RNSG 2201-061 CARE OF CHILDREN AND
FAMILIES
PEDI EXAM #2 CHAPTER 4, 5, 6
Chapter 04: Communication, Physical,
and Developmental Assessment
MULTIPLE CHOICE
1. The nurse is seeing an adolescent and the parents in the clinic for the first time.
Which should the nurse do first?
a. Introduce him- or herself.
b. Make the family comfortable.
c. Give assurance of privacy.
d. Explain the purpose of the interview.
ANS: A The first thing that nurses must do is to introduce themselves to the patient
and family. Parents and other adults should be addressed with appropriate titles unless
they specify a preferred name. Clarification of the purpose of the interview and the
nurses role is the second thing that should be done. During the initial part of the
interview, the nurse should include general conversation to help make the family feel
at ease. The interview also should take place in an environment as free of distraction
as possible. In addition, the nurse should clarify which information will be shared
with other members of the health care team and any limits to the confidentiality.
,2. Which is considered a block to effective communication?
a. Using silence
b. Using clichs
c. Directing the focus
d. Defining the problem
ANS: B Using stereotyped comments or clichs can block effective communication.
After the nurse uses such trite phrases, parents often do not respond. Silence can be an
effective interviewing tool. Silence permits the interviewee to sort out thoughts and
feelings and search for responses to questions. To be effective, the nurse must be able
to direct the focus of the interview while allowing maximum freedom of expression.
By using open-ended questions and guiding questions, the nurse can obtain the
necessary information and maintain a relationship with the family. The nurse and
parent must collaborate and define the problem that will be the focus of the nursing
intervention.
3. Which is the single most important factor to consider when communicating
with children?
a. Presence of the childs parent
b. Childs physical condition
c. Childs developmental level
d. Childs nonverbal behaviors
ANS: C The nurse must be aware of the childs developmental stage to engage in
effective communication. The use of both verbal and nonverbal communication
should be appropriate to the developmental level. Nonverbal behaviors vary in
importance based on the childs developmental level and physical condition. Although
the childs physical condition is a consideration, developmental level is much more
important. The presence of parents is important when communicating with young
children but may be detrimental when speaking with adolescents.
,4. Because children younger than 5 years are egocentric, the nurse should do
which when communicating with them?
a. Focus communication on the child.
b. Use easy analogies when possible.
c. Explain experiences of others to the child.
d. Assure the child that communication is private.
ANS: A Because children of this age are able to see things only in terms of
themselves, the best approach is to focus communication directly on them. Children
should be provided with information about what they can do and how they will feel.
With children who are egocentric, analogies, experiences, and assurances that
communication is private will not be effective because the child is not capable of
understanding.
5. The nurses approach when introducing hospital equipment to a preschooler
who seems afraid should be based on which principle?
a. The child may think the equipment is alive.
b. Explaining the equipment will only increase the childs fear.
c. One brief explanation will be enough to reduce the childs fear.
d. The child is too young to understand what the equipment does.
ANS: A Young children attribute human characteristics to inanimate objects. They
often fear that the objects may jump, bite, cut, or pinch all by themselves without
human direction. Equipment should be kept out of sight until needed. Simple,
concrete explanations about what the equipment does and how it will feel will help
alleviate the childs fear. Preschoolers need repeated explanations as reassurance.
, 6. When the nurse interviews an adolescent, which is especially important?
a. Focus the discussion on the peer group.
b. Allow an opportunity to express feelings.
c. Use the same type of language as the adolescent.
d. Emphasize that confidentiality will always be maintained.
ANS: B Adolescents, like all children, need opportunities to express their feelings.
Often they interject feelings into their words. The nurse must be alert to the words and
feelings expressed. The nurse should maintain a professional relationship with
adolescents. To avoid misunderstanding or misinterpretation of words and phrases
used, the nurse should clarify the terms used, what information will be shared with
other members of the health care team, and any limits to confidentiality. Although the
peer group is important to this age group, the interview should focus on the
adolescent.
7. The nurse is preparing to assess a 10-month-old infant. He is sitting on his
fathers lap and appears to be afraid of the nurse and of what might happen next.
Which initial actions by the nurse should be most appropriate?
a. Initiate a game of peek-a-boo.
b. Ask the infants father to place the infant on the examination table.
c. Talk softly to the infant while taking him from his father.
d. Undress the infant while he is still sitting on his fathers lap.
ANS: A Peek-a-boo is an excellent means of initiating communication with infants
while maintaining a safe, nonthreatening distance. The child will most likely become
upset if separated from his father. As much of the assessment as possible should be
done with the child on the fathers lap. The nurse should have the father undress the
child as needed during the examination.
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