Nursing Care of Children Principles and Practice 3rd edition by Susan R. James – Test Bank
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James:
Nursing Care of Children: Principles and Practice, 3rd Edition
Test
Bank
Chapter
03: Communicating with Children
MULTIPLE CHOICE
1. Which
of the following information would the nurse include when preparing a
5-year-old child for a cardiac catheterization?
|
a. |
A detailed explanation of
the procedure |
|
b. |
A description of what the
child will feel and see during procedure |
|
c. |
An explanation about the
dye that will go directly into his vein |
|
d. |
An assurance to the child
that he and the nurse can talk about the procedure when it is over |
ANS: B
|
|
Feedback |
|
A |
Explaining the procedure in
detail is probably more than the 5-year-old child can comprehend and it will
produce anxiety. |
|
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. |
|
C |
Using the word “dye” with a
preschooler can be frightening for the child. |
|
D |
The child needs information
before the procedure. |
DIF: Cognitive Level:
Application
REF: Text Reference: pg 59
OBJ: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance
2. Who
are the “experts” in planning for the care of a 9-year-old child with a
profound sensory impairment who is hospitalized for surgery?
|
a. |
The child’s parents |
|
b. |
The child’s teacher |
|
c. |
The case manager |
|
d. |
The primary nurse |
ANS: A
|
|
Feedback |
|
A |
The parents, as primary
caregivers, can identify the child’s needs to help develop an effective,
individualized plan of care. |
|
B |
The child’s teacher is not
as “expert” as her parents for planning her care. |
|
C |
The case manager is not as
aware as the parents are of the child’s individual needs. |
|
D |
The primary nurse would use
the child’s parents as resources in planning the best approach to the child’s
care. |
DIF: Cognitive Level:
Comprehension REF: Text
Reference: pg 60
OBJ: Nursing Process Step:
Planning MSC:
NCLEX: Psychosocial Integrity
3. Which
of the following is an effective technique for communicating with toddlers?
|
a. |
Have the toddler make up a
story from a picture. |
|
b. |
Involve the toddler in
dramatic play with dress-up clothing. |
|
c. |
Repeatedly read familiar
stories to the child. |
|
d. |
Ask the toddler to draw
pictures of his fears. |
ANS: C
|
|
Feedback |
|
A |
Most toddlers do not have
the vocabulary to make up stories. |
|
B |
Dramatic play is associated
with older children. |
|
C |
Ritualism is a
characteristic of the toddler period. By repeating familiar stories and other
rituals, the toddler feels a sense of control, which facilitates
communication. |
|
D |
Toddlers probably are not
capable of drawing or verbally articulating their fears. |
DIF: Cognitive Level:
Application
REF: Text Reference: pg 55
OBJ: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance
4. What
is the most important consideration for effectively communicating with a child?
|
a. |
The child’s chronologic age |
|
b. |
The parent-child
interaction |
|
c. |
The child’s receptiveness |
|
d. |
The child’s developmental
level |
ANS: D
|
|
Feedback |
|
A |
The child’s age may not
correspond with the developmental level; therefore, it is not the most
important consideration for communicating with children. |
|
B |
Parent-child interaction is
useful in planning communication with children, but it is not the primary
factor in establishing effective communication. |
|
C |
The child’s receptiveness
is a consideration in evaluating the effectiveness of communication. |
|
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. |
DIF: Cognitive Level:
Comprehension REF: Text
Reference: pg 54
OBJ: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance
5. Which
of the following behaviors is most likely to encourage open communication?
|
a. |
Avoiding eye contact |
|
b. |
Folding arms across chest |
|
c. |
Standing with head bowed |
|
d. |
Soft stance with arms loose
at the side |
ANS: D
|
|
Feedback |
|
A |
Avoiding eye contact does
not facilitate communication. |
|
B |
Folding arms across the
chest is a closed-body posture, which does not facilitate communication. |
|
C |
Standing with head bowed is
a closed-body posture, which does not facilitate communication. |
|
D |
A swaying body with arms
loose at the sides suggests openness. |
DIF: Cognitive Level:
Comprehension REF: Text
Reference: pg 50
OBJ: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
6. Which
of the following strategies is most likely to encourage a child to express his
feelings about the hospital experience?
