child that the parents will not be able to see him or her until after the child returns to the hospital room.
Take the child on a tour of the facility and surgical suite and explain what to expect preoperatively and postoperatively.
The registered nurse (RN) and licensed practical nurse (LPN) are caring for a hospitalized child. Which action by the LPN will cause the RN to intervene? The LPN lets the child keep their security blanket during a lumbar puncture The LPN requests minimal laboratory blood draws The LPN attempts to follow the child's home schedule as best as possible The LPN holds down the child while another nurse starts an IV
The LPN holds down the child while another nurse starts an IV
The nurse is educating an 8-year-old client newly diagnosed with diabetes mellitus on how to administer insulin. Which finding indicates the nurse's education was successful? 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 lists five foods to ingest when determining that blood glucose levels are too low. The child demonstrates good technique in self-injection of insulin.
The child demonstrates good technique in self-injection of insulin.
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 avoiding periods of silence being sympathetic using direct questions
using open-ended questions
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: "This will only take a few minutes. You should be with your child." "Good. That is what the team doing the procedure would prefer." "Come, stand by his head. You won't see much up there" "Certainly. I will stay with your child during the procedure." "Stay. It will be less scary for your child."
"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." "It is best to stoop to a child's level when listening." "It is good to sit, not stand when listening." "It is good to lean forward when listening."
"It is best to stand when listening to a child to demonstrate knowledge."
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." "We make sure our toddler wears a helmet and knee pads." "Our child has a medical alert bracelet that is worn at all times." "We had a trampoline but got rid of it after our child was diagnosed."
"Our child always wears a helmet and body padding when playing football."
The child with cancer spends time watching TV and talking very little about a new chemotherapy regimen that is to start next week. What is the best statement the nurse could use to help the child discuss feelings about the new treatment? "Are you worried about the new treatment plan?" "You don't seem concerned about the new treatment regimen." "You must be scared of taking a new chemo." "You haven't said anything about your feelings toward the new treatment plan."
"You haven't said anything about your feelings toward the new treatment plan."
How much ahead of time should nurses recommend that a school-ager be prepared for elective surgery? Immediately before 1 week 2 weeks A few days 1 hour
A few days
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 determine if he or she wants to take the medication at that time. Allow the child to choose between juice, water, or soda to take the medication. Use medical terminology when discussing the medication with the child. Show the child a video about medication administration.
Allow the child to choose between juice, water, or soda to take the medication.
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? Allow the toddler to blow bubbles in the room 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
The nurse is teaching a 7-year-old girl about her upcoming tonsillectomy. Which techniques would be appropriate for this child? Select all that apply. Using plays or puppets to help explain the procedure Allowing the child to do as much self care as possible Explaining the procedure that will happen later in the day Explaining that anesthesia is a lot like falling asleep Offering choices of drinks and gelatin after the procedure
Allowing the child to do as much self care as possible Offering choices of drinks and gelatin after the procedure Explaining that anesthesia is a lot like falling asleep
An expectant client asks the childbirth educator about the advantages of going to a birthing center for delivery. Which are the nurse's best responses? Select all that apply. Birth centers have transfer agreements with local hospitals if complications occur. Birth centers focus on pregnancy as a state of wellness and on women and families as a whole. Birthing centers are a good option for every pregnant client who wants this alternative. Care is usually provided by midwives for pregnant clients with lower risk of complications. The rate of cesarean delivery for clients who deliver in a birth center is less than for those who deliver in hospitals. Birth centers are designed to be more home-like and comfortable with fewer interventions.
Birth centers are designed to be more home-like and comfortable with fewer interventions. Birth centers focus on pregnancy as a state of wellness and on women and families as a whole. The rate of cesarean delivery for clients who deliver in a birth center is less than for those who deliver in hospitals. Care is usually provided by midwives for pregnant clients with lower risk of complications. Birth centers have transfer agreements with local hospitals if complications occur.
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.
