CreatedlBy:lAlSolution
TEST BANK FOR PEDIATRIC PRIMARY CARE: PRACTICE GUI
l l l l l l l
DELINES FOR NURSES: PRACTICE GUIDELINES FOR NURSES
l l l l l l l
5TH EDITION BY BETH RICHARDSON A+
l l l l l
Chapterl1lObtaininglanlInitiallHistory
MULTIPLElCHOICE
1. Thelnurselislseeinglanladolescentlandlthelparentslinlthelcliniclforlthelfirstltime.lWhichlshoul
dlthelnurseldolfirst?
a. Introducelhim-lorlherself.
b. Makelthelfamilylcomfortable.
c. Givelassuranceloflprivacy.
d. Explainlthelpurposeloflthelinterview.lANS:lA
Thelfirstlthinglthatlnurseslmustldolisltolintroducelthemselvesltolthelpatientlandlfamily.lParentslandloth
erladultslshouldlbeladdressedlwithlappropriateltitleslunlessltheylspecifylalpreferredlname.lClarificatio
nloflthelpurposeloflthelinterviewlandlthelnurseslrolelislthelsecondlthinglthatlshouldlbeldone.lDuringltheli
nitiallpartloflthelinterview,lthelnurselshouldlincludelgenerallconversationltolhelplmakelthelfamilylfeell
atlease.lThelinterviewlalsolshouldltakelplacelinlanlenvironmentlaslfreelofldistractionlaslpossible.lInlad
dition,lthelnurselshouldlclarifylwhichlinformationlwilllbelsharedlwithlotherlmembersloflthelhealthlcar
elteamlandlanyllimitsltolthelconfidentiality.
2. Whichlislconsideredlalblockltoleffectivelcommunication?
a. Usinglsilence
b. Usinglclichs
c. Directinglthelfocus
d. DefininglthelproblemlANS:lB
Usinglstereotypedlcommentslorlclichslcanlblockleffectivelcommunication.lAfterlthelnurseluseslsuchl
tritelphrases,lparentsloftenldolnotlrespond.lSilencelcanlbelanleffectivelinterviewingltool.lSilencelper
mitslthelintervieweeltolsortloutlthoughtslandlfeelingslandlsearchlforlresponsesltolquestions.lTolbeleff
ective,lthelnurselmustlbelableltoldirectlthelfocusloflthelinterviewlwhilelallowinglmaximumlfreedomlo
flexpression.lBylusinglopen-
endedlquestionslandlguidinglquestions,lthelnurselcanlobtainlthelnecessarylinformationlandlmaintainl
alrelationshiplwithlthe
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family.lThelnurselandlparentlmustlcollaboratelandldefinelthelproblemlthatlwilllbelthelfocusloflthelnurs
inglintervention.
3. Whichlislthelsinglelmostlimportantlfactorltolconsiderlwhenlcommunicatinglwithlchil
dren?
a. Presenceloflthelchildslparent
b. Childslphysicallcondition
c. Childsldevelopmentalllevel
d. ChildslnonverballbehaviorslANS:lC
Thelnurselmustlbelawareloflthelchildsldevelopmentallstageltolengagelinleffectivelcommunication.lTh
eluseloflbothlverballandlnonverballcommunicationlshouldlbelappropriateltoltheldevelopmentalllevel.l
Nonverballbehaviorslvarylinlimportancelbasedlonlthelchildsldevelopmentalllevellandlphysicallcondit
ion.lAlthoughlthelchildslphysicallconditionlislalconsideration,ldevelopmentalllevellislmuchlmorelimp
ortant.lThelpresenceloflparentslislimportantlwhenlcommunicatinglwithlyounglchildrenlbutlmaylbeldet
rimentallwhenlspeakinglwithladolescents.
4. Becauselchildrenlyoungerlthanl5lyearslarelegocentric,lthelnurselshouldldolwhichlwhenlcom
municatinglwithlthem?
a. Focuslcommunicationlonlthelchild.
b. Useleasylanalogieslwhenlpossible.
c. Explainlexperiencesloflothersltolthelchild.
d. Assurelthelchildlthatlcommunicationlislprivate.lANS:lA
Becauselchildrenloflthislagelarelableltolseelthingslonlylinltermsloflthemselves,lthelbestlapproachlisltolfo
cuslcommunicationldirectlylonlthem.lChildrenlshouldlbelprovidedlwithlinformationlaboutlwhatltheylc
anldolandlhowltheylwilllfeel.lWithlchildrenlwholarelegocentric,lanalogies,lexperiences,landlassurance
slthatlcommunicationlislprivatelwilllnotlbeleffectivelbecauselthelchildlislnotlcapableloflunderstanding.
5. Thelnurseslapproachlwhenlintroducinglhospitallequipmentltolalpreschoolerlwholseemslafra
idlshouldlbelbasedlonlwhichlprinciple?
a. Thelchildlmaylthinklthelequipmentlislalive.
b. Explaininglthelequipmentlwilllonlylincreaselthelchildslfear.
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c. Onelbrieflexplanationlwilllbelenoughltolreducelthelchildslfear.
d. Thelchildlisltoolyoungltolunderstandlwhatlthelequipmentldoes.lANS:lA
Younglchildrenlattributelhumanlcharacteristicsltolinanimatelobjects.lTheyloftenlfearlthatlthelobjectsl
mayljump,lbite,lcut,lorlpinchlalllbylthemselveslwithoutlhumanldirection.lEquipmentlshouldlbelkeptlou
tloflsightluntillneeded.lSimple,lconcretelexplanationslaboutlwhatlthelequipmentldoeslandlhowlitlwilllfe
ellwilllhelplalleviatelthelchildslfear.lPreschoolerslneedlrepeatedlexplanationslaslreassurance.
6. Whenlthelnurselinterviewslanladolescent,lwhichlislespeciallylimportant?
a. Focusltheldiscussionlonlthelpeerlgroup.
b. Allowlanlopportunityltolexpresslfeelings.
c. Uselthelsameltypelofllanguagelasltheladolescent.
d. Emphasizelthatlconfidentialitylwilllalwayslbelmaintained.lANS:lB
Adolescents,llikelalllchildren,lneedlopportunitiesltolexpressltheirlfeelings.lOftenltheylinterjectlfeelin
gslintoltheirlwords.lThelnurselmustlbelalertltolthelwordslandlfeelingslexpressed.lThelnurselshouldlmai
ntainlalprofessionallrelationshiplwithladolescents.lTolavoidlmisunderstandinglorlmisinterpretationl
oflwordslandlphraseslused,lthelnurselshouldlclarifyltheltermslused,lwhatlinformationlwilllbelsharedlw
ithlotherlmembersloflthelhealthlcarelteam,landlanyllimitsltolconfidentiality.lAlthoughlthelpeerlgroupli
slimportantltolthislagelgroup,lthelinterviewlshouldlfocuslonltheladolescent.
7. Thelnurselislpreparingltolassesslal10-month-
oldlinfant.lHelislsittinglonlhislfathersllaplandlappearsltolbelafraidloflthelnurselandloflwhatlmightlhappe
nlnext.lWhichlinitiallactionslbylthelnurselshouldlbelmostlappropriate?
a. Initiatelalgameloflpeek-a-boo.
b. Asklthelinfantslfatherltolplacelthelinfantlonlthelexaminationltable.
c. Talklsoftlyltolthelinfantlwhileltakinglhimlfromlhislfather.
d. Undresslthelinfantlwhilelhelislstilllsittinglonlhislfathersllap.lANS:lA
Peek-a-
boolislanlexcellentlmeansloflinitiatinglcommunicationlwithlinfantslwhilelmaintaininglalsafe,lnonthreat
eningldistance.lThelchildlwilllmostllikelylbecomelupsetliflseparatedlfromlhislfather.lAslmuchloflthelas
sessmentlaslpossiblelshouldlbeldonelwithlthelchildlonlthelfathersllap.lThelnurselshouldlhavelthelfatherl
undresslthelchildlaslneededlduringlthelexamination.