|
a. |
Avoiding periods of silence |
|
b. |
Asking direct questions |
|
c. |
Sharing personal
experiences |
|
d. |
Using open-ended questions |
ANS: D
|
|
Feedback |
|
A |
Periods of silence can
serve to facilitate communication. |
|
B |
Direct questions can
threaten and block communication. |
|
C |
Talking about yourself
shifts the focus of the conversation away from the child. |
|
D |
Open-ended questions
encourage conversation. |
DIF: Cognitive Level:
Application
REF: Text Reference: pg 50
OBJ: Nursing Process Step:
Planning MSC:
NCLEX: Psychosocial Integrity
7. Which
of the following is the most appropriate question to ask when interviewing an
adolescent to encourage conversation?
|
a. |
“Are you in school?” |
|
b. |
“Are you doing well in
school?” |
|
c. |
“How is school going for
you?” |
|
d. |
“How do your parents feel
about your grades?” |
ANS: C
|
|
Feedback |
|
A |
Direct questions with “yes”
or “no” answers do not encourage conversation. |
|
B |
Direct questions that can
be interpreted as judgmental do not enhance communication. |
|
C |
Open-ended questions
encourage communication. |
|
D |
Asking adolescents about
their parents’ feelings may block communication. |
DIF: Cognitive Level:
Application
REF: Text Reference: pg 50
OBJ: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
8. 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?
|
a. |
“You must never leave the
child in the room alone with the side rails down.” |
|
b. |
“I am very concerned about
your child’s safety when you leave the side rails down. The hospital has
guidelines stating that side rails need to be up if the child is in the bed.” |
|
c. |
“It is hospital policy that
side rails need to be up if the child is in bed.” |
|
d. |
“When parents leave side
rails down, they might be considered as uncaring.” |
ANS: B
|
|
Feedback |
|
A |
Framing the communication
in the negative does not facilitate effective communication. |
|
B |
To express concern and then
choose words that convey a policy is appropriate. |
|
C |
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. |
|
D |
This statement conveys
blame and judgment to the parent. |
DIF: Cognitive Level:
Application
REF: Text Reference: pg 52
OBJ: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
9. Which
of the following is an appropriate preoperative teaching plan for a school-age
child?
|
a. |
Begin preoperative teaching
the morning of surgery. |
|
b. |
Schedule a tour of the
hospital a few weeks before surgery. |
|
c. |
Show the child books and
pictures 4 days before surgery. |
|
d. |
Limit teaching to 5 minutes and use
simple terminology. |
ANS: C
|
|
Feedback |
|
A |
Preoperative teaching a few
hours before surgery is more appropriate for the preschool child. |
|
B |
Preparation too far in
advance of the procedure can be forgotten or cause undue anxiety for an
extended period of time. |
|
C |
Preparatory material can be
introduced to the school-age child several days (1-5) in advance of the
event. Books, pictures, charts, and videos are appropriate. |
|
D |
A very short, simple
explanation of the surgery is appropriate for a younger child such as a
toddler. |
DIF: Cognitive Level:
Comprehension REF: Text
Reference: pgs 55-56
OBJ: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance
10. 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?
|
a. |
The nurse is displaying
signs of overinvolvement. |
|
b. |
The nurse is a kind and
generous person. |
|
c. |
The nurse feels a special
closeness to the child. |
|
d. |
The nurse wants to make the
child happy. |
ANS: A
|
|
Feedback |
|
A |
Buying gifts for individual
children is a warning sign of overinvolvement. |
|
B |
Nurses are kind and
generous people, but buying gifts for individual children is unprofessional. |
|
C |
Nurses may feel closer to
some clients and families. This does not make giving gifts to children or
families acceptable from a professional standpoint. |
|
D |
It is not the nurse’s
responsibility to replace lost items. Becoming overly involved with a child
can inhibit a healthy relationship. |
DIF: Cognitive Level: Analysis
REF: Text Reference: pg 53
OBJ: Nursing Process Step:
Assessment MSC: NCLEX: Psychosocial
Integrity
11. When
meeting a toddler for the first time, the nurse initiates contact by:
|
a. |
calling the toddler by name
and picking the toddler up. |
|
b. |
asking the toddler for her
first name. |
|
c. |
kneeling in front of the
toddler and speaking softly to the child. |
|
d. |
telling the toddler that
you are her nurse. |
ANS: C
|
|
Feedback |
|
A |
Picking a toddler up at an initial
meeting is a threatening action and will more likely result in a negative
response from the child. |
|
B |
Toddlers are unlikely to
respond to direct questions at a first meeting. |
|
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. |
|
D |
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 |
DIF: Cognitive Level:
Application
REF: Text Reference: pg 48
OBJ: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
James:
Nursing Care of Children: Principles and Practice, 3rd Edition
Test
Bank
Chapter
04: Health Promotion for the Developing Child
MULTIPLE CHOICE
1. Which
of the following statements best describes development in infants and children?