The nurse is providing discharge instructions to a 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. Report any persistent numbness of the fingers. Cover the cast with a fabric wrap when preparing to bathe. If itching occurs around the edges of the cast, use a water-based lubricant to relieve it. Wiggle the fingers throughout the day and evening.
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 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? Attentive listening Genuineness Empathy Warmth
Empathy
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? Communal Blended Nuclear Extended
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? Educating the parents regarding appropriate play activities for the child Nutritional guidance for healthy meals for the family. Finding a company to provide a helmet for the child to wear daily. Performing a well-child checkup, noting weight gain
Finding a company to provide a helmet for the child to wear daily.
A nurse is providing care for a child diagnosed with beta-thalassemia who is receiving a blood transfusion. The child reports being bored and asks to go to the playroom. What is the bestaction for the nurse to take? Have a child-life specialist find an appropriate activity to occupy the child during the transfusion. Explain the need for quiet rest during a blood transfusion. Accompany the child to the playroom if the child is stable. Explain that the child cannot go to the playroom during the transfusion.
Have a child-life specialist find an appropriate activity to occupy the child during the transfusion.
A parent has just learned that the infant has sickle cell anemia. The parent expressed concern that the disorder was something that could have been prevented. What is the best action for the nurse to take? Explain that it is normal to want to learn how the disorder could happen. Provide written material on the disorder and answer any questions the parent may have. Have a discussion with the parent regarding the etiology of the disorder. Tell the parent that there was nothing he or she could have done to prevent it.
Have a discussion with the parent regarding the etiology of the disorder.
The nurse is caring for an adolescent with a newly diagnosed disease process. The adolescent refuses to learn about the disease. Which technique should the nurse use to encourage the adolescent to be actively involved in education about this disease? Help the adolescent understand how new information about the disease will improve health status now. Urge the adolescent to listen attentively to what information the nurse wants to teach. Help the adolescent to realize that he or she is different from peers and needs teaching while they do not. Encourage the adolescent to be educated about the disease to know what to expect concerning treatments.
Help the adolescent understand how new information about the disease will improve health status now.
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? Using reflection to clarify the parents' understanding Using the adolescent's words during the conversation Paraphrasing the parents' comments before responding Ignoring the adolescent's tirade about his therapy
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 Presenting options for treatment Supporting the child's desires for treatment Recognizing the parents' desire to use all options
Informing the child in terms she can understand
The nurse is caring for a 14-year-old girl with terminal cancer and her family. Which intervention provides the best therapeutic communication? Recognizing the parents' desire to use all options Presenting options for treatment Informing the child in terms she can understand Supporting the child's desires for treatment
Informing the child in terms she can understand
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? Discussing treatment options with the child and parents Involving the child and family in decision making Describing postoperative home care for the child Arranging an additional meeting with the nurse practitioner
Involving the child and family in decision making
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? Promote family-centered care. Advocate for minimal laboratory blood draws. Maintain the child's home routine related to activities of daily living. Provide appropriate pain management.
Maintain the child's home routine related to activities of daily living.
The nurse is assessing the learning needs of the parents of 5-year-old girl who is scheduled for surgery. Which nonverbal cue should the nurse use to show interest in what the family members are saying? Look at child when the father is talking Stand several steps away from parents Sit straight with feet flat on the floor Nod head while the mother speaks
Nod head while the mother speaks
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.
The mother of an infant child only speaks Spanish. The 8-year-old sibling speaks English, and the mother wants to communicate through the sibling. How should the nurse best handle teaching to the mother? Use a translation app on a phone. Provide a Spanish-speaking nurse. Teach the 8-year-old. Obtain an interpreter.
Obtain an interpreter.
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 pamphlet about the importance of exercise. Play a game like "Simon Says" to introduce exercises. Show a video about exercising. Give the client a coloring book about arthritis.
Play a game like "Simon Says" to introduce exercises.
A child is diagnosed with type 1 diabetes. The parents are devastated. They state, "No one in our family has ever had any problems like this." What interventions can the nurse provide to promote a sense of control and reduce fear of the unknown for the child and family? Provide a comprehensive education program regarding the care of the child with diabetes. Inform them that the child has not eaten healthy foods and now it is a necessity. Show them how to administer injections so that the child will not have to do it. Inform them that someone in the family must have some form of diabetes.
