Pediatric Nursing The Critical Components of Nursing Care 1st Edition by Kathryn Rudd

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Sample Test

Chapter 3: Family Dynamics and Communicating with Children and Families

Multiple Choice

1. Latrisha is a 15-year-old girl who is in the clinic for her school physical. Latrisha’s mother informs the nurse that the forms for her school physical must be filled out by the nurse or the doctor so that Latrisha can play on the volleyball team. When speaking with Latrisha and her mom, the nurse knows it is important to:

2. Be mindful of letting the patient answer questions.

3. Give attention to the doctor’s schedule and make sure the visit goes as quickly as possible.

4. Respond quickly to Latrisha’s questions so there are no long pauses in conversation.

5. Speak loudly so Latrisha and her mother can hear the conversation clearly.

ANS: 1

	Feedback
1.	Some answers may be sensitive to a teenager and take longer to receive a reply. Giving a patient time to answer is important so that they do not feel rushed.
2.	The schedule is important, but the patient needs should be met. The nurse may need to advocate for the patient in this situation.
3.	Quick responses increase anxiety.
4.	Speaking loudly can increase anxiety.

2. According to Title III of the Americans with Disabilities Act (ADA), health-care providers must supply:

3. Quality care for all patients.

4. Quality care for patients and families.

5. Auxiliary aids and services for communication with people who are deaf or hard of hearing.

6. Auxiliary aids and services for communication with people who are blind or have difficulty seeing.

ANS: 3

	Feedback
1.	The ADA’s Title III does not address the quality of care for patients.
2.	The ADA’s Title III does not address the quality of care for patients or families.
3.	The ADA’s Title III addresses the needs for hearing-impaired individuals.
4.	The ADA’s Title III does not address vision.

3. A new mother is receiving information about the newborn hearing screens for her baby girl. The nurse knows that the mother understands the reason for the screening when she states:

4. “My daughter will need this screen, and then a follow-up in three months.”

5. “My daughter will need the screen done now. It should be repeated if we note she is not meeting developmental milestones.”

6. “It is my decision to participate in this hearing screen, so I am going to decline the screening because I do not know if my insurance will cover it.”

7. “I should have a hearing screen done again when she enters school.”

ANS: 2

	Feedback
1.	Follow-up screens are done only if an abnormality is noted.
2.	It is important to assess all the ways the communication and comprehension of a child are not meeting developmental milestones.
3.	Hearing screens are done on all newborn infants.
4.	A hearing screen may be done when entering school, but that does not address this question.

4. When speaking with a family about the plan of care for the day, Leslie knows she should avoid using:

5. Medical jargon.

6. Time for questions.

7. Active listening skills.

8. All of the answers should be used for effective communication.

9. All the answers should not be used for effective communication.

ANS: 1

	Feedback
1.	Medical jargon can be confusing for families, thus explaining what terms mean will enable the family to better understand the needs of the child.
2.	Time for questions is important in promote understanding for the patient/family.
3.	Listening skills are needed for quality communication.
4.	One answer is correct.
5.	One answer is correct.

5. When speaking with a family who is experiencing a medical emergency with their child, it is important for the nurse to:

6. Allow time for questions.

7. Avoid false hope.

8. Allow for a quiet environment.

9. Be empathetic and sincere.

10. All of the above are correct.

11. None of the above are correct.

ANS: 5

	Feedback
1.	This is a component of effective communication for the situation, along with other answers.
2.	This is a component of effective communication for the situation, along with other answers.
3.	This is a component of effective communication for the situation, along with other answers.
4.	This is a component of effective communication for the situation, along with other answers.
5.	All of the answers provide effective communication for the situation.
6.	One answer is correct.

6. Trevon, a 4-year-old has been admitted to the emergency room via ambulance after a motor vehicle accident. Trevon is unconscious and is being given life-sustaining treatment. When the family arrives, the charge nurse takes Trevon’s parents to a family room. It is important that the nurse:

7. Provides clear information.

8. Does not provide promises.

9. Calls a member of the clergy and a social worker to be with the family.

10. All of the above should be addressed for Trevon’s family.

11. None of the above should be addressed for Trevon’s family.

ANS: 4

	Feedback
1.	Needed for effective care for the family, along with other answers
2.	Needed for effective care for the family, along with other answers
3.	Needed for effective care for the family, along with other answers
4.	All the answers provide effective communication for the situation.
5.	One answer is correct.