|
a. |
Development, a predictable
and orderly process, occurs at varying rates within normal limits. |
|
b. |
Development is primarily
related to the growth in the number and size of cells. |
|
c. |
Development occurs in a
proximodistal direction with fine muscle development occurring first. |
|
d. |
Development is more easily
and accurately measured than growth. |
ANS: A
|
|
Feedback |
|
A |
Development, a continuous
orderly process, provides the basis for increases in the child’s function and
complexity of behavior. The increases in rate of function and complexity can
vary normally within limits for each child. |
|
B |
An increase in the number
and size of cells is a definition for growth. |
|
C |
Development proceeds in a
proximodistal direction with fine muscle organization occurring as a result
of large muscle organization. |
|
D |
Development is a more
complex process that is affected by many factors; therefore, it is less
easily and accurately measured. Growth is a predictable process with standard
measurement methods. |
DIF: Cognitive Level:
Knowledge
REF: Text Reference: pgs 64-65
OBJ: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance
2. Frequent
developmental assessments are important for which of the following reasons?
|
a. |
Stable developmental
periods during infancy provide an opportunity to identify any delays or
deficits. |
|
b. |
Infants need stimulation
specific to the stage of development. |
|
c. |
Critical periods of
development occur during childhood. |
|
d. |
Child development is
unpredictable and needs monitoring. |
ANS: C
|
|
Feedback |
|
A |
Infancy is a dynamic time
of development that requires frequent evaluations to assess appropriate
developmental progress. |
|
B |
Infants in a nurturing
environment will develop appropriately and will not necessarily need
stimulation specific to their developmental stage. |
|
C |
Critical periods are blocks
of time during which children are ready to master specific developmental
tasks. Children can master these tasks more easily during particular periods
of time in their growth and developmental process. |
|
D |
Normal growth and
development is orderly and proceeds in a predictable pattern on the basis of
each individual’s abilities and potentials. |
DIF: Cognitive Level:
Comprehension REF: Text
Reference: pg 66
OBJ: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance
3. Which
of the following factors has the greatest influence on child growth and
development?
|
a. |
Culture |
|
b. |
Environment |
|
c. |
Genetics |
|
d. |
Nutrition |
ANS: C
|
|
Feedback |
|
A |
Culture is a significant
factor that influences how children grow toward adulthood. Culture influences
both growth and development but does not eliminate inborn genetic influences. |
|
B |
Environment has a
significant role in determining growth and development both before and after
birth. The environment can influence how and to which extent genetic traits
are manifested, but environmental factors cannot eliminate the effect of
genetics. |
|
C |
Genetic factors (heredity)
determine each individual’s growth and developmental rate. Although factors
such as environment, culture, nutrition, and family can influence genetic
traits, they do not eliminate the effect of the genetic endowment, which is
permanent. |
|
D |
Nutrition is critical for growth
and plays a significant role throughout childhood. |
DIF: Cognitive Level:
Comprehension REF: Text
Reference: pgs 65, 66, 72
OBJ: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance
4. According
to Piagetian theory, the period of cognitive development in which the child is
able to distinguish fact from fantasy is which of the following?
