Review Play and distraction techniques

Nursing Care of Hospitalized Children > Pediatrics

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Play and distraction techniques

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Total Questions : 12

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Question 1:

A nurse is planning to use therapeutic play with a child who is scheduled for a blood draw. What type of play would be most appropriate for this purpose and why?

A. Role play: the nurse can act out the blood draw procedure with a doll or a stuffed animal and let the child practice on it. B. Board game: the nurse can play a board game with the child and explain the blood draw procedure during the game. C. Art activity: the nurse can provide the child with crayons and paper and ask the child to draw their feelings about the blood draw procedure. D. Music activity: the nurse can play soothing music for the child and sing along with the child during the blood draw procedure.

Answer and Explanation

Choice A:

Choice A reason: This is the correct answer, as role play is a type of therapeutic play that helps the child cope with a specific health problem or procedure. Role play allows the child to express their fears, ask questions, and gain mastery over the situation.

Choice B:

Choice B reason: This is not the correct answer, as board game is a type of recreational play that provides fun, enjoyment, or entertainment for the child. Board game may distract the child from their anxiety, but it does not address their specific concerns or prepare them for the procedure.

Choice C:

Choice C reason: This is not the correct answer, as art activity is a type of developmental play that supports the child's growth and development according to their age and stage. Art activity may help the child express their emotions, but it does not provide them with information or skills to cope with the procedure.

Choice D:

Choice D reason: This is not the correct answer, as music activity is a type of multimodal play that uses more than one type of play or more than one mode of delivery. Music activity may soothe the child and reduce their pain perception, but it does not familiarize them with the procedure or allow them to participate in it.

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Question 2:

A nurse is caring for a child who is hospitalized for a chronic illness. The nurse wants to use recreational play to provide fun and enjoyment for the child. What type of play would be most suitable for this purpose and why?

A. Video game: the nurse can play a video game with the child or let the child play with other children online. B. Puzzle: the nurse can give the child a puzzle to solve or help the child with it. C. Storytelling: the nurse can tell the child a story or ask the child to make up a story. D. Puppet show: the nurse can perform a puppet show for the child or let the child create their own puppet show.

Answer and Explanation

Choice A:

Choice A reason: This is the correct answer, as the video game is a type of recreational play that provides fun, enjoyment, or entertainment for the child. Video games can also enhance the child's cognitive, motor, and social skills, as well as provide a sense of control and escape from reality.

Choice B:

Choice B reason: This is not the correct answer, as puzzle is a type of developmental play that supports the child's growth and development according to their age and stage. Puzzle can also provide fun and enjoyment for the child, but it may not be as engaging or stimulating as video game.

Choice C:

Choice C reason: This is not the correct answer, as storytelling is a type of therapeutic play that helps the child cope with a specific health problem or procedure. Storytelling can also provide fun and enjoyment for the child, but it may not be as interactive or exciting as video game.

Choice D:

Choice D reason: This is not the correct answer, as puppet show is a type of multimodal play that uses more than one type of play or more than one mode of delivery. Puppet show can also provide fun and enjoyment for the child, but it may not be as accessible or convenient as video game.

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Question 3:

A nurse is caring for a child who is undergoing chemotherapy for cancer. The nurse wants to use developmental play to support the child's growth and development according to their age and stage. What type of play would be most appropriate for this purpose and why? (Select all that apply.)

A. Sensorimotor play: the nurse can provide the child with toys that stimulate their senses and motor skills, such as rattles, balls, or blocks. B. Symbolic play: the nurse can provide the child with toys that allow them to use their imagination and creativity, such as dolls, cars, or costumes. C. Games with rules: the nurse can provide the child with games that have clear rules and objectives, such as card games, board games, or sports. D. Social play: the nurse can provide the child with opportunities to interact with other children or adults, such as playing together, talking, or sharing. E. Solitary play: the nurse can provide the child with activities that they can do by themselves, such as reading, drawing, or listening to music.

Answer and Explanation

Choice A:

This type of play would be appropriate for this purpose, as it helps support the child's physical development and coordination, especially for infants and toddlers who are in the sensorimotor stage of cognitive development.