7. Ellie was adopted at the age of two. Her adoptive family is known as her:

8. Family of choice.

9. Family of origin.

10. Nuclear family.

11. Nontraditional family.

ANS: 2

	Feedback
1.	This type of family occurs by marriage or co-habitation, not adoption.
2.	This type of family is correct because the adoptive parents are raising Ellie.
3.	This defines the members of the family.
4.	This defines the members of the family that are not part of a nuclear family.

8. The nurse is reviewing Keirnan’s extended family tree to help the family identify genetic makeup due to Kiernan’s diagnosis of cystic fibrosis. The nurse knows that when looking at the extended family, it usually reviews:

9. One set of grandparents from the paternal and maternal side.

10. Three generations of family members from the paternal and maternal sides.

11. Nontraditional family patterns.

12. Nuclear family patterns.

ANS: 2

	Feedback
1.	Extended family goes beyond one generation.
2.	Extended family is viewed as reaching the third generation.
3.	Nontraditional family patterns review types of families, not the generations.
4.	Nuclear family patterns review the families, not the generations.

9. Alec, a 7-year-old, lives with his biological parents, but they are not married. This type of family would be considered:

10. A dyad family.

11. An adoptive family.

12. A cohabitating family.

13. An extended family.

ANS: 3

	Feedback
1.	This type of family does not have children.
2.	Alec is a biological child, so adoptive does not apply.
3.	This family is living together, but the parents are not married.
4.	There is no skip in a generation with this family.

10. Family dynamics for children can impact:

11. Interactions with all family members.

12. Communication patterns.

13. Sibling rivalry.

14. 1 and 2 only.

15. All of the above.

ANS: 5

	Feedback
1.	Family dynamics are influenced by all interactions and other answers.
2.	Family dynamics are influenced by all communication patterns and other answers.
3.	Family dynamics are influenced by all sibling rivalry and other answers.
4.	More than one answer is correct.
5.	All the answers influence family dynamics.

11. “Forming” in the Group Theory of Pediatric Nursing discusses the relationships between:

12. marriage or cohabitation.

13. family or group accomplishments.

14. emotional clashes of personalities.

15. death, divorce, and empty nesters.

ANS: 1

	Feedback
1.	This is the definition in the Group Family Theory.
2.	This is considered “performing” in the Group Family Theory.
3.	This is considered “storming” in the Group Family Theory.
4.	This is considered “adjourning” in the Group Family Theory.

12. Lesa is working with a family that has eight children. Lesa knows that the relationships between siblings can be viewed as a subsystem of which theory?

13. Family Group Theory

14. Family Systems Theory

15. Murray Bowen Theory

16. Satir Family Therapy

ANS: 2

	Feedback
1.	This theory does not break the family into subsystems.
2.	The family is looked at in subsystems to identify interactions.
3.	This theory does not break the family into subsystems.
4.	This theory does not break the family into subsystems.

13. Cael was diagnosed with terminal cancer six months ago. His family has been adjusting to the changes in Cael’s condition. His diagnosis is affecting each member of the family in a different way. The nurse knows Cael’s family is exhibiting behaviors similar to:

14. The Death and Dying Theory.

15. The Resiliency Model of Family Stress, Adjustment, and Adaptation.

16. Murray Bowen’s Theory.

17. The Family Group Theory.

ANS: 2

	Feedback
1.	Death has not occurred, so this theory is not applicable.
2.	This model demonstrates how the family adjusts to the changes and adapts.
3.	This theory does not address the adaptation of the family members.
4.	This theory does not address the adaptation of the family members.

14. How would Bowen’s Family Systems Theory view the relationship of an adoptive daughter who is older than the biological son?

15. The theory sees each family member as interdependent, so the interactions between the siblings are not of importance in this theory.

16. The theory is not appropriate for this relationship because of the birth order.

17. The theory assists with the analysis of behavior and development due to the sibling order.

18. The theory is not appropriate for this relationship because not enough information is supplied.

ANS: 3

	Feedback
1.	Sibling order is important to this theory.
2.	Sibling order is important to this theory.
3.	Behavior and development because of sibling order is part of the theory.
4.	There is enough information to identify the theory.