|
a. |
The sensorimotor period of
cognitive development |
|
b. |
The formal operations
period of cognitive development |
|
c. |
The concrete operations
period of cognitive development |
|
d. |
The preoperational period
of cognitive development |
ANS: C
|
|
Feedback |
|
A |
The sensorimotor stage
occurs in infancy and is a period of reflexive behavior. During this period
the infant’s world becomes more permanent and organized. The stage ends with
the infant demonstrating some evidence of reasoning. |
|
B |
Formal operations is a
period in development in which new ideas are created through previous
thoughts. Analytic reason and abstract thought emerge in this period. |
|
C |
Concrete operations is the
period of cognitive development in which children’s thinking is shifted from
egocentric to being able to see another’s point of view. They develop the
ability to distinguish fact from fantasy. |
|
D |
The preoperational stage is
a period of egocentrism in which the child’s judgments are illogical and
dominated by magical thinking and animism. |
DIF: Cognitive Level:
Knowledge
REF: Text Reference: pgs 67-70
OBJ: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance
5. The
theorist who viewed developmental progression as a lifelong series of conflicts
that need resolution is:
|
a. |
Erikson. |
|
b. |
Freud. |
|
c. |
Kohlberg. |
|
d. |
Piaget. |
ANS: A
|
|
Feedback |
|
A |
Erik Erikson viewed
development as a series of conflicts affected by social and cultural factors.
Each conflict must be resolved for the child to progress emotionally, with
unsuccessful resolution leaving the child emotionally disabled. |
|
B |
Sigmund Freud proposed a
psychosexual theory of development. He proposed that certain parts of the
body assume psychological significance as foci of sexual energy. The foci
shift as the individual moves through the different stages (oral, anal,
phallic, latency, and genital) of development. |
|
C |
Lawrence Kohlberg described
moral development as having three levels (preconventional, conventional, and
postconventional). His theory closely parallels Piaget’s. |
|
D |
Jean Piaget’s cognitive theory
interprets how children learn and think and how this thinking progresses and
differs from adult thinking. Stages of his theory include sensorimotor,
preoperations, concrete operations, and formal operations. |
DIF: Cognitive Level: Comprehension
REF: Text Reference: pg 70
OBJ: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance
6. What
does the nurse need to know when observing chronically ill children at play?
|
a. |
Play is not important to hospitalized
children. |
|
b. |
Children need to have
structured play periods. |
|
c. |
Children’s play is an
indication of their response to treatment. |
|
d. |
Play is to be discouraged
because it tires hospitalized children. |
ANS: C
|
|
Feedback |
|
A |
Play is important to all
children in all environments. Play for children is a mechanism for mastering
their environment. |
|
B |
Although children’s play
activities appear unorganized and at times chaotic, play has purpose and
meaning. Imposing structure on play interferes with the tasks being worked
on. |
|
C |
Play for all children is an
activity woven with meaning and purpose. For chronically ill children, play
can indicate their state of wellness and response to treatment. |
|
D |
Children who have fewer
energy reserves still require play. For these children, less-active play
activities will be important. |
DIF: Cognitive Level:
Implementation REF: Text
Reference: pgs 84-85
OBJ: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance
7. Which
of the following children is most likely to be frightened by hospitalization?
|
a. |
A 4-month-old infant
admitted with a diagnosis of bronchiolitis |
|
b. |
A 2-year-old toddler
admitted for cystic fibrosis |
|
c. |
A 9-year-old child hospitalized
with a fractured femur |
|
d. |
A 15-year-old adolescent
admitted for abdominal pain |
ANS: B
|
|
Feedback |
|
A |
Young infants are not as
likely to be frightened as toddlers by hospitalization because they are not
as aware of the environment. |
|
B |
Toddlers are most likely to
be frightened by hospitalization because their thought processes are
egocentric, magical, and illogical. They feel very threatened by unfamiliar
people and strange environments. |
|
C |
The 9-year-old child’s
cognitive ability is sufficient enough for the child to understand the reason
for hospitalization. |
|
D |
The 15-year-old adolescent
has the cognitive ability to interpret the reason for hospitalization. |
DIF: Cognitive Level:
Comprehension REF: Text Reference:
pgs 70-71
OBJ: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance
8. Which
of the following statements made by a 15-year-old adolescent with a diagnosis
of neurofibromatosis (an autosomal dominant genetic disorder) best demonstrates
an understanding of the mechanism of inheritance for the disease?
|
a. |
“My babies will probably
not have neurofibromatosis.” |
|
b. |
“My babies have a 50%
chance of having neurofibromatosis.” |
|
c. |
“Whether my babies have
problems depends on the father.” |
|
d. |
“My babies have a 25%
chance of having neurofibromatosis.” |
ANS: B
|
|
Feedback |
|
A |
An individual with a
defective gene for neurofibromatosis can have a child without the disease;
however, there is a 50% probability with each pregnancy of having a child
with the disease. |
|
B |
Neurofibromatosis is an
autosomal dominant genetic disorder that occurs when the abnormal gene is
carried on the affected chromosome with a normal gene. Because the abnormal
gene is dominant, an individual with the defective gene has a 50% chance of
transmitting the defect to an infant with each pregnancy. |
|
C |
Neurofibromatosis is not a
sex-linked genetic disease; therefore, either the father or the mother
genetically transfers it to the infant. |
|
D |
A parent with the defective
gene will genetically transfer either a normal or abnormal gene to an infant.