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8. Anl8-year-
oldlgirllaskslthelnurselhowlthelbloodlpressurelapparatuslworks.lThelmostlappropriatelnursinglact
ionlislwhich?
a. Asklherlwhylshelwantsltolknow.
b. Determinelwhylshelislsolanxious.
c. Explainlinlsimpleltermslhowlitlworks.
d. Telllherlshelwilllseelhowlitlworkslaslitlislused.lANS:lC
School-
agelchildrenlrequirelexplanationslandlreasonslforleverything.lTheylarelinterestedlinlthelfunctionallasp
ectloflalllprocedures,lobjects,landlactivities.lItlislappropriatelforlthelnurseltolexplainlhowlequipmentlw
orkslandlwhatlwilllhappenltolthelchildlsolthatlthelchildlcanlthenlobservelduringlthelprocedure.lThelnurs
elshouldlrespondlpositivelylforlrequestslforlinformationlaboutlprocedureslandlhealthlinformation.lByl
notlresponding,lthelnurselmaylbellimitinglcommunicationlwithlthelchild.lThelchildlislnotlexhibitingla
nxietylinlaskinglhowlthelbloodlpressurelapparatuslworks,ljustlrequestinglclarificationloflwhatlwilllocc
ur.
9. Thelnurselislhavingldifficultylcommunicatinglwithlalhospitalizedl6-year-
oldlchild.lWhichltechniquelshouldlbelmostlhelpful?
a. Recommendlthatlthelchildlkeeplaldiary.
b. Providelsupplieslforlthelchildltoldrawlalpicture.
c. Suggestlthatlthelparentlreadlfairyltalesltolthelchild.
d. Asklthelparentliflthelchildlislalwaysluncommunicative.lANS:lB
Drawinglisloneloflthelmostlvaluablelformsloflcommunication.lChildrensldrawingsltelllalgreatldeallabo
utlthemlbecauseltheylarelprojectionsloflthelchildrenslinnerlself.lAldiarylshouldlbeldifficultlforlal6-
year-
oldlchild,lwholislmostllikelyllearningltolread.lThelparentlreadinglfairyltalesltolthelchildlislalpassivelacti
vitylinvolvinglthelparentlandlchild;litlshouldlnotlfacilitatelcommunicationlwithlthelnurse.lThelchildlisli
nlalstressfullsituationlandlislprobablyluncomfortablelwithlstrangers,lnotlalwaysluncommunicative.
10. Whichldatalshouldlbelincludedlinlalhealthlhistory?
a. Reviewloflsystems
b. Physicallassessment
c. Growthlmeasurements
d. RecordloflvitallsignslANS:lA
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TEST BANK FOR PEDIATRIC PRIMARY CARE: PRACTICE GUI
l l l l l l l
DELINES FOR NURSES: PRACTICE GUIDELINES FOR NURSES
l l l l l l l
5TH EDITION BY BETH RICHARDSON A+
l l l l l
Chapterl1lObtaininglanlInitiallHistory
MULTIPLElCHOICE
1. Thelnurselislseeinglanladolescentlandlthelparentslinlthelcliniclforlthelfirstltime.lWhichlshoul
dlthelnurseldolfirst?
a. Introducelhim-lorlherself.
b. Makelthelfamilylcomfortable.
c. Givelassuranceloflprivacy.
d. Explainlthelpurposeloflthelinterview.lANS:lA
Thelfirstlthinglthatlnurseslmustldolisltolintroducelthemselvesltolthelpatientlandlfamily.lParentslandloth
erladultslshouldlbeladdressedlwithlappropriateltitleslunlessltheylspecifylalpreferredlname.lClarificatio
nloflthelpurposeloflthelinterviewlandlthelnurseslrolelislthelsecondlthinglthatlshouldlbeldone.lDuringltheli
nitiallpartloflthelinterview,lthelnurselshouldlincludelgenerallconversationltolhelplmakelthelfamilylfeell
atlease.lThelinterviewlalsolshouldltakelplacelinlanlenvironmentlaslfreelofldistractionlaslpossible.lInlad
dition,lthelnurselshouldlclarifylwhichlinformationlwilllbelsharedlwithlotherlmembersloflthelhealthlcar
elteamlandlanyllimitsltolthelconfidentiality.