15. The main difference in Duvall’s view of the Family Development Theory and other theorists is:

16. Family is placed into categories throughout its lifespan.

17. A healthy family is open-minded and shares love.

18. A family cutting off emotionally from others is viewed as healthy.

19. Families are viewed as constantly adjusting due to crisis.

ANS: 1

	Feedback
1.	The view of family through a lifespan is one of the key elements of Duvall’s theory.
2.	This is a different theory.
3.	This is a different theory.
4.	This is a different theory.

16. Kenisha is a home health pediatric nurse. She has been working with a family for the past month. Kenisha has to fill out paperwork describing the family unit. Kenisha is aware that “family” can be described as all of the following except:

17. A group of two people.

18. A blood relationship only between the parent and child.

19. A same-sex couple with children.

20. A grandparent, mother, and child living in the house.

ANS: 2

	Feedback
1.	Can be labeled a family
2.	This is not the only way to define a family.
3.	Can be labeled a family
4.	Can be labeled a family

17. Stella is assessing the family of her pediatric home health care patient. Stella’s is using Neuman’s Systems Theory to assess the family’s needs. When using this theory, it is important to:

18. Make sure all members of the family are assessed and able to express their personal needs for the care of the patient.

19. Focus solely on the patient’s needs.

20. Work with the family and health-care professionals to provide advanced directives.

21. Meet the developmental needs of the child.

ANS: 1

	Feedback
1.	A key factor in Neuman’s theory is to let all members of the family express themselves.
2.	Focusing on one family member’s needs is not part of Neuman’s theory.
3.	This is a key factor in Family-Focused Care, not Neuman’s theory.
4.	This is a key factor in Family-Focused Care, not Neuman’s theory.

18. Miriam, a nursing student, has been learning about theory in regards to family and pediatric nursing. The case study that has been presented describes the role of the provider, therapists, and the child’s caregivers. Miriam knows these descriptors are assessments noted in:

19. King’s theory.

20. Roy’s theory of Adaptation.

21. Family-Focused Theory.

22. Structural-Functional Theory.

ANS: 4

	Feedback
1.	This theory reviews family as a social system.
2.	This theory reviews how the family deals with life stress.
3.	This theory emphasizes family involvement in caregiving.
4.	This theory reviews the roles of the provider, therapists, and the child’s caregivers in the care of the child.

19. A student nurse is doing her clinical practicum experience in an outpatient family access clinic. The student nurse watches the registered nurse review the family history with a mother. Important questions to ask on an initial history assessments of a child should include:

20. Socioeconomic status.

21. Parenting styles.

22. Family structure.

23. All of the above

ANS: 4

	Feedback
1.	A factor in family assessment, along with other choices
2.	A factor in family assessment, along with other choices
3.	A factor in family assessment, along with other choices
4.	All the factors listed are part of a quality family assessment.

20. Jessica is complaining to the school nurse about her parents. She states that she feels her parents do not let her make any decisions and have strict rules. The school nurse knows this type of parenting style is known as:

21. Permissive.

22. Democratic.

23. Authoritarian.

24. Ambiguous.

ANS: 3

	Feedback
1.	Children have full control of decisions in this parenting style.
2.	A combination of firm rules and freedom for children to make a decisions characterize this parenting style.
3.	Parents have absolute rule and do not let the child make decisions in this parenting style.
4.	This is not a parent style.

21. Dora, a 4-year-old child, has been asked to create a family drawing. This is being asked of Dora because it will show the nurse:

22. The child’s view of the family members.

23. The child’s wish for a family.

24. The child’s perception of family values.

25. Nothing. This is an activity for the child while the nurse obtains a cognitive assessment.

ANS: 1

	Feedback
1.	The purpose is to identify how the child views the family.
2.	This is not a wish activity.
3.	Family values are not assessed in this task.
4.	This task can give an indication of the cognitive level of understanding of family, but the main purpose is to see how the child views the family.

