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Maternal-Child Nursing 5th Edition by Mckinney-Test Bank
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Chapter 02: The Nurse’s Role in Maternity, Women’s Health, and Pediatric Nursing
McKinney: Evolve Resources for Maternal-Child Nursing, 5th Edition
MULTIPLE CHOICE
- Which principle of teaching should the nurse use to ensure learning in a family situation?
- Motivate the family with praise and positive reinforcement.
- Present complex subject material first, while the family is alert and ready to learn.
- Families should be taught using medical jargon so they will be able to understand the technical language used by physicians.
- Learning is best accomplished using the lecture format.
ANS: A
Praise and positive reinforcement are particularly important when a family is trying to master a frustrating task, such as breastfeeding. Learning is enhanced when the teaching is structured to present the simple tasks before the complex material. Even though a family may understand English fairly well, they may not understand the medical terminology or slang terms. A lively discussion stimulates more learning than a straight lecture, which tends to inhibit questions.
| PTS: | 1 | DIF: | Cognitive Level: Knowledge/Remembering |
| REF: | p. 25 | OBJ: | Nursing Process: Planning |
| MSC: | Client Needs: Health Promotion and Maintenance | ||
- When addressing the questions of a newly pregnant woman, the nurse can explain that the certified nurse-midwife is qualified to perform
- regional anesthesia.
- cesarean deliveries.
- vaginal deliveries.
- internal versions.
ANS: C
The nurse-midwife is qualified to deliver infants vaginally in uncomplicated pregnancies. The other procedures must be performed by a physician or other medical provider.
| PTS: | 1 | DIF: | Cognitive Level: Knowledge/Remembering |
| REF: | p. 26 | OBJ: | Integrated Process: Teaching-Learning |
| MSC: | Client Needs: Safe and Effective Care Environment | ||
- Which nursing intervention is an independent (nurse-driven) function of the nurse?
- Administering oral analgesics
- Teaching the woman perineal care
- Requesting diagnostic studies
- Providing wound care to a surgical incision
ANS: B
.
Nurses are responsible for various independent functions, including teaching, counseling, and intervening in nonmedical problems. Interventions initiated by the physician and carried out by the nurse are called dependent functions. Administering oral analgesics is a dependent function; it is initiated by a physician or other provider and carried out by the nurse. Requesting diagnostic studies is a dependent function. Providing wound care is a dependent function; it is usually initiated by the physician or other provider through direct orders or protocol.
| PTS: | 1 | DIF: | Cognitive Level: Comprehension/Understanding |
| REF: | Box 2.3 | OBJ: | Integrated Process: Teaching-Learning |
| MSC: | Client Needs: Health Promotion and Maintenance | ||
- Which response by the nurse to the woman’s statement, “I’m afraid to have a cesarean birth,” would be the most therapeutic?
- “What concerns you most about a cesarean birth?”
- “Everything will be OK.”
- “Don’t worry about it. It will be over soon.”
- “The doctor will be in later, and you can talk to him.”
ANS: A
Focusing on what the woman is saying and asking for clarification are the most therapeutic responses. Stating that “everything will be ok” or “don’t worry about it” belittles the woman’s feelings and might be providing false hope. Telling the patient to talk to the doctor does not allow the woman to verbalize her feelings when she desires.
| PTS: | 1 | DIF: | Cognitive Level: Application/Applying |
| REF: | Box 2.2 | OBJ: | Integrated Process: Communication and Documentation |
| MSC: | Client Needs: Psychosocial Integrity | ||
- To evaluate the woman’s learning about performing infant care, the nurse should
- demonstrate infant care procedures.
- allow the woman to verbalize the procedure.
- observe the woman as she performs the procedure.
- routinely assess the infant for cleanliness.
ANS: C
The woman’s ability to perform the procedure correctly under the nurse’s supervision is the best method of evaluation. Demonstration is an excellent teaching method but not an evaluation method. During verbalization of the procedure, the nurse may not pick up on techniques that are incorrect. It is not the best tool for evaluation. Observing the infant for cleanliness does not ensure the proper procedure is carried out. The nurse may miss seeing unsafe techniques being used.
| PTS: | 1 | DIF: | Cognitive Level: Evaluation/Evaluating |
| REF: | p. 31 | OBJ: | Nursing Process: Evaluation |
| MSC: | Client Needs: Health Promotion and Maintenance | ||
- What situation is most conducive to learning?
- A teacher who speaks very little Spanish is teaching a class of Latino students.
- A class is composed of students of various ages and educational backgrounds.
- An auditorium is being used as a classroom for 300 students.
.
- An Asian nurse provides nutritional information to a group of pregnant Asian women.
ANS: D
Teaching is a vital function of the professional nurse. A patient’s language and culture influence the learning process; thus a situation that is most conducive to learning is one in which the teacher has knowledge and understanding of the patient’s language and cultural beliefs. The ability to understand the language in which teaching is done determines how much the patient learns. Patients for whom English is not their primary language may not understand idioms, nuances, slang terms, informal usage of words, or medical words. The teacher should be fluent in the language of the student. Developmental levels and educational levels influence how a person learns best. In order for the teacher to best present information, the class should be composed of the same levels. A large class is not conducive to learning. It does not allow for questions, and the teacher is not able to see the nonverbal cues from the students to ensure understanding.
| PTS: | 1 | DIF: | Cognitive Level: Application/Applying |
| REF: | p. 25 | OBJ: | Nursing Process: Planning |
| MSC: | Client Needs: Psychosocial Integrity | ||
- What is the primary role of practicing nurses in the research process?
- Designing research studies
- Collecting data for other researchers
- Identifying researchable problems
- Seeking funding to support research studies
ANS: C
Nursing generates and answers its own questions based on evidence within its unique subject area. Nurses of all educational levels are in a position to find researchable questions based on problems seen in their practice area. Designing research studies is generally left to nurses with advanced degrees. Collecting data may be part of a nurse’s daily activity, but not all nurses will have this opportunity. Seeking funding goes along with designing and implementing research studies.
| PTS: | 1 | DIF: | Cognitive Level: Comprehension/Understanding |
| REF: | p. 25 | OBJ: | Integrated Process: Teaching-Learning |
| MSC: | Client Needs: Safe and Effective Care Environment | ||
- The step of the nursing process in which the nurse determines the appropriate interventions for the identified nursing diagnosis is called
ANS: B
The third step in the nursing process involves planning care for problems that were identified during assessment. The first step of the nursing process is assessment, during which data are collected. The intervention phase is when the plan of care is carried out. The evaluation phase is determining whether the goals have been met.
.
| PTS: | 1 | DIF: | Cognitive Level: Knowledge/Remembering |
| REF: | pp. 30-31 | OBJ: | Nursing Process: Planning |
| MSC: | Client Needs: Safe and Effective Care Environment | ||
- Which goal is most appropriate for demonstrating effective parenting?
- The parents will demonstrate correct bathing by discharge.
- The mother will make an appointment with the lactation specialist prior to discharge.
- The parents will place the baby in the proper position for sleeping and napping by 2300 on postpartum day 1.
- The parents will demonstrate effective parenting by discharge.
ANS: D
Outcomes and goals are not the same. Goals are broad and not measurable and so must be linked to more measurable outcome criteria. Demonstrating effective parenting is one such goal. The other options are measurable outcome indicators that help determine if the goal has been met.
| PTS: | 1 | DIF: | Cognitive Level: Evaluation/Evaluating |
| REF: | p. 31 | OBJ: | Nursing Process: Planning |
| MSC: | Client Needs: Safe and Effective Care Environment | ||
- Which nursing intervention is correctly written?
- Encourage turning, coughing, and deep breathing.
- Force fluids as necessary.
- Assist to ambulate for 10 minutes at 8 AM, 2 PM, and 6 PM.
- Observe interaction with infant.
ANS: C
This intervention is the most specific and details what should be done, for how long, and when. The other interventions are too vague.
| PTS: | 1 | DIF: | Cognitive Level: Comprehension/Understanding |
| REF: | p. 31 | OBJ: | Nursing Process: Planning |
| MSC: | Client Needs: Safe and Effective Care Environment | ||
- What part of the nursing process includes the collection of data on vital signs, allergies, sleep patterns, and feeding behaviors?
- Assessment
- Planning
- Intervention
- Evaluation
ANS: A
Assessment includes gathering baseline data. Planning is based on baseline data and physical assessment. Implementation is the initiation and completion of nursing interventions. Evaluation is the last step in the nursing process and involves determining whether the goals were met.
| PTS: | 1 | DIF: | Cognitive Level: Knowledge/Remembering |
| REF: | p. 29 | OBJ: | Nursing Process: Assessment |
.
MSC: Client Needs: Safe and Effective Care Environment
- The nurse who coordinates and manages a patient’s care with other members of the health care team is functioning in which role?
- Teacher
- Collaborator
- Researcher
- Advocate
ANS: B
The nurse collaborates with other members of the health care team, often coordinating and managing the patient’s care. Care is improved by this interdisciplinary approach as nurses work together with dietitians, social workers, physicians, and others. Education is an essential role of today’s nurse. The nurse functions as a teacher during prenatal care, during maternity care, and when teaching parents of children regarding normal growth and development. Nurses contribute to their profession’s knowledge base by systematically investigating theoretic for practice issues and nursing. A nursing advocate is one who speaks on behalf of another. As the health professional who is closest to the patient, the nurse is in an ideal position to humanize care and to intercede on the patient’s behalf.
| PTS: | 1 | DIF: | Cognitive Level: Knowledge/Remembering |
| REF: | p. 25 | OBJ: | Nursing Process: Planning |
| MSC: | Client Needs: Safe and Effective Care Environment | ||
- Which statement about alternative and complementary therapies is true?
- Replace conventional Western modalities of treatment
- Are used by only a small number of American adults
- Allow for more patient autonomy but also may carry risks
- Focus primarily on the disease an individual is experiencing
ANS: C
Being able to choose alternative and complementary health products and practices does allow for patient autonomy, but the major concern is risk as patients may not disclose their use or substances may interact with other medications the patient is taking. Alternative and complementary therapies are part of an integrative approach to health care for most people, although some may choose only these types of therapies. An increasing number of American adults are seeking alternative and complementary health care options. Alternative healing modalities offer a holistic approach to health, focusing on the whole person and not just the disease.
| PTS: | 1 | DIF: | Cognitive Level: Comprehension/Understanding |
| REF: | p. 31 | OBJ: | Integrated Process: Culture and Spirituality |
| MSC: | Client Needs: Physiologic Integrity | ||
- Which step in the nursing process identifies the basis or cause of the patient’s problem?
- Intervention
- Expected outcome
- Nursing diagnosis
- Evaluation
ANS: C
.
A nursing diagnosis states the problem and its cause (“related to”). Interventions are actions taken to meet the problem. Expected outcome is a statement of how the goal will be measured. Evaluation determines whether the goal has been met.
| PTS: | 1 | DIF: | Cognitive Level: Knowledge/Remembering |
| REF: | pp. 30-31 | OBJ: | Nursing Process: Planning |
| MSC: | Client Needs: Safe and Effective Care Environment | ||
MULTIPLE RESPONSE
- Today’s nurse often assumes the role of teacher or educator. Which strategies would be best to use for a nurse working with a new mother? (Select all that apply.)
- Computer-based learning
- Videos
- Printed material
- Group discussion
- Lecture
ANS: A, B, C, D
To be effective as a teacher, the nurse must tailor teaching to specific needs and characteristics of the patient. Computer-based learning, videos, printed material, and group discussions have all be shown to be effective teaching strategies. Lecture is probably the least effective method as it does not allow for participation.
| PTS: | 1 | DIF: | Cognitive Level: Knowledge/Remembering |
| REF: | p. 24 | OBJ: | Integrated Process: Teaching-Learning |
| MSC: | Client Needs: Health Promotion and Maintenance | ||
- The nurse who uses critical thinking understands that the steps of critical thinking include (Select all that apply.)
- therapeutic communication.
- examining biases.
- setting priorities.
- managing data.
- evaluating other factors.
ANS: B, D, E
The five steps of critical thinking include recognizing assumptions, examining biases,analyzing the need for closure, managing data, and evaluating other factors such as emotions and environmental factors. Therapeutic communication is a skill that nurses must have tocarry out the many roles expected in the profession; however, it is not one of the steps of critical thinking. Setting priorities is part of the planning phase of the nursing process.
| PTS: | 1 | DIF: | Cognitive Level: Knowledge/Remembering |
| REF: | p. 27 | OBJ: | Nursing Process: Planning |Nursing Process: Implementation |
| MSC: | Client Needs: Safe and Effective Care Environment | ||
- A nurse wishes to incorporate the American Nurses Association Code of Ethics for Nurses in daily practice. Which of the following actions best demonstrates successful integration of the code into daily routines?
