CreatedBy:ASolution
TESTBANKFORPEDIATRICPRIMARYCARE:PRACTICEgGUID
ELINESgFORgNURSES:gPRACTICEgGUIDELINESgFORgNURSESg
5THgEDITIONgBYgBETHgRICHARDSONgA+
Chapter1gObtainingganInitialgHistory
MULTIPLECHOICE
1. Thenurseisseeinganadolescentandtheparentsintheclinicforthefirsttime.Whichgs
houldgthegnursegdogfirst?
a. Introducehim-orherself.
b. Makethegfamilycomfortable.
c. Giveassuranceofgprivacy.
d. Explainthegpurposeoftheginterview.gANS:gA
Thegfirstgthinggthatgnursesgmustgdogisgtogintroducegthemselvesgtogthegpatientgandgfamily.gParentsg
andgotheradultsgshouldgbeaddressedgwithgappropriatetitlesgunlessgtheyspecifyapreferredgname.gCl
arificationofthepurposeoftheinterviewandthenursesroleisthesecondthingthatshouldbegdone.gDurin
ggtheginitialgpartgofgtheginterview,gthegnursegshouldgincludeggeneralgconversationgtoghelpgmakegth
egfamilyfeelgatgease.gTheginterviewgalsogshouldgtakeplacegingangenvironmentgasgfreegofgdistractio
ngasgpossible.gIngaddition,gthegnursegshouldgclarifygwhichginformationgwillgbegsharedgwithgotherg
membersgofgtheghealthgcaregteamgandganyglimitsgtogthegconfidentiality.
2. Whichisconsideredablocktoeffectivecommunication?
a. Usingsilence
b. Usingclichs
c. Directingthegfocus
d. DefiningtheproblemgANS:gB
Usingstereotypedcommentsorclichscanblockeffectivecommunication.Afterthenurseusesgsuchgtri
tegphrases,gparentsgoftengdognotgrespond.gSilencegcangbegangeffectiveginterviewinggtool.gSilenceg
permitsgthegintervieweegtogsortgoutgthoughtsgandgfeelingsgandgsearchgforgresponsesgtogquestions.
gTogbegeffective,gthegnursegmustgbegablegtogdirectgthegfocusgofgtheginterviewgwhilegallowinggma
ximumgfreedomgofgexpression.gBygusinggopen-
endedgquestionsgandgguidinggquestions,gthegnursegcangobtaingthegnecessaryginformationgandgmai
ntaingagrelationshipgwithgthe
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family.Thenurseandparentmustcollaborateanddefinetheproblemthatwillbethefocusofgthegnursing
gintervention.
3. Whichisthesinglemostimportantfactortoconsiderwhencommunicatingwit
hgchildren?
a. Presenceofthechildsgparent
b. Childsphysicalcondition
c. Childsdevelopmentallevel
d. ChildsnonverbalbehaviorsANS:C
Thegnursegmustgbegawaregofgthegchildsgdevelopmentalgstagegtogengagegingeffectivegcommunicati
on.gThegusegofgbothgverbalgandgnonverbalgcommunicationgshouldgbegappropriategtogthegdevelop
mentalglevel.gNonverbalgbehaviorsgvarygingimportancegbasedgongthegchildsgdevelopmentalglevelg
andgphysicalgcondition.gAlthoughgthegchildsgphysicalgconditiongisgagconsideration,developmental
levelismuchmoreimportant.Thepresenceofparentsisimportantgwhengcommunicatinggwithgyoungg
childrengbutgmaygbegdetrimentalgwhengspeakinggwithgadolescents.
4. Becausechildrengyoungerthan5yearsareegocentric,thenurseshoulddowhichwhe
ngcommunicatinggwithgthem?
a. Focuscommunicationongthechild.
b. Useeasyanalogiesgwhenpossible.
c. Explainexperiencesofotherstothegchild.
d. Assurethechildgthatcommunicationisgprivate.ANS:gA
Becausechildrenofthisgageareabletoseethingsonlyintermsofthemselves,thebestapproachgistofocus
communicationdirectlyonthem.Childrenshouldbeprovidedwithinformationaboutgwhatgtheygcangd
ogandghowgtheygwillgfeel.gWithgchildrengwhogaregegocentric,ganalogies,gexperiences,andassuranc
esthatcommunicationisprivatewillnotbeeffectivebecausethechildgisgnotgcapablegofgunderstanding.
