Homework Lance
MULTIPLE CHOICE
1. A nurse is teaching parents how to apply “time-out” as a disciplinary method for their 4 year old. Parents have understood the teaching if they state which formula correctly guides the use of “time-out”?
a.
Use the guideline of 1 minute per each year of the child’s age.
b.
Relate the length of the time-out to the severity of the behavior.
c.
Never use time-out for a child younger than age 4 years.
d.
Follow the time-out with a treat.
ANS: A
In time-out, the child is told to sit on a chair for a predetermined time, usually 1 minute per year of age. Relating time to a behavior is subjective and inappropriate when the child is very young. Time-out can be used with a toddler. Negative behavior should not be reinforced with a positive action.
DIF: Cognitive Level: Comprehension REF: p. 34
OBJ: Nursing Process Step: Evaluation MSC: Health Promotion and Maintenance
2. What is the nurse’s best approach when an 8-year-old boy frequently causes a disruption in the playroom by taking toys from other children?
a.
Exclude the child from the playroom.
b.
Explain to the children in the playroom that he is very ill and should be allowed to have the toys.
c.
Approach the child in his room and ask, “Would you like it if the other children took your toys from you?”
d.
Approach the child in his room and state, “I am concerned that you are taking the other children’s toys. It upsets them and me.”
ANS: D
The nurse can focus on the behavior most effectively by using “I” rather than “you” messages. A “you” message criticizes the child and uses guilt in an attempt to change behavior. Banning the child from the playroom will not solve the problem. The problem is the child’s behavior, not the place where the child exhibits it. Illness is not a reason for a child to be undisciplined. When the child recovers, the parents will have to deal with a child who is undisciplined and unruly. The child should not be made to feel guilty and to have his or her self-esteem attacked.
DIF: Cognitive Level: Application REF: p. 34
OBJ: Nursing Process Step: Implementation MSC: Psychosocial Integrity
3. Families that deal most effectively with stress have which behavior patterns?
a.
Focus on family problems.
b.
Feel weakened by stress.
c.
Expect that some stress is normal.
d.
Feel guilty when stress exists.
ANS: C
Healthy families recognize that some stress is normal in all families, focus on family strengths rather than on the problems, and know that stress is temporary and may be positive. Because some stress is normal in all families, there is no reason to feel guilty. Guilt only immobilizes the family and does not lead to a resolution of the stress.
DIF: Cognitive Level: Comprehension REF: p. 25
OBJ: Nursing Process Step: Assessment MSC: Psychosocial Integrity
4. Which family will most likely have the greatest difficulty in coping with an ill child?
a.
A single-parent mother who has the support of her parents and siblings
b.
Parents who have just moved to the area and are living in an apartment while they look for a house
c.
The family of a child who has had multiple hospitalizations related to asthma and has adequate relationships with the nursing staff
d.
A family in which there is a young child and four older married children who live in the area
ANS: B
Parents who are in a new environment will have increased stress related to their lack of a support system. If only one parent is available but has the support of her extended family, this will assist in her adjustment to the crisis. The family that has had positive experiences in the past with hospitalizations can draw from those experiences and feel confident about the current setting. For the family with one younger child and four older married children who live in the area, the family has an extensive support system, which will assist the parents in adjusting to the crisis.
DIF: Cognitive Level: Application REF: p. 27
OBJ: Nursing Process Step: Planning MSC: Psychosocial Integrity
5. Which is the priority nursing intervention for the family of a child who has been admitted to the hospital?
a.
Begin discharge teaching.
b.
Identify and mobilize internal and external strengths.
c.
Identify ways in which the family could have prevented their child’s hospitalization.
d.
Instruct the parents on normal growth and development.
ANS: B
Family interventions should be directed toward enhancing positive coping strategies and directing the family to appropriate resources. Although discharge teaching is begun as soon as possible, it is ineffective if trust has not been established with the parents or if the level of stress precludes learning. By identifying weaknesses instead of focusing on strengths, the family’s anxiety and feelings of powerlessness or guilt may increase. Normal growth and development should be interwoven into teaching; however, teaching cannot take place until the parents have less stress and are open to information.
