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A 3-year-old child has been admitted to the hospital after an automobile accident. Which statement by the nurse would be most appropriate when discussing the type of behavior the parents can expect their child to display while hospitalized?
- A. Your child may not be able to accept how the injury has changed your child?s appearance.
- B. Your child may seem unduly anxious in the presence of strangers.
- C. Your child may experience some guilt feelings associated with the accident.
- D. Your child will exhibit intermittent periodic mood swings, but these should be brief.
Correct Answer: B
Rationale: A 3-year-old is likely to exhibit stranger anxiety, especially in a stressful hospital setting, as they are developmentally prone to fear of unfamiliar people. Appearance concerns, guilt, or mood swings are more typical in older children with greater cognitive awareness.
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A home-health nurse is working with a poverty-stricken family that has two small children, ages 2 and 3 years. The family lives in an isolated rural area. The family?s home has a dirt floor, and there are chickens living in the house with the family. Because of a recent wind storm, there is a sizeable hole in the roof that lets rain and snow into the house. Which nursing intervention would be the highest priority in this situation?
- A. Make immunization appointments for the children in a nearby town?s public health clinic.
- B. Help the family find funding and manpower to patch and repair the roof of their home.
- C. Determine the educational readiness of the two children.
- D. Report the family for child abuse because of neglect.
Correct Answer: B
Rationale: Repairing the roof is the highest priority to ensure a safe, habitable environment, protecting the children from health risks due to exposure. Immunizations are important but less urgent, educational readiness is secondary, and reporting neglect is premature without assessing intent or resources.
While caring for a family who lost a 10-year-old son in a car accident, the nurse should instruct the parents to tell the 4-year-old sister which of the following about her brother?
- A. He died and is not coming back.
- B. He passed on to the other side.
- C. He departed on a long journey.
- D. He has gone to see the Lord above.
Correct Answer: A
Rationale: For a 4-year-old, clear, simple language like 'He died and is not coming back' is appropriate to help them understand death without confusion. Euphemisms like 'passed on,' 'long journey,' or 'seeing the Lord' may confuse young children who think concretely and may expect the person to return.
A nurse is providing teaching to a group of parents with children and adolescents who have experienced losses. The nurse determines that the teaching was successful when the group states which of the following?
- A. Children grieve in similar ways regardless of their age.
- B. Children often use fantasy to fill in their gaps in understanding.
- C. Families tend to grieve at similar times after the loss.
- D. Children and adults grieve much in the same manner.
Correct Answer: B
Rationale: Children often use fantasy to process grief, filling gaps in their understanding due to developmental limitations, indicating successful teaching. Grief varies by age, families may grieve at different times, and children?s grief differs from adults? due to cognitive differences.
The nurse is counseling a family with two parents and two children, ages 8 and 10 years. The mother complains that the children are constantly fighting and have intense sibling rivalry. When statement would be most appropriate when advising the parents about how to respond to the sibling rivalry?
- A. Try reacting to each as unique individuals with talents and interests distinctly their own.
- B. Be firm about telling the children they have to cooperate with one another.
- C. Slowly decrease the amount of attention and control shown to the older child.
- D. Make sure they have a quiet, subdued home environment to avoid stimulating conflict.
Correct Answer: A
Rationale: Treating children as unique individuals with distinct talents reduces sibling rivalry by fostering individual identity and reducing competition. Forcing cooperation, reducing attention to one child, or enforcing a quiet environment may not address the root cause and could escalate tension.
The nurse is working with a child who has engaged in bullying. Which of the following would be most effective for the nurse to implement?
- A. Psychoeducation
- B. Bibliotherapy
- C. Early intervention program
- D. Social skills training
Correct Answer: D
Rationale: Social skills training is most effective for addressing bullying, as it teaches empathy, communication, and conflict resolution, targeting the root behaviors. Psychoeducation provides knowledge, bibliotherapy uses reading, and early intervention is broader, not specific to bullying.