2. Whichlislconsideredlalblockltoleffectivelcommunication?
a. Usinglsilence
b. Usinglclichs
c. Directinglthelfocus
d. DefininglthelproblemlANS:lB
Usinglstereotypedlcommentslorlclichslcanlblockleffectivelcommunication.lAfterlthelnurseluseslsuchl
tritelphrases,lparentsloftenldolnotlrespond.lSilencelcanlbelanleffectivelinterviewingltool.lSilencelper
mitslthelintervieweeltolsortloutlthoughtslandlfeelingslandlsearchlforlresponsesltolquestions.lTolbeleff
ective,lthelnurselmustlbelableltoldirectlthelfocusloflthelinterviewlwhilelallowinglmaximumlfreedomlo
flexpression.lBylusinglopen-
endedlquestionslandlguidinglquestions,lthelnurselcanlobtainlthelnecessarylinformationlandlmaintainl
alrelationshiplwithlthe
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family.lThelnurselandlparentlmustlcollaboratelandldefinelthelproblemlthatlwilllbelthelfocusloflthelnurs
inglintervention.
3. Whichlislthelsinglelmostlimportantlfactorltolconsiderlwhenlcommunicatinglwithlchil
dren?
a. Presenceloflthelchildslparent
b. Childslphysicallcondition
c. Childsldevelopmentalllevel
d. ChildslnonverballbehaviorslANS:lC
Thelnurselmustlbelawareloflthelchildsldevelopmentallstageltolengagelinleffectivelcommunication.lTh
eluseloflbothlverballandlnonverballcommunicationlshouldlbelappropriateltoltheldevelopmentalllevel.l
Nonverballbehaviorslvarylinlimportancelbasedlonlthelchildsldevelopmentalllevellandlphysicallcondit
ion.lAlthoughlthelchildslphysicallconditionlislalconsideration,ldevelopmentalllevellislmuchlmorelimp
ortant.lThelpresenceloflparentslislimportantlwhenlcommunicatinglwithlyounglchildrenlbutlmaylbeldet
rimentallwhenlspeakinglwithladolescents.
4. Becauselchildrenlyoungerlthanl5lyearslarelegocentric,lthelnurselshouldldolwhichlwhenlcom
municatinglwithlthem?
a. Focuslcommunicationlonlthelchild.
b. Useleasylanalogieslwhenlpossible.
c. Explainlexperiencesloflothersltolthelchild.
d. Assurelthelchildlthatlcommunicationlislprivate.lANS:lA
Becauselchildrenloflthislagelarelableltolseelthingslonlylinltermsloflthemselves,lthelbestlapproachlisltolfo
cuslcommunicationldirectlylonlthem.lChildrenlshouldlbelprovidedlwithlinformationlaboutlwhatltheylc
anldolandlhowltheylwilllfeel.lWithlchildrenlwholarelegocentric,lanalogies,lexperiences,landlassurance
slthatlcommunicationlislprivatelwilllnotlbeleffectivelbecauselthelchildlislnotlcapableloflunderstanding.
5. Thelnurseslapproachlwhenlintroducinglhospitallequipmentltolalpreschoolerlwholseemslafra
idlshouldlbelbasedlonlwhichlprinciple?
a. Thelchildlmaylthinklthelequipmentlislalive.
b. Explaininglthelequipmentlwilllonlylincreaselthelchildslfear.
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c. Onelbrieflexplanationlwilllbelenoughltolreducelthelchildslfear.
d. Thelchildlisltoolyoungltolunderstandlwhatlthelequipmentldoes.lANS:lA
Younglchildrenlattributelhumanlcharacteristicsltolinanimatelobjects.lTheyloftenlfearlthatlthelobjectsl
mayljump,lbite,lcut,lorlpinchlalllbylthemselveslwithoutlhumanldirection.lEquipmentlshouldlbelkeptlou
tloflsightluntillneeded.lSimple,lconcretelexplanationslaboutlwhatlthelequipmentldoeslandlhowlitlwilllfe
ellwilllhelplalleviatelthelchildslfear.lPreschoolerslneedlrepeatedlexplanationslaslreassurance.
6. Whenlthelnurselinterviewslanladolescent,lwhichlislespeciallylimportant?
a. Focusltheldiscussionlonlthelpeerlgroup.
b. Allowlanlopportunityltolexpresslfeelings.
c. Uselthelsameltypelofllanguagelasltheladolescent.
d. Emphasizelthatlconfidentialitylwilllalwayslbelmaintained.lANS:lB
Adolescents,llikelalllchildren,lneedlopportunitiesltolexpressltheirlfeelings.lOftenltheylinterjectlfeelin
gslintoltheirlwords.lThelnurselmustlbelalertltolthelwordslandlfeelingslexpressed.lThelnurselshouldlmai
ntainlalprofessionallrelationshiplwithladolescents.lTolavoidlmisunderstandinglorlmisinterpretationl
oflwordslandlphraseslused,lthelnurselshouldlclarifyltheltermslused,lwhatlinformationlwilllbelsharedlw
ithlotherlmembersloflthelhealthlcarelteam,landlanyllimitsltolconfidentiality.lAlthoughlthelpeerlgroupli
slimportantltolthislagelgroup,lthelinterviewlshouldlfocuslonltheladolescent.
