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Pediatric Primary Care: Practical Guid
m m m m
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m m m m m
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Chapterm1mObtainingmanmInitialmHistory
MULTIPLEmCHOICE
1. Themnursemismseeingmanmadolescentmandmthemparentsminmthemclinicmformthemfirstmtime.mWhichmsho
uldmthemnursemdomfirst?
a. Introducemhim-mormherself.
b. Makemthemfamilymcomfortable.
c. Givemassurancemofmprivacy.
d. Explainmthempurposemofmthemintervie
w.mANS:mA
Themfirstmthingmthatmnursesmmustmdomismtomintroducemthemselvesmtomthempatientmandmfamily.mParents
andmothermadultsmshouldmbemaddressedmwithmappropriatemtitlesmunlessmtheymspecifymampreferredmna
me.mClarificationmofmthempurposemofmtheminterviewmandmthemnursesmrolemismthemsecondmthingmthatmsh
ouldmbemdone.mDuringmtheminitialmpartmofmtheminterview,mthemnursemshouldmincludemgeneralmconvers
ationmtomhelpmmakemthemfamilymfeelmatmease.mTheminterviewmalsomshouldmtakemplaceminmanmenviron
mentmasmfreemofmdistractionmasmpossible.mInmaddition,mthemnursemshouldmclarifymwhichminformationm
willmbemsharedmwithmothermmembersm ofmthemhealthmcaremteammandmanymlimitsmtomthemconfidentiality
.
2. Whichmismconsideredmamblockmtomeffectivemcommunication?
a. Usingmsilence
b. Usingmclichs
c. Directingmthemfocus
d. Definingmthemproble
mmANS:mB
Usingmstereotypedmcommentsmormclichsmcanmblockmeffectivemcommunication.mAftermthemnursemuses
suchmtritemphrases,mparentsmoftenmdomnotmrespond.mSilencemcanmbemanmeffectiveminterviewingmto
ol.mSilencempermitsmthemintervieweemtomsortmoutmthoughtsmandmfeelingsmandmsearchmformresponse
smtomquestions.mTombemeffective,mthemnursemmustmbemablemtomdirectmthemfocusmofmtheminterviewm
whilemallowingmmaximummfreedommofmexpression.mBymusingmopen-
endedmquestionsmandmguidingmquestions,mthemnursemcanmobtainmthemnecessaryminformationmandm
maintainmamrelationshipmwithmthemfamily.mThemnursemandmparentmmustmcollaboratemandmdefinemth
emproblemmthatmwillmbemthemfocusmofmthemnursingmintervention.
3. Whichmismthemsinglemmostmimportantmfactormtomconsidermwhenmcommunicatingmwithmchildren?
a. Presencemofmthemchildsmparent
b. Childsmphysicalmcondition
c. Childsmdevelopmentalmlevel
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d. Childsmnonverbalmbehavior
smANS:mC
Themnursemmustmbemawaremofmthemchildsmdevelopmentalmstagemtomengageminmeffective
communication.mThemusemofmbothmverbalmandmnonverbalmcommunicationmshouldmbemappropriatemto
mthemdevelopmentalmlevel.mNonverbalmbehaviorsmvaryminmimportancembasedm onmthemchildsmdevelop
mentalmlevelmandmphysicalmcondition.mAlthoughmthemchildsmphysicalmconditionmismamconsideration,m
developmentalmlevelmismmuchmmoremimportant.mThempresencemofmparentsmismimportantmwhenmcomm
unicatingmwithmyoungmchildrenmbutmmaymbemdetrimentalmwhenmspeakingmwithmadolescents.
4. Becausemchildrenmyoungermthanm5myearsmaremegocentric,mthemnursemshouldmdomwhichmwh
enmcommunicatingmwithmthem?
a. Focusmcommunicationmonmthemchild.
b. Usemeasymanalogiesmwhenmpossible.
c. Explainmexperiencesmofmothersmtomthemchild.
d. Assuremthemchildmthatmcommunicationmismprivat
e.mANS:mA
Becausemchildrenmofmthismagemaremablemtomseemthingsmonlyminmtermsmofmthemselves,mthembestmapproach
ismtomfocusmcommunicationmdirectlymonmthem.mChildrenmshouldmbemprovidedmwithminformationmab
outmwhatmtheymcanmdomandmhowmtheymwillmfeel.mWithmchildrenmwhomaremegocentric,manalogies,mexp
eriences,mandmassurancesmthatmcommunicationmismprivatemwillmnotmbemeffectivembecausemthemchildmi
smnotmcapablemofmunderstanding.
