Chapter 21: The Child's Experience of Hospitalization
MULTIPLE CHOICE
1. Which child would have the most difficulty in coping with separation from parents
because of hospitalization?
a. 3-month-old child
b. 16-month-old child
c. 4-year-old child
d. 7-year-old child
ANS: B
Separation anxiety occurs after age 6 months and is most pronounced in the toddler. DIF:
Cognitive Level: Comprehension REF: Page 481
OBJ: 3 TOP: Separation Anxiety
KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
2. A 2-year-old child has been crying constantly for his mother since he was hospitalized
3 days ago. What does this behavior suggest?
a. The toddler feels abandoned by his mother. b. The child still has not adjusted to his
hospitalization. c. The child is not separated from his mother often. d. There is a poor
mother-child bond.
ANS: A
Unless toddlers are extremely ill, their grief and sense of abandonment during hospitalization
are obvious. DIF: Cognitive Level: Analysis REF: Page 481
OBJ: 3 TOP: Separation Anxiety
KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
3. Which statement best corresponds to a preschoolers understanding of
hospitalization?
a. A germ made me get sick.
b. I got sick because I was mad at my brother.
c. My tonsils are sick and they have to come out.
d. I have a cast because I broke my leg.
ANS: B
,The preschooler may feel guilty, particularly if an accident happens as a result of mischief on his
or her part. DIF: Cognitive Level: Application REF: Page 491
TOP: The Hospitalized Preschooler KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
4. The parents of a hospitalized toddler are upset because she seems more interested in
her toys when they come to visit her. In which stage of separation anxiety is the toddler?
a. Protest
b. Despair
c. Denial
d. Attachment
ANS: C
In the stage of denial or detachment, the child appears to deny the need for the parents and
becomes
uninterested in their visits. DIF: Cognitive Level: Comprehension REF: Page 481
Test Bank - Introduction to Maternity and Pediatric Nursing 8e (by Leifer) 191
OBJ: 3 TOP: Separation Anxiety
KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
5. The nurse must make a room assignment for a 16-year-old with cystic fibrosis. Which
roommate would be the most appropriate for this patient?
a. A 4-year-old child who had an appendectomy
b. A 10-year-old child with sickle cell disease in vaso-occlusive crisis
c. A 15-year-old with type 1 diabetes mellitus
d. To assign the adolescent to a private room
ANS: C
Adolescents usually do better in rooms with one or more roommates than in single rooms. The
adolescent
would do best with a roommate who is closest to his or her age and also lives with a chronic
illness. DIF: Cognitive Level: Application REF: Page 493
TOP: The Hospitalized Adolescent KEY: Nursing Process Step: Planning
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
6. The parents of a hospitalized 9-month-old infant ask if their preschool child may visit
his younger sibling. What understanding would assist the nurse most in formulating a
response?
a. Preschool children can be disruptive in the hospital environment.
,b. Seeing his younger sibling would probably frighten the preschooler and thus should be
avoided.
c. The sibling could view the infant from the doorway but not enter the room to prevent the
spread of
microorganisms.
d. The preschooler needs to visit his infant sister to reassure himself that she is all right.
ANS: D
Siblings are affected by a childs hospitalization. Their ability to cope is influenced by their age,
experience, and intactness of the family. DIF: Cognitive Level: Application REF: Page 487
TOP: SiblingsParents Reaction to Hospitalization
KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
7. A hospitalized toddler was drinking from a cup at home but now refuses to drink from
anything except his favorite bottle. What is the most likely reason for this behavior?
a. He is dealing with the anxiety of hospitalization by regressing.
b. He is demonstrating attention-seeking behaviors because of an overabundance of attention in
the hospital.
c. He is attempting to refocus the attention of the adults around him to avoid further painful
procedures.
d. He is exhibiting normal behavior for his age, as children often stop new behaviors after they
believe they have mastered them.
ANS: A
Hospitalization is frustrating for toddlers. They show their displeasure when illness restricts
satisfaction of
their desires. It is not unusual for a toddler who was drinking from a cup to refuse it in the
hospital. DIF: Cognitive Level: Comprehension REF: Page 484
OBJ: 1 TOP: Regression KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
8. A nurse encourages a school-age child to draw a picture after a painful procedure.
What is the best rationale for this nursing intervention?
a. Attempting to re-establish rapport
b. Providing a way for the child to express his feelings
c. Encouraging quiet play
d. Distracting the child from thinking about the pain
, ANS: B
After treatments, the nurse should encourage children to draw and talk about their drawings or
to act out their feelings through puppet play.
DIF: Cognitive Level: Comprehension REF: Page 492
TOP: The Hospitalized School-Age Child
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
9. What is the best suggestion by the nurse when parents ask, When is the best time to
begin to prepare a 5- year-old for surgery and hospitalization?
a. As soon as the surgery is scheduled
b. About 2 weeks before surgery
c. About 4 days before surgery
d. On the night before admission to the hospital
ANS: C
Parents should prepare children for procedures and hospitalization a few days in advance.
DIF: Cognitive Level: Application REF: Page 487
TOP: The Nurses Role in Hospital AdmissionPreparing the Child
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
10. The mother of a 3-year-old tells the nurse that she will be in to visit tomorrow around
12:00 PM. The next morning, the child asks the nurse, When is my mommy coming?
What is the nurses best response?
a. Your mommy will be here around noon.
b. Your mommy will be here when you have lunch.
c. Mommy will be here very soon.
d. Your mommy is coming in 4 hours.
ANS: B
The toddler and preschooler do not understand time yet. They understand time relationships
through activities in their experience, such as naptime and mealtimes.