Provide a comprehensive education program regarding the care of the child with diabetes.
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 Discuss how to handle a possible emergency situation Use the USDAs "MyPlate" diagram to teach necessary nutrition alterations Explain the disorder in common terms
Provide literature for the parent to read and then have them ask questions
A nurse is providing care for a child hospitalized with a diagnosis of aplastic anemia. In planning the child's care, which intervention(s) will assist the child in adapting to being hospitalized? Select all that apply. Discuss the plan of care out of earshot of the child. Answer any questions the child may have in generalized terms. Provide opportunities for the parents to participate in the child's care. Encourage the parents to bring personal items to make the child feel more at home. Make the child's room off limits to invasive procedures.
Provide opportunities for the parents to participate in the child's care. Encourage the parents to bring personal items to make the child feel more at home. Make the child's room off limits to invasive procedures.
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? All adult members share the financial responsibilities. It is primarily the younger members who teach the older members in a family. Reproduction remains an important function of all families. Couples today are more concerned about unplanned pregnancies.
Reproduction remains an important function of all families.
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? Request that the adolescent teach the information to the nurse. Provide an opportunity for the adolescent to ask questions. Ask the adolescent if the teaching was understood. Provide written materials to reinforce teaching.
Request that the adolescent teach the information to the nurse.
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? Provide information and allow the adolescent to process and ask questions. Offer choices whenever possible. Speak directly to the adolescent and consider the client's input in the decisions about care and education. Praise the adolescent often.
Speak directly to the adolescent and consider the client's input in the decisions about care and education
The nurse is teaching a 6-year-old girl and parent about home care for an eye infection. Which communication techniques would be least effective with this child? Listening attentively to the child while giving time to finish thoughts and ideas Standing beside the child when doing the teaching Talking directly to the child even though the parent makes comments Asking permission to touch the child before doing so
Standing beside the child when doing the teaching
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: Have the mother speak firmly to the child to correct the crying and screaming. Ask the child to be less noisy because he is "scaring and bothering other children." Tell the child, "It's OK to cry, but I need you to hold still." Close the door tightly and reassure the child, "I am being gentle and am almost done." Review safety measures that could have prevented the injury.
Tell the child, "It's OK to cry, but I need you to hold still."
The registered nurse (RN) and licensed practical nurse (LPN) are caring for a hospitalized child. Which action by the LPN will cause the RN to intervene? The LPN attempts to follow the child's home schedule as best as possible The LPN requests minimal laboratory blood draws The LPN lets the child keep their security blanket during a lumbar puncture The LPN holds down the child while another nurse starts an IV
The LPN holds down the child while another nurse starts an IV
The nurse is educating an 8-year-old client newly diagnosed with diabetes mellitus on how to administer insulin. Which finding indicates the nurse's education was successful? The child demonstrates good technique in self-injection of insulin. The child is able to draw the correct amount of insulin up in the syringe. The parents of the child demonstrate good technique in administering insulin to their child. The child lists five foods to ingest when determining that blood glucose levels are too low.
The child demonstrates good technique in self-injection of insulin.
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 mother asks the nurse to complete paperwork for her. The child's mother asks for additional resources to review about the planned treatment. The child's mother asks many questions. The child's medical record contains information indicating the family frequently misses appointments.
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 school nurse plans to teach children in the fourth grade some basic first-aid skills before they take a field trip. Which fact would make the nurse believe the children will learn this information most readily? The topic is new to them. The topic concerns actions, not ideas. The material is review information. The topic will have direct application.
The topic will have direct application.
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? Therapeutic play lets the nursing staff observe the child's developmental level. This type of play gives the child an outlet to deal with stress. Playing provides the child with a way to expend some energy during the hospitalization. All children like to play.
This type of play gives the child an outlet to deal with stress.
