Hospitalized Child

Question 1

How do you promote trust vs. mistrust in hospitalized child?

Answer 1

simulate home routine
create routines
assign same nurse
keep frightening objects out of view
hold infant for feedings even with NG tube
control light and sound stimulation

Question 2

how to prepare an infant for a procedure

Answer 2

keep parents calm
cuddles and hugs
safe restraint (swaddling)
sensory soothing (non-nutrive sucking)
security objects from home

Question 3

when assessing a 4 month old, which of the following would the nurse expect to find as being most developed?

a) cooing
b) babbling
c) imitated sounds
d) combined syllables

Answer 3

a) cooing

Question 4

Which of the following toys should the nurse recommend for a 5 month old?

a) red balloon
b) teddy bear with button eyes
c) a push-pull wooden truck
d) a colorful busy box

Answer 4

D) colorful busy box

Question 5

which of the following is the primary nursing intervention used to help a 1 month old infant tolerate hospitalization?

a) using consistent care givers
b) providing sensorimotor stimulation
c) following the home schedule as closely as possible
d) keeping the infant warm and dry

Answer 5

A) using consistent care givers (most correct answer, really all answers are correct)

Question 6

PRAISE- toddlers

Answer 6

p- parallel play
r- rituals, routines, regression
a- autonomy vs. shame and doubt, accidents
i- involve parents
s- separation anxiety
e- explore

Question 7

what is the biggest fear of a hospitalized toddler?

Answer 7

loss of bodily control

Question 8

hospitalized toddlers will exibit

Answer 8

regression
separation anxiety
have a perception the of illness that is unrelated to the event
autonomy vs. shame and doubt

Question 9

how do you promote toddler developement?

Answer 9

develop care rituals and write in care plan
allow security objects from home
praise everything
allow outlet for aggression
access to finger foods
allow exploration of environment
repeat syllables and talk through patient care

Question 10

toys that promote toddler development

Answer 10

board and mallet
push-pull toys
toy telephone
stuffed animals 
story books with pictures
*allow them to go to play room*

Question 11

how do you prepare a toddler for a procedure

Answer 11

KISS ( keep it short and sweet)
do this the day of!!!
let them know what they will see, hear, smell, and feel
praise everything they do!
tell them “ mommy and daddy will be waiting”

Question 12

which of the following is an appropriate toy for an 18m old?

a) multiple piece puzzle
b) miniature cars
c) finger paints
d) comic books

Answer 12

C) finger paints

Question 13

wellness promotion for toddlers should include which of the following?

a) discussing negativity and temper tantrums
b) discussing nightmares and night terrors
c) encouraging gross motor skills
d) reinforcing supine sleeping positions
e) talking about bedtime rituals
f) helping a child differentiate junk from healthy foods

Answer 13

a) discussing negativity and temper tantrums
c) encouraging gross motor skills
e) talking about bedtime rituals

Question 14

when teaching parents about typical toddler eating patterns, which of the following should be included?

a) food jags
b) preference to eat alone
c) consistent table manners
d) increase in appetitie

Answer 14

a) food jags ( means they are not consistent in what they eat, they could only want grapes and mac and cheese for a week)

Question 15

MAGIC- preschoolers

Answer 15

m- mutilation
a- associative play, abandonment
g- guilt vs. initiative
i- imaginary playmate, imagination
c- curious

Question 16

what is the biggest fear of the hospitalized preschooler?

Answer 16

mutilation

abandonment

Question 17

cognitive development of the hospitalized preschooler

Answer 17

transductive reasoning
animism
magical thinking
egocentrism

Question 18

guilt vs. initiative for the hospitalized toddler

Answer 18

they think they are being punished, let them know that they are not being punished that they are sick.

Question 19

what is vital for the hospitalized preschooler?

Answer 19

socailization

Question 20

what to expect of the hospitalized preschooler

Answer 20

overly aggressive or extreme withdraw
imaginary playmates
often refuse meds or to cooperate with care
have little understanding of time
regress (potty training)
need transitional objects
enjoy play time with other children
enjoy silly humor

Question 21

how do we promote preschoolers development when hospitalized

Answer 21

use very specific language and look directly at child
make silly mistakes and let them catch you
speak using socially excepted words
comfort them by holding and rocking
make sure they have a transitional object

Question 22

how do you get a hospitalized preschooler to cooperate?

Answer 22

use phrases such as “lets do this” or “how about”
keep them as close to home routine as possible
make everything a game (let them throw and catch objects)

Question 23

toys to promote preschooler development in the hospital

Answer 23

coloring books, puzzles, cutting and pasting, dolls, building blocks

Question 24

how to prepare the preschooler for procedures

Answer 24

use simple explanations and diagrams or dolls (very basic pictures)
let the child play with surgical caps, gowns, and stethoscope
describe ONLY what they will feel, hear, see and smell
SAY OUT LOUD- this is not a punishment
allow medical play

Question 25

when providing therapeutic play, which of the following toys would be best to promote imaginative play in a 4 year old?

a) large blocks
b) dress up clothes
c) wooden puzzles
d) big wheels

Answer 25

B) dress up clothes

Question 26

after administering an IM injections to a preschoolers, which of the following is the primary reason for the nurse to apply a band-aid to the site?

a) children will use them to get attention from their parents
b) children are afraid that they will leak from the “hole”
c) bandages help to alleviate fear of strangers
d) children will collect bandages to show their peers

Answer 26

b) children are afraid that they will leak from the “hole”

Question 27

DIMPLE- schoolagers

Answer 27

d- doers
i- industry vs. inferiority
m- modesty
p- peers
l- loss of control
e- explanation of procedures

Question 28

what is the biggest fear of hospitalized schoolagers

Answer 28

loss of control

Question 29

what type of thinkers are schoolagers?

