Chapter 34 Emergency Care of the Child

Chapter 34  Emergency Care of the Child

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. Which nursing action facilitates care being provided to a child in an emergency situation?

a. Encourage the family to remain in the waiting room.
b. Include parents as partners in providing care for the child.
c. Always reassure the child and family.
d. Give explanations using professional terminology.

ANS: B
Include parents as partners in the child’s treatments. Parents may need direct guidance in
concrete terms to help distract the child. Allowing the parents to remain with the child may
help calm the child. Telling the truth is the most important thing. False reassurance does not
facilitate a trusting relationship. Professional terminology may not be understood. Speak to
the child and family in language that they will understand.

PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 752 OBJ: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity

2. The father of a child in the emergency department is yelling at the physician and nurses.

Which action is contraindicated in this situation?
a. Provide a nondefensive response.
b. Encourage the father to talk about his feelings.
c. Speak in simple, short sentences.
d. Tell the father he must wait in the waiting room.

ANS: D
Because a parent who is upset may be aggravated by observers, he should be directed to a
quiet area. When dealing with parents who are upset, it is important not to be defensive or
attempt to justify anyone’s actions. Encouraging the father to talk about his feelings may
assist him to acknowledge his emotions and may defuse his angry reaction. People who are
upset need to be spoken to with simple words (no longer than five letters) and short
sentences (no more than five words).

PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 753 OBJ: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity

3. What is an appropriate nursing intervention for a 6-month-old infant in the emergency

department?
a. Distract the infant with noise or bright lights.
b. Avoid warming the infant.
c. Remove any pacifiers from the baby.
d. Encourage the parent to hold the infant.

ANS: D

Parents should be encouraged to hold the infant as much as possible while in the emergency
department. Having the parent hold the infant may help to calm the child. Distraction with
noise or bright lights is most appropriate for a preschool-age child. In an emergency health
care facility, it is important to keep infants warm. Infants use pacifiers to comfort
themselves; therefore the pacifier should not be taken away.

PTS: 1 DIF: Cognitive Level: Comprehension/Understanding
REF: p. 756 OBJ: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity

4. Which action should the nurse working in the emergency department implement in order to

decrease fear in a 2-year-old child?
a. Keep the child physically restrained during nursing care.
b. Allow the child to hold a favorite toy or blanket.
c. Direct the parents to remain outside the treatment room.
d. Let the child decide whether to sit up or lie down for procedures.

ANS: B
Allowing a child this age to hold a favorite toy or blanket is comforting. It may be necessary
to restrain the toddler for some nursing care or procedures. Because toddlers need autonomy
and do not respond well to restrictions, the nurse should remove any restriction or restraint
as soon as safety permits. Parents should remain with the child as much as possible to calm
and reassure her. The toddler should not be given the overwhelming choice of deciding
which position she prefers. In addition, the procedure itself may dictate the child’s position.

PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 755 | Box 34.1 OBJ: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity

5. Which nursing action is most appropriate to assist a preschool-age child in coping with the

emergency department experience?
a. Explain procedures and give the child at least 1 hour to prepare.
b. Remind the child that she is a big girl.
c. Avoid the use of bandages.
d. Use positive terms, and avoid terms such as “shot” and “cut.”

ANS: D
Using positive terms and avoiding words that have frightening connotations assist the child
in coping. Preschool-age children should be told about procedures immediately before they
are done. Allowing 1 hour of time to prepare only allows time for fantasies and increased
anxiety. Children should not be shamed into cooperation. Bandages are important to
preschool-age children. Children in this age-group believe that their insides can leak out and
that bandages stop this from happening. Plus a fancy bandage can be used as a reward.

PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 755 | Box 34.1 OBJ: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity