Deck 22: Family-Centered Care of the Child During Illness and Hospitalization

Question 1

The parents of a 4-month-old infant cannot visit except on weekends. What action by the nurse indicates an understanding of the emotional needs of a young infant?

A) Place her in a room away from other children.
B) Assign her to the same nurse as much as possible.
C) Tell the parents that frequent visiting is unnecessary.
D) Assign her to different nurses so she will have varied contacts.

Answer 1

Assign her to the same nurse as much as possible.

Question 2

A 9-year-old boy has an unplanned admission to the intensive care unit (ICU) after abdominal surgery. The nursing staff has completed the admission process, and his condition is beginning to stabilize. When speaking with the parents, the nurse should expect what additional stressor to be evident?

A) Usual day-night routine
B) Calming influence of staff
C) Adequate privacy and support
D) Insufficient remembering of his condition and routine

Answer 2

Insufficient remembering of his condition and routine

Question 3

The nurse is caring for a 10-year-old child during a long hospitalization. What intervention should the nurse include in the care plan to minimize loss of control and autonomy during the hospitalization?

A) Allow the child to skip morning self-care activities to watch a favorite television program.
B) Create a calendar with special events such as a visit from a friend to maintain a routine.
C) Allow the child to sleep later in the morning and go to bed later at night to promote control.
D) Create a restrictive environment so the child feels in control of sensory stimulation.

Answer 3

Create a calendar with special events such as a visit from a friend to maintain a routine.

Question 4

The mother of a 7-month-old infant newly diagnosed with cystic fibrosis is rooming in with her infant. She is breastfeeding and provides all the care except for the medication administration. What should the nurse include in the plan of care?

A) Ensuring that the mother has time away from the infant
B) Making sure the mother is providing all of the infant's care
C) Determining whether other family members can provide the necessary care so the mother can rest
D) Contacting the social worker because of the mother's interference with the nursing care

Question 5

The nurse is admitting a 7-year-old child to the pediatric unit for abdominal pain. To determine what the child understands about the reason for hospitalization, what should the nurse do?

A) Find out what the parents have told the child.
B) Review the note from the admitting practitioner.
C) Ask the child why he came to the hospital today.
D) Question the parents about why they brought the child to the hospital.

Question 6

An 8-year-old girl is being admitted to the hospital from the emergency department with an injury from falling off her bicycle. What intervention will help her most in her adjustment to the hospital?

A) Explain hospital schedules to her, such as mealtimes.
B) Use terms such as "honey" and "dear" to show a caring attitude.
C) Explain when parents can visit and why siblings cannot come to see her.
D) Orient her parents, because she is too young, to her room and hospital facility.

Question 7

A 13-year-old child with cystic fibrosis (CF) is a frequent patient on the pediatric unit. This admission, she is sleeping during the daytime and unable to sleep at night. What should be a beneficial strategy for this child?

A) Administer prescribed sedative at night to aid in sleep.
B) Negotiate a daily schedule that incorporates hospital routine, therapy, and free time.
C) Have the practitioner speak with the child about the need for rest when receiving therapy for CF.
D) Arrange a consult with the social worker to determine whether issues at home are interfering with her care.

Question 8

A 6-year-old is being discharged home, which is 90 miles from the hospital, after an outpatient hernia repair. In addition to explicit discharge instructions, what should the nurse provide?

A) An ambulance for transport home
B) Verbal information about follow-up care
C) Prescribed pain medication before discharge
D) Driving instructions for a route with less traffic

Question 9

A child, age 4 years, tells the nurse that she "needs a Band-Aid" where she had an injection. What nursing action should the nurse implement?

A) Apply a Band-Aid.
B) Ask her why she wants a Band-Aid.
C) Explain why a Band-Aid is not needed.
D) Show her that the bleeding has already stopped.

Question 10

Because of their striving for independence and productivity, which age group of children is particularly vulnerable to events that may lessen their feeling of control and power?

A) Infants
B) Toddlers
C) Preschoolers
D) School-age children

Question 11

A 6-year-old child is admitted to the pediatric unit and requires bed rest. Having art supplies available meets which purpose?

A) Allows the child to create gifts for parents
B) Provides developmentally appropriate activities
C) Is essential for play therapy so the child can work on past problems
D) Lets the child express thoughts and feelings through pictures rather than words

Question 12

The psychosexual conflicts of preschool children make them extremely vulnerable to which threat?

A) Loss of control
B) Loss of identity
C) Separation anxiety
D) Bodily injury and pain

Question 13

What behavior should most likely be manifested in an infant experiencing the protest phase of separation anxiety?

A) Inactivity
B) Depression and sadness
C) Inconsolable and crying
D) Regression to earlier behavior

Question 14

Two hospitalized adolescents are playing pool in the activity room. Neither of them seems enthusiastic about the game. How should the nurse interpret this situation?

A) Playing pool requires too much concentration for this age group.
B) Pool is an activity better suited for younger children.
C) The adolescents may be enjoying themselves but have lower energy levels than healthy children.
D) The adolescents' lack of enthusiasm is one of the signs of depression.

Question 15

A 10-year-old girl needs to have another intravenous (IV) line started. She keeps telling the nurse, "Wait a minute," and, "I'm not ready." How should the nurse interpret this behavior?

A) IV insertions are viewed as punishment.
B) This is expected behavior for a school-age child.
C) Protesting like this is usually not seen past the preschool years.
D) The child has successfully manipulated the nurse in the past.

Question 16

The nurse is notified that a 9-year-old boy with nephrotic syndrome is being admitted. Only semiprivate rooms are available. What roommate should be best to select?

A) A 10-year-old girl with pneumonia
B) An 8-year-old boy with a fractured femur
C) A 10-year-old boy with a ruptured appendix
D) A 9-year-old girl with congenital heart disease

Question 17

The nurse is doing a prehospitalization orientation for a girl, age 7 years, who is scheduled for cardiac surgery. As part of the preparation, the nurse explains that after the surgery, the child will be in the intensive care unit. How might the explanation by the nurse be viewed?

A) Unnecessary
B) The surgeon's responsibility
C) Too stressful for a young child
D) An appropriate part of the child's preparation

Question 18

The parents of a 3-year-old admitted for recurrent diarrhea are upset that the practitioner has not told them what is going on with their child. What is the priority intervention for this family?

A) Answer all of the parents' questions about the child's illness.
B) Immediately page the practitioner to come to the unit to speak with the family.
C) Help the family develop a written list of specific questions to ask the practitioner.
D) Inform the family of the time that hospital rounds are made so that they can be present.

Question 19

Cognitive development influences response to pain. What age group is most concerned with the fear of losing control during a painful experience?

A) Toddlers
B) Preschoolers
C) School-age children
D) Adolescents

Question 20

A spinal tap must be done on a 9-year-old boy. While he is waiting in the treatment room, the nurse observes that he seems composed. When the nurse asks him if he wants his mother to stay with him, he says, "I am fine." How should the nurse interpret this situation?

A) This child is unusually brave.
B) He has learned that support does not help.
C) Nine-year-old boys do not usually want a parent present during the procedure.
D) Children in this age group often do not request support even though they need and want it.

Question 21

The nurse is providing support to parents adapting to the hospitalization of their child to the pediatric intensive care unit. The nurse notices that the parents keep asking the same questions. What should the nurse do?

A) Patiently continue to answer questions, trying different approaches.
B) Kindly refer them to someone else for answering their questions.
C) Recognize that some parents cannot understand explanations.
D) Suggest that they ask their questions when they are not upset.

Question 22

What factors influence the effects of a child's hospitalization on siblings? (Select all that apply.)

A) Older siblings
B) Experiencing minimal changes
C) Receiving little information about their ill brother or sister
D) Being cared for outside the home by care providers who are not relatives
E) Perceiving that their parents treat them differently compared with before their sibling's hospitalization

Question 23

What influences a child's reaction to the stressors of hospitalization? (Select all that apply.)

A) Gender
B) Separation
C) Support systems
D) Developmental age
E) Previous experience with illness

Question 24

What are signs and symptoms of the stage of detachment in relation to separation anxiety in young children? (Select all that apply.)

A) Appears happy
B) Lacks interest in the environment
C) Regresses to an earlier behavior
D) Forms new but superficial relationships
E) Interacts with strangers or familiar caregivers

Question 25

Parents of a hospitalized child often question the skill of staff. The nurse interprets this behavior by the parents as what?

A) Normal
B) Paranoid
C) Indifferent
D) Wanting attention

Question 26

The nurse needs to assess a 15-month-old child who is sitting quietly on his father's lap. What initial action by the nurse would be most appropriate?

A) Ask the father to place the child on the exam table.
B) Undress the child while he is still sitting on his father's lap.
C) Talk softly to the child while taking him from his father.
D) Begin the assessment while the child is in his father's lap.

Question 27

A parent needs to leave a hospitalized toddler for a short period of time. What action should the nurse suggest to the parent to ease the separation for the toddler?

A) Bring a new toy when returning.
B) Leave when the child is distracted.
C) Tell the child when they will return.
D) Leave a favorite article from home with the child.

