The nurse is conducting an interview with the mother of an 8-year-old.
The child keeps interrupting the interview.
What is the best action for the nurse to take at this time?
Take the child to the unit playroom and then return to finish the interview.
Provide some art supplies and paper to the child for distraction.
Turn on a children's program on the TV in the room.
Ask the mom to keep the child quiet during the interview.
The Correct Answer is B
Choice A rationale
Removing the child from the room to a playroom may cause the child to feel excluded or anxious, especially in a new and unfamiliar hospital environment. At age eight, children are still very attached to their primary caregivers during stressful events. Separation during the interview could lead to distress for both the mother and the child, potentially hindering the collection of accurate and thorough health history data. It is better to keep the family unit together.
Choice B rationale
Providing age appropriate distractions like art supplies or paper is an effective strategy to engage an eight year old while allowing the adult to focus on the interview. This technique utilizes the child's natural need for industry and activity. By giving the child a task, the nurse acknowledges their presence and developmental needs without requiring them to remain unnaturally still or silent. This approach facilitates a smoother data collection process while minimizing interruptions in a positive way.
Choice C rationale
While television can be a distraction, it is often a passive and loud one that may interfere with the audio clarity of the interview. It does not engage the child's fine motor skills or creativity as effectively as art supplies might. Additionally, the nurse has less control over the content being shown, which may not be appropriate or calming. Using active engagement tools is generally preferred over passive screen time in a clinical developmental setting for a school age child.
Choice D rationale
Asking a parent to force a child to remain quiet is often ineffective and can create tension during the interview. An eight year old child has a limited capacity for prolonged silence when they feel they have something to contribute or when they are bored. This request places an unnecessary burden on the mother and may make her feel defensive or embarrassed, which can negatively impact the rapport and the quality of information she provides. .
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Related Questions
Correct Answer is C
Explanation
Choice C rationale
Increasing the volume of speech often results in distortion of sound and can alter the natural cadence and inflection of the voice, making it harder for a child with hearing loss to interpret. Shouting also changes the visual appearance of the mouth, which interferes with lip-reading. Most hearing-impaired individuals benefit from clarity and directness rather than increased decibels. Effective communication relies on a consistent, moderate tone that does not visually or auditorily mask speech patterns.
Choice A rationale
Maintaining direct eye contact and facing the child is a fundamental technique for communicating with the hearing impaired. This position allows the child to utilize non-verbal cues, facial expressions, and lip-reading to supplement any residual hearing they may have. It ensures that the sound waves are directed toward the listener without being muffled by the speaker turning away. This alignment is essential for maximizing the child's ability to process linguistic information through multiple sensory channels.
Choice B rationale
Speaking clearly and at a slightly moderated pace allows the child more time to process each phoneme and word. Rapid speech can cause sounds to blend together, making it difficult for the child to distinguish between similar-sounding syllables. By slowing down slightly without over-exaggerating, the nurse provides a clearer auditory and visual template for the child to follow. This technique supports cognitive processing and reduces the frustration associated with missing parts of a conversation.
Choice D rationale
Background noise creates a poor signal-to-noise ratio, which is particularly challenging for children with hearing loss or those using hearing aids. Hearing aids often amplify all sounds equally, meaning that a humming air conditioner or a television can drown out human speech. Minimizing environmental noise ensures that the nurse's voice is the primary auditory input. This allows the child to focus their limited auditory resources on the intended message without competing with irrelevant environmental stimuli.
Choice E rationale
Ensuring the child is attentive before speaking prevents the loss of the initial parts of the message. Children with hearing loss cannot rely on peripheral hearing to "catch" the start of a sentence if they are distracted. By securing their attention first, the nurse ensures the child is ready to use all available visual and auditory tools. This practice establishes a focused communicative environment where the child is mentally prepared to receive and interpret the incoming information.
Correct Answer is A
Explanation
Choice A rationale
Child life specialists are experts in human development and the specific psychological needs of children in healthcare settings. They use play, preparation, and distraction techniques to help children cope with invasive procedures like radiation. For an 8-year-old, the specialist can provide age appropriate explanations and therapeutic play to reduce anxiety. Collaborating with this professional ensures that the child's emotional and developmental needs are met alongside their physical medical treatments for cancer.
Choice B rationale
An oncology radiologist focuses on the technical delivery and medical planning of radiation therapy. While they oversee the treatment, they may not have specialized training in pediatric behavioral interventions or coping strategies for school age children. Relying solely on the physician for adjustment issues might overlook the psychosocial aspects of care. The nurse should consult someone specialized in the child's emotional response rather than just the clinical administration of the radiation doses.
Choice C rationale
Parent comfort is a vital component of pediatric care, but parents may also be overwhelmed by the diagnosis and treatment process. They might not possess the specific tools or techniques to help a child adjust to the rigid requirements of radiation therapy. While parental presence should always be encouraged, professional intervention from a child life specialist provides a structured approach to coping that supplements parental support and addresses the child's fears more effectively.
Choice D rationale
Educating an 8-year-old on the medical importance of radiation is necessary but often insufficient for improving adjustment. School age children understand basic cause and effect, but the physical environment and the need for immobilization during radiation are naturally frightening. Purely cognitive education does not address the underlying sensory and emotional fears the child is experiencing. A more holistic approach involving play and psychological preparation is needed to achieve a successful adjustment to therapy.
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