Deck 40: Nursing Considerations for the Child and Family With a Chronic Condition

Question 1

The school nurse completes an assessment of a 6-year-old child to determine the services the child will need in the classroom.The child needs respiratory support with oxygen.The child also requires enteral tube feedings and intravenous medication during the school day.With these needs,the school nurse evaluates the child to be:

A)Developmentally delayed.
B)Mentally handicapped.
C)Socially withdrawn.
D)Medically fragile.

Answer 1

Medically fragile.

Question 2

A child who has a history of renal failure and has undergone kidney transplantation is starting school this year.The school nurse knows this child would be classified into which category?

A)Increased use of health care services
B)Dependent on medications or special diet
C)Functional limitations
D)Dependent on medical technology

Answer 2

Dependent on medications or special diet

Question 3

The nurse is discussing the option of home care with the parents of a child with complex health care needs.Which statement indicates the need for further teaching?

A)"It is more expensive if we care for our child at home,as we will need caregivers."
B)"Our family might experience more stress caring for our child at home."
C)"It might become necessary to modify our home to make home care easier."
D)"If we decide on home care,we will be given training in all medications and treatments."

Answer 3

"It is more expensive if we care for our child at home,as we will need caregivers."

Question 4

The nurse has set up a group discussion for several families with chronically ill children.The nurse informs these parents that they might face which of the following ethical issues?

A)Normalization
B)Withholding and refusal of treatment
C)Repeated hospital admissions
D)Lack of proper dietary needs

Question 5

The school nurse assesses a child with a history of asthma who has an acute onset of wheezing.The initial action by the nurse is to:

A)Call 911 to request emergency medical assistance.
B)Call the child's parents to come and pick up the child.
C)Have the child use his metered-dose inhaler.
D)Have the child lie down to see if the symptoms subside.

Question 6

A 6-year-old sibling of an 11-year-old child with cystic fibrosis tells the nurse,"I wish I had a breathing disease,too." The nurse knows the parents are striving to spend quality time with each child and with both children together.The nurse recognizes this statement to represent which of the following?

A)Jealousy
B)Isolation
C)Loneliness
D)Anger

Question 7

Which outcome indicates a successful transition from hospital to home for the family of a 2-year-old child with a tracheostomy due to bronchopulmonary dysplasia?

A)The parents demonstrate proper technique of suctioning tracheostomy in the hospital.
B)The child demonstrates self-care skills prior to discharge.
C)The family provides appropriate home care for the child while maintaining family routines.
D)The parents demonstrate how to take the child's vital signs at home.

Question 8

While at a follow-up appointment,the mother of a child with complex health care needs makes this statement: "I think my child would be doing better if I weren't so tired all the time." What is the nurse's priority response?

A)"Why are you tired all the time?"
B)"Have there been any changes in your daily routine?"
C)"I am sure he is doing as well as can be expected."
D)"I think you are doing everything you can for him."

Question 9

The nurse is working with a child with multiple disabilities.The parents have asked the nurse to help them in meeting with the school board to develop an individualized education plan (IEP)and an individualized health plan (IHP).The nurse can best partner with families with children with special health care needs to develop the child's IEP by:

A)Providing a written list of the child's medical diagnoses for the IEP meeting.
B)Offering to wait with the child while the parent attend the IEP meeting.
C)Listening to the parents' concerns and complaints about the school district.
D)Presenting verbally the child's cognitive physical and social skills to school officials at the IEP meeting.

Question 10

The nurse in the long-term-care clinic is reviewing the charts of a group of children with chronic physical,psychologic,functional,and social limitations.The nurse recognized that chronic limitations can result from which of the following? Select all that apply.

A)Near drowning
B)Congenital heart defect
C)Pneumonia from Haemophilus influenzae virus
D)Fetal insult when the mother contracted rubella in the first trimester of pregnancy
E)Sepsis contracted in a neonate

Question 11

The nurse is working with the family of a 5-year-old child with spina bifida.The nurse partners with the family to plan goals of care.An appropriate goal for this child and the family would be for the parents to:

A)Refuse a wheelchair for the child,to motivate the child to learn to walk.
B)Verbalize their frustrations to the nurse.
C)Accept the school district's individualized transition plan (ITP).
D)Alternately assume care for the child 24 hours a day,7 days a week.

Question 12

For a 17 year-old adolescent with diabetes mellitus,which is the priority nursing goal?

A)Completing high school
B)Assuming responsibility for all care
C)Transitioning to adult care
D)Teaching friends about diet needs

Question 13

Which nursing intervention is directed to the school-age child's independent management of asthma symptoms?

A)Assess the child and family's level of understanding of asthma.
B)Encourage the child to use the flow meter and record results every day.
C)Discuss with the child how to tell friends about asthma.
D)Teach the parents proper use of inhalers.

Question 14

In working with families of children with chronic diseases,the nurse is concerned with helping the parents and siblings to protect themselves from compassion fatigue.The nurse would encourage which of the following activities? Select all that apply.

A)Getting more than 9 hours of sleep in a 24-hour period
B)Exercising
C)Fostering social relationships in their community
D)Developing a hobby,either individually or as a family
E)Moving away to another city

Question 15

Which would be the priority nursing intervention for a child who has been involved in an automobile collision and is now a paraplegic?

A)Develop and implement a teaching plan.
B)Discuss improvement for family coping.
C)Contact the family clergy for support.
D)Arrange for the child's friends to visit.