Chapter 33: Communication, History, Physical, and Developmental Assessment
MULTIPLE CHOICE
1. The nurse is seeing an adolescent boy and his parents in the clinic for the first time. What should
the nurse do first?
a. Introduce him- or herself.
b. Make the family comfortable.
c. Explain the purpose of the interview.
d. Give an assurance of privacy.
ANS: A
The first thing that nurses must do is introduce themselves to the patient and family. Parents
and other adults should be addressed with appropriate titles unless they specify a preferred
name. During the initial part of the interview, the nurse should include general conversation to
help make the family feel at ease. Next, the purpose of the interview and the nurse’s role
should be clarified. The interview 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 confidentiality.
DIF: Cognitive Level: Application REF: p. 897
OBJ: Nursing Process: Implementation
2. What approach is most likely to encourage parents to talk about their feelings related to their
child’s illness?
a. Being sympathetic
b. Using direct questions
c. Using open-ended questions
d. Avoiding periods of silence
ANS: C
Closed-ended questions should be avoided when attempting to elicit parents’ feelings. Open-
ended questions require the parent to respond with more than a brief answer. Sympathy is
defined as having feelings or emotions in common with another person, rather than
understanding those feelings (which is called empathy). Sympathy is not therapeutic in the
helping relationship. Direct questions may only obtain limited information. In addition, the
parent may consider them threatening. Silence can be an effective interviewing tool. It allows
two or more people to share feelings and absorb one another’s emotions in depth. Silence
, permits the interviewee to sort out thoughts and feelings and search for responses to
questions.
DIF: Cognitive Level: Application REF: p. 898 OBJ: Nursing
Process: Implementation
3. What is the single most important factor to consider when communicating with children?
a. The child’s physical condition
b. The presence or absence of the child’s
parent
c. The child’s developmental level
d. The child’s nonverbal behaviours
ANS: C
The nurse must be aware of the child’s developmental stage to engage in effective
communication. An understanding of the typical characteristics of these stages provides the
nurse with a framework to facilitate social communication. The use of both verbal and
nonverbal communication should be appropriate to the developmental level. Although the
child’s physical condition is a consideration, developmental level is much more important. The
parents’ presence is important when communicating with young children, but it may be
detrimental when speaking with adolescents. Nonverbal behaviours vary in importance, based
on the child’s developmental level.
DIF: Cognitive Level: Comprehension REF: p. 900 OBJ: Nursing
Process: Implementation
4. What is an important consideration for the nurse who is communicating with a very young child?
a. Speak loudly, clearly, and directly.
b. Use transition objects, such as a doll.
, c. Disguise one’s own feelings, attitudes, and
anxiety.
d. Initiate contact with the child when his
or her parent is not present.
ANS: B
Using a transition object allows the young child an opportunity to evaluate an unfamiliar
person (the nurse), facilitating communication. Speaking loudly, clearly, and directly tends to
increase anxiety in very young children. The nurse must be honest with the child. Attempts at
deception lead to a lack of trust. Whenever possible, a parent should be present for
interactions with young children.
DIF: Cognitive Level: ComprehensionREF: p. 900 |Guidelines box OBJ:
Nursing Process: Implementation
5. When introducing hospital equipment to a preschooler who seems afraid, which principle
should the nurse keep in mind?
a. The child may think the equipment is
alive.
b. The child is too young to understand what
the equipment does.
c. Explaining the equipment will only
increase the child’s fear.
d. One brief explanation is enough to
reduce the child’s fear.
ANS: A
Young children attribute human characteristics to inanimate objects. They often fear that an
object may jump, bite, cut, or pinch all by themselves without human direction. Equipment
should be kept out of sight until needed. The nurse should give the child simple, concrete
explanations about what the equipment does and how it will feel to help alleviate the child’s
fear. Preschoolers will need repeated explanations for reassurance.