Question 28

The nurse is instructing student nurses about the stress of hospitalization for children from middle infancy throughout the preschool years. What major stress should the nurse relate to the students?

A) Pain
B) Bodily injury
C) Loss of control
D) Separation anxiety

Question 29

The nurse should expect a toddler to cope with the stress of a short period of separation from parents by displaying what?

A) Regression
B) Happiness
C) Detachment
D) Indifference

Question 30

The nurse is assessing a child's functional self-care level for feeding, bathing and hygiene, dressing, and grooming and toileting. The child requires assistance or supervision from another person and equipment or device. What code does the nurse assign for this child?

A) I
B) II
C) III
D) IV

Question 31

The nurse is caring for a 3-year-old child during a long hospitalization. The parent is concerned about how to support the child's siblings during the hospitalization. What statement is appropriate for the nurse to make?

A) "You should choose one parent to spend every night in the hospital while the other parent stays at home with the other children."
B) "You could leave your hospitalized child for periods at night to be at home with the other children."
C) "You should discourage the siblings from visiting because this could upset everyone in the family."
D) "You could encourage a nightly phone call between the siblings as part of the bedtime routine."

Question 32

What factors can negatively affect parents' reactions to their child's illness? (Select all that apply.)

A) Additional stresses
B) Previous coping abilities
C) Lack of support systems
D) Seriousness of the threat to the child
E) Previous experience with hospitalization

Question 33

What parents should have the most difficult time coping with their child's hospitalization?

A) Parents of a child hospitalized for juvenile arthritis
B) Parents of a child hospitalized with a recent diagnosis of bronchiolitis
C) Parents of a child hospitalized for sepsis resulting from an untreated injury
D) Parents of a child hospitalized for surgical correction of undescended testicles

Question 34

The nurse is assessing a family's use of complementary medicine practices. What practices are classified as mind-body control therapies? (Select all that apply.)

A) Relaxation
B) Acupuncture
C) Prayer therapy
D) Guided imagery
E) Herbal medicine

Question 35

When a preschool-age child is hospitalized without adequate preparation, the nurse should recognize that the child may likely see hospitalization as what?

A) Punishment
B) Loss of parental love
C) Threat to the child's self-image
D) Loss of companionship with friends

Question 36

Parents tell the nurse that siblings of their hospitalized child are feeling "left out." What suggestions should the nurse make to the parents to assist the siblings to adjust to the hospitalization of their brother or sister? (Select all that apply.)

A) Arrange for visits to the hospital.
B) Limit information given to the siblings.
C) Encourage phone calls to the hospitalized child.
D) Make or buy inexpensive toys or trinkets for the siblings.
E) Identify an extended family member to be their support system.

Question 37

The nurse is assessing a family's use of complementary medicine practices. What practices are classified as nutrition, diet, and lifestyle or behavioral health changes? (Select all that apply.)

A) Reflexology
B) Macrobiotics
C) Megavitamins
D) Health risk reduction
E) Chiropractic medicine

Question 38

What choice of words or phrases would be inappropriate to use with a child?

A) "Rolling bed" for "stretcher"
B) "Special medicine" for "dye"
C) "Make sleepy" for "deaden"
D) "Catheter" for "intravenous"

Question 39

What are signs and symptoms of the stage of despair in relation to separation anxiety in young children? (Select all that apply.)

A) Withdrawn from others
B) Uncommunicative
C) Clings to parents
D) Physically attacks strangers
E) Forms new but superficial relationships
F) Regresses to early behaviors

Question 40

The parents tell a nurse "our child is having some short-term negative outcomes since the hospitalization." The nurse recognizes that what can negatively affect short-term negative outcomes? (Select all that apply.)

A) Parents' anxiety
B) Consistent nurses
C) Number of visitors
D) Length of hospitalization
E) Multiple invasive procedures

Question 41

What nursing interventions should the nurse plan for a hospitalized toddler to minimize fear of bodily injury? (Select all that apply.)

A) Perform procedures slowly.
B) Maintain parent-child contact.
C) Use progressively smaller dressings on surgical incisions.
D) Tell the child bleeding will stop after the needle is removed.
E) Remove a dressing as quickly as possible from surgical incisions.

Question 42

The nurse relates to parents that there are some beneficial effects of hospitalization for their child. What are beneficial effects of hospitalization? (Select all that apply.)

A) Recovery from illness
B) Improve coping abilities
C) Opportunity to master stress
D) Provide a break from school
E) Provide new socialization experiences

Question 43

What are core principles of patient- and family-centered care? (Select all that apply.)

A) Collaboration
B) Empowering families
C) Providing formal and informal support
D) Maintaining strict policy and procedure routines
E) Withholding information that is likely to cause anxiety