Children may believe that they are responsible for their parents divorce and interpret the separation as punishment. At which age is this most likely to occur?
- A. 1 year
- B. 4 years
- C. 8 years
- D. 13 years
Correct Answer: B
Rationale: Preschool-age children are most likely to blame themselves for the divorce. A 4-year-old child will fear abandonment and express bewilderment regarding all human relationships. A 4-year-old child has magical thinking and believes his or her actions cause consequences, such as divorce. For infants, divorce may increase their irritability and interfere with the attachment process, but they are too young to feel responsibility. School-age children will have feelings of deprivation, including the loss of a parent, attention, money, and a secure future. Adolescents are able to disengage themselves from the parental conflict.
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The parents of a young child ask the nurse for suggestions about discipline. When discussing the use of time-outs, which should the nurse include?
- A. Send the child to his or her room if the child has one.
- B. A general rule for length of time is 1 hour per year of age.
- C. Select an area that is safe and nonstimulating, such as a hallway.
- D. If the child cries, refuses, or is more disruptive, try another approach.
Correct Answer: C
Rationale: The area must be nonstimulating and safe. The child becomes bored in this environment and then changes behavior to rejoin activities. The childs room may have toys and activities that negate the effect of being separated from the family. The general rule is 1 minute per year of age. An hour per year is excessive. When the child cries, refuses, or is more disruptive, the time-out does not start; the time-out begins when the child quiets.
The nurse is aware that if patients different cultures are implied to be inferior, the emotional attitude the nurse is displaying is what?
- A. Acculturation
- B. Ethnocentrism
- C. Cultural shock
- D. Cultural sensitivity
Correct Answer: B
Rationale: Ethnocentrism is the belief that ones way of living and behaving is the best way. This includes the emotional attitude that the values, beliefs, and perceptions of ones ethnic group are superior to those of others. Acculturation is the gradual changes that are produced in a culture by the influence of another culture that cause one or both cultures to become more similar. The minority culture is forced to learn the majority culture to survive. Cultural shock is the helpless feeling and state of disorientation felt by an outsider attempting to adapt to a different culture group. Cultural sensitivity, a component of culturally competent care, is an awareness of cultural similarities and differences.
A Hispanic toddler has pneumonia. The nurse notices that the parent consistently feeds the child only the broth that comes on the clear liquid tray. Food items, such as Jell-O, Popsicles, and juices, are left. Which statement best explains this?
- A. The parent is trying to feed the child only what the child likes most.
- B. Hispanics believe the evil eye enters when a person gets cold.
- C. The parent is trying to restore normal balance through appropriate hot remedies.
- D. Hispanics believe an innate energy called chi is strengthened by eating soup.
Correct Answer: C
Rationale: In several cultures, including Filipino, Chinese, Arabic, and Hispanic, hot and cold describe certain properties completely unrelated to temperature. Respiratory conditions such as pneumonia are cold conditions and are treated with hot foods. The child may like broth but is unlikely to always prefer it to Jell-O, Popsicles, and juice. The evil eye applies to a state of imbalance of health, not curative actions. Chinese individuals, not Hispanic individuals, believe in chi as an innate energy.
Which family theory explains how families react to stressful events and suggests factors that promote adaptation to these events?
- A. Interactional theory
- B. Family stress theory
- C. Eriksons psychosocial theory
- D. Developmental systems theory
Correct Answer: B
Rationale: Family stress theory explains the reaction of families to stressful events. In addition, the theory helps suggest factors that promote adaptation to the stress. Stressors, both positive and negative, are cumulative and affect the family. Adaptation requires a change in family structure or interaction. Interactional theory is not a family theory. Interactions are the basis of general systems theory. Eriksons theory applies to individual growth and development, not families. Developmental systems theory is an outgrowth of Duvalls theory. The family is described as a small group, a semiclosed system of personalities that interact with the larger cultural system. Changes do not occur in one part of the family without changes in others.
When discussing discipline with the mother of a 4-year-old child, which should the nurse include?
- A. Parental control should be consistent.
- B. Withdrawal of love and approval is effective at this age.
- C. Children as young as 4 years rarely need to be disciplined.
- D. One should expect rules to be followed rigidly and unquestioningly.
Correct Answer: A
Rationale: For effective discipline, parents must be consistent and must follow through with agreed-on actions. Withdrawal of love and approval is never appropriate or effective. The 4-year-old child will test limits and may misbehave. Children of this age do not respond to verbal reasoning. Realistic goals should be set for this age group. Discipline is necessary to reinforce these goals. Discipline strategies should be appropriate to the childs age and temperament and the severity of the misbehavior. Following rules rigidly and unquestioningly is beyond the developmental capabilities of a 4-year-old child.
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