5. Themnursesmapproachmwhenmintroducingmhospitalmequipmentmtomampreschoolermwhomseemsmafr
aidmshouldmbembasedmonmwhichmprinciple?
a. Themchildmmaymthinkmthemequipmentmismalive.
b. Explainingmthemequipmentmwillmonlymincreasemthemchildsmfear.
c. Onembriefmexplanationmwillmbemenoughmtomreducemthemchildsmfear.
d. Themchildmismtoomyoungmtomunderstandmwhatmthemequipmentmdoe
s.mANS:mA
Youngmchildrenmattributemhumanmcharacteristicsmtominanimatemobjects.mTheymoftenmfearmthatmthe
objectsmmaymjump,mbite,mcut,mormpinchmallmbymthemselvesmwithoutmhumanmdirection.mEquipmentmsh
ouldmbemkeptmoutmofmsightmuntilmneeded.mSimple,mconcretemexplanationsmaboutmwhatmthemequipmen
tmdoesmandmhowmitmwillmfeelmwillmhelpmalleviatemthemchildsmfear.mPreschoolersmneedmrepeatedmexplan
ationsmasmreassurance.
6. Whenmthemnurseminterviewsmanmadolescent,mwhichmismespeciallymimportant?
a. Focusmthemdiscussionmonmthempeermgroup.
b. Allowmanmopportunitymtomexpressmfeelings.
c. Usemthemsamemtypemofmlanguagemasmthemadolescent.
d. Emphasizemthatmconfidentialitymwillmalwaysmbemmaintaine
d.mANS:mB
Adolescents,mlikemallmchildren,mneedmopportunitiesmtomexpressmtheirmfeelings.mOftenmtheyminterject
feelingsmintomtheirmwords.mThemnursemmustmbemalertmtomthemwordsmandmfeelingsmexpressed.mThemnurse
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shouldmmaintainmamprofessionalmrelationshipmwithmadolescents.mTomavoidmmisunderstandingm
ormmisinterpretationmofmwordsmandmphrasesmused,mthemnursemshouldmclarifymthemtermsmused,mw
hatminformationmwillmbemsharedmwithmothermmembersmofmthemhealthmcaremteam,mandmanymlimit
smtomconfidentiality.mAlthoughmthempeermgroupmismimportantmtomthismagemgroup,mtheminterview
mshouldmfocusm onmthemadolescent.
7. Themnursemismpreparingmtomassessmam10-month-
oldminfant.mHemismsittingmonmhismfathersmlapmandmappearsmtombemafraidmofmthemnursemandmofmwha
tmmightmhappenmnext.mWhichminitialmactionsmbymthemnursemshouldmbemmostmappropriate?
a. Initiatemamgamemofmpeek-a-boo.
b. Askmtheminfantsmfathermtomplacemtheminfantmonmthemexaminationmtable.
c. Talkmsoftlymtomtheminfantmwhilemtakingmhimmfrommhismfather.
d. Undressmtheminfantmwhilemhemismstillmsittingmonmhismfathersml
ap.mANS:mA
Peek-a-boomismanmexcellentmmeansmofminitiatingmcommunicationmwithminfantsmwhilemmaintainingma
safe,mnonthreateningmdistance.mThemchildmwillmmostmlikelymbecomemupsetmifmseparatedmfrommhis
mfather.mAsmmuchmofmthemassessmentmasmpossiblemshouldmbemdonemwithmthemchildmonmthemfathers
mlap.mThemnursemshouldmhavemthemfathermundressmthemchildmasmneededmduringmthemexamination.