Based on school-aged cognitive development, which teaching technique would the nurse anticipate as being received the best? Using containers of water to demonstrate how hemorrhage leads to decreased body fluid Asking children to conceptualize the effect of falling blood pressure Asking children to think through "what if" situations and blood pressure Explaining elevated and decreased blood pressure as a concept
Using containers of water to demonstrate how hemorrhage leads to decreased body fluid
A group of nursing students are analyzing the various aspects of a family. At the end of the session the students correctly point out the family structure is illustrated best by which information? Activities of family members Religion of the family Roles family members carry out Who its members are
Who its members are
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? having the child keep a diary attending a group discussion drawing pictures playing video games
drawing pictures
A student nurse has shared a presentation detailing the various functions of a family. The nurse determines the session is successful after the class correctly chooses which actions as a basic function of the family? Select all that apply. support socialization nurturing economic provisions of care determine future occupations
economic provisions of care socialization nurturing support
After teaching the parents of a toddler how to change the dressing on their child's abdomen, the nurse should use which method to best evaluate the parent's technique? using an evaluation tool having parents perform a return demonstration assessing parent anxiety having parents verbalize procedure steps
having parents perform a return demonstration
Two previously divorced people are getting married and becoming a blended family. They each have two children from prior marriages. They have met with a family counselor to discuss potential problems of blended families and ways to deal with the problems. Which potential problem will likely occur at some early point in the marriage? sleeping arrangements resulting in arguments among all children financial changes affecting social activities children want to attend rivalry for attention of a parent children being unreasonable in requests for privacy
rivalry for attention of a parent
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? make up false stories, pretending they are "one big happy family" tell their friends that their parents are always "mad" at them act out their feelings by crying and screaming at their parents to "Stop!" take blame for their parents quarreling and try to behave better
take blame for their parents quarreling and try to behave better
A new staff member asks veteran nurses about the meaning of atraumatic care for children. These nurses explain that the concept is based on: units staffed to provide one nurse for each child. the underlying premise of "do no harm." the child's need to experience no trauma. peers being helped to develop empathy for the child.
the underlying premise of "do no harm."
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? "Would you like to go see an operating room?" "You sound worried. Let's talk about tomorrow." "I hope you are better tomorrow, too." "I had my tonsils removed at your age and everything was just fine."
"You sound worried. Let's talk about tomorrow."
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." "I don't think you will be in the X-ray department very long." "The big machine will look inside you to see why you are sick so just hold still." "The technician needs to take several tubes of blood from you."
"You will lie on a special bed that moves in the machine but you can still see out."
A young child has been brought to the emergency department (ED) groaning and crying with pain located, "in their tummy." The parent states the child did not want to eat supper and was lethargic all evening. When the parent went to pick the child up at bedtime, the child was, "burning up with a fever" and reporting nausea. On admission, WBCs are elevated. The child also guards the abdomen when it is palpated and cries when hands are removed from the abdomen (rebound tenderness). The nurse begins paperwork for potential emergency surgery. Knowing this is a single-parent family due to divorce, which precautions should the nurse implement? Page the nursing supervisor to come assist with this family dynamic. Ask when the other biological parent will be arriving in the ED. Ask to clarify which parent has the legal, custodial rights to consent for procedures. Inquire as to which biological parent is financially responsible for the child's health care.
Ask to clarify which parent has the legal, custodial rights to consent for procedures.
The nurse is educating a 15-year-old girl with Graves' disease and her family about the disease and its treatment. Which method of evaluating learning is least effective? Having the child and family demonstrate skills Setting up a scenario for them to talk through Requesting the parent to teach the child skills Asking closed-ended questions for specific facts
Asking closed-ended questions for specific facts
A nurse manager on a pediatric unit is making assignments for the day. The nurse's goals are atraumatic care for pediatric clients and minimizing parent-child separation. What method of care delivery should the nurse implement? Assign an unlicensed assistive personnel to care for the child to give the parents a break. Assign a team of nurses and unlicensed assistive personnel. Assign a core primary nurse. Assign a medication nurse and a primary nurse.