.
- Strives to treat all patients equally and with caring kindness
- Calls the provider when the patient’s pain is not controlled with prescribed medications
- Reads current literature related to practice area and brings ideas to unit management
- Routinely stays overtime in order to visit and bond with new families
- Decides to “play nicely” and not get involved in disputes about patient care
ANS: A, B, C
The ANAs Code of Ethics includes statements about practicing with compassion and respect for the inherent dignity, worth, and unique attributes of every person, advocating for the patient, and advancing the profession through research and scholarly inquiry, professional standards development, and the generation of both nursing and health policy. Staying overtime may contribute to burn out and does not advance the Code of Ethics. Nurses are responsible for making decisions and taking action consistent with the obligation to promote health and to provide optimal care; not getting involved in patient care disputes does not uphold this standard.
| PTS: | 1 | DIF: | Cognitive Level: Analysis/Analyzing |
| REF: | Box 2.1 | OBJ: | Integrated Process: Caring |
| MSC: | Client Needs: Safe and Effective Care Environment | ||
Chapter 04: Communicating with Children and Families
McKinney: Evolve Resources for Maternal-Child Nursing, 5th Edition
MULTIPLE CHOICE
- Which information should the nurse include when preparing a 5-year-old child for a cardiac catheterization?
- A detailed explanation of the procedure
- A description of what the child will feel and see during procedure
- An explanation about the dye that will go directly into his vein
- An assurance to the child that he and the nurse can talk about the procedure when it is over
ANS: B
For a preschooler, the provision of sensory information about what to expect during the procedure will enhance the child’s ability to cope with the events of the procedure and will decrease anxiety. Explaining the procedure in detail is probably more than the 5-year-old child can comprehend, and it will likely produce anxiety. Using the word “dye” with a preschooler can be frightening for the child. The child needs information before the procedure.
| PTS: | 1 | DIF: | Cognitive Level: Comprehension/Understanding |
| REF: | Table 4.3 | OBJ: | Integrated Process: Teaching-Learning |
| MSC: | Client Needs: Health Promotion and Maintenance | ||
- An important consideration for the nurse who is communicating with a 5-year-old child is to
- speak loudly, clearly, and directly.
- use picture or story books, or puppets.
- disguise own feelings, attitudes, and anxiety.
- initiate contact with child when parent is not present.
ANS: B
Using objects such as a puppet or doll allows the young child an opportunity to evaluate an unfamiliar person (the nurse) . This will facilitate communication with a child of this age. Speaking in this manner will tend to increase anxiety in very young children as they may interpret this as being yelled at. The nurse must be honest with the child. Attempts at deception will lead to a lack of trust. Whenever possible, the parent should be present for interactions with young children.
| PTS: | 1 | DIF: | Cognitive Level: Comprehension/Understanding |
| REF: | Table 4.3 | OBJ: | Integrated Process: Communication and Documentation |
| MSC: | Client Needs: Psychosocial Integrity | ||
- An effective technique for communicating with toddlers is to
- have the toddler make up a story from a picture.
- involve the toddler in dramatic play with dress-up clothing.
- use picture books.
- ask the toddler to draw pictures of his fears.
ANS: C
.
Activities and procedures should be described as they are about to be done. Use picture books and play for demonstration. Toddlers experience the world through their senses. Most toddlers do not have the vocabulary to make up stories. Dramatic play is associated with older children. Toddlers probably are not capable of drawing or verbally articulating their fears.
| PTS: | 1 | DIF: | Cognitive Level: Knowledge/Remembering |
| REF: | Table 4.3 | OBJ: | Integrated Process: Communication and Documentation |
| MSC: | Client Needs: Health Promotion and Maintenance | ||
- What is the most important consideration for effectively communicating with a child?
