328 Exam 1 Review

How can the nurse best facilitate the trust relationship between infant and parents while the infant is hospitalized? The nurse should:

• Encourage the parents to remain at their child’s bedside as much as possible.

• Keep parents informed about all aspects of their child’s condition.

• Encourage the parents to hold their child as much as possible.

• Advise the parents to participate actively in their child’s care.

Which statement accurately describes the best method for assessing a 12-month-old?

• The nurse should assess the child on the examining table.

• The nurse should assess the child in a head-to-toe sequence.

• The nurse should have the child’s parent assist in holding her down.

• The nurse should assess the child while she is in her parent’s lap.

A first-time mother brings in her 5-day-old baby for a well-child visit. The nurse weighs the infant and reports a weight of 7 lb 5 oz to the mother. The mother looks concerned and tells the nurse that her baby weighed 7 lb 10 oz when she was discharged 4 days ago. The nurse’s best response to the mother is:

• I will let the doctor know, and he will talk with you about possible causes of your infant’s weight loss.

• A weight loss of a few ounces is common among newborns, especially for breastfeeding mothers.

• I can tell you are a first-time mother. Don’t worry; we will find out why she is losing weight.

• Maybe she isn’t getting enough milk. How often are you breastfeeding her?

The parents of a newborn are asking the nurse how to use the infant car seat and where it should be placed in their vehicle. Which is the best action for the nurse to take to ensure proper car-seat installation for the parents?

• Provide written instructions only.

• Accompany the parents to the car and show them how to install the car seat.

• Contact the hospital’s care coordinator or nurse educator and ask them to accompany the parents to the car for car-seat installation.

• Show the parents a video on car-seat installation and safety and ask if they are comfortable with the information.

An 8-day-old was admitted to the hospital with vomiting and dehydration. The newborn’s heart rate is 170, respiratory rate is 44, blood pressure is 85/52, and temperature is 99°F (37.2°C). What is the nurse’s best response to the parents who ask if the vital signs are normal?

• The blood pressure is elevated, but the other vital signs are within normal limits.

• The temperature is elevated, but the other vital signs are within normal limits.

• The respiratory rate is elevated, but the other vital signs are within normal limits.

• The heart rate is elevated, but the other vital signs are within normal limits.

The nurse is using the FLACC scale to rate the pain level in a 9-month-old. Which is the nurse’s best response to the father’s question of what the FLACC scale is?

• It estimates a child’s level of pain utilizing vital sign information.

• It estimates a child’s level of pain based on parents’ perception.

• It estimates a child’s level of pain utilizing behavioral and physical responses.

• It estimates a child’s level of pain utilizing a numeric scale from 0 to 5.

Which should the nurse do to prevent separation anxiety in a hospitalized toddler?

• Assume the parental role when parents are not able to be at the bedside.

• Encourage the parents to always remain at the bedside.

• Establish a routine similar to that of the child’s home.

• Rotate nursing staff so the child becomes comfortable with a variety of nurses.

The mother of a child who is 2 years 6 months in age has arranged a play date with the neighbor and her child who is 2 years 9 months old. During the play date the two mothers should expect that the children will do which of the following?

• Share and trade their toys while playing.

• Play with one another with little or no conflict.

• Play alongside one another but not actively with one another.

• Only play with one or two items, ignoring most of the other toys.

The best method to explain a procedure to a hospitalized preschool-age child is to:

• Show the child a pamphlet with pictures showing the procedure.

• Have the 5-year-old next door tell the 4-year-old about the experience.

• Demonstrate the procedure on a doll.

• Show the child a video of the procedure

A 4-year-old is hospitalized for an ASD repair. The parents have decided to go home for a few hours to spend time with their other children. The child asks when her mommy and daddy will be back. The nurse’s best response is:

• Your mommy and daddy will be back after your nap.

• Your mommy and daddy will be back at 6:00 p.m.

• Your mommy and daddy will be back later this evening.

• Your mommy and daddy will be back in 3 hours.