Assign a core primary nurse.
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. Provide education for the child in regards to testing blood glucose levels. Explore the possibility of the mother quitting her job for a few months until the child's glucose level is stabilized. Explore how other family members can help with a portion of the responsibility for medication administration. Turn over all the daily glucose monitoring and insulin administration to the school nurse solely. Suggest that a nearby grandparent help with healthy meal preparation while the mother is at work.
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.
A family with a 13-year-old child who has cystic fibrosis is having a stressful time since the father is currently unemployed while the mother works full-time. The ill child has been acting out at school. He is "sick of taking medications and doing chest expansion exercises" and "just wants to be like all the other kids." There are two stepbrothers living in the home creating problems of their own. At the moment, the ill child has a respiratory rate of 32 breaths/minute and has a productive cough with bilateral rales in both lung bases. The nurse assessing this family will document which priority NANDA related to the current family dynamics? Impaired social interaction Caregiver role strain Parental role conflict Interrupted family processes
Interrupted family processes
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? Use the USDAs "MyPlate" diagram to teach necessary nutrition alterations Discuss how to handle a possible emergency situation Provide literature for the parent to read and then have them ask questions Explain the disorder in common terms
Provide literature for the parent to read and then have them ask questions
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? Use a stuffed animal to tell a story. Write on a whiteboard. Use puppets to communicate with the infant. Sing to the infant.
Sing to the infant.
A family that regularly takes in foster children is visiting the junior high school nurse to inform the staff that there will be a new 8th grade foster child beginning school the following week. The school nurse should monitor this new student for which psychosocial response to being moved to the foster care system? aggressive behavior as the child acts out feelings high level of insecurity refusal to complete required immunizations eating disorders like anorexia nervosa
high level of insecurity
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 manual dexterity ability reason for the colostomy presence of parent
learning style
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 socialization of family members problem solver allocation of resources
maintenance of order
A high school nurse has noted several of the incoming freshmen are "only children" (they have no siblings). The nurse plans some "brown bag lunch discussions" for this group of students. Which topics should be addressed in these sessions? Select all that apply. getting a "failing" grade at school healthy eating 101 when a favorite sports team loses amount of sleep one should get daily managing stress
managing stress getting a "failing" grade at school when a favorite sports team loses
A child who has had several surgeries to correct a congenital defect is found crying after receiving the news another surgery will be needed. The nurse could best assist this child through what form of communication? reassurance silence touch supportive statements
touch
A parent calls the pediatric clinic and tells the nurse "I think my child is having a sickle cell crisis. Should I bring the child to the office?" What is the nurse's best response? "Call 911 and give the child some water while you wait." "Tell me about the symptoms your child is experiencing" "What makes you think your child is in crisis?" "Take your child to the emergency department now."
"Tell me about the symptoms your child is experiencing"
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? Ask the child questions until he or she begins talking freely. Ask the parents to step out of the room and talk with the child privately. Talk to the parents first to give the child a chance to "warm up." Give information to the parents and let them talk to the child later.
Talk to the parents first to give the child a chance to "warm up."
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? One explanation will be enough to reduce the child's fear. The child may think the equipment causes the pain. Explaining the equipment will only increase the child's fear. The child is too young to for an explanation of the equipment.
The child may think the equipment causes the pain.
When caring for hospitalized teens, nurses should choose their words and actions carefully since adolescents typically are concerned about: mobility restrictions. mutilation of their body. appearing out of control of the situation and/or themselves. separation from peers and family.
appearing out of control of the situation and/or themselves.
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? story video pictures dolls
dolls
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. Avoid criticizing the biological parents but reinforce how much the adoptive mom and dad love them. 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. Tell the child that her biological mom could not care for her after birth because she was HIV positive. Inform the child that her biological mom was in prison and would not be able to care for her for a long time. Explain that her biological mom could not care for her so she was given away.
