Which reactions does a nurse expect of a four year old child in response to illness and hospitalization?

Which nursing action would help foster a hospitalized 3-year-old’s sense of autonomy?
1. Let the child choose what time to take the oral antibiotics.
2. Allow the child to have a doll for medical play.
3. Allow the child to administer her own dose of Keflex (cephalexin) via oral syringe.
4. Let the child watch age-appropriate videos.

3. Allowing preschoolers to participate in actions of which they are capable is an excellent way to enhance their autonomy.

The best method to explain a procedure to a hospitalized preschool-age child is to:
1. Show the child a pamphlet with pictures showing the procedure.
2. Have the 5-year-old next door tell the 4-year-old about the experience.
3. Demonstrate the procedure on a doll.
4. Show the child a video of the procedure

3. A 4-year-old child understands in very concrete and simple terms. Therefore, medical play is an excellent method for helping to understand the procedure.

A 3-year-old is hospitalized for an ASD repair. The parents have decided to go home for a few hours to spend time with her siblings. The child asks when her mommy and daddy will be back. The nurse’s best response is:
1. “Your mommy and daddy will be back after your nap.”
2. “Your mommy and daddy will be back at 6:00 p.m.”
3. “Your mommy and daddy will be back later this evening.”
4. “Your mommy and daddy will be back in 3 hours.

1. Preschoolers understand time in relation to events.

Which approach should the nurse use to gather information from a child brought to the ED for suspected child abuse?
1. Promise the child that her parents will not know what she tells the nurse.
2. Promise the child that she will not have to see the suspected abuser again.
3. Use correct anatomical terms to discuss body parts. 4. Tell the child that the abuse is not her fault and that she is a good person.

4. Many young children believe abuse or illness is their fault, and they should be reminded they are not to blame. Many children this age believe they have acquired a disease or have been abused because they are bad people.

Which reaction would a nurse expect when giving a preschooler immunizations?
1. The child remains silent and still.
2. The child cries and tells the nurse that it hurts.
3. The child tries to stall the nurse.
4. The child remains still while telling the nurse that she is hurting him.

2. The common response of a 5-year-old is to cry and protest during an immunization.

What can a nurse do to reinforce a 5-year-old’s intellectual initiative when he asks about his upcoming surgery?
1. Answer the child’s questions about his upcoming surgery in simple terms.
2. Provide the child with a book that has vivid illustrations about his surgery.
3. Tell the child he should wait and ask the doctor his questions.
4. Tell the child that she will answer his questions at a later time.

1. The child is taking the initiative to ask questions, as all preschoolers do, and the nurse should always answer those questions as appropriately and accurately as possible.

A 5-year-old boy has always been one of the shortest children in class. His mother tells the school nurse that her husband is 6 tall and she is 57. What should the nurse tell the child’s mother?
1. He is expected to grow about 3 inches every year from ages 6 to 9 years.
2.. He is expected to grow about 2 inches every year from ages 6 to 9 years.
3. He should be seen by an endocrinologist for growth-hormone injections.
4. His growth should be re-evaluated when he is 7 years old.

2. During the school-age years, a child grows approximately 2 inches per year.

The nurse realizes that a 5-year-old’s mother needs further education about the Denver Developmental Screening Test when she states:
1. “It screens for gross motor skills.”
2. “It screens for fine motor skills.”
3. “It screens for intelligence level.”
4. “It screens for language development.”

3. The Denver Developmental Test does not test a child’s level of intelligence.

A 3-year-old admitted to the hospital with croup has the following vital signs: heart rate 90, respiratory rate 44, blood pressure 100/52, and temperature 98.8°F (37.1°C). The parents ask the nurse if these vital signs are normal. The nurse’s best response is:
1. “Your son’s blood pressure is elevated, but the other vital signs are within the normal range..”
2. “Your son’s temperature is elevated, but the other vital signs are within the normal range..”
3. “Your son’s respiratory rate is elevated, but the other vital signs are within the normal range.”
4. “Your son’s heart rate is elevated, but the other vital signs are within the normal range.”

3. A normal respiratory rate for a child from 3 to 6 years is 20 to 30 breaths per minute.

Which action is a developmentally appropriate method for eliciting a 4-year-old’s cooperation in obtaining the blood pressure?
1. Have the child’s parents help put on the blood pressure cuff.
2. Tell the child that if he sits still, the blood pressure machine will go quickly.
3. Ask the child if he feels a squeezing of his arm.
4. Tell the child that measuring the blood pressure will not hurt.

3. Preschool children enjoy games, and it is a good way to elicit their assistance and cooperation during a procedure.

A 4-year-old hospitalized with FTT has orders for daily weights, strict intake and output, and calorie counts. Which action by the nurse would be a concern?
1. The nurse weighs the child every morning before breakfast.
2. The nurse weighs the child with no clothing except for undergarments.
3. The nurse sits with the child while the child eats her meals.
4. The nurse weighs the child using the same scale every morning.

1. The child should be weighed every day on the same scale before eating. Her weight will not be an accurate reflection if she is fed prior to being weighed.

A 3-year-old is attending her grandfather’s funeral. Her parents told her that her grandfather is in heaven with God. Which statement describes a 3-year-old child’s understanding of spirituality?
1. “The body is here with us on Earth, and the spirit is in heaven.”
2. “He is in heaven. Is this heaven?”
3. “The spirit is no longer in his body.”
4. “He won’t need his body in heaven.”

2. Three-year-old children are literal thinkers. The child’s parents told her that Grandpa was in heaven. She sees his body, so she thinks they are all in heaven.

A 3-year-old boy has been hospitalized because he fell down the stairs. His mother is crying and states, “This is all my fault.” Which is the nurse’s best response?
1. “Accidents happen. You shouldn’t blame yourself.”
2. “Falls are one of the most common injuries in this age group.”
3. “It may be a good idea to put a baby gate on the stairs.”
4. “Your son should be proficient at walking down the stairs by now.”

2. Falls are one of the most common injuries, and it may make the parent feel better to know that this is common.