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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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.
Which is an accurate description of homosexual (or gay-lesbian) families?
- A. A nurturing environment is lacking.
- B. The children become homosexual like their parents.
- C. The stability needed to raise healthy children is lacking.
- D. The quality of parenting is equivalent to that of nongay parents.
Correct Answer: D
Rationale: Although gay or lesbian families may be different from heterosexual families, the environment can be as healthy as any other. Lacking a nurturing environment and stability is reflective on the parents and family, not the type of family. There is little evidence to support that children become homosexual like their parents.
The nurse is teaching a group of new nursing graduates about identifiable qualities of strong families that help them function effectively. Which quality should be included in the teaching?
- A. Lack of congruence among family members
- B. Clear set of family values, rules, and beliefs
- C. Adoption of one coping strategy that always promotes positive functioning in dealing with life events
- D. Sense of commitment toward growth of individual family members as opposed to that of the family unit
Correct Answer: B
Rationale: A clear set of family rules, values, and beliefs that establish expectations about acceptable and desired behavior is one of the qualities of strong families that help them function effectively. Strong families have a sense of congruence among family members regarding the value and importance of assigning time and energy to meet needs. Varied coping strategies are used by strong families. The sense of commitment is toward the growth and well-being of individual family members, as well as the family unit.
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.
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.
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