5. Thenursesapproachwhenintroducinghospitalequipmenttoapreschoolerwhoseem
sgafraidgshouldgbegbasedgongwhichgprinciple?
a. Thechildgmaythinkgthegequipmentgisgalive.
b. Explainingthegequipmentgwillgonlyincreasethegchildsfear.
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c. Onebriefexplanationwillgbeenoughgtoreducethechildsgfear.
d. Thechildistooyoungtounderstandwhatthegequipmentdoes.ANS:gA
Younggchildrengattributeghumangcharacteristicsgtoginanimategobjects.gTheygoftengfeargthatgthegob
jectsgmaygjump,gbite,gcut,gorgpinchgallgbygthemselvesgwithoutghumangdirection.gEquipmentgshoul
dbekeptoutofsightuntilneeded.Simple,concreteexplanationsaboutwhattheequipmentgdoesgandgho
wgitgwillgfeelgwillghelpgalleviategthegchildsgfear.gPreschoolersgneedgrepeatedgexplanationsgasgreas
surance.
6. Whenthegnurseinterviewsgangadolescent,gwhichgisgespeciallyimportant?
a. Focusthediscussionongthepeergroup.
b. Allowangopportunitytoexpressgfeelings.
c. Usethegsametypeoflanguageastheadolescent.
d. Emphasizethatconfidentialitywillalwaysbemaintained.ANS:gB
Adolescents,glikegallgchildren,gneedgopportunitiesgtogexpressgtheirgfeelings.gOftengtheyginterjectg
feelingsintotheirwords.Thenursemustbealerttothewordsandfeelingsexpressed.Thenursegs
houldgmaintaingagprofessionalgrelationshipgwithgadolescents.gTogavoidgmisunderstanding
g orgmisinterpretationgofgwordsgandgphrasesgused,gthegnursegshouldgclarifygthegtermsgused
,gwhatginformationgwillgbegsharedgwithgothergmembersgofgtheghealthgcaregteam,gandganyg
limitsgtogconfidentiality.gAlthoughgthegpeerggroupgisgimportantgtogthisgageggroup,gthegint
erviewgshouldgfocusgongthegadolescent.
7. Thenurseispreparingtogassessa10-month-
oldinfant.Heissittingonhisfatherslapandgappearsgtogbegafraidgofgthegnursegandgofgwhatgmi
ghtghappengnext.gWhichginitialgactionsgbygthegnursegshouldgbegmostgappropriate?
a. Initiateagameofpeek-a-boo.
b. Asktheginfantsfathergtoplacetheinfantgontheexaminationgtable.
c. Talksoftlytotheinfantwhiletakinghimfromghisfather.
d. Undresstheinfantwhilegheisstillsittingonghisfatherslap.ANS:gA
Peek-a-
booisanexcellentmeansofinitiatingcommunicationwithinfantswhilemaintainingagsafe,gnonthreate
ninggdistance.gThegchildgwillgmostglikelygbecomegupsetgifgseparatedgfromghisgfather.gAsgmuchgof
gtheassessmentgasgpossiblegshouldgbegdonewithgthechildgongthegfathersglap.gThegnursegshouldghav
egthegfathergundressgthegchildgasgneededgduringgthegexamination.