Choice B:

This type of play would be appropriate for this purpose, as it helps support the child's cognitive and emotional development, especially for preschoolers who are in the preoperational stage of cognitive development and use symbolic play to represent their thoughts and feelings.

Choice C:

This type of play would not be appropriate for this purpose, as it is more suitable for older children who are in the concrete operational or formal operational stages of cognitive development and can understand and follow rules and logic. Games with rules may also be too competitive or stressful for a child who is undergoing chemotherapy.

Choice D:

This type of play would be appropriate for this purpose, as it helps support the child's social and moral development, especially for school-age children who are in the conventional stage of moral development and value social interactions and norms.

Choice E:

This type of play would be appropriate for this purpose, as it helps support the child's self-esteem and coping skills, especially for adolescents who are in the postconventional stage of moral development and value individuality and autonomy. Solitary play may also provide a sense of relaxation and distraction for a child who is undergoing chemotherapy.

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Question 4:

A nurse is using multimodal play with a child who is hospitalized for asthma. What type of play would be most effective for this purpose and why?

A. Music and art: the nurse can play soothing music for the child and provide them with crayons and paper to draw their feelings or experiences. B. Storytelling and puppet show: the nurse can tell the child a story about a character who has asthma and how they cope with it, and use puppets to act out the story. C. Video game and board game: the nurse can play a video game with the child that teaches them about asthma and how to manage it, and then play a board game with them to reinforce the learning. D. Role play and sensorimotor play: the nurse can act out the asthma attack and inhaler use with a doll or a stuffed animal, and then let the child practice on it, while providing them with toys that stimulate their senses and motor skills.

Answer and Explanation

Choice A:

Choice A reason: This is not the correct answer, as music and art are not the most effective types of multimodal play for a child who is hospitalized for asthma. Music and art may provide relaxation, distraction, or emotional expression for the child, but they do not address their specific health problem or teach them how to cope with it.

Choice B:

Choice B reason: This is the correct answer, as storytelling and puppet show are effective types of multimodal play for a child who is hospitalized for asthma. Storytelling and puppet show can help the child understand their condition, learn coping strategies, express their fears or concerns, and gain mastery over the situation.

Choice C:

Choice C reason: This is not the correct answer, as video game and board game are not the most effective types of multimodal play for a child who is hospitalized for asthma. Video game and board game may provide fun, enjoyment, or entertainment for the child, as well as enhance their cognitive, motor, and social skills, but they may not be as engaging or interactive as storytelling and puppet show.

Choice D:

Choice D reason: This is not the correct answer, as role play and sensorimotor play are not the most effective types of multimodal play for a child who is hospitalized for asthma. Role play and sensorimotor play may help the child practice their skills, improve their coordination, and reduce their anxiety, but they may not be as creative or imaginative as storytelling and puppet show.

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Question 5:

A nurse is planning to use play and distraction techniques for a child who is undergoing a painful procedure. Which of the following principles should the nurse follow when choosing the appropriate technique? (Select all that apply.)

A. The technique should be child-centered and tailored to the child's preferences and needs. B. The technique should be developmentally appropriate and match the child's cognitive and emotional level. C. The technique should be culturally sensitive and respect the child's values and beliefs. D. The technique should be evidence-based and supported by research and clinical guidelines. E. The technique should be collaborative and involve the child, family, and health care team.

Answer and Explanation

Choice A:

This is correct. The technique should be child-centered and tailored to the child's preferences and needs, such as their favorite toys, games, or music.

Choice B:

This is correct. The technique should be developmentally appropriate and match the child's cognitive and emotional level, such as their attention span, language skills, or coping strategies.

Choice C:

This is correct. The technique should be culturally sensitive and respect the child's values and beliefs, such as their religious practices, family roles, or communication styles.

Choice D:

This is correct. The technique should be evidence-based and supported by research and clinical guidelines, such as the best practices for pain management, anxiety reduction, or procedural preparation.

Choice E:

This is correct. The technique should be collaborative and involve the child, family, and health care team, such as their parents, siblings, or nurses.

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Question 6:

A nurse is evaluating the effectiveness of play and distraction techniques for a child who is undergoing a medical procedure. Which of the following tools and methods can the nurse use to measure the outcomes of play and distraction techniques? (Select all that apply.)