DIF: Cognitive Level: Application REF: p. 27
OBJ: Nursing Process Step: Implementation MSC: Psychosocial Integrity
6. A nurse is planning culturally competent care for a child of Hispanic descent. Which characteristic found in a Hispanic family should the nurse include in the plan of care?
a.
Stoicism
b.
Close extended family
c.
Docile children are considered weak
d.
Very interested in health-promoting lifestyles
ANS: B
Most Mexican-American families are very close and it is not unusual for children to be surrounded by parents, siblings, grandparents, and godparents. It is important to respect this cultural characteristic and to see it as a strength, not a weakness. Although stoicism may be present in any family, Mexican-American families tend to be more expressive. Considering docile children as weak is a characteristic of American Indians. Although there is a trend for everyone to embrace more health-promoting lifestyles, it is more prominent in Anglo-Americans.
DIF: Cognitive Level: Application REF: p. 28
OBJ: Nursing Process Step: Planning MSC: Psychosocial Integrity
7. While reviewing nursing documentation on dietary intake for a 7-year-old child of Asian descent, the nurse notes that he consistently refuses to eat the food on his tray. Which assumption is most likely accurate?
a.
He is a picky eater.
b.
He needs less food because he is on bed rest.
c.
He may have culturally related food preferences.
d.
He is probably eating between meals and spoiling his appetite.
ANS: C
When cultural differences are noted, food preferences should always be obtained. A child will often not eat unfamiliar foods. Although the child may be a picky eater, the key point is that he is from a different culture. The foods he is being served may seem strange to him. Nutrition plays an important role in healing. Although the child expends less energy while on bed rest, he has increased needs for good nutrition. Although it should be determined whether the child is eating food the family has brought from home, it is more important to determine his food preferences.
DIF: Cognitive Level: Application REF: p. 28
OBJ: Nursing Process Step: Assessment MSC: Psychosocial Integrity
8. To resolve family conflict, it is necessary to have open communication, accurate perception of the problem, and a(n):
a.
intact family structure.
b.
arbitrator.
c.
willingness to consider the view of others.
d.
balance in personality types.
ANS: C
Without the willingness of the members of a group to consider the views of others, conflict resolution cannot take place. The structure of a family may affect their dynamics, but it is still possible to resolve conflict without an intact family structure if all the ingredients of conflict resolution are present. Conflicts can be resolved without the assistance of an arbitrator. Most families have diverse personality types among their members. This may make conflict resolution more difficult; however, it should not impede it if the ingredients of conflict resolution are present.
DIF: Cognitive Level: Knowledge REF: p. 27
OBJ: Nursing Process Step: Implementation MSC: Psychosocial Integrity
9. A nurse is planning a parenting class for expectant parents. Which statement is true about the characteristics of a healthy family?
a.
The parents and children have rigid assignments for all the family tasks.
b.
Young families assume total responsibility for the parenting tasks, refusing any assistance.
c.
The family is overwhelmed by the significant changes that occur as a result of childbirth.
d.
Adults agree on the majority of basic parenting principles.
ANS: D
A trait of a healthy family is that adults agree on the basic principles of parenting so that minimal discord exists. A significant stressor for families is lack of shared responsibility in the family. Lack of flexibility in parental tasks is likely to create stress and conflict. Admitting to and seeking help with problems, rather than refusing assistance, is a trait of a healthy family. Adjusting to the birth of a child is a significant change for a family. A sense of feeling overwhelmed by this change indicates that the family is not coping effectively.
DIF: Cognitive Level: Comprehension REF: p. 25
OBJ: Nursing Process Step: Planning MSC: Psychosocial Integrity
10. A nurse determines that a child consistently displays predictable behavior and is regular in performing daily habits. Which temperament is the child displaying?
a.
Easy
b.
Slow-to-warm-up
c.
Difficult
d.
Shy
ANS: A
Children with an easy temperament are even tempered, predictable, and regular in their habits. They react positively to new stimuli. A high activity level and adapting slowly to new stimuli are characteristics of a difficult temperament. The slow-to-warm-up temperament type prefers to be inactive and moody. Shyness is a personality type and not a characteristic of temperament. Being moody is a characteristic of a slow-to-warm up temperament.