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8. An8-year-
oldgirlasksthenursehowthebloodpressureapparatusworks.Themostgappropriategnursi
nggactiongisgwhich?
a. Askhergwhyshegwantsgtogknow.
b. Determinewhyshegisgsoanxious.
c. Explainingsimpletermsghowitgworks.
d. Tellhergshewillseehowitworksgasgitisgused.gANS:gC
School-
agechildrenrequireexplanationsandreasonsforeverything.Theyareinterestedinthegfunctionalgaspec
tgofgallgprocedures,gobjects,gandgactivities.gItgisgappropriategforgthegnursegtogexplainghowgequipm
entgworksgandgwhatgwillghappengtogthegchildgsogthatgthegchildgcangthengobserveduringtheprocedu
re.Thenurseshouldrespondpositivelyforrequestsforinformationgaboutgproceduresgandghealthginfor
mation.gBygnotgresponding,gthegnursegmaygbeglimitinggcommunicationgwithgthegchild.gThegchildg
isgnotgexhibitingganxietygingaskingghowgthegbloodgpressuregapparatusgworks,gjustgrequestinggclari
ficationgofgwhatgwillgoccur.
9. Thenurseishavingdifficultycommunicatingwithahospitalized6-year-
oldchild.Whichgtechniquegshouldgbegmostghelpful?
a. Recommendthatgthechildgkeepadiary.
b. Providesuppliesgforthegchildgtodrawgapicture.
c. Suggestthatgtheparentgreadfairytalestogthechild.
d. Asktheparentifthechildisalwaysuncommunicative.ANS:B
Drawinggisgonegofgthegmostgvaluablegformsgofgcommunication.gChildrensgdrawingsgtellgaggreatgd
ealgaboutgthemgbecausegtheygaregprojectionsgofgthegchildrensginnergself.gAgdiarygshouldgbegdiffic
ultgforgag6-year-
oldgchild,gwhogisgmostglikelylearningtogread.gTheparentgreadingfairytalesgtogthegchildgisgagpassiv
egactivityginvolvinggthegparentgandgchild;gitgshouldgnotgfacilitategcommunicationwiththenurse.Th
echildisinastressfulsituationandisprobablyuncomfortablegwithgstrangers,gnotgalwaysguncommuni
cative.
10. Whichdatashouldgbeincludedingahealthghistory?
a. Reviewofgsystems
b. Physicalassessment
c. Growthmeasurements
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TESTBANKFORPEDIATRICPRIMARYCARE:PRACTICEgGUID
ELINESgFORgNURSES:gPRACTICEgGUIDELINESgFORgNURSESg
5THgEDITIONgBYgBETHgRICHARDSONgA+
Chapter1gObtainingganInitialgHistory
MULTIPLECHOICE
1. Thenurseisseeinganadolescentandtheparentsintheclinicforthefirsttime.Whichgs
houldgthegnursegdogfirst?
a. Introducehim-orherself.
b. Makethegfamilycomfortable.
c. Giveassuranceofgprivacy.
d. Explainthegpurposeoftheginterview.gANS:gA
Thegfirstgthinggthatgnursesgmustgdogisgtogintroducegthemselvesgtogthegpatientgandgfamily.gParentsg
andgotheradultsgshouldgbeaddressedgwithgappropriatetitlesgunlessgtheyspecifyapreferredgname.gCl
arificationofthepurposeoftheinterviewandthenursesroleisthesecondthingthatshouldbegdone.gDurin
ggtheginitialgpartgofgtheginterview,gthegnursegshouldgincludeggeneralgconversationgtoghelpgmakegth
egfamilyfeelgatgease.gTheginterviewgalsogshouldgtakeplacegingangenvironmentgasgfreegofgdistractio
ngasgpossible.gIngaddition,gthegnursegshouldgclarifygwhichginformationgwillgbegsharedgwithgotherg
membersgofgtheghealthgcaregteamgandganyglimitsgtogthegconfidentiality.
