Chapter 11: The Ill Child in the Hospital and Other Care Settings

Chapter 11: The Ill Child in the Hospital and Other Care Settings

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1. Which of the following situations poses the greatest challenge to the nurse working with a child and family?

a.	Twenty-four hour observation
b.	Emergency hospitalization
c.	Outpatient admission
d.	Rehabilitation admission

 

 

ANS:   B

 

	Feedback
A	Although preparation time may be limited with a 24-hour observation, this situation does not usually involve the acuteness of the situation and the high levels of anxiety associated with emergency admission.
B	Emergency hospitalization involves (1) limited time for preparation both for the child and family, (2) situations that cause fear for the family that the child may die or be permanently disabled, and (3) a high level of activity, which can foster further anxiety.
C	Outpatient admission generally involves preparation time for family and child. Because of the lower level of acuteness in these settings, anxiety levels are not as high.
D	Rehabilitation admission follows a serious illness or disease. This type of unit may resemble a home environment, which decreases the child and family’s anxiety.

 

 

DIF:    Cognitive Level: Comprehension      REF:    Text Reference: pg 285

OBJ:    Nursing Process Step: Planning

MSC:   NCLEX: Safe Effective Care Environment

 

2. What is the primary disadvantage associated with outpatient and day facility care?

a.	Increased cost
b.	Increased risk of infection
c.	Lack of physical connection to the hospital
d.	Longer separation of the child from family

 

 

ANS:   C

 

	Feedback
A	This type of care decreases cost.
B	This type of care decreases risk of infection.
C	Outpatient and day facility care do not provide extended care; therefore, a child requiring extended care would have to be transferred to the hospital, causing increased stress to the child and parents.
D	This type of care minimizes separation of the child from family.

 

 

DIF:    Cognitive Level: Comprehension      REF:    Text Reference: pg 285

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Safe Effective Care Environment

 

3. Which child would have the most difficulty with separation from family during hospitalization?

a.	A 5-month-old infant
b.	A 15-month-old toddler
c.	A 4-year-old child
d.	A 7-year-old child

 

 

ANS:   B

 

	Feedback
A	Infants younger than 6 months of age will generally adapt to hospitalization if their basic needs for food, warmth, and comfort are met.
B	Separation is the major stressor for children hospitalized between the ages of 6 and 30 months.
C	Although separation anxiety occurs in hospitalized preschoolers, it is usually less obvious and less serious than that experienced by the toddler.
D	The school-age child is accustomed to separation from parents. Although hospitalization is a stressor, the 7-year-old child will have less separation anxiety than a 15-month-old toddler.

 

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: pg 288

OBJ:    Nursing Process Step: Assessment    MSC:   NCLEX: Psychosocial Integrity

 

4. What is the best explanation for a 2-year-old child who is quiet and withdrawn on the fourth day of a hospital admission?

a.	The child is protesting her separation from her caregivers.
b.	The child has adjusted to the hospitalization.
c.	The child is experiencing the despair stage of separation.
d.	The child has reached the stage of detachment.

 

 

ANS:   C

 

	Feedback
A	In the protest stage, the child would be agitated, crying, resistant to caregivers, and inconsolable.
B	Toddlers do not readily “adjust” to hospitalization and separation from caregivers.
C	In the despair stage of separation, the child exhibits signs of hopelessness and becomes quiet, withdrawn, and apathetic.
D	The detachment stage occurs after prolonged separation. During this phase, the child becomes interested in the environment and begins to play.

 

 

DIF:    Cognitive Level: Comprehension      REF:    Text Reference: pg 289

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Psychosocial Integrity