22. When performing the family APGAR questionnaire on Wesley’s family, the nurse notes that his father spends very little time with him. The nurse knows that with this area being low, the family:

23. Lacks quality growth and function, so there is risk.

24. Lacks the ability to devote time to children and has a highly functional pattern.

25. Is at risk for not nurturing a child and could be at risk for developing a dysfunctional family pattern.

26. Is at risk for sharing responsibility for the child and is highly dysfunctional.

ANS: 3

	Feedback
1.	Bonding is the concern for the family based on this type of response from the father
2.	Bonding is the concern for the family based on this type of response from the father.
3.	The father is not demonstrating a nurturing bond with the child.
4.	Bonding is the concern for the family based on this type of response from the father.

23. Damon is a 3-month-old patient on the pediatric floor for a post-operative stay. Cyndie, his primary nurse, is about to assess Damon for the first time this shift. A therapeutic approach to the assessment would be:

24. Cooing, speaking in soft tones, and smiling at Damon as she performs the assessment.

25. Talking loudly and not making eye contact with Damon during the assessment.

26. Speaking to the parent during the entire assessment so as much information can be gathered from the parent as possible.

27. To not talk and try to keep Damon as quiet as possible to during the assessment.

ANS: 1

	Feedback
1.	This action is appropriate because a 3-month-old responds to quiet interactions and likes to watch faces.
2.	Talking loudly can upset small infants and cause restlessness.
3.	It is important to gather information from the parent, but this should be done before or after the physical assessment is completed.
4.	It is important to keep the baby quiet during the assessment, but the lack of human interaction is not therapeutic for an infant.

24. When attempting to get the blood pressure of a 3 year old, it is important to:

25. Encourage questions.

26. Let the child touch, smell, and see the equipment prior to taking the blood pressure.

27. Place the cuff on a teddy bear so the child can see what is going to occur.

28. All are appropriate actions when taking the blood pressure of a 3 year old.

29. 1 and 2 are appropriate actions for attempting to take the blood pressure of a 3 year old.

ANS: 4

	Feedback
1.	Correct action, along with others
2.	Correct action, along with others
3.	Correction action, along with others
4.	All the actions are appropriate to let a 3 year old experience prior to taking the blood pressure.
5.	All answers are correct.

25. When starting an IV on a 9 year old, the nurse knows it is important to:

26. Answer any questions.

27. Give the child a task to do for the IV, such as preparing the tape.

28. Allow time for the child to express how he/she feels about getting an IV.

29. All of the above are important when starting an IV on the child.

30. 2 and 3 are important when starting an IV on the child.

ANS: 4

	Feedback
1.	This age range will ask questions so that they have control of the situation. Other answers are also correct.
2.	Giving a task to the child enables them to feel part of the procedure and have control over what is happening. Other answers are also correct.
3.	Expressing feelings can help alleviate anxieties about the procedure. Other answers are also correct.
4.	This age range will ask questions so that they have control of the situation. Giving a task to the child enables them to feel part of the procedure and have control over what is happening. Expressing feelings can help alleviate anxieties about the procedure.

26. Sarah is a 14-year-old girl about to get her HPV vaccine. The nurse working with Sarah knows that, as a nurse, she should:

27. Explain that the vaccine is very important and all of her friends are receiving it.

28. Explain the injection procedure and provide information about the HPV vaccine on her level.

29. Use language such as “pokie” and “owwie” to describe the possible pain of the injection.

30. Allow her to text while the injection is occurring so that Sarah is distracted in order to help reduce the pain of the injection.

ANS: 2

	Feedback
1.	This is not being truthful to the patient and should be avoided.
2.	Appropriate answer
3.	The terms can be used for younger children. A teenager is beyond this language level.
4.	Distraction works, but texting is not appropriate because it requires two hands, thus the nurse would have difficulty administering the vaccine correctly.

27. Donavon has expressed to the school nurse that his mother’s boyfriend drinks several beers each night. When Donavon’s mother is at work, the boyfriend has offered Donavon a beer. Donavon expresses that he feels like he needs to take care of the boyfriend while his mother is at work. This shift in roles is known as:

28. Responsible Member Role.

29. Hero Member Role.

30. Scapegoat Role.

31. Lost Child Role.

ANS: 1

	Feedback
1.	The child has taken on the role of the adult when the mother is not present.
2.	The child is not performing a heroic deed, thus this answer is incorrect.
3.	The child is not being blamed for the actions of the adult.
4.	The child is able to identify that the actions are not safe and does not feel comfortable, but lacks the idea of the child feeing responsible.