Because the defective gene is dominant, there is a 50% probability of the
child inheriting the disease. |
DIF: Cognitive Level:
Application
REF: Text Reference: pgs 75-76
OBJ: Nursing Process Step: Evaluation
MSC: NCLEX: Health Promotion and Maintenance
9. During
a routine health care visit, a parent asks the nurse why her 9-month-old infant
is not walking as her older child did at the same age. Which of the following
responses by the nurse best demonstrates an understanding of child development?
|
a. |
“She’s a little slow.” |
|
b. |
“If she is pulling up, you
can help her by holding her hand.” |
|
c. |
“Babies progress at
different rates. Your infant’s development is within normal limits.” |
|
d. |
“Maybe she needs to see a
behavioral specialist.” |
ANS: C
|
|
Feedback |
|
A |
The infant is within normal
developmental limits. The statement is inappropriate for the nurse to make. |
|
B |
Infants will walk when they
are developmentally ready. “Hurrying” an infant does not result in the
developmental task being achieved at an earlier time period. |
|
C |
Ninety percent of infants
walk by 14 months of age. (See DDST II in Appendix, which assesses for
age-appropriate development in children from birth to age 6 years.) |
|
D |
Consulting a behavioral
specialist for diagnostic evaluation is indicated when a child demonstrates
developmental delays. The child has no evidence of a delay. |
DIF: Cognitive Level: Implementation
REF: Text Reference: pgs 79-80, see appendix
DDST II
OBJ: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance
10. Which
of the following “expected outcomes” would be developmentally appropriate for a
hospitalized 4-year-old child?
|
a. |
The child will be dressed
and fed by the parents. |
|
b. |
The child will
independently ask for play materials or other personal needs. |
|
c. |
The child will be able to
verbalize an understanding of the reason for the hospitalization. |
|
d. |
The child will have a
parent stay in the room at all times. |
ANS: B
|
|
Feedback |
|
A |
Parents need to foster
appropriate developmental behavior in the 4-year-old child. Dressing and
feeding the child do not encourage independent behavior. |
|
B |
Erikson identifies
initiative as a developmental task for the preschool child. Initiating play
activities and asking for play materials or assistance with personal needs
demonstrates developmental appropriateness. |
|
C |
A 4-year-old child cannot
be expected to cognitively understand the reason for hospitalization.
Expecting the child to verbalize an understanding for hospitalization is an
inappropriate outcome. |
|
D |
Parents staying with the
child throughout a hospitalization is an inappropriate outcome. Although
children benefit from parental involvement, parents may not have the support
structure to stay in the room with the child at all times. |
DIF: Cognitive Level:
Application
REF: Text Reference: pg 68
OBJ: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance
11. Which
of the following statements identifies an appropriate level of language
development for a 4-year-old child?
|
a. |
The child has a vocabulary
of 300 words and uses simple sentences. |
|
b. |
The child uses correct
grammar in sentences. |
|
c. |
The child is able to
pronounce consonants clearly. |
|
d. |
The child uses language to
express abstract thought. |
ANS: B
|
|
Feedback |
|
A |
Simple sentences and a
300-word vocabulary are appropriate for a 2-year-old child. |
|
B |
The 4-year-old child is
able to use correct grammar in sentence structure. |
|
C |
The 4-year-old child
typically has difficulty in pronouncing consonants. |
|
D |
The use of language to
express abstract thought is developmentally appropriate for the adolescent. |
DIF: Cognitive Level:
Knowledge
REF: Text Reference: pg 72
OBJ: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance
12. Which
of the following does the nurse need to evaluate before administering the
DDST-II (Denver Developmental Screening Test II)?
|
a. |
The child’s height and
weight |
|
b. |
The parent’s ability to
comprehend the results |
|
c. |
The child’s mood |
|
d. |
The parent-child
interaction |
ANS: C
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