- The child’s chronologic age
- The parent-child interaction
- The child’s receptiveness
- The child’s developmental level
ANS: D
The child’s developmental level is the basis for selecting the terminology and structure of the message most likely to be understood by the child. The child’s age may not correspond with the child’s developmental level; therefore it is not the most important consideration for communicating with children. Parent-child interaction is useful in planning communication with children, but it is not the primary factor in establishing effective communication. The child’s receptiveness is a consideration in evaluating the effectiveness of communication.
| PTS: | 1 | DIF: | Cognitive Level: Comprehension/Understanding |
| REF: | p. 54 | OBJ: | Nursing Process: Assessment |
| MSC: | Client Needs: Health Promotion and Maintenance | ||
- Which behavior is most likely to encourage open communication?
- Avoiding eye contact
- Folding arms across chest
- Standing with head bowed
- Soft stance with arms loose at the side
ANS: D
An open body stance and positioning such as loose arms at the side invite communication and interaction. Avoiding eye contact, folding the arms across the chest, and standing with the head bowed, are closed body postures and do not facilitate communication.
| PTS: | 1 | DIF: | Cognitive Level: Knowledge/Remembering |
| REF: | Table 4.1 | OBJ: | Integrated Process: Communication and Documentation |
| MSC: | Client Needs: Psychosocial Integrity | ||
- Which strategy is most likely to encourage a child to express feelings about the hospital experience?
- Avoiding periods of silence
- Asking yes/no questions
- Sharing personal experiences
- Using open-ended questions
ANS: D
.
Open-ended questions encourage conversation. Periods of silence can serve to facilitate communication, but this is not the most effective means of getting the child to communicate. Yes/no questions are closed ended and do not encourage conversation. Talking about yourself shifts the focus of the conversation away from the child.
| PTS: | 1 | DIF: | Cognitive Level: Knowledge/Remembering |
| REF: | p. 50 | OBJ: | Integrated Process: Communication and Documentation |
| MSC: | Client Needs: Psychosocial Integrity | ||
- Which is the most appropriate question to ask when interviewing an adolescent to encourage conversation?
- “Are you in school?”
- “Are you doing well in school?”
- “How is school going for you?”
- “How do your parents feel about your grades?”
ANS: C
Open-ended questions encourage communication. Questions with “yes” or “no” answers do not encourage conversation. Questions that can be interpreted as judgmental do not enhance communication. Asking adolescents about their parents’ feelings may block communication.
| PTS: | 1 | DIF: | Cognitive Level: Comprehension/Understanding |
| REF: | Table 4.3 | OBJ: | Integrated Process: Communication and Documentation |
| MSC: | Client Needs: Psychosocial Integrity | ||
- What is the most appropriate response for the nurse to make to the parent of a 3-year-old child found in a bed with the side rails down?
- “You must never leave the child in the room alone with the side rails down.”
- “I am very concerned about your child’s safety when you leave the side rails down.”
- “It is hospital policy that side rails need to be up if the child is in bed.”
- “When parents leave side rails down, they might be considered as uncaring.”
ANS: B
To express concern and then choose words that convey a policy without appearing to cast blame on improper behavior is appropriate. Framing the communication in the negative does not facilitate effective communication. Stating a policy to parents conveys the attitude that the hospital has authority over parents in matters concerning their children and may be perceived negatively. It also does not give information as to why the side rails need to be up. This statement conveys blame and judgment to the parent.
| PTS: | 1 | DIF: | Cognitive Level: Application/Applying |
| REF: | Table 4.2 | OBJ: | Integrated Process: Communication and Documentation |
| MSC: | Client Needs: Psychosocial Integrity | ||
- What is an appropriate preoperative teaching plan for a school-age child?
- Begin preoperative teaching the morning of surgery.
- Schedule a tour of the hospital a few weeks before surgery.
- Show the child books and pictures 4 days before surgery.
- Limit teaching to 5 minutes and use simple terminology.
.
ANS: C
Preparatory material can be introduced to the school-age child several days (1 to 5) in advance of the event. Books, pictures, charts, and videos are appropriate. Preoperative teaching a few hours before surgery is more appropriate for the preschool child. Preoperative materials should be introduced 1 to 5 days in advance for school-age children. Preparation too far in advance of the procedure can be forgotten or cause undue anxiety for an extended period of time. A very short, simple explanation of the surgery is appropriate for a younger child such as a toddler.
| PTS: | 1 | DIF: | Cognitive Level: Comprehension/Understanding |
| REF: | Table 4.3 | OBJ: | Nursing Process: Planning |
| MSC: | Client Needs: Health Promotion and Maintenance | ||
- When a child broke her favorite doll during a hospitalization, her primary nurse bought the child a new doll and gave it to her the next day. What is the best interpretation of the nurse’s behavior?