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 parents of a child admitted for a new diagnosis tell the nurse they have researched the disease on the Internet so they do not have any questions regarding their child's care. Which response(s) by the nurse is therapeutic? Select all that apply. "I will let the health care provider know that you feel confident in the information you have researched about the diagnosis." "It is great that you have researched the diagnosis, but please be aware that each case can differ somewhat based on the individual." "Educating yourself is always good as long as you are using reliable resources. What sources have you used?" "Please feel free to call me if you have any questions." "I am surprised you do not have any questions. There are always variances that can make each case a little different."
"It is great that you have researched the diagnosis, but please be aware that each case can differ somewhat based on the individual." "Educating yourself is always good as long as you are using reliable resources. What sources have you used?" "Please feel free to call me if you have any questions."
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." "We had a trampoline but got rid of it after our child was diagnosed." "We make sure our toddler wears a helmet and knee pads." "Our child has a medical alert bracelet that is worn at all times."
"Our child always wears a helmet and body padding when playing football."
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. "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." "You will end up in 'ICU' where you will wake up with some electrodes on your chest." "I am going to give you this shot and it will put you to sleep." "This little tube will go in your nose and down into your belly."
"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 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: Develop a written account of the infant's status with the physician that the daughter can read and explain to her parents. Support the 14-year-old while she interprets for her parents and the physician at the bedside. Coordinate physician and interpreter schedules and arrange an information-sharing session for later in the day. Have the teenage daughter and physician discuss the information thoroughly and help her share this data with her parents.
Coordinate physician and interpreter schedules and arrange an information-sharing session for later in the day.
The nurse is caring for a hospitalized pediatric client. Which intervention will the nurse include to encourage family-centered care? Have a team meeting with the client, family, and involved health care providers Have the family members meet with a child psychologist to ensure the child's needs are being met Have the primary health care provider meet with the family to tell them about the child's plan of care Encourage the caregivers to room-in with the client and siblings to visit when possible
Have a team meeting with the client, family, and involved health care providers
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? Use a stuffed animal to tell a story. Write on a whiteboard. Sing to the infant. Use puppets to communicate with the infant.
Sing to the infant.
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 Giving the child an influenza vaccination Starting the child's intravenous line Showing the child where the pediatric play room is located Speaking to the physician as the child's advocate
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
Which is most likely to encourage parents to talk about their feelings related to the poor prognosis their child has been given? using direct questions using open-ended questions avoiding periods of silence being sympathetic
using open-ended questions
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 his right arm will require surgery. Which response by the nurse would be the most appropriate in this situation? "I am really sorry about your arm, but surgery is needed to correct the problem." "I understand you are angry, but please don't shout or slam doors." "Stop shouting at the nurses. We're only trying to help you." "Once surgery is over you'll be back playing baseball in no time."
"I understand you are angry, but please don't shout or slam doors."
A nurse is assisting the health care provider with suturing a laceration on a preschooler's leg. What distraction methods can the nurse perform to promote atraumatic care? Select all that apply. Ask the child to squeeze the nurse's hand. Allow the child to play with surgical instruments. Let the child suture a doll. Sing a song and have the child sing along. Have the child blow bubbles.
Ask the child to squeeze the nurse's hand. Sing a song and have the child sing along. Have the child blow bubbles.
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? Attentive listening Genuineness Warmth Empathy
Empathy
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? Reassure the parents that they have been fully briefed on their child's treatment. Answer the parents' questions as completely as possible. Encourage the parents to focus their attention on their child. Notify the health care provider that the parents still have questions.
Answer the parents' questions as completely as possible.
