©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
UMB ABSN NU 435 Exam 1 Practice
Questions and Answers
1. A nurse is caring for four patients; three are toddlers and one is a preschooler. Which represents the
major stressor of hospitalization for these four patients?
a. Separation anxiety
b. Loss of control
c. Fear of bodily injury
d. Fear of pain - Ans:✔✔-ANS: A
The major stressor for children from infancy through the preschool years is separation anxiety, also
called anaclitic depression. This is a major stressor of hospitalization. Loss of control, fear of bodily injury,
and fear of pain are all stressors associated with hospitalization. However, separation from family is a
primary stressor in this age group.
2. During the first 4 days of hospitalization, Eric, age 18 months, cried inconsolably when his parents left
him, and he refused the staff's attention. Now the nurse observes that Eric appears to be "settled in" and
unconcerned about seeing his parents. The nurse should interpret this as which statement?
Page 1/77
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
a. He has successfully adjusted to the hospital environment.
b. He has transferred his trust to the nursing staff.
c. He may be experiencing detachment, which is the third stage of separation anxiety.
d. Because he is "at home" in the hospital now, seeing his mother frequently will only start the cycle
again. - Ans:✔✔-ANS: C
Detachment is a behavior manifestation of separation anxiety. Superficially it appears that the child has
adjusted to the loss. Detachment is a sign of resignation, not contentment. Parents should be
encouraged to be with their child. If parents restrict visits, they may begin a pattern of misunderstanding
the child's cues and not meeting his needs.
3. When a preschool child is hospitalized without adequate preparation, how does the child often react
to the hospitalization?
a. Sees it as a punishment
b. A threat to child's self-image
c. An opportunity for regression
d. Loss of companionship with friends - Ans:✔✔-ANS: A
Page 2/77
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
If a toddler is not prepared for hospitalization, a typical preschooler fantasy is to attribute the
hospitalization to punishment for real or imagined misdeeds. Attributing the hospitalization to
punishment for real or imagined misdeeds is a reaction typical of toddler and school-age children when
threatened with loss of control.
4. Which age group should the pediatric nurse recognize as being vulnerable to events that lessen their
feeling of control and power?
a. Infants
b. Toddlers
c. Preschoolers
d. School-age children - Ans:✔✔-ANS: D
When a child is hospitalized, the altered family role, physical disability, loss of peer acceptance, lack of
productivity, and inability to cope with stress usurp individual power and identity. This is especially
detrimental to school-age children, who are striving for independence and productivity and are now
experiencing events that lessen their control and power. Infants, toddlers, and preschoolers, although
affected to different extents by loss of power, are not as significantly affected as are school-age children.
5. A 10-year-old girl needs to have another intravenous (IV) line started. She keeps telling the nurse,
"Wait a minute" and "I'm not ready." The nurse should recognize this as which description?
a. This is normal behavior for a school-age child.
Page 3/77
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
b. The behavior is not seen past the preschool years.
c. The child thinks the nurse is punishing her.
d. The child has successfully manipulated the nurse in the past. - Ans:✔✔-ANS: A
The 10-year-old girl is attempting to maintain control. The nurse should provide the girl with structured
choices about when the IV will be inserted. Telling the nurse "Wait a minute" and "I'm not ready" can be
characteristic behavior when an individual needs to maintain some control over a situation.
6. What is a common initial reaction of parents to illness or injury and hospitalization in their child?
a. Anger
b. Fear
c. Depression
d. Helplessness - Ans:✔✔-ANS: D
Recent research has identified common themes among parents whose children were hospitalized,
including feeling an overall sense of helplessness, questioning the skills of staff, accepting the reality of
hospitalization, needing to have information explained in simple language, dealing with fear, coping with
uncertainty, and seeking reassurance from caregivers. Anger or guilt is usually the second reaction stage.
Fear, anxiety, and frustrations also are common feelings. Parents may finally react with some form of
depression related to the physical and emotional exhaustion associated with a hospitalized child.