7. Thelnurselislpreparingltolassesslal10-month-
oldlinfant.lHelislsittinglonlhislfathersllaplandlappearsltolbelafraidloflthelnurselandloflwhatlmightlhappe
nlnext.lWhichlinitiallactionslbylthelnurselshouldlbelmostlappropriate?
a. Initiatelalgameloflpeek-a-boo.
b. Asklthelinfantslfatherltolplacelthelinfantlonlthelexaminationltable.
c. Talklsoftlyltolthelinfantlwhileltakinglhimlfromlhislfather.
d. Undresslthelinfantlwhilelhelislstilllsittinglonlhislfathersllap.lANS:lA
Peek-a-
boolislanlexcellentlmeansloflinitiatinglcommunicationlwithlinfantslwhilelmaintaininglalsafe,lnonthreat
eningldistance.lThelchildlwilllmostllikelylbecomelupsetliflseparatedlfromlhislfather.lAslmuchloflthelas
sessmentlaslpossiblelshouldlbeldonelwithlthelchildlonlthelfathersllap.lThelnurselshouldlhavelthelfatherl
undresslthelchildlaslneededlduringlthelexamination.
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8. Anl8-year-
oldlgirllaskslthelnurselhowlthelbloodlpressurelapparatuslworks.lThelmostlappropriatelnursinglact
ionlislwhich?
a. Asklherlwhylshelwantsltolknow.
b. Determinelwhylshelislsolanxious.
c. Explainlinlsimpleltermslhowlitlworks.
d. Telllherlshelwilllseelhowlitlworkslaslitlislused.lANS:lC
School-
agelchildrenlrequirelexplanationslandlreasonslforleverything.lTheylarelinterestedlinlthelfunctionallasp
ectloflalllprocedures,lobjects,landlactivities.lItlislappropriatelforlthelnurseltolexplainlhowlequipmentlw
orkslandlwhatlwilllhappenltolthelchildlsolthatlthelchildlcanlthenlobservelduringlthelprocedure.lThelnurs
elshouldlrespondlpositivelylforlrequestslforlinformationlaboutlprocedureslandlhealthlinformation.lByl
notlresponding,lthelnurselmaylbellimitinglcommunicationlwithlthelchild.lThelchildlislnotlexhibitingla
nxietylinlaskinglhowlthelbloodlpressurelapparatuslworks,ljustlrequestinglclarificationloflwhatlwilllocc
ur.
9. Thelnurselislhavingldifficultylcommunicatinglwithlalhospitalizedl6-year-
oldlchild.lWhichltechniquelshouldlbelmostlhelpful?
a. Recommendlthatlthelchildlkeeplaldiary.
b. Providelsupplieslforlthelchildltoldrawlalpicture.
c. Suggestlthatlthelparentlreadlfairyltalesltolthelchild.
d. Asklthelparentliflthelchildlislalwaysluncommunicative.lANS:lB
Drawinglisloneloflthelmostlvaluablelformsloflcommunication.lChildrensldrawingsltelllalgreatldeallabo
utlthemlbecauseltheylarelprojectionsloflthelchildrenslinnerlself.lAldiarylshouldlbeldifficultlforlal6-
year-
oldlchild,lwholislmostllikelyllearningltolread.lThelparentlreadinglfairyltalesltolthelchildlislalpassivelacti
vitylinvolvinglthelparentlandlchild;litlshouldlnotlfacilitatelcommunicationlwithlthelnurse.lThelchildlisli
nlalstressfullsituationlandlislprobablyluncomfortablelwithlstrangers,lnotlalwaysluncommunicative.
10. Whichldatalshouldlbelincludedlinlalhealthlhistory?
a. Reviewloflsystems
b. Physicallassessment
c. Growthlmeasurements
d. RecordloflvitallsignslANS:lA
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