DIF: Cognitive Level: Analysis REF: p. 901
OBJ: Nursing Process: Implementation
6. Which age group is most concerned with body integrity?
MULTIPLE CHOICE
1. The nurse is seeing an adolescent boy and his parents in the clinic for the first time. What should
the nurse do first?
a. Introduce him- or herself.
b. Make the family comfortable.
c. Explain the purpose of the interview.
d. Give an assurance of privacy.
ANS: A
The first thing that nurses must do is introduce themselves to the patient and family. Parents
and other adults should be addressed with appropriate titles unless they specify a preferred
name. During the initial part of the interview, the nurse should include general conversation to
help make the family feel at ease. Next, the purpose of the interview and the nurse’s role
should be clarified. The interview 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 confidentiality.
DIF: Cognitive Level: Application REF: p. 897
OBJ: Nursing Process: Implementation
2. What approach is most likely to encourage parents to talk about their feelings related to their
child’s illness?
a. Being sympathetic
b. Using direct questions
c. Using open-ended questions
d. Avoiding periods of silence
ANS: C
Closed-ended questions should be avoided when attempting to elicit parents’ feelings. Open-
ended questions require the parent to respond with more than a brief answer. Sympathy is
defined as having feelings or emotions in common with another person, rather than
understanding those feelings (which is called empathy). Sympathy is not therapeutic in the
helping relationship. Direct questions may only obtain limited information. In addition, the
parent may consider them threatening. Silence can be an effective interviewing tool. It allows
two or more people to share feelings and absorb one another’s emotions in depth. Silence
, permits the interviewee to sort out thoughts and feelings and search for responses to
questions.
DIF: Cognitive Level: Application REF: p. 898 OBJ: Nursing
Process: Implementation
3. What is the single most important factor to consider when communicating with children?
a. The child’s physical condition
b. The presence or absence of the child’s
parent
c. The child’s developmental level
d. The child’s nonverbal behaviours
ANS: C
The nurse must be aware of the child’s developmental stage to engage in effective
communication. An understanding of the typical characteristics of these stages provides the
nurse with a framework to facilitate social communication. The use of both verbal and
nonverbal communication should be appropriate to the developmental level. Although the
child’s physical condition is a consideration, developmental level is much more important. The
parents’ presence is important when communicating with young children, but it may be
detrimental when speaking with adolescents. Nonverbal behaviours vary in importance, based
on the child’s developmental level.
DIF: Cognitive Level: Comprehension REF: p. 900 OBJ: Nursing
Process: Implementation
4. What is an important consideration for the nurse who is communicating with a very young child?
a. Speak loudly, clearly, and directly.
b. Use transition objects, such as a doll.
, c. Disguise one’s own feelings, attitudes, and
anxiety.
d. Initiate contact with the child when his
or her parent is not present.
ANS: B
Using a transition object allows the young child an opportunity to evaluate an unfamiliar
person (the nurse), facilitating communication. Speaking loudly, clearly, and directly tends to
increase anxiety in very young children. The nurse must be honest with the child. Attempts at
deception lead to a lack of trust. Whenever possible, a parent should be present for
interactions with young children.
DIF: Cognitive Level: ComprehensionREF: p. 900 |Guidelines box OBJ:
Nursing Process: Implementation
5. When introducing hospital equipment to a preschooler who seems afraid, which principle
should the nurse keep in mind?
a. The child may think the equipment is
alive.
b. The child is too young to understand what
the equipment does.
c. Explaining the equipment will only
increase the child’s fear.
d. One brief explanation is enough to
reduce the child’s fear.
ANS: A
Young children attribute human characteristics to inanimate objects. They often fear that an
object may jump, bite, cut, or pinch all by themselves without human direction. Equipment
should be kept out of sight until needed. The nurse should give the child simple, concrete
explanations about what the equipment does and how it will feel to help alleviate the child’s
fear. Preschoolers will need repeated explanations for reassurance.
DIF: Cognitive Level: Analysis REF: p. 901
OBJ: Nursing Process: Implementation
6. Which age group is most concerned with body integrity?