8. Anm8-year-
oldmgirlmasksmthemnursemhowmthembloodmpressuremapparatusmworks.mThemmostmappropriat
emnursingmactionmismwhich?
a. Askmhermwhymshemwantsmtomknow.
b. Determinemwhymshemismsomanxious.
c. Explainminmsimplemtermsmhowmitmworks.
d. Tellmhermshemwillmseemhowmitmworksmasmitmismus
ed.mANS:mC
School-agemchildrenmrequiremexplanationsmandmreasonsmformeverything.mTheymareminterestedminmthe
functionalmaspectmofmallmprocedures,mobjects,mandmactivities.mItmismappropriatemformthemnursemtome
xplainmhowmequipmentmworksmandmwhatmwillmhappenmtomthemchildmsomthatmthemchildmcanmthenmob
servemduringmthemprocedure.mThemnursemshouldmrespondmpositivelymformrequestsmforminformationm
aboutmproceduresmandmhealthminformation.mBymnotmresponding,mthemnursemmaymbemlimitingmcom
municationmwithmthemchild.mThemchildmismnotmexhibitingmanxietyminmaskingmhowmthembloodmpress
uremapparatusmworks,mjustmrequestingmclarificationmofmwhatmwillmoccur.
9. Themnursemismhavingmdifficultymcommunicatingmwithmamhospitalizedm6-year-
oldmchild.mWhichmtechniquemshouldmbemmostmhelpful?
a. Recommendmthatmthemchildmkeepmamdiary.
b. Providemsuppliesmformthemchildmtomdrawmampicture.
c. Suggestmthatmthemparentmreadmfairymtalesmtomthemchild.
d. Askmthemparentmifmthemchildmismalwaysmuncommunicativ
e.mANS:mB
Drawingmismonemofmthemmostmvaluablemformsmofmcommunication.mChildrensmdrawingsmtellmamgreat
dealmaboutmthemmbecausemtheymaremprojectionsmofmthemchildrensminnermself.mAmdiarymshouldmbemdif
ficultmformam6-year-
oldmchild,mwhomismmostmlikelymlearningmtomread.mThemparentmreadingmfairymtalesmtomthemchildmismamp
assivemactivityminvolvingmthemparentmandmchild;mitmshouldmnotmfacilitate
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Testbankfor m m
Pediatric Primary Care: Practical Guid
m m m m
elines for Nurses - 4th edition
m m m m m
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Pediatric Primary Care 4th Edition Richardson
m m m m m m
Testbank/StudyGuide
Chapterm1mObtainingmanmInitialmHistory
MULTIPLEmCHOICE
1. Themnursemismseeingmanmadolescentmandmthemparentsminmthemclinicmformthemfirstmtime.mWhichmsho
uldmthemnursemdomfirst?
a. Introducemhim-mormherself.
b. Makemthemfamilymcomfortable.
c. Givemassurancemofmprivacy.
d. Explainmthempurposemofmthemintervie
w.mANS:mA
Themfirstmthingmthatmnursesmmustmdomismtomintroducemthemselvesmtomthempatientmandmfamily.mParents
andmothermadultsmshouldmbemaddressedmwithmappropriatemtitlesmunlessmtheymspecifymampreferredmna
me.mClarificationmofmthempurposemofmtheminterviewmandmthemnursesmrolemismthemsecondmthingmthatmsh
ouldmbemdone.mDuringmtheminitialmpartmofmtheminterview,mthemnursemshouldmincludemgeneralmconvers
ationmtomhelpmmakemthemfamilymfeelmatmease.mTheminterviewmalsomshouldmtakemplaceminmanmenviron
mentmasmfreemofmdistractionmasmpossible.mInmaddition,mthemnursemshouldmclarifymwhichminformationm
willmbemsharedmwithmothermmembersm ofmthemhealthmcaremteammandmanymlimitsmtomthemconfidentiality
.
2. Whichmismconsideredmamblockmtomeffectivemcommunication?
a. Usingmsilence
b. Usingmclichs
c. Directingmthemfocus
d. Definingmthemproble
mmANS:mB
Usingmstereotypedmcommentsmormclichsmcanmblockmeffectivemcommunication.mAftermthemnursemuses
suchmtritemphrases,mparentsmoftenmdomnotmrespond.mSilencemcanmbemanmeffectiveminterviewingmto
ol.mSilencempermitsmthemintervieweemtomsortmoutmthoughtsmandmfeelingsmandmsearchmformresponse
smtomquestions.mTombemeffective,mthemnursemmustmbemablemtomdirectmthemfocusmofmtheminterviewm
whilemallowingmmaximummfreedommofmexpression.mBymusingmopen-
endedmquestionsmandmguidingmquestions,mthemnursemcanmobtainmthemnecessaryminformationmandm
maintainmamrelationshipmwithmthemfamily.mThemnursemandmparentmmustmcollaboratemandmdefinemth
emproblemmthatmwillmbemthemfocusmofmthemnursingmintervention.