The nurse from a rural area moves to a large city to work in a family clinic where there are families from a variety of different cultures. The nurse should prioritize which goal as she begins working in this new environment? Ask the families about their cultural beliefs Encourage the family to compromise with similarities Examine her own feelings concerning cultures Use each family's culture as a guideline for care
Examine her own feelings concerning cultures
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? Getting paper and markers so that he can draw and color Providing Play-Doh for him to manipulate Discussing the reasons for the procedure with the child and parents Finding an age-appropriate action DVD for him to view
Providing Play-Doh for him to manipulate
The nurse is teaching a child how to self-administer insulin. Place the steps in the order the nurse will complete them when teaching the child. Use each option once. Click an option, hold and drag it to the desired position, or click an option to highlight it and move it up or down in the order using the arrows to the left. 3Show the child how to correctly perform the procedure 1Given time to practice and increase proficiency 2Have the child perform a return demonstration of the procedure 4Evaluate the child's performance of the procedure
Show the child how to correctly perform the procedure Given time to practice and increase proficiency Have the child perform a return demonstration of the procedure Evaluate the child's performance of the procedure
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: explain to the mother the limits on the consultant's time. assist the mother in preparing a list of questions for the physician's next visit. ask the mother for her questions so that the nurse can relay them to the medical team. encourage the mother to remain at the infant's bedside so as not to miss any future consultant visits.
assist the mother in preparing a list of questions for the physician's next visit.
The nurse is educating a 15-year-old girl with Graves' disease and her family about the disease and its treatment. Which method of evaluating learning is least effective? Asking closed-ended questions for specific facts Setting up a scenario for them to talk through Requesting the parent to teach the child skills Having the child and family demonstrate skills
Asking closed-ended questions for specific facts
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? defining the problem using clichés clarifying using silence
using clichés
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." "Would you like to go see an operating room?" "I hope you are better tomorrow, too." "I had my tonsils removed at your age and everything was just fine."
"You sound worried. Let's talk about tomorrow."
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? Encourage the parents to focus their attention on their child. Reassure the parents that they have been fully briefed on their child's treatment. Notify the health care provider that the parents still have questions. Answer the parents' questions as completely as possible.
Answer the parents' questions as completely as possible.
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? Allowing too little appointment time for the translation Using an older sibling to communicate with the parents Using a person who is not a professional interpreter Asking the interpreter questions not meant for the family
Asking the interpreter questions not meant for the family
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 Allowing too little appointment time for the translation Using an older sibling to communicate with the parents Using a person who is not a professional interpreter
Asking the interpreter questions not meant for the family
A nurse is attempting to reduce pain that a child is experiencing after an emergency appendectomy. What intervention can the nurse provide to meet this goal? Encourage oral fluids after surgery. Assess the child frequently and use pharmacologic and nonpharmacologic methods of pain relief as needed. Have the child turn every 2 hours prior to administering pain medication. Provide diversional activities postoperatively so the child will not focus on the pain.
Assess the child frequently and use pharmacologic and nonpharmacologic methods of pain relief as needed.
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? Provide a plan of action. Assist the child to control emotions. Assess the perception of the problem. Inform the child of priority problems.
Assess the perception of the problem.
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 Developing outcome standards for the nutritional aspect of the plan Giving the child a pamphlet about the reason for a gluten-free diet Collecting data of current dietary likes and dislikes
Assessing the child's current level of understanding
A nurse manager on a pediatric unit is making assignments for the day. The nurse's goals are atraumatic care for pediatric clients and minimizing parent-child separation. What method of care delivery should the nurse implement? Assign a core primary nurse. Assign a team of nurses and unlicensed assistive personnel. Assign a medication nurse and a primary nurse. Assign an unlicensed assistive personnel to care for the child to give the parents a break.
Assign a core primary nurse.
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. Allow the child to review instructional pamphlets as the nurse is teaching. Tell the child different ways to perform the technique so the child can choose. Suggest the child tell the nurse how he or she wants the range-of-motion exercises to be done.
Demonstrate the technique by performing it the same way each time.
An adolescent remarks rather sarcastically that she feels like a "lab rat." What is the priority nursing action? Provide more physical privacy for this teenager. Ensure information is shared with and decisions about care are made with the teen and not for the teen. Enable the teen to stay in contact with peers electronically. Share with the adolescent that everyone on the unit enjoys working with teenagers. Arrange for additional bedside activities of the adolescent's choice.
Ensure information is shared with and decisions about care are made with the teen and not for the teen.