2. Whichisconsideredablocktoeffectivecommunication?
a. Usingsilence
b. Usingclichs
c. Directingthegfocus
d. DefiningtheproblemgANS:gB
Usingstereotypedcommentsorclichscanblockeffectivecommunication.Afterthenurseusesgsuchgtri
tegphrases,gparentsgoftengdognotgrespond.gSilencegcangbegangeffectiveginterviewinggtool.gSilenceg
permitsgthegintervieweegtogsortgoutgthoughtsgandgfeelingsgandgsearchgforgresponsesgtogquestions.
gTogbegeffective,gthegnursegmustgbegablegtogdirectgthegfocusgofgtheginterviewgwhilegallowinggma
ximumgfreedomgofgexpression.gBygusinggopen-
endedgquestionsgandgguidinggquestions,gthegnursegcangobtaingthegnecessaryginformationgandgmai
ntaingagrelationshipgwithgthe
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family.Thenurseandparentmustcollaborateanddefinetheproblemthatwillbethefocusofgthegnursing
gintervention.
3. Whichisthesinglemostimportantfactortoconsiderwhencommunicatingwit
hgchildren?
a. Presenceofthechildsgparent
b. Childsphysicalcondition
c. Childsdevelopmentallevel
d. ChildsnonverbalbehaviorsANS:C
Thegnursegmustgbegawaregofgthegchildsgdevelopmentalgstagegtogengagegingeffectivegcommunicati
on.gThegusegofgbothgverbalgandgnonverbalgcommunicationgshouldgbegappropriategtogthegdevelop
mentalglevel.gNonverbalgbehaviorsgvarygingimportancegbasedgongthegchildsgdevelopmentalglevelg
andgphysicalgcondition.gAlthoughgthegchildsgphysicalgconditiongisgagconsideration,developmental
levelismuchmoreimportant.Thepresenceofparentsisimportantgwhengcommunicatinggwithgyoungg
childrengbutgmaygbegdetrimentalgwhengspeakinggwithgadolescents.
4. Becausechildrengyoungerthan5yearsareegocentric,thenurseshoulddowhichwhe
ngcommunicatinggwithgthem?
a. Focuscommunicationongthechild.
b. Useeasyanalogiesgwhenpossible.
c. Explainexperiencesofotherstothegchild.
d. Assurethechildgthatcommunicationisgprivate.ANS:gA
Becausechildrenofthisgageareabletoseethingsonlyintermsofthemselves,thebestapproachgistofocus
communicationdirectlyonthem.Childrenshouldbeprovidedwithinformationaboutgwhatgtheygcangd
ogandghowgtheygwillgfeel.gWithgchildrengwhogaregegocentric,ganalogies,gexperiences,andassuranc
esthatcommunicationisprivatewillnotbeeffectivebecausethechildgisgnotgcapablegofgunderstanding.
5. Thenursesapproachwhenintroducinghospitalequipmenttoapreschoolerwhoseem
sgafraidgshouldgbegbasedgongwhichgprinciple?
a. Thechildgmaythinkgthegequipmentgisgalive.
b. Explainingthegequipmentgwillgonlyincreasethegchildsfear.
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c. Onebriefexplanationwillgbeenoughgtoreducethechildsgfear.
d. Thechildistooyoungtounderstandwhatthegequipmentdoes.ANS:gA
Younggchildrengattributeghumangcharacteristicsgtoginanimategobjects.gTheygoftengfeargthatgthegob
jectsgmaygjump,gbite,gcut,gorgpinchgallgbygthemselvesgwithoutghumangdirection.gEquipmentgshoul
dbekeptoutofsightuntilneeded.Simple,concreteexplanationsaboutwhattheequipmentgdoesgandgho
wgitgwillgfeelgwillghelpgalleviategthegchildsgfear.gPreschoolersgneedgrepeatedgexplanationsgasgreas
surance.
6. Whenthegnurseinterviewsgangadolescent,gwhichgisgespeciallyimportant?
a. Focusthediscussionongthepeergroup.
b. Allowangopportunitytoexpressgfeelings.
c. Usethegsametypeoflanguageastheadolescent.
d. Emphasizethatconfidentialitywillalwaysbemaintained.ANS:gB
Adolescents,glikegallgchildren,gneedgopportunitiesgtogexpressgtheirgfeelings.gOftengtheyginterjectg
feelingsintotheirwords.Thenursemustbealerttothewordsandfeelingsexpressed.Thenursegs
houldgmaintaingagprofessionalgrelationshipgwithgadolescents.gTogavoidgmisunderstanding
g orgmisinterpretationgofgwordsgandgphrasesgused,gthegnursegshouldgclarifygthegtermsgused
,gwhatginformationgwillgbegsharedgwithgothergmembersgofgtheghealthgcaregteam,gandganyg
limitsgtogconfidentiality.gAlthoughgthegpeerggroupgisgimportantgtogthisgageggroup,gthegint
erviewgshouldgfocusgongthegadolescent.