3. Whichmismthemsinglemmostmimportantmfactormtomconsidermwhenmcommunicatingmwithmchildren?
a. Presencemofmthemchildsmparent
b. Childsmphysicalmcondition
c. Childsmdevelopmentalmlevel
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d. Childsmnonverbalmbehavior
smANS:mC
Themnursemmustmbemawaremofmthemchildsmdevelopmentalmstagemtomengageminmeffective
communication.mThemusemofmbothmverbalmandmnonverbalmcommunicationmshouldmbemappropriatemto
mthemdevelopmentalmlevel.mNonverbalmbehaviorsmvaryminmimportancembasedm onmthemchildsmdevelop
mentalmlevelmandmphysicalmcondition.mAlthoughmthemchildsmphysicalmconditionmismamconsideration,m
developmentalmlevelmismmuchmmoremimportant.mThempresencemofmparentsmismimportantmwhenmcomm
unicatingmwithmyoungmchildrenmbutmmaymbemdetrimentalmwhenmspeakingmwithmadolescents.
4. Becausemchildrenmyoungermthanm5myearsmaremegocentric,mthemnursemshouldmdomwhichmwh
enmcommunicatingmwithmthem?
a. Focusmcommunicationmonmthemchild.
b. Usemeasymanalogiesmwhenmpossible.
c. Explainmexperiencesmofmothersmtomthemchild.
d. Assuremthemchildmthatmcommunicationmismprivat
e.mANS:mA
Becausemchildrenmofmthismagemaremablemtomseemthingsmonlyminmtermsmofmthemselves,mthembestmapproach
ismtomfocusmcommunicationmdirectlymonmthem.mChildrenmshouldmbemprovidedmwithminformationmab
outmwhatmtheymcanmdomandmhowmtheymwillmfeel.mWithmchildrenmwhomaremegocentric,manalogies,mexp
eriences,mandmassurancesmthatmcommunicationmismprivatemwillmnotmbemeffectivembecausemthemchildmi
smnotmcapablemofmunderstanding.
5. Themnursesmapproachmwhenmintroducingmhospitalmequipmentmtomampreschoolermwhomseemsmafr
aidmshouldmbembasedmonmwhichmprinciple?
a. Themchildmmaymthinkmthemequipmentmismalive.
b. Explainingmthemequipmentmwillmonlymincreasemthemchildsmfear.
c. Onembriefmexplanationmwillmbemenoughmtomreducemthemchildsmfear.
d. Themchildmismtoomyoungmtomunderstandmwhatmthemequipmentmdoe
s.mANS:mA
Youngmchildrenmattributemhumanmcharacteristicsmtominanimatemobjects.mTheymoftenmfearmthatmthe
objectsmmaymjump,mbite,mcut,mormpinchmallmbymthemselvesmwithoutmhumanmdirection.mEquipmentmsh
ouldmbemkeptmoutmofmsightmuntilmneeded.mSimple,mconcretemexplanationsmaboutmwhatmthemequipmen
tmdoesmandmhowmitmwillmfeelmwillmhelpmalleviatemthemchildsmfear.mPreschoolersmneedmrepeatedmexplan
ationsmasmreassurance.
