The nurse is having difficulty communicating with a hospitalized 6-year-old child. Which technique should be most helpful?

Correct Answer: B

Rationale: In this scenario, the most appropriate technique to help the nurse communicate with the hospitalized 6-year-old child is to provide supplies for the child to draw a picture (Option B). Drawing allows children to express themselves when they may find it challenging to communicate verbally. It can help the child convey emotions, thoughts, and experiences that they may not be able to articulate. Drawing can also serve as a therapeutic outlet, providing a non-verbal way for the child to cope with the stress of hospitalization. Option A, recommending that the child keep a diary, may not be as effective as drawing for a young child who may not have developed strong writing skills or the ability to express themselves through writing. Option C, suggesting that the parent read fairy tales to the child, does not directly address the child's communication barriers and may not actively engage the child in self-expression. Option D, asking the parent if the child is always uncommunicative, does not provide a proactive approach to facilitating communication with the child and may not yield immediate results in improving the nurse-child interaction. In an educational context, understanding age-appropriate communication techniques is crucial for nurses caring for pediatric patients. By recognizing and utilizing strategies such as drawing, nurses can establish effective communication channels with children, fostering trust, understanding, and cooperation in a healthcare setting.

Correct Answer: B

Rationale: In the context of nursing care of children, determining the chief complaint when taking a health history of an adolescent is crucial for providing effective care. Option B, "Ask the adolescent, 'Why did you come here today?'" is the correct choice because it directly involves the adolescent in expressing their reason for seeking healthcare, empowering them to be active participants in their own care. This approach promotes patient-centered care and encourages open communication between the nurse and the adolescent. Option A, requesting a detailed listing of symptoms, may be overwhelming for the adolescent and may not capture the primary reason for their visit. It is important to remember that adolescents may not always be able to articulate their symptoms clearly, making it essential to approach them in a supportive and non-threatening manner. Option C, interviewing the parent away from the adolescent, is not ideal as it bypasses the adolescent's perspective and may lead to missing important information or concerns that the adolescent themselves may have. Option D, using what the adolescent says to determine the problem in medical terminology, may not be appropriate as it can create a barrier to effective communication and understanding between the nurse and the adolescent, potentially leading to misinterpretation of the chief complaint. In an educational context, it is important to teach nursing students the significance of involving adolescents in their care, respecting their autonomy, and promoting open communication to ensure holistic and patient-centered care delivery. Building trust and rapport with adolescent patients is essential in providing quality care in the nursing practice.

Correct Answer: A

Rationale: In this scenario, the correct heading to record the information provided by the mother is under "History." This is because the information about a difficult delivery and premature birth is considered past medical history which is typically documented under the history section of a patient's medical record. Option B, "Present illness," would be incorrect as this heading is typically used to document the current health concerns or issues the patient is experiencing at the time of the visit. The information provided by the mother pertains to events that occurred in the past. Option C, "Chief complaint," would also be incorrect as this heading is used to document the main reason for the patient seeking medical attention during the current visit. The information provided does not represent a current complaint. Option D, "Review of systems," would be incorrect as this heading is typically used to document a systematic review of the patient's body systems to identify any current or potential health issues. The information provided does not relate to the review of current symptoms. Educationally, it is important for nurses to accurately document patient history as it provides crucial information for understanding the patient's overall health status, planning appropriate care, and making informed clinical decisions. Understanding the correct organization of a patient's medical record is essential for effective communication among healthcare providers and ensuring continuity of care.

Correct Answer: A

Rationale: In the health history, a record of immunizations belongs under the "History" section. This is because immunizations are a crucial aspect of a patient's medical history, providing important information about the individual's past and current vaccination status. Including immunizations in the history section allows healthcare providers to easily track and verify the vaccinations a child has received, ensuring they are up to date with recommended vaccines and protected against preventable diseases. Option B, "Present illness," is incorrect because immunizations are not directly related to the current illness or chief complaint. Option C, "Review of systems," is also incorrect as this section focuses on specific symptoms and not on past medical interventions like immunizations. Option D, "Physical assessment," is not the appropriate section for documenting immunizations as it pertains to the physical examination findings of the patient, not their medical history. Educationally, understanding where to document immunizations in a health history is essential for nurses caring for children. It ensures accurate and comprehensive documentation, aiding in providing safe and effective care. By placing immunizations in the history section, nurses can easily access this vital information when making clinical decisions, promoting optimal health outcomes for pediatric patients.

Correct Answer: A

Rationale: The best way to determine whether an adolescent girl is sexually active is by asking her directly, "Are you sexually active?" This direct and open-ended question allows the girl to provide a straightforward answer without feeling judged or pressured. It respects her autonomy and confidentiality while promoting open communication between the nurse and the patient. Option B, "Are you having sex with anyone?" is less specific and may not provide a clear answer regarding the girl's sexual activity. Option C, "Are you having sex with a boyfriend?" assumes a specific relationship status and may not be applicable to all adolescent girls who may be sexually active. Option D, "Ask both the girl and her parent if she is sexually active," violates the adolescent's right to privacy and confidentiality. It is important to establish trust with the adolescent by respecting her autonomy and privacy when discussing sensitive topics like sexual activity. In an educational context, it is crucial for nurses to develop effective communication skills when assessing adolescent patients. By using open-ended and non-judgmental questions, nurses can create a safe space for adolescents to discuss their sexual health concerns and behaviors openly. This approach promotes trust, confidentiality, and patient-centered care in nursing practice.