- The nurse is displaying signs of overinvolvement.
- The nurse is a kind and generous person.
- The nurse feels a special closeness to the child.
- The nurse wants to make the child happy.
ANS: A
Buying gifts for individual children is a warning sign of overinvolvement. Nurses are kind and generous people, but buying gifts for individual children is unprofessional. Nurses may feel closer to some patients and families. This does not make giving gifts to children or families acceptable from a professional standpoint. Replacing lost items is not the nurse’s responsibility. Becoming overly involved with a child can inhibit a healthy relationship.
| PTS: | 1 | DIF: | Cognitive Level: Knowledge/Remembering |
| REF: | Box 4.2 | OBJ: | Nursing Process: Assessment |
| MSC: | Client Needs: Psychosocial Integrity | ||
- When meeting a toddler for the first time, the nurse initiates contact by
- calling the toddler by name and picking the toddler up.
- asking the toddler for his or her first name.
- kneeling in front of the toddler and speaking softly to the child.
- telling the toddler that you are his or her nurse today.
ANS: C
More positive interactions occur when the toddler perceives the meeting in a nonthreatening way. Placing yourself at the toddler’s level and speaking softly can be less threatening for the child. Picking a toddler up at an initial meeting is a threatening action and will more likely result in a negative response from the child. Toddlers are unlikely to respond to direct questions at a first meeting. Telling the toddler you are the nurse is not likely to facilitate or encourage cooperation. The toddler perceives you as a stranger and will find the action threatening.
| PTS: | 1 | DIF: | Cognitive Level: Application/Applying |
| REF: | p. 48 | OBJ: | Nursing Process: Implementation |
| MSC: | Client Needs: Psychosocial Integrity | ||
.
- An 8-year-old girl asks the nurse how the blood pressure apparatus works. The most appropriate nursing action is to
- ask why the child wants to know.
- determine why the child is so anxious.
- explain in simple terms how it works.
- tell the child he or she will see how it works as it is used.
ANS: C
School-age children require explanations and reasons for everything. They are interested in the functional aspect of all procedures, objects, and activities. It is appropriate for the nurse to explain how equipment works and what will happen to the child. The nurse should respond positively for requests for information about procedures and health information. By not responding, the nurse may be limiting communication with the child. The child is not exhibiting anxiety, just requesting clarification of what will be occurring. The nurse must explain how the blood pressure cuff works so that the child can then observe during the procedure.
| PTS: | 1 | DIF: | Cognitive Level: Comprehension/Understanding |
| REF: | Table 4.3 | OBJ: | Nursing Process: Implementation |
| MSC: | Client Needs: Health Promotion and Maintenance | ||
- A positive, supportive communication technique that is effective from birth throughout adulthood is
- physical proximity.
ANS: D
Touch can convey warmth, comfort, reassurance, security, caring, and support. In infancy, messages of security and comfort are conveyed when they are being held. Toddlers and preschoolers find it soothing and comforting to be held and rocked. School-aged children and adolescents appreciate receiving a hug or pat on the back (with permission). Listening is an essential component of the communication process. By practicing active listening skills, nurses can be effective listeners. Listening is a component of verbal communication. Individuals have different comfort zones for physical distance. The nurse should be aware of these differences and move cautiously when meeting new children and families. It is important to create a supportive and friendly environment for children including the use of child-sized furniture, posters, developmentally appropriate toys, and art displayed at a child’s eye level.
| PTS: | 1 | DIF: | Cognitive Level: Comprehension/Understanding |
| REF: | p. 48 | OBJ: | Integrated Process: Communication and Documentation |
| MSC: | Client Needs: Health Promotion and Maintenance | ||
- A nurse is caring for a child who does not speak English. The parents are able to understand and speak only limited English. What action by the nurse is best?
- Allow the patient’s 12-year-old sister to interpret.
- See if there is another family member who can interpret.
- Use a professionally trained interpreter for this family.
.
- Use the Internet to translate written information in the native language.