A. Self-report scales that assess the child's pain intensity, anxiety level, or satisfaction with the technique. B. Behavioral observation scales that measure the child's facial expressions, body movements, or vocalizations during the procedure. C. Physiological indicators that monitor the child's heart rate, blood pressure, or oxygen saturation before, during, and after the procedure. D. Qualitative feedback that collects the child's comments, feelings, or suggestions about the technique. E. Quantitative data that analyzes the child's length of stay, medication use, or complication rate after the procedure.

Answer and Explanation

Choice A:

This is correct. Self-report scales are valid and reliable measures that assess the child's pain intensity, anxiety level, or satisfaction with the technique, such as the Wong-Baker FACES Pain Rating Scale¹, the State-Trait Anxiety Inventory for Children², or the Child Satisfaction with Play Technique Scale³.

Choice B:

This is correct. Behavioral observation scales are objective and standardized measures that observe the child's facial expressions, body movements, or vocalizations during the procedure, such as the FLACC Scale, the Child Facial Coding System, or the Non-communicating Children's Pain Checklist.

Choice C:

This is correct. Physiological indicators are accurate and sensitive measures that monitor the child's heart rate, blood pressure, or oxygen saturation before, during, and after the procedure using devices such as a pulse oximeter, a sphygmomanometer, or an electrocardiogram.

Choice D:

This is correct. Qualitative feedback is an in-depth and rich source of information that collects the child's comments, feelings, or suggestions about the technique using methods such as interviews, focus groups, or open-ended questions.

Choice E:

This is correct. Quantitative data is a numerical and statistical source of information that analyzes the child's length of stay, medication use, or complication rate after the procedure using methods such as charts, records, or databases.

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Question 7:

A nurse is using play and distraction techniques for a child who is receiving an intravenous injection. Which of the following statements by the nurse is most appropriate to use as a distraction technique?

A. "This will only hurt for a second, and then it will be over." B. "Do you want to watch a video of your favorite cartoon on my tablet?" C. "Can you tell me the names of all the animals on this poster?" D. "Why are you so scared? It's not a big deal."

Answer and Explanation

Choice A:

This is incorrect. Telling the child that the injection will hurt can increase their fear and anticipation of pain, and may also damage the trust between the nurse and the child.

Choice B:

This is incorrect. Offering the child to watch a video on a tablet may not be effective as a distraction technique, as the child may still be aware of the procedure and may not be able to focus on the video.

Choice C:

This is correct. Asking the child to name the animals on a poster is an example of a distraction technique that can divert the child's attention from the procedure and reduce their anxiety and pain.

Choice D:

This is incorrect. Criticizing or minimizing the child's feelings can make them feel ashamed or guilty, and may also worsen their emotional distress.

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Question 8:

A nurse is using play and distraction techniques for a child who is having a dressing change. Which of the following statements by the child indicates that the technique is effective?

A. "I don't want you to touch me, go away!" B. "I'm so scared, please don't hurt me!" C. "Look, I made a bracelet with these beads!" D. "Can you please hurry up and finish?"

Answer and Explanation

Choice A:

This is incorrect. Saying that they don't want to be touched or asking the nurse to go away is an indication that the child is feeling anxious and defensive, and not distracted from the procedure.

Choice B:

This is incorrect. Expressing fear or pleading with the nurse not to hurt them is an indication that the child is feeling anxious and fearful, and not distracted from the procedure.

Choice C:

This is correct. Showing interest and pride in making a bracelet with beads is an indication that the child is engaged in the play activity and distracted from the procedure.

Choice D:

This is incorrect. Asking the nurse to hurry up and finish is an indication that the child is feeling impatient and uncomfortable, and not distracted from the procedure.

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Question 9:

A nurse is educating a parent about how to use play and distraction techniques for their child who has chronic pain. Which of the following information should the nurse include in the teaching? (Select all that apply.)

A. Play and distraction techniques can help reduce pain by stimulating endorphins in the brain. B. Play and distraction techniques can help improve mood by increasing serotonin levels in the brain. C. Play and distraction techniques can help enhance coping by providing a sense of control and mastery. D. Play and distraction techniques can help promote healing by improving blood flow and oxygen delivery. E. Play and distraction techniques can help prevent infection by boosting immune system function.