7. Thenurseispreparingtogassessa10-month-
oldinfant.Heissittingonhisfatherslapandgappearsgtogbegafraidgofgthegnursegandgofgwhatgmi
ghtghappengnext.gWhichginitialgactionsgbygthegnursegshouldgbegmostgappropriate?
a. Initiateagameofpeek-a-boo.
b. Asktheginfantsfathergtoplacetheinfantgontheexaminationgtable.
c. Talksoftlytotheinfantwhiletakinghimfromghisfather.
d. Undresstheinfantwhilegheisstillsittingonghisfatherslap.ANS:gA
Peek-a-
booisanexcellentmeansofinitiatingcommunicationwithinfantswhilemaintainingagsafe,gnonthreate
ninggdistance.gThegchildgwillgmostglikelygbecomegupsetgifgseparatedgfromghisgfather.gAsgmuchgof
gtheassessmentgasgpossiblegshouldgbegdonewithgthechildgongthegfathersglap.gThegnursegshouldghav
egthegfathergundressgthegchildgasgneededgduringgthegexamination.
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8. An8-year-
oldgirlasksthenursehowthebloodpressureapparatusworks.Themostgappropriategnursi
nggactiongisgwhich?
a. Askhergwhyshegwantsgtogknow.
b. Determinewhyshegisgsoanxious.
c. Explainingsimpletermsghowitgworks.
d. Tellhergshewillseehowitworksgasgitisgused.gANS:gC
School-
agechildrenrequireexplanationsandreasonsforeverything.Theyareinterestedinthegfunctionalgaspec
tgofgallgprocedures,gobjects,gandgactivities.gItgisgappropriategforgthegnursegtogexplainghowgequipm
entgworksgandgwhatgwillghappengtogthegchildgsogthatgthegchildgcangthengobserveduringtheprocedu
re.Thenurseshouldrespondpositivelyforrequestsforinformationgaboutgproceduresgandghealthginfor
mation.gBygnotgresponding,gthegnursegmaygbeglimitinggcommunicationgwithgthegchild.gThegchildg
isgnotgexhibitingganxietygingaskingghowgthegbloodgpressuregapparatusgworks,gjustgrequestinggclari
ficationgofgwhatgwillgoccur.
9. Thenurseishavingdifficultycommunicatingwithahospitalized6-year-
oldchild.Whichgtechniquegshouldgbegmostghelpful?
a. Recommendthatgthechildgkeepadiary.
b. Providesuppliesgforthegchildgtodrawgapicture.
c. Suggestthatgtheparentgreadfairytalestogthechild.
d. Asktheparentifthechildisalwaysuncommunicative.ANS:B
Drawinggisgonegofgthegmostgvaluablegformsgofgcommunication.gChildrensgdrawingsgtellgaggreatgd
ealgaboutgthemgbecausegtheygaregprojectionsgofgthegchildrensginnergself.gAgdiarygshouldgbegdiffic
ultgforgag6-year-
oldgchild,gwhogisgmostglikelylearningtogread.gTheparentgreadingfairytalesgtogthegchildgisgagpassiv
egactivityginvolvinggthegparentgandgchild;gitgshouldgnotgfacilitategcommunicationwiththenurse.Th
echildisinastressfulsituationandisprobablyuncomfortablegwithgstrangers,gnotgalwaysguncommuni
cative.
10. Whichdatashouldgbeincludedingahealthghistory?
a. Reviewofgsystems
b. Physicalassessment
c. Growthmeasurements
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