Nokea
The nurses approach when introducing hospital equipment to a preschooler who seems afraid should be based on which principle?
- A. The child may think the equipment is alive.
- B. Explaining the equipment will only increase the childs fear.
- C. One brief explanation will be enough to reduce the childs fear.
- D. The child is too young to understand what the equipment does.
Correct Answer: A
Rationale: Young children attribute human characteristics to inanimate objects. They often fear that the objects may jump, bite, cut, or pinch all by themselves without human direction. Equipment should be kept out of sight until needed. Simple, concrete explanations about what the equipment does and how it will feel will help alleviate the childs fear. Preschoolers need repeated explanations as reassurance.
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The nurse is preparing to assess a 10-month-old infant. He is sitting on his fathers lap and appears to be afraid of the nurse and of what might happen next. Which initial actions by the nurse should be most appropriate?
- A. Initiate a game of peek-a-boo.
- B. Ask the infants father to place the infant on the examination table.
- C. Talk softly to the infant while taking him from his father.
- D. Undress the infant while he is still sitting on his fathers lap.
Correct Answer: A
Rationale: Peek-a-boo is an excellent means of initiating communication with infants while maintaining a safe, nonthreatening distance. The child will most likely become upset if separated from his father. As much of the assessment as possible should be done with the child on the fathers lap. The nurse should have the father undress the child as needed during the examination.
The nurse needs to take the blood pressure of a small child. Of the cuffs available, one is too large and one is too small. The best nursing action is which?
- A. Use the small cuff.
- B. Use the large cuff.
- C. Use either cuff using the palpation method.
- D. Wait to take the blood pressure until a proper cuff can be located.
Correct Answer: B
Rationale: If blood pressure measurement is indicated and the appropriate size cuff is not available, the next larger size is used. The nurse recognizes that this may be a falsely low blood pressure. Using the small cuff will give an incorrectly high reading. The palpation method will not improve the inaccuracy inherent in the cuff.
During a funduscopic examination of a school-age child, the nurse notes a brilliant, uniform red reflex in both eyes. The nurse should recognize that this is which?
- A. A normal finding
- B. A sign of a possible visual defect and a need for vision screening
- C. An abnormal finding requiring referral to an ophthalmologist
- D. A sign of small hemorrhages, which usually resolve spontaneously
Correct Answer: A
Rationale: A brilliant, uniform red reflex is an important normal finding. It rules out many serious defects of the cornea, aqueous chamber, lens, and vitreous chamber.
The nurse is having difficulty communicating with a hospitalized 6-year-old child. Which technique should be most helpful?
- A. Recommend that the child keep a diary.
- B. Provide supplies for the child to draw a picture.
- C. Suggest that the parent read fairy tales to the child.
- D. Ask the parent if the child is always uncommunicative.
Correct Answer: B
Rationale: Drawing is one of the most valuable forms of communication. Childrens drawings tell a great deal about them because they are projections of the childrens inner self. A diary should be difficult for a 6-year-old child, who is most likely learning to read. The parent reading fairy tales to the child is a passive activity involving the parent and child; it should not facilitate communication with the nurse. The child is in a stressful situation and is probably uncomfortable with strangers, not always uncommunicative.
The nurse is seeing an adolescent and the parents in the clinic for the first time. Which should the nurse do first?
- A. Introduce him- or herself.
- B. Make the family comfortable.
- C. Give assurance of privacy.
- D. Explain the purpose of the interview.
Correct Answer: A
Rationale: The first thing that nurses must do is to introduce themselves to the patient and family. Parents and other adults should be addressed with appropriate titles unless they specify a preferred name. Clarification of the purpose of the interview and the nurses role is the second thing that should be done. During the initial part of the interview, the nurse should include general conversation to help make the family feel at ease. The interview also should take place in an environment as free of distraction as possible. In addition, the nurse should clarify which information will be shared with other members of the health care team and any limits to the confidentiality.