Page 4/77
FIRST PUBLISH OCTOBER 2024
UMB ABSN NU 435 Exam 1 Practice
Questions and Answers
1. A nurse is caring for four patients; three are toddlers and one is a preschooler. Which represents the
major stressor of hospitalization for these four patients?
a. Separation anxiety
b. Loss of control
c. Fear of bodily injury
d. Fear of pain - Ans:✔✔-ANS: A
The major stressor for children from infancy through the preschool years is separation anxiety, also
called anaclitic depression. This is a major stressor of hospitalization. Loss of control, fear of bodily injury,
and fear of pain are all stressors associated with hospitalization. However, separation from family is a
primary stressor in this age group.
2. During the first 4 days of hospitalization, Eric, age 18 months, cried inconsolably when his parents left
him, and he refused the staff's attention. Now the nurse observes that Eric appears to be "settled in" and
unconcerned about seeing his parents. The nurse should interpret this as which statement?
Page 1/77
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
a. He has successfully adjusted to the hospital environment.
b. He has transferred his trust to the nursing staff.
c. He may be experiencing detachment, which is the third stage of separation anxiety.
d. Because he is "at home" in the hospital now, seeing his mother frequently will only start the cycle
again. - Ans:✔✔-ANS: C
Detachment is a behavior manifestation of separation anxiety. Superficially it appears that the child has
adjusted to the loss. Detachment is a sign of resignation, not contentment. Parents should be
encouraged to be with their child. If parents restrict visits, they may begin a pattern of misunderstanding
the child's cues and not meeting his needs.
3. When a preschool child is hospitalized without adequate preparation, how does the child often react
to the hospitalization?
a. Sees it as a punishment
b. A threat to child's self-image
c. An opportunity for regression
d. Loss of companionship with friends - Ans:✔✔-ANS: A
Page 2/77
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
If a toddler is not prepared for hospitalization, a typical preschooler fantasy is to attribute the
hospitalization to punishment for real or imagined misdeeds. Attributing the hospitalization to
punishment for real or imagined misdeeds is a reaction typical of toddler and school-age children when
threatened with loss of control.
4. Which age group should the pediatric nurse recognize as being vulnerable to events that lessen their
feeling of control and power?
a. Infants
b. Toddlers
c. Preschoolers
d. School-age children - Ans:✔✔-ANS: D
When a child is hospitalized, the altered family role, physical disability, loss of peer acceptance, lack of
productivity, and inability to cope with stress usurp individual power and identity. This is especially
detrimental to school-age children, who are striving for independence and productivity and are now
experiencing events that lessen their control and power. Infants, toddlers, and preschoolers, although
affected to different extents by loss of power, are not as significantly affected as are school-age children.
5. A 10-year-old girl needs to have another intravenous (IV) line started. She keeps telling the nurse,
"Wait a minute" and "I'm not ready." The nurse should recognize this as which description?
a. This is normal behavior for a school-age child.
Page 3/77
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
b. The behavior is not seen past the preschool years.
c. The child thinks the nurse is punishing her.
d. The child has successfully manipulated the nurse in the past. - Ans:✔✔-ANS: A
The 10-year-old girl is attempting to maintain control. The nurse should provide the girl with structured
choices about when the IV will be inserted. Telling the nurse "Wait a minute" and "I'm not ready" can be
characteristic behavior when an individual needs to maintain some control over a situation.
6. What is a common initial reaction of parents to illness or injury and hospitalization in their child?
a. Anger
b. Fear
c. Depression
d. Helplessness - Ans:✔✔-ANS: D
Recent research has identified common themes among parents whose children were hospitalized,
including feeling an overall sense of helplessness, questioning the skills of staff, accepting the reality of
hospitalization, needing to have information explained in simple language, dealing with fear, coping with
uncertainty, and seeking reassurance from caregivers. Anger or guilt is usually the second reaction stage.
Fear, anxiety, and frustrations also are common feelings. Parents may finally react with some form of
depression related to the physical and emotional exhaustion associated with a hospitalized child.
Page 4/77