6. Whenmthemnurseminterviewsmanmadolescent,mwhichmismespeciallymimportant?
a. Focusmthemdiscussionmonmthempeermgroup.
b. Allowmanmopportunitymtomexpressmfeelings.
c. Usemthemsamemtypemofmlanguagemasmthemadolescent.
d. Emphasizemthatmconfidentialitymwillmalwaysmbemmaintaine
d.mANS:mB
Adolescents,mlikemallmchildren,mneedmopportunitiesmtomexpressmtheirmfeelings.mOftenmtheyminterject
feelingsmintomtheirmwords.mThemnursemmustmbemalertmtomthemwordsmandmfeelingsmexpressed.mThemnurse
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shouldmmaintainmamprofessionalmrelationshipmwithmadolescents.mTomavoidmmisunderstandingm
ormmisinterpretationmofmwordsmandmphrasesmused,mthemnursemshouldmclarifymthemtermsmused,mw
hatminformationmwillmbemsharedmwithmothermmembersmofmthemhealthmcaremteam,mandmanymlimit
smtomconfidentiality.mAlthoughmthempeermgroupmismimportantmtomthismagemgroup,mtheminterview
mshouldmfocusm onmthemadolescent.
7. Themnursemismpreparingmtomassessmam10-month-
oldminfant.mHemismsittingmonmhismfathersmlapmandmappearsmtombemafraidmofmthemnursemandmofmwha
tmmightmhappenmnext.mWhichminitialmactionsmbymthemnursemshouldmbemmostmappropriate?
a. Initiatemamgamemofmpeek-a-boo.
b. Askmtheminfantsmfathermtomplacemtheminfantmonmthemexaminationmtable.
c. Talkmsoftlymtomtheminfantmwhilemtakingmhimmfrommhismfather.
d. Undressmtheminfantmwhilemhemismstillmsittingmonmhismfathersml
ap.mANS:mA
Peek-a-boomismanmexcellentmmeansmofminitiatingmcommunicationmwithminfantsmwhilemmaintainingma
safe,mnonthreateningmdistance.mThemchildmwillmmostmlikelymbecomemupsetmifmseparatedmfrommhis
mfather.mAsmmuchmofmthemassessmentmasmpossiblemshouldmbemdonemwithmthemchildmonmthemfathers
mlap.mThemnursemshouldmhavemthemfathermundressmthemchildmasmneededmduringmthemexamination.
8. Anm8-year-
oldmgirlmasksmthemnursemhowmthembloodmpressuremapparatusmworks.mThemmostmappropriat
emnursingmactionmismwhich?
a. Askmhermwhymshemwantsmtomknow.
b. Determinemwhymshemismsomanxious.
c. Explainminmsimplemtermsmhowmitmworks.
d. Tellmhermshemwillmseemhowmitmworksmasmitmismus
ed.mANS:mC
School-agemchildrenmrequiremexplanationsmandmreasonsmformeverything.mTheymareminterestedminmthe
functionalmaspectmofmallmprocedures,mobjects,mandmactivities.mItmismappropriatemformthemnursemtome
xplainmhowmequipmentmworksmandmwhatmwillmhappenmtomthemchildmsomthatmthemchildmcanmthenmob
servemduringmthemprocedure.mThemnursemshouldmrespondmpositivelymformrequestsmforminformationm
aboutmproceduresmandmhealthminformation.mBymnotmresponding,mthemnursemmaymbemlimitingmcom
municationmwithmthemchild.mThemchildmismnotmexhibitingmanxietyminmaskingmhowmthembloodmpress
uremapparatusmworks,mjustmrequestingmclarificationmofmwhatmwillmoccur.
9. Themnursemismhavingmdifficultymcommunicatingmwithmamhospitalizedm6-year-
oldmchild.mWhichmtechniquemshouldmbemmostmhelpful?
a. Recommendmthatmthemchildmkeepmamdiary.
b. Providemsuppliesmformthemchildmtomdrawmampicture.
c. Suggestmthatmthemparentmreadmfairymtalesmtomthemchild.
d. Askmthemparentmifmthemchildmismalwaysmuncommunicativ
e.mANS:mB
Drawingmismonemofmthemmostmvaluablemformsmofmcommunication.mChildrensmdrawingsmtellmamgreat
dealmaboutmthemmbecausemtheymaremprojectionsmofmthemchildrensminnermself.mAmdiarymshouldmbemdif
ficultmformam6-year-
oldmchild,mwhomismmostmlikelymlearningmtomread.mThemparentmreadingmfairymtalesmtomthemchildmismamp
assivemactivityminvolvingmthemparentmandmchild;mitmshouldmnotmfacilitate
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