Identify the choice that best completes the statement or answers the question.
1. In an acute care setting, the pediatric nurse is providing care to a 4-year-old patient with
an exacerbation of cystic fibrosis. The nurse notes that there is little interaction between
the patient and the older siblings when they visit. The siblings often seek to divert the
staff’s attention during their visits. What is the most appropriate nursing intervention at
this time?
a. Ask the parents to leave the siblings at home to avoid disruptions.
b. Interact with the siblings and show them the playroom during visits.
c. Encourage the siblings to visit and bring familiar objects to the hospital.
d. Develop a plan to include the siblings in age-appropriate care of the patient.
ANS: C
Chapter: Chapter 3 Family Dynamics and Communicating With Children and
Families
Chapter Learning Objective: 3. Describe family dynamics; 11. Identify the role of
family-centered care in caring for the hospitalized child.
Page: 42
Heading: Definition of a Family > Stressors on Families > Nursing Interventions to
Assist Families
Integrated Processes: Caring
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Family
Difficulty: Moderate
Feedback
A. This is incorrect. This would disrupt the family-centered care and may increase
the sibling rivalry between the ill and healthy children.
B. This is incorrect. This would distract the staff from performing their duties, and it
would distract from the necessary family-centered care.
C. This is correct. Encouraging the siblings to bring a familiar object with them
when they visit can increase their comfort level and encourage family-centered
care.
D. This is incorrect. The sibling may not be comfortable with performing care of
their sibling.
PTS: 1 CON: Family
,2. The nurse is assessing the family of a pediatric patient in the home-care setting. Which of
the following family APGAR (adaptation, partnership, growth, affection, resolve)
findings best correlates with the nursing diagnosis of caregiver role strain?
a. They have recently moved to the area and have not been able to form relationships
within the community.
b. They show affection to each other and are able to devote time to other family
members.
c. They have formed a partnership to carry forth the usual household responsibilities
and support each other.
d. The mother provides primary care for the ill child and household while the father
works two jobs to provide financial support.
ANS: D
Chapter: Chapter 3 Family Dynamics and Communicating With Children and
Families
Chapter Learning Objective: 5. Identify family function roles.
Page: 47
Heading: Box 3-2: Examples of Family Nursing Diagnoses
Integrated Processes: Teaching and Learning
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Communication
Difficulty: Moderate
Feedback
A. This is incorrect. This may lead to caregiver role strain, but there is no indication
of one member performing all of the care.
B. This is incorrect. This is a sign of a healthy relationship, where the family is able
to show care toward each other.
C. This is incorrect. This is a sign of a healthy relationship, where the
responsibilities are shared.
D. This is correct. It appears that both parents are strained with their responsibilities,
the mother with primary care of the child, and the father’s employment status.
PTS: 1 CON: Communication
3. The nurse is performing a functional family assessment of a chronically ill pediatric
patient. In what way can the nurse enhance communication with the family?
a. Identify the leader of the family and provide options for respite care.
b. Assess for abuse and report suspected abuse to the authorities.
c. Complete a family APGAR questionnaire and share the results.
d. Educate the family on resources in the community to help with care.
, ANS: C
Chapter: Chapter 3 Family Dynamics and Communicating With Children and
Families
Chapter Learning Objective: 9. Describe strategies for incorporating communication
into assessment.
Page: 47
Heading: Family Assessment > Tools for Assessment > Family APGAR Five-Item
Questionnaire
Integrated Processes: Teaching and Learning
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Communication
Difficulty: Moderate
Feedback
A. This is incorrect. Although it is important to locate the leader of the family, it is
not necessary to locate respite care immediately.
B. This is incorrect. Although the nurse is legally obligated to report abuse, this is a
stereotype of families with chronically ill children.
C. This is correct. Assessing the family regarding the family dynamics and ability to
cope with crises enhances communication with the family.
D. This is incorrect. This will not enhance the communication with the family. This
would be performed once communication is accomplished.
PTS: 1 CON: Communication
4. The nurse is providing care to a 10-year-old patient hospitalized for multiple injuries from
a motor vehicle crash. Which nursing intervention is appropriate for communication with
this child?
a. Include the child in some decisions regarding care, such as choosing food from the
hospital menu.
b. Offer the child a chance to play with the medical instruments when possible.
c. Communicate primarily to the parents regarding treatments and the child’s
progress.
d. Recognize that behavior may fluctuate between adult and childlike during
hospitalization.
ANS: A
Chapter: Chapter 3 Family Dynamics and Communicating With Children and
Families
Chapter Learning Objective: 7. Identify age-specific approaches for communicating
with parents, families, toddlers, school-age children, and adolescents.
Page: 51
Heading: Communicating With the Family > Communicating With School-Age