Question 1

Which describes avoidance behaviors parents may exhibit when learning that their child has a chronic condition? (Select all that apply.)

Accepted Answer

A parent who refuses to agree to treatment,withdraws from the outside world,and punishes self because of guilt and shame is exhibiting avoidance coping behaviors.A parent who shares the burden of disorder with others and verbalizes possible loss of child is exhibiting approach coping behaviors.

Question 2

Which are appropriate statements the nurse should make to parents after the death of their child? (Select all that apply.)

Accepted Answer

By saying,"We feel so sorry that we couldn't save your child," the nurse is expressing personal feeling of loss or frustration,which is therapeutic.Stating,"You're feeling all the pain of losing a child," focuses on a feeling,which is therapeutic.The statement,"Your child isn't suffering anymore," is a judgmental statement,which is nontherapeutic."I know how you feel" and "You're still young enough to have another baby" are statements that give artificial consolation and are nontherapeutic.

Question 3

At what age do most children have an adult concept of death as being inevitable,universal,and irreversible?

Accepted Answer

By age 9 to 11 years,children have an adult concept of death.They realize that it is inevitable,universal,and irreversible.

Question 4

Parents are asking about an early intervention program for their child who has special needs.The nurse relates that this program is for which age of child?

Accepted Answer

A variety of supplemental programs have been designed in the school system to accommodate special needs,both at school age and younger,through early intervention,which consists of any sustained and systematic effort to assist children from birth to age 3 years with disabilities and those who are developmentally vulnerable.

Question 5

The nurse and a new nurse are caring for a child who will require palliative care.Which statement made by the new nurse would indicate a correct understanding of palliative care?

Accepted Answer

One of the goals of palliative care is to provide pain and symptom management.

Question 6

Which best describes how preschoolers react to the death of a loved one?

Accepted Answer

Because of egocentricity,the preschooler may feel guilty and responsible for the death.

Question 7

Which is most descriptive of a school-age child's reaction to death?

Accepted Answer

The school-age child is interested in post-death services and may be inquisitive about what happens to the body.

Question 8

Which term best describes a multidisciplinary approach to the management of a terminal illness that focuses on symptom control and support?

Accepted Answer

This is one of the definitions of palliative care.The goal of palliative care is the achievement of the highest possible quality of life for patients and their families.

Question 9

A preschooler is found digging up a pet bird that was recently buried after it died.The best explanation for this behavior is that:

Accepted Answer

The preschooler can recognize that the pet has died but has difficulties with the permanence.Digging up the bird gives reassurance that the bird is still present.

Question 10

Which are adaptive coping patterns used by children with special needs? (Select all that apply.)

Accepted Answer

Adaptive coping patterns used by children with special needs include seeking support and developing optimism.Maladaptive behaviors are seeing themselves as different and withdrawing and becoming irritable,moody,and beginning to act out.

Question 11

A school-age child is diagnosed with a life-threatening illness.The parents want to protect their child from knowing the seriousness of the illness.The nurse should explain that:

Accepted Answer

The child needs honest and accurate information about the illness,treatments,and prognosis.Children,even at a young age,realize that something is seriously wrong and that it involves them.The nurse should help the parents understand the importance of honesty.

Question 12

At what developmental period do children have the most difficulty coping with death,particularly if it is their own?

Accepted Answer

Adolescents,because of their mature understanding of death,remnants of guilt and shame,and issues with deviations from normal,have the most difficulty coping with death.

Question 13

The nurse is caring for a child who has just died.The parents ask to be left alone so that they can rock their child one more time.The nurse's most appropriate response is to:

Accepted Answer

The parents should be allowed to remain with their child after the death.The nurse can remove all the tubes and equipment and offer the parents the option of preparing the body.

Question 14

The nurse is providing support to a family who is experiencing anticipatory grief related to their child's imminent death.Which of the following is an appropriate nursing intervention?

Accepted Answer

One of the most important nursing interventions of death is the availability of the nurse for the family.

Question 15

A nurse is planning palliative care for a child with severe pain.Which should the nurse expect to be prescribed for pain relief?

Accepted Answer

Pain medications,for children in palliative care,should be given on a regular schedule,and extra doses for breakthrough pain should be available to maintain comfort.Opioid drugs such as morphine should be given for severe pain,and the dose should be increased as necessary to maintain optimal pain relief.Techniques such as distraction,relaxation techniques,and guided imagery should be combined with drug therapy to provide the child and family strategies to control pain.Nonsteroidal anti-inflammatory drugs are not sufficient to manage severe pain for children in palliative care.

Question 16

Which is an appropriate nursing intervention when providing comfort and support for a child when death is imminent?

Accepted Answer

When death is imminent,care should be limited to interventions for palliative care.

Question 17

The nurse is talking with the parents of a child who died 6 months ago.They sometimes still "hear" the child's voice and have trouble sleeping.They describe feeling "empty" and depressed.The nurse should recognize that:

Accepted Answer

These are normal grief responses.The process of grief work is lengthy.

Question 18

At the time of a child's death,the nurse tells his mother,"We will miss him so much." The best interpretation of this is that the nurse is:

Accepted Answer

A patient's death is one of the most stressful aspects of critical care or oncology nursing.Nurses experience reactions similar to those of family members because of their involvement with the child and family during the illness.Nurses often have feelings of personal loss when a patient dies.

Question 19

A cure is no longer possible for a young child with cancer.The nursing staff recognizes that the goal of treatment must shift from cure to palliation.Which is an important consideration at this time?

Accepted Answer

When the child reaches the terminal stage,the nurse and physician should explore the family's wishes.The family should help decide what interventions will occur as they plan for their child's death.

Question 20

A nurse is caring for a child who is near death.Which physical signs indicate the child is approaching death? (Select all that apply.)

Accepted Answer

Physical signs of approaching death include: tactile sensation beginning to decrease,a change in respiratory pattern,and difficulty swallowing.Even though there is a sensation of heat the body feels cool,not warm,and speech becomes slurred,not rapid.

Quiz 18: Quality of Life for Children Living with Chronic or Complex Diseases