True/False

28. Trey has been admitted from the operating room to the pediatric floor for the repair of a broken humorous. On the chart, it states that Trey has been blind for two years. The nurse should communicate each action prior to performing the action so Trey knows what is going to occur.

ANS: T

	Feedback
1.	Telling the patient what will occur will help reduce anxiety since the patient cannot see what is occurring.
2.	Telling the patient what will occur will help reduce anxiety since the patient cannot see what is occurring.

Multiple Response

29. Jared has assessed a family with a 6-year-old boy and an 8-year-old boy for his family assessment project for a nursing course. The faculty member knows that Jared has assessed for family structure, development, and rituals with which of the following comments?

30. The two boys live with their maternal grandmother and mother.

31. The family lives in a rundown area of a mobile-home park.

32. Both boys are in the school-age stages, exhibiting Industry vs. Inferiority.

33. The family requires “quite time.” During this time, each boy goes to their room in the evening to read or play.

34. The family receives food stamps.

ANS: 1, 3, 4, 5

	Feedback
1.	Structural Family Assessment
2.	Does not apply and is a biased statement
3.	Family Developmental Stage
4.	Family Rituals
5.	Structural Family Assessment

Chapter 4: Cultural, Spiritual, and Environmental Influences on the Child

Multiple Choice

1. Elsa is working with an 11-year-old patient in the outpatient pediatric clinic. As Elsa reviews the chart, she reads that the patient follows the Muslim tradition. When Elsa enters the room, she notes that the child is wearing a hijab on her head. Elsa has never worked with this tradition before. Elsa should:

2. Realize that her verbal and non-verbal communication will impact the care she gives the child.

3. Not ask the parent for input on the care of the child because this would disrespect the family and child.

4. Have another nurse, who has experience with this culture, take care of the patient.

5. Realize that the patient is uncomfortable and seek a fellow nurse to help her.

ANS: 1

	Feedback
1.	Verbal and non-verbal communication differs in each culture, thus this must be taken into consideration when working with the child.
2.	The lack of communication with the parent and child is not therapeutic for the child.
3.	Another nurse may be beneficial, but since Elsa has already started caring for the child, this may create problems.
4.	There is no indication of the patient feeling uncomfortable.

2. A pediatric nursing class has been assigned to use the Giger and Davidhizar Transcultural Assessment Model. The students are assigned to families they do not have a prior relationship with. When performing the assessment, one of the students is given a seat in close proximity to a grandmother on the couch. The student should know that according to this model:

3. Visiting a family is considered a privilege.

4. It is important to identify the family lifestyle.

5. Sitting close to the grandmother can affect the communication.

6. Only the interpersonal relationships of the individuals are emphasized.

ANS: 3

	Feedback
1.	Does not address the economic standing of the family
2.	Does not identify a “lifestyle”
3.	Space is a component of the model.
4.	Views the family’s interactions with society

3. A staff educational day has been planned for the pediatric unit of a major hospital. The goal is to make the staff culturally competent. This is important because:

4. This competency meets JCAHO requirements.

5. This competency meets cultural care requirements for the hospital system.

6. This allows nurses to tailor their care to the patient and provide holistic care.

7. This education is needed to reach Magnet status.

ANS: 3

	Feedback
1.	Not the purpose of the goal
2.	Can be a purpose of the hospital, but does not take precedence over the patient.
3.	Important to view the patient holistically in order to provide quality care
4.	Not the purpose of the goal

4. Hussain’s parents have a language barrier with the nursing staff on the pediatric floor. When working with communication barriers, it is important to:

5. Use pictures when an interpreter is not available.

6. Use hand gestures to attempt to communicate.

7. Ask the interpreter to speak to the family over the phone.

8. Require the family to provide a family member to interpret.

ANS: 1

	Feedback
1.	This is appropriate if there are pictures for the conversation.
2.	Each culture is sensitive to body language. Avoid using gestures because this may offend the family.
3.	Speaking over the phone can cause communication breakdown, which will not be effective for the conversation.
4.	It is a responsibility of the hospital to provide an interpreter for the patient.

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