Answer and Explanation

Choice A:

This is correct. Play and distraction techniques can help reduce pain by stimulating endorphins in the brain, which are natural painkillers that block pain signals.

Choice B:

This is correct. Play and distraction techniques can help improve mood by increasing serotonin levels in the brain, which are neurotransmitters that regulate mood, sleep, appetite, and memory.

Choice C:

This is correct. Play and distraction techniques can help enhance coping by providing a sense of control and mastery, which can increase self-esteem, confidence, and resilience.

Choice D:

This is correct. Play and distraction techniques can help promote healing by improving blood flow and oxygen delivery, which can facilitate tissue repair, wound healing, and infection prevention.

Choice E:

This is correct. Play and distraction techniques can help prevent infection by boosting immune system function, which can fight off pathogens, inflammation, and disease.

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Question 10:

A nurse uses guided imagery as a play technique for a 10-year-old client who has cancer. The nurse asks
the client to imagine being in a place where he feels happy and safe. Which of
the following actions should
the nurse take next?

A. Ask B. Ask C. Ask D. Ask

Answer and Explanation

Choice A:

This is correct. Asking the client to describe what he sees, hears, smells, and feels in that place is the next action that the nurse should take when using guided imagery as a play technique. This can help the client to focus on the sensory details of the imagined place and enhance the relaxation and distraction effects of the technique.

Choice B:

This is incorrect. Asking the client to rate his pain level on a scale of 0 to 10 is not the next action that the nurse should take when using guided imagery as a play technique. This can interrupt the flow of the technique and remind the client of his pain.

Choice C:

This is incorrect. Asking the client to draw a picture of that place is not the next action that the nurse should take when using guided imagery as a play technique. This can distract the client from the mental imagery and reduce the effectiveness of the technique.

Choice D:

This is incorrect. Asking the client to repeat positive affirmations about that place is not the next action that the nurse should take when using guided imagery as a play technique. This can be done after the technique is completed, but not during it. Questions on conclusion

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Question 11:

A nurse is caring for a 6-year-old child who is admitted to the hospital with pneumonia. The nurse knows that the child's developmental stage is school-age, which is characterized by:

A. Egocentrism and magical thinking. B. Concrete operations and conservation. C. Formal operations and abstract reasoning. D. Identity formation and peer pressure.

Answer and Explanation

Choice A:

Egocentrism and magical thinking are characteristics of the preschool stage, not the school-age stage.

Choice B:

Concrete operations and conservation are characteristics of the school-age stage, which involves logical thinking and understanding of physical properties.

Choice C:

Formal operations and abstract reasoning are characteristics of the adolescent stage, not the school-age stage.

Choice D:

Identity formation and peer pressure are characteristics of the adolescent stage, not the school-age stage.

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Question 12:

A nurse is planning to discharge a 4-year-old child who had surgery for appendicitis. Which of the following actions should the nurse include in the discharge plan? (Select all that apply.)

A. Provide written instructions and verbal explanations to the parents. B. Teach the child how to change the dressing and monitor for signs of infection. C. Encourage the parents to let the child resume normal activities as tolerated. D. Give the child a stuffed animal or a toy as a reward for being brave. E. Refer the child to a support group or a counselor if needed.

Answer and Explanation

Choice A:

Providing written instructions and verbal explanations to the parents is an important action to ensure understanding and compliance with the discharge plan.

Choice B:

Teaching the child how to change the dressing and monitor for signs of infection is not appropriate for a 4-year-old child, who may not have the cognitive or motor skills to perform these tasks. The parents should be taught how to do these instead.

Choice C:

Encouraging the parents to let the child resume normal activities as tolerated is an important action to promote recovery and prevent complications such as constipation or adhesions.

Choice D:

Giving the child a stuffed animal or a toy as a reward for being brave is an important action to provide positive reinforcement and reduce anxiety or fear associated with hospitalization or surgery.

Choice E:

Referring the child to a support group or a counselor if needed is not a necessary action for a 4-year-old child who had surgery for appendicitis, unless there are signs of emotional distress or trauma that require professional intervention.

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Play and distraction techniques

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