DIF: Cognitive Level: Analysis REF: p. 33
OBJ: Nursing Process Step: Assessment MSC: Psychosocial Integrity
11. The parent of a child who has had numerous hospitalizations asks the nurse for advice because her child has been having behavior problems at home and in school. In discussing effective discipline, which is an essential component?
a.
All children display some degree of acting out and this behavior is normal.
b.
The child is manipulative and should have firmer limits set on her behavior.
c.
Use positive reinforcement and encouragement to promote cooperation and the desired behaviors.
d.
Underlying reasons for rules should be given and the child should be allowed to decide on which rules should be followed.
ANS: C
Using positive reinforcement and encouragement to promote cooperation and desired behaviors is one of the three essential components of effective discipline. Behavior problems should not be disregarded as normal. It would be incorrect to assume the child is being manipulative and should have firmer limits set on her behaviors. Providing the underlying reasons for rules and giving the child a choice concerning which rules to follow constitute a component of permissive parenting and are not considered an essential component of effective discipline.
DIF: Cognitive Level: Comprehension REF: p. 33
OBJ: Nursing Process Step: Assessment MSC: Psychosocial Integrity
12. A nurse assesses that parents discuss rules with their children when the children do not agree with the rules. Which style of parenting is being displayed?
a.
Authoritarian
b.
Authoritative
c.
Permissive
d.
Disciplinarian
ANS: B
A parent who discusses the rules with which children do not agree is using an authoritative parenting style. A parent who expects children to follow rules without questioning is using an authoritarian parenting style. A parent who does not consistently enforce rules and allows the child to decide whether he or she wishes to follow rules is using a permissive parenting style. A disciplinarian style would be similar to the authoritarian style.
DIF: Cognitive Level: Analysis REF: p. 32
OBJ: Nursing Process Step: Assessment MSC: Psychosocial Integrity
13. Which should the nurse expect to be problematic for a family whose religious affiliation is Jehovah’s Witness?
a.
Immunizations
b.
Autopsy
c.
Organ donation
d.
Blood transfusion
ANS: D
Jehovah’s Witness believers are opposed to blood transfusions. They may accept alternatives to transfusions, such as nonblood plasma expanders; they can make individual decisions about autopsy. Christian Science believers may seek exemption from immunizations. Believers in Islam are opposed to organ donation.
DIF: Cognitive Level: Comprehension REF: p. 29
OBJ: Nursing Process Step: Assessment MSC: Psychosocial Integrity
MULTIPLE RESPONSE
1. The nurse is caring for a child from a Middle Eastern family. Which interventions should the nurse include in planning care? Select all that apply.
a.
Include the father in the decision making.
b.
Ask for a dietary consult to maintain religious dietary practices.
c.
Plan for a male nurse to care for a female patient.
d.
Ask the housekeeping staff to interpret if needed.
ANS: A, B
The man is typically the head of the household in Muslim families. So the father should be included in all decision making. Muslims do not eat pork and do not use alcohol. Many are vegetarians. The dietician should be consulted for dietary preferences. Muslim women often prefer a female healthcare provider because of laws of modesty; the female client should not be assigned a male nurse. A housekeeping staff should not be asked to interpret. When interpreters are used, they should be of the same country and religion, if possible, because of regional differences and hostilities.
DIF: Cognitive Level: Application REF: p. 31
OBJ: Nursing Process Step: Implementation MSC: Psychosocial Integrity
2. A nurse is caring for a child with the religion of Christian Science. What interventions should the nurse include in the care plan for this child? Select all that apply.
a.
Offer iced tea to the child who is experiencing fluid volume deficit.
b.
Inform the Christian Science practitioner that the child has been admitted to the hospital.
c.
Allow parents to sign a form opting out of routine immunizations.
d.
Ask parents if the child has been baptized and if parents want a pastor to visit.
ANS: B, C
When a Christian Science believer is hospitalized, a parent or client may request that a Christian Science practitioner be notified. Christian Science believers seek exemption from immunizations but obey legal requirements. Coffee and tea are declined as a drink.
Baptism is not a ceremony for the Christian Science religion.
DIF: Cognitive Level: Application REF: p. 29
OBJ: Nursing Process Step: Implementation MSC: Psychosocial Integrity
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