While managing a child with behavioural problems nurse should focus on all of the following, except:

IGNOU PB Bsc Entrance-2022

Child Health Nursing (Pediatrics)

Easy

Appeared in: IGNOU PB Bsc Entrance-2022

Explanation

Punishment is the correct answer because it is a punitive action that nurses should avoid. It focuses on penalizing past mistakes rather than teaching appropriate future behaviors.
According to pediatric guidelines, punishment can lead to negative outcomes, including worsening behavioral problems, aggression, anxiety, and depression.
Punishment, especially corporal punishment, is considered a form of child abuse by organizations like the CDC and does not correct the underlying behavior.
The goal of managing behavioral problems is to build a therapeutic relationship and foster self-control, which punishment undermines.

Option A: Discipline is a positive and necessary approach. It involves teaching, guiding, and setting healthy boundaries to help the child learn self-control and acceptable behavior.
Option B: 'Planned ignoring' is a valid and effective behavior modification strategy for minor, attention-seeking behaviors like whining or mild tantrums. By removing attention (the reward), the negative behavior is often extinguished.
Option C: This option describes a comprehensive, evidence-based approach to behavior management. It correctly combines teaching (discipline), structured changes (behavior modification), and extinction of negative acts (ignoring).

Clinical Relevance

Nursing practice connection: Use the key finding related to Behavioral management techniques in pediatric nursing to guide bedside assessment, documentation, and the next nursing action.
A nurse's primary role is to promote health and well-being. Using punishment damages the therapeutic relationship and can cause psychological harm, violating the principle of 'do no harm'.
Nurses are key educators for parents. They must be able to explain the difference between discipline and punishment and teach parents effective, positive parenting strategies.
What if the child's behavior is immediately dangerous (e.g., running towards a busy street)? The nurse's first action is physical intervention to ensure safety. This is a protective measure, not a punishment. The discipline (teaching about road safety) occurs after the danger is removed and the child is calm.

How to Approach the Question

First, recognize that the question uses the word 'except'. This means you are looking for the option that is NOT an appropriate nursing action.
Analyze the core concept: managing behavioral problems in a child. The approach should be therapeutic, safe, and constructive.
Evaluate each option against this standard. Ask yourself, 'Is this a recommended, therapeutic action for a nurse to take?'
Option A (Discipline), B (Ignore), and C (Combination) are all recognized therapeutic strategies.
Option D (Punish) is punitive and known to be harmful and ineffective. It is the outlier.
Therefore, 'Punish the child' is the correct answer as it is the action the nurse should NOT focus on.

Concept Tested & Keywords

Concept Tested: Behavioral management techniques in pediatric nursing
Stem keywords: child, behavioural problems, managing
Lead-in keywords: except
Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.
Negative lead-in flag: The question asks for the exception among the given options.

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E6 Nelson Textbook of Pediatrics(2024) — Volume 1 pp. 187-189, 323-325