Chapter 20: Pediatric Variations of Nursing Interventions

Chapter 20: Pediatric Variations of Nursing Interventions

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Which should the nurse consider when having consent forms signed for surgery and procedures on children?

a.	Only a parent or legal guardian can give consent.
b.	The person giving consent must be at least 18 years old.
c.	The risks and benefits of a procedure are part of the consent process.
d.	A mental age of 7 years or older is required for a consent to be considered “informed.”

 

 

ANS:  C

The informed consent must include the nature of the procedure, benefits and risks, and alternatives to the procedure. In special circumstances, such as emancipated minors, the consent can be given by someone younger than 18 years without the parent or legal guardian. A mental age of 7 years is too young for consent to be informed.

 

DIF:    Cognitive Level: Understand            REF:   p. 575

TOP:   Integrated Process: Nursing Process: Planning

MSC:  Area of Client Needs: Safe and Effective Care Environment: Management of Care

 

2. The nurse is planning to prepare a 4-year-old child for some diagnostic procedures. Guidelines for preparing this preschooler should include which action?

a.	Plan for a short teaching session of about 30 minutes.
b.	Tell the child that procedures are never a form of punishment.
c.	Keep equipment out of the child’s view.
d.	Use correct scientific and medical terminology in explanations.

 

 

ANS:  B

Illness and hospitalization may be viewed as punishment in preschoolers. Always state directly that procedures are never a form of punishment. Teaching sessions for this age group should be 10 to 15 minutes in length. Demonstrate the use of equipment, and allow the child to play with miniature or actual equipment. Explain procedure in simple terms and how it affects the child.

 

DIF:    Cognitive Level: Apply                   REF:   p. 575

TOP:   Integrated Process: Teaching/Learning

MSC:  Area of Client Needs: Health Promotion and Maintenance

 

3. Katie, 4 years old, is admitted to outpatient surgery for removal of a cyst on her foot. Her mother puts the hospital gown on her, but Katie is crying because she wants to leave on her underpants. What is the most appropriate nursing action?

a.	Allow her to wear her underpants
b.	Discuss with her mother why this is important to Katie
c.	Ask her mother to explain to her why she cannot wear them
d.	Explain in a kind, matter-of-fact manner that this is hospital policy

 

 

ANS:  A

It is appropriate for the child to leave her underpants on. This allows her some measure of control in this procedure, foot surgery. Further discussions may make the child more upset. Katie is too young to understand what hospital policy means.

 

DIF:    Cognitive Level: Apply                   REF:   p. 578

TOP:   Integrated Process: Nursing Process: Implementation

MSC:  Area of Client Needs: Health Promotion and Maintenance

 

4. Using knowledge of child development, which is the best approach when preparing a toddler for a procedure?

a.	Avoid asking the child to make choices.
b.	Demonstrate the procedure on a doll.
c.	Plan for the teaching session to last about 20 minutes.
d.	Show necessary equipment without allowing the child to handle it.

 

 

ANS:  B

Prepare toddlers for procedures by using play. Demonstrate on a doll, but avoid the child’s favorite doll because the toddler may think the doll is really “feeling” the procedure. In preparing a toddler for a procedure, allow the child to participate in care and help whenever possible. Teaching sessions for toddlers should be about 5 to 10 minutes. Use a small replica of the equipment, and allow the child to handle it.

 

DIF:    Cognitive Level: Apply                   REF:   p. 578

TOP:   Integrated Process: Nursing Process: Planning

MSC:  Area of Client Needs: Health Promotion and Maintenance

 

5. The nurse is preparing a 12-year-old girl for a bone marrow aspiration. The girl tells the nurse she wants her mother with her “like before.” What is the most appropriate nursing action?

a.	Grant her request
b.	Explain why this is not possible
c.	Identify an appropriate substitute for her mother
d.	Offer to provide support to her during the procedure

 

 

ANS:  A

The parent’s preferences for assisting, observing, or waiting outside the room should be assessed, along with the child’s preference for parental presence. The child’s choice should be respected. If the mother and child are agreeable, then the mother is welcome to stay. An appropriate substitute for the mother is necessary only if the mother does not wish to stay. Support is offered to the child regardless of parental presence.

 

DIF:    Cognitive Level: Apply                   REF:   p. 596

TOP:   Integrated Process: Nursing Process: Implementation

MSC:   Area of Client Needs: Health Promotion and Maintenance