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. Tell the child that her biological mom could not care for her after birth because she was HIV positive. Inform the child that her biological mom was in prison and would not be able to care for her for a long time. Avoid criticizing the biological parents but reinforce how much the adoptive mom and dad love them. Explain that her biological mom could not care for her so she was given away. 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.
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 is preparing a 9-year-old child for a lumbar puncture. What would be appropriate preparation techniques for this procedure? Explaining how the procedure is performed and what the child might feel during the procedure Encouraging the parent to stand near the child during the procedure to offer support Determining what distraction techniques would be desired by the client during the procedure Asking the child if they would prefer the treatment room or their hospital room for the procedure Letting the child know that if they feel any discomfort during the procedure that is okay to verbalize this in any way they want
Explaining how the procedure is performed and what the child might feel during the procedure Determining what distraction techniques would be desired by the client during the procedure Encouraging the parent to stand near the child during the procedure to offer support Letting the child know that if they feel any discomfort during the procedure that is okay to verbalize this in any way they want
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. Provide education for the child in regards to testing blood glucose levels. Suggest that a nearby grandparent help with healthy meal preparation while the mother is at work. Turn over all the daily glucose monitoring and insulin administration to the school nurse solely. Explore the possibility of the mother quitting her job for a few months until the child's glucose level is stabilized.
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.
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 block party where the nurses can meet the mothers and encourage them to supervise their children's homework assignments. Organize a group of local high school students to begin a reading program in the grade school to increase interest in reading. Suggest that the nurses in all the area schools stay after school to work with the students who are behind in their tested reading level. Encourage all area nurses to write to the school board asking for funds to provide teachers who specialize in reading for all area schools.
Organize a group of local high school students to begin a reading program in the grade school to increase interest in reading.
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. Because the adolescent did not pay attention during his teaching sessions, he now does not know what to do. More assistance from the family is needed for the teen to manage his care. The developmental thinking skills of the adolescent prevent him from seeing the connection between his actions and the effect on his health.
Some noncompliance should be expected due to the teen's desire for independence, expression of his personal values, and peer acceptance.
The nurse is teaching a 6-year-old girl and parent about home care for an eye infection. Which communication techniques would be least effective with this child? Standing beside the child when doing the teaching Listening attentively to the child while giving time to finish thoughts and ideas Asking permission to touch the child before doing so Talking directly to the child even though the parent makes comments
Standing beside the child when doing the teaching
The nurse is assessing the learning needs for a 12-year-old boy with a chronic health condition, as well as his parents. Which aspect would be least pertinent to a learning needs assessment? Finding that the mother relies on American Sign Language Discovering that the father is highly health care literate Concluding that the parents are emotionally distraught The family belongs to a mainline traditional faith community
The family belongs to a mainline traditional faith community
The nurse is caring for a 6-year-old girl who will be undergoing a surgical procedure that will result in a temporary ileostomy. Which approach would be most effective in helping prepare the child for surgery? Show the child a teaching DVD about ileostomy care. Show the child photographs of another girl with her ileostomy. Use a doll to role-play the events surrounding the surgical experience and the procedure. Draw a picture that explains the procedure.
Use a doll to role-play the events surrounding the surgical experience and the procedure.
How can the nurse increase communication between the family of a child with sickle-cell disease and the health care team? Inform the family when present in the child's room about changes in the child's condition. Using a dry erase board for updating the daily plan of care. Tell the child to inform the parents that of new medications for control of pain. Have the physician talk to the parents about treatment.
Using a dry erase board for updating the daily plan of care.
A couple with infertility has decided to adopt an infant and receive a call several months later that an infant is available. The social worker gives them the history of the biological mom, a teenager who tried to conceal her pregnancy by dieting and taking laxatives. However, at 26 weeks' gestation, the teenager shared her pregnancy with the family and received prenatal care. Given this history, the couple should be counseled to observe the infant for which possible abnormality? excess swelling related to kidney problems risk for autism following immunizations abnormal neurologic development potential eating disorder as a teenager
abnormal neurologic development
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 demonstration dolls
dolls