Which child would have the most difficulty in coping with separation from

parents because of hospitalization?

16-month-old child

A 2-year-old child has been crying constantly for his mother since he was
hospitalized 3 days ago. The nurse understands that this behavior suggests

the toddler feels abandoned by his mother.

The statement that best corresponds to a preschoolers understanding of

hospitalization is:

I got sick because I was mad at my brother.

The parents of a hospitalized toddler are upset because she seems more
interested in her toys when they come to visit her. The toddler is most likely in which
stage of separation anxiety?

Denial

The nurse must make a room assignment for a 16-year-old with cystic fibrosis. An
optimal roommate might be:
a 15-year-old with type 1 diabetes mellitus.

A nurse encourages a school-age child to draw a picture after a painful procedure.

What is the best rationale for this nursing intervention?
on: July 24, 2015, 10:46:20 PM

a.
Attempting to re-establish rapport
b.
Providing a way for the child to express his feelings
c.
Encouraging quiet play

d.
Distracting the child from thinking about the pain
ANS:

After treatments, the nurse should encourage children to draw and talk about their drawings
or to act out their feelings through puppet play.
A hospitalized toddler was drinking from a cup at home but now refuses to drink
from anything except his favorite bottle. What is the most likely reason for this
behavior?
on: July 24, 2015, 10:46:20 PM

a. He is dealing with the anxiety of hospitalization by regressing.

b. He is demonstrating attention-seeking behaviors because of an overabundance of
attention in the hospital.
c. He is attempting to refocus the attention of the adults around him to avoid further
painful procedures.
d. He is exhibiting normal behavior for his age, as children often stop new behaviors
after they believe they have mastered them.
ANS:

Hospitalization is frustrating for toddlers. They show their displeasure when illness restricts
satisfaction of their desires. It is not unusual for a toddler who was drinking from a cup to
refuse it in the hospital.
The nurse notices that the mother of a child with cerebral palsy corrects and redoes
many of the things the nurse does for her child. What is the nurse's most
appropriate response to this mother?
on: July 24, 2015, 10:47:20 PM

a.
"Would you like to do all of your child's care?"
b.
"I'm doing the very best job that I can with your child."
c.
"Why don't you go have a cup of coffee? You are going to be exhausted if you don't take a
break."
d.
"I'd love for you to share with me some of the special things you do for your child."
ANS:

The person who cares daily for the child with a chronic illness can provide information that
will best guarantee continuity of care between the home and the hospital.
What should the nurse, preparing to collect an admission history from parents who
have recently emigrated from Russia, keep in mind?
on: July 24, 2015, 10:47:20 PM

a.
Eye-to-eye contact is considered disrespectful.

b.
Touching the child's head means the nurse is superior.
c.
Smiling is inappropriate in a serious situation.
d.
Staring is a sign of the nurse's rudeness.
ANS:

In Russia, a smile indicates happiness and is inappropriate in a serious or sad situation.

When a 2-year-old returns to her hospital room following a diagnostic procedure,
her parents are not available, and the child is crying loudly. Which technique is
most appropriate to alleviate the child's distress?
on: July 24, 2015, 10:47:20 PM

a.
Rock the child gently to sleep.
b.
Play with the child using pop-up toys.
c.
Role play with the child to act out her feelings.
d.
Ask the child to draw a picture about her feelings.
ANS:

Distractions such as blowing bubbles, looking through a kaleidoscope, and playing with popup toys may help reduce anxiety and pain.
The mother of a hospitalized toddler states, "He cries when I visit. Maybe I should
just stay away." What is the nurse's best response?
on: July 24, 2015, 10:47:20 PM

a.
"Perhaps you are right. He only gets upset when you have to leave."
b.
"It is important that you are here. This is a common reaction in children when they are
separated from their parents."
c.
"It might be easier for your child if you would stay with him, but this decision is up to you."
d.
"We take good care of him and he seems fine when you are not here."
ANS:

During the second stage of separation anxiety (despair), the child is quiet, is not crying, and
is sad and depressed. The child will revert to protest when the parent arrives for a visit.

Which nursing action would facilitate rapport with a child and the child's parents
during the admission process?

 on: July 24, 2015, 10:47:20 PM

a. Direct the parents to undress the child.

b. Answer questions in a calm and matter-of-fact way.
c. Perform assessments and ask questions as quickly as possible.
d. Express concern about the seriousness of the child's condition.

ANS: B
The nurse tries not to appear rushed. A matter-of-fact attitude must be maintained
regardless of the child's condition.

When a 2-year-old returns to her hospital room following a diagnostic procedure,

her parents are not available, and the child is crying loudly. Which technique is
most appropriate to alleviate the child's distress?
on: July 24, 2015, 10:47:20 PM

a.
Rock the child gently to sleep.
b.
Play with the child using pop-up toys.
c.
Role play with the child to act out her feelings.
d.
Ask the child to draw a picture about her feelings.

ANS: B
Distractions such as blowing bubbles, looking through a kaleidoscope, and playing with popup toys may help reduce anxiety and pain.

The nurse explains to the parents of a hospitalized child that their child will receive
fentanyl for an upcoming procedure. What advantage of fentanyl will the nurse
explain?
on: July 24, 2015, 10:48:19 PM

a.
It is specifically designed for children.
b.
It has a rapid onset.
c.
It is nonaddicting.
d.
It has a long duration.

ANS: B
Fentanyl is a drug useful for all ages because of its rapid onset and brief duration.

What will the nurse include when documenting the discharge of a pediatric patient?
(Select all that apply.)
on: July 24, 2015, 10:49:19 PM

a.
Time of discharge
b.
Adult(s) accompanying the child and the relationship to the child
c.
Condition of the child
d.
Method of transportation
e.
Instructions that were given to physician
ANS:

A, B, C, D

Information that should be included in the discharge note include time of discharge, adults
accompanying the child and relationship to child, condition of the child, and method of
transportation. It should also be documented that instructions were given to parents.
The anxious parent asks if there is a danger of her 2-year-old child becoming
addicted to the opioid pain reliever. What is the nurse's most helpful response?
on: July 24, 2015, 10:49:19 PM

a.
"Although this drug is addictive, the doctor monitors the dose very carefully."
b.
"Don't worry. Addicted children are very easy to wean off the drug."
c.
"Addiction is rare in children when opiates are given for pain."
d.
"Addictive behaviors are easy to assess. The drug will be stopped if that happens."

ANS: C
Addiction is rare in children.

The nurse suggests to parents that they use the outpatient surgical center for their
child's upcoming surgery. What advantage(s) does this type of facility have to offer?
(Select all that apply.)
on: July 24, 2015, 10:50:18 PM

a.
Lower cost
b.
Less incidence of health care-associated infections
c.
Reduction of parent-child separation

d.
Ample time for recuperation at the facility
e.
Decreased emotional impact of illness
ANS: A, B, C, E
All options listed are advantages of outpatient services with the exception of recuperating at
the facility.
The nurse understands that no matter the reason for the young child being
hospitalized, there are basic fears. What are they? Select all that apply.
a. Separation
b. Permanent scarring
c. Pain
d. Cost
e. Body intrusion

4.

What information will the nurse include when taking a developmental history? (Select
all that apply.)
on: July 24, 2015, 10:51:17 PM

a.
Previous experience with hospitalization
b.
Cultural needs
c.
History of illness
d.
Allergies
e.
Child's nickname
ANS:

A, B, E

The developmental history has information about the child and the child's developmental and
cultural needs and personal preferences. The information relative to history of illness or
allergies would be covered in the medical history.