ANS: C
A professional interpreter is the best option in this situation. They are trained in medical interpreting and do not allow cultural influences into their work. A child should never be asked to interpret; the child may be too young to understand sophisticated concepts involved in the discussion and the information from the patient may be misconstrued and disturbing to the child. An adult family member may have to do temporarily in an emergency, but the best option is a professional interpreter.
| PTS: | 1 | DIF: | Cognitive Level: Knowledge/Remembering |
| REF: | p. 53 | OBJ: | Integrated Process: Communication and Documentation |
| MSC: | Client Needs: Psychosocial Integrity | ||
MULTIPLE RESPONSE
- In planning care for a preschool-age child, the nurse knows that which open body postures encourage positive communication? (Select all that apply.)
- Leaning away from the preschooler
- Frequent eye contact
- Hands on hips
- Conversing at eye level
- Asking the parents to stay in the room
ANS: B, D
Frequent eye contact and conversing at eye level are both open body postures that encourage positive communication. Leaning away from the child and placing your hands on your hips are both closed body postures that do not facilitate effective communication. Asking the parents to stay in the room while the nurse is talking to the child is helpful but is not an open body posture.
| PTS: | 1 | DIF: | Cognitive Level: Knowledge/Remembering |
| REF: | Table 4.1 | OBJ: | Integrated Process: Communication and Documentation |
| MSC: | Client Needs: Psychosocial Integrity | ||
- Which behaviors by the nurse may indicate professional separation or underinvolvement? (Select all that apply.)
- Avoiding the child or his or her family
- Revealing personal information
- Calling in sick
- Spending less time with a particular child
- Asking to trade assignments
ANS: A, C, D, E
Whether nurses become too emotionally involved or find themselves at the other end of the spectrum—being underinvolved—they lose effectiveness as objective professional resources. These are all indications of the nurse who is underinvolved in a child’s care. Revealing personal information to a patient or his or her family is an indication of overinvolvement.
PTS:
REF:
1
Box 4.3
DIF: Cognitive Level: Knowledge/Remembering
OBJ: Integrated Process: Communication and Documentation
.
MSC: Client Needs: Safe and Effective Care Environment
- While developing a care plan for a school-age child with a visual impairment, the nurse knows that which of the following actions are important in working with this special needs child? (Select all that apply.)
- Obtain a thorough assessment of the child’s self-care abilities.
- Orient the child to various sounds in the environment.
- Tell the child’s parents to stay continuously with their child during hospitalization.
- Allow the child to handle equipment as procedures are explained.
- Encourage the child to use a dry erase board to write his needs.
ANS: A, B, D
Conducting a thorough assessment of the child’s self-care abilities, orienting the child to various sounds in the environment, and allowing the child to handle equipment are all ways to enhance communication with a visually impaired child. Mandating that the child’s parents stay continuously with their child may not be possible and is not usually necessary if the school-age child is at the expected level of growth and development. Encouraging a child to write his needs on a dry erase board would be an appropriate intervention for a child who is hearing impaired, not for a child with a visual deficit.
| PTS: | 1 | DIF: | Cognitive Level: Knowledge/Remembering |
| REF: | p. 59 | OBJ: | Integrated Process: Communication and Documentation |
| MSC: | Client Needs: Psychosocial Integrity | ||
- A preschool-age child is being admitted for some diagnostic tests and possible surgery. The nurse planning care should use which phrases when explaining procedures to the child? (Select all that apply.)
- Fluids will be given through tubing connected to a tiny tube inserted into your arm.
- After surgery we will be doing dressing changes.
- You will get a shot before surgery.
- The doctor will give you medicine that will help you go into a deep sleep.
- We will take you to surgery on a bed on wheels.
ANS: A, D, E
A preschool child needs simple concrete explanations that cannot be misinterpreted. An IV should be explained as fluids going into a tube connected to a small tube in your hand; anesthesia can be explained as a medicine that will help you go into a deep sleep (put to sleep should be avoided); and a stretcher can be described as riding on a bed with wheels. The term “dressing changes” is ambiguous and will not be understood by a preschooler. The term “get a shot” should not be used. A preschooler or young child is likely to misinterpret this information.
| PTS: | 1 | DIF: | Cognitive Level: Comprehension/Understanding |
| REF: | Table 4.4 | OBJ: | Integrated Process: Communication and Documentation |
| MSC: | Client Needs: Psychosocial Integrity | ||
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