Answer 29

concrete thinkers

Question 30

what is important to remember about hospitalized schoolagers?

Answer 30

need to be involved in structuring care
privacy and modesty
they miss their peers
get bored easily but can cope with hospitalization

Question 31

what to expect with hospitalized schoolagers

Answer 31

like to take risks (resetting IV pumps)
likes adults to be involved in decision making
enjoy contact with other children of same age/sex
want to be by themselves
RULES!!!!

Question 32

how do we promote schoolager’s development

Answer 32

encourage continuation of schoolwork
give realistic and truthful explanations
allow quiet and private time
allow them to teach new staff
allow them to be involved in care (making ice packs)
allow them to collect things ( syringes, BP cuffs)
make a game out of normal routines

Question 33

how do you prepare schoolager’s for procedures?

Answer 33

use correct simple terminology
explain why
explain equipment in concrete terms
allow child to manipulate equipment (start BP machine)
allow responsibility, and time for questioning
suggest ways of maintaing control

Question 34

When assessing a school age child, which of the following best describes typical annual growth?

a) the child grows an average of 2 inches per year
b) the child gains an average of 3 pounds per year
c) few differences are noted between age mates
d) increased fat pads give school age children a chubby appearance

Answer 34

a) the child grows an average of 2 inches per year

Question 35

unrealistic expectations or a sense of failing to meet standards would cause a school-age child to develop a sense of which of the following?

a) shame
b) guilt
c) inferiority
d) role confusion

Answer 35

c) inferiority

Question 36

PAIRS- adolescents

Answer 36

p- peer group
a- altered body image
i- identity
r- role confusion
s- separation from peers

Question 37

what is the biggest fear of the hospitalized adolescents

Answer 37

altered body image, loss of control and separation from peers

Question 38

what to expect of a hospitalized adolescent

Answer 38

they want to be related to their own level
be able to answer and ask reasonable questions about their care
follow instructions r/t mobility, diet, and medication compliance
let them be a part of the team
can act like an adult one min and a child the next

Question 39

how do we promote adolescent development during hospitalization

Answer 39

teach at a realistic level
discuss concerns about the future and bring issues up if necessary
want parents to be involved
help maintain their identity
ask open ended questions

Question 40

preparing adolescents for procedures

Answer 40

they are capable of abstract thought and reasoning
answer their why questions
conscious of appearance (let them know what to expect)
strive for independence
peer relationships and group identity are very important
suggest ways they can maintain control

Question 41

when teaching about accident prevention to a group of high school juniors, the school nurse’s primary focus would be on which of the following areas?

a) falls
b) MVA
c) firearms
d) diving accidents

Answer 41

b) MVA

Question 42

Which of the following characteristics would the nurse expect to see in an adolescent who had developed the capacity of formal thought?

a) ability to analyze relationships for the effects
b) use of random cognitive behavior to approach problems
c) ability to say that something is wrong but not why
d) focusing on immediate physical reality of hear and now

Answer 42

a) ability to analyze relationships for the effects

Question 43

parental reactions to their child’s hospitalization

Answer 43

disbelief
anger
guilt
fear
frustration
depression
* don't take it personally*

Question 44

how do you work effectively with parents of the hospitalized child?

Answer 44

encourage visitation and rooming in
allow parents to be present during procedures and comfort them afterwards
participate in care
provide respite to the parents
model appropriate interactions

Question 45

children who are particularly vulnerable when hospitalized

Answer 45

have a difficult temperament
lack of fit between parent and child
male children
ages 6m-4yr
rural children 
passive children

Question 46

separation anxiety manifestations

Answer 46

phase of protest
phase of despair
phase of detachment

Question 47

strategies’ to decrease separation anxiety

Answer 47

have a primary nurse (assign same patients)
take a thorough history
maintain parental contact
teach parents to be honest ( tell kids they are leaving and when they will be back)
make surroundings more familiar
soften medical equipment ( ex: NS is really super hero juice)

Question 48

after returning home from the hospital children may reject what?

Answer 48

caregivers

Question 49

things to consider after hospitalization (children)

Answer 49

schoolagers and adolescents adjust more easily to home
infants, toddlers, and preschoolers make adjust more slowly to home
they my regress
consider pain

Question 50

things to consider after hospitalization (parents)

Answer 50

re-establish routines
fill days with activities
let children tell their stories
do not take trips to soon after hospitalization