DIF: Cognitive Level: Application REF: Page 489
OBJ: 10 TOP: The Hospitalized Toddler/Preschooler
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
MULTIPLE CHOICE
1. Which child would have the most difficulty in coping with separation from parents
because of hospitalization?
a. 3-month-old child
b. 16-month-old child
c. 4-year-old child
d. 7-year-old child
ANS: B
Separation anxiety occurs after age 6 months and is most pronounced in the toddler. DIF:
Cognitive Level: Comprehension REF: Page 481
OBJ: 3 TOP: Separation Anxiety
KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
2. A 2-year-old child has been crying constantly for his mother since he was hospitalized
3 days ago. What does this behavior suggest?
a. The toddler feels abandoned by his mother. b. The child still has not adjusted to his
hospitalization. c. The child is not separated from his mother often. d. There is a poor
mother-child bond.
ANS: A
Unless toddlers are extremely ill, their grief and sense of abandonment during hospitalization
are obvious. DIF: Cognitive Level: Analysis REF: Page 481
OBJ: 3 TOP: Separation Anxiety
KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
3. Which statement best corresponds to a preschoolers understanding of
hospitalization?
a. A germ made me get sick.
b. I got sick because I was mad at my brother.
c. My tonsils are sick and they have to come out.
d. I have a cast because I broke my leg.
ANS: B
,The preschooler may feel guilty, particularly if an accident happens as a result of mischief on his
or her part. DIF: Cognitive Level: Application REF: Page 491
TOP: The Hospitalized Preschooler KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
4. The parents of a hospitalized toddler are upset because she seems more interested in
her toys when they come to visit her. In which stage of separation anxiety is the toddler?
a. Protest
b. Despair
c. Denial
d. Attachment
ANS: C
In the stage of denial or detachment, the child appears to deny the need for the parents and
becomes
uninterested in their visits. DIF: Cognitive Level: Comprehension REF: Page 481
Test Bank - Introduction to Maternity and Pediatric Nursing 8e (by Leifer) 191
OBJ: 3 TOP: Separation Anxiety
KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
5. The nurse must make a room assignment for a 16-year-old with cystic fibrosis. Which
roommate would be the most appropriate for this patient?
a. A 4-year-old child who had an appendectomy
b. A 10-year-old child with sickle cell disease in vaso-occlusive crisis
c. A 15-year-old with type 1 diabetes mellitus
d. To assign the adolescent to a private room
ANS: C
Adolescents usually do better in rooms with one or more roommates than in single rooms. The
adolescent
would do best with a roommate who is closest to his or her age and also lives with a chronic
illness. DIF: Cognitive Level: Application REF: Page 493
TOP: The Hospitalized Adolescent KEY: Nursing Process Step: Planning
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
6. The parents of a hospitalized 9-month-old infant ask if their preschool child may visit
his younger sibling. What understanding would assist the nurse most in formulating a
response?
a. Preschool children can be disruptive in the hospital environment.
,b. Seeing his younger sibling would probably frighten the preschooler and thus should be
avoided.
c. The sibling could view the infant from the doorway but not enter the room to prevent the
spread of
microorganisms.
d. The preschooler needs to visit his infant sister to reassure himself that she is all right.
ANS: D
Siblings are affected by a childs hospitalization. Their ability to cope is influenced by their age,
experience, and intactness of the family. DIF: Cognitive Level: Application REF: Page 487
TOP: SiblingsParents Reaction to Hospitalization
KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
7. A hospitalized toddler was drinking from a cup at home but now refuses to drink from
anything except his favorite bottle. What is the most likely reason for this behavior?
a. He is dealing with the anxiety of hospitalization by regressing.
b. He is demonstrating attention-seeking behaviors because of an overabundance of attention in
the hospital.
c. He is attempting to refocus the attention of the adults around him to avoid further painful
procedures.
d. He is exhibiting normal behavior for his age, as children often stop new behaviors after they
believe they have mastered them.
ANS: A
Hospitalization is frustrating for toddlers. They show their displeasure when illness restricts
satisfaction of
their desires. It is not unusual for a toddler who was drinking from a cup to refuse it in the
hospital. DIF: Cognitive Level: Comprehension REF: Page 484
OBJ: 1 TOP: Regression KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
8. A nurse encourages a school-age child to draw a picture after a painful procedure.
What is the best rationale for this nursing intervention?
a. Attempting to re-establish rapport
b. Providing a way for the child to express his feelings
c. Encouraging quiet play
d. Distracting the child from thinking about the pain
, ANS: B
After treatments, the nurse should encourage children to draw and talk about their drawings or
to act out their feelings through puppet play.
DIF: Cognitive Level: Comprehension REF: Page 492
TOP: The Hospitalized School-Age Child
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
9. What is the best suggestion by the nurse when parents ask, When is the best time to
begin to prepare a 5- year-old for surgery and hospitalization?
a. As soon as the surgery is scheduled
b. About 2 weeks before surgery
c. About 4 days before surgery
d. On the night before admission to the hospital
ANS: C
Parents should prepare children for procedures and hospitalization a few days in advance.
DIF: Cognitive Level: Application REF: Page 487
TOP: The Nurses Role in Hospital AdmissionPreparing the Child
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
10. The mother of a 3-year-old tells the nurse that she will be in to visit tomorrow around
12:00 PM. The next morning, the child asks the nurse, When is my mommy coming?
What is the nurses best response?
a. Your mommy will be here around noon.
b. Your mommy will be here when you have lunch.
c. Mommy will be here very soon.
d. Your mommy is coming in 4 hours.
ANS: B
The toddler and preschooler do not understand time yet. They understand time relationships
through activities in their experience, such as naptime and mealtimes.
DIF: Cognitive Level: Application REF: Page 489
OBJ: 10 TOP: The Hospitalized Toddler/Preschooler
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
