Deck 17: Chronic Conditions

Question 1

Which of the following best describes the term disability?

A) unable to work at 100% of the ability of the average person in the society
B) functional limitation preventing or interfering with the ability to perform age-expected activities
C) a condition in which a person is prevented by limitations from doing the work he or she needs to do
D) having a part of the body that functions at 75% or less of its ability

Answer 1

functional limitation preventing or interfering with the ability to perform age-expected activities

Question 2

The term chronic condition typically refers to a medical state or degree of health that exists for a minimum of how many months?

A) 3
B) 6
C) 9
D) 12

Answer 2

3

Question 3

The nurse assessing a child with a chronic illness evaluates the trajectory. The nurse is trying to find out:

A) how fast the child can move
B) how long the child has had the illness
C) whether the condition will get better, worse, or stay the same
D) who else in the family has this condition

Answer 3

whether the condition will get better, worse, or stay the same

Question 4

A child has a disability that is not visible to others. Research has shown that children with a condition that is less visible to others will:

A) frequently have more difficulty adjusting to the condition than those with a more visible disability
B) have the same amount of difficulty adjusting to the condition as people with a visible disability
C) often forget for long periods of time that they have a disability since it is not visible
D) seek more attention from significant others compared to people with a more visible disability

Question 5

The deficit-orientation model of chronic conditions assumes that people with chronic conditions are:

A) lacking important aspects of life
B) lacking in sufficient finances to receive adequate medical services
C) intellectually impaired
D) unable to function in society

Question 6

Using the deficit-orientation model of chronic conditions, clinicians assessing the client would look for:

A) unusual strengths and talents
B) personality traits
C) abnormalities and problems
D) financial problems and debts

Question 7

The deficit-orientation model of chronic conditions tends to see which of the following as the expert?

A) the client
B) the client's family
C) the professional(s)
D) the evidence-based literature

Question 8

The health-orientation model of disability tends to be critical of:

A) people who are disabled
B) professionals making negative appraisals
C) the family of the person who is disabled
D) healthy persons who ignore people who are disabled

Question 9

The ordinary model of chronic conditions differs from other models because in this model, people with chronic conditions view themselves as:

A) leading ordinary lifestyles
B) wanting to be more ordinary
C) somewhat extraordinary compared to others
D) experiencing conditions similar to those experienced by many other individuals

Question 10

The health-orientation model of chronic conditions portrays the relationship between client and professional as a:

A) partnership
B) contract
C) patient-client relationship
D) teacher-learner relationship

Question 11

Children with a chronic condition must learn to manage the symptoms. The other priority, time-consuming thing they must manage is which of the following aspects of their lives?

A) their emotions
B) the treatments
C) their interaction with peers
D) their success in academics

Question 12

A mother complains to the nurse that her school-aged child with a disability does not readily comply with treatments and wants to do them differently or at a later time. Select the best response for the nurse.

A) "I suggest you have some form of punishment for not responding positively to the treatments."
B) "School-aged children often respond to treatments with manipulative behavior or boundary testing."
C) "You must remember that she has a disability and deserves that you accept some deviance from normal behavior."
D) "Your child should be allowed to participate in planning her care, thus requiring you to be flexible in planning treatments."

Question 13

The nurse is administering treatments to a school-aged child with a disability. This child is in a state of remission and nearly symptom-free. He tries to talk his caregivers into not bringing him to treatments and wants to stop as soon as he starts the treatment, saying he really does not need it. After assessing for the need, the nurse would begin work to get him to accept his treatments by:

A) offering him some positive reinforcements, such as candy or a food treat that is allowed in his diet in return for doing the treatments
B) asking his caregivers to talk with him and offer some consequences if he does not do the treatments as prescribed
C) listening to the child, then explaining and discussing why treatments are necessary during periods of lessened or no symptoms
D) telling the child about other children his age who have continued their treatments despite being in remission

Question 14

A mother tells the school nurse that she thinks her son, who has a chronic illness, is upset about what other children may think about his disability. Which course of action would be best for the nurse to take initially?

A) Ask the child what is bothering him, to see if it is what the other children are thinking.
B) Teach the mother to ask open-ended, age-appropriate questions to find out what is of concern to the child.
C) Include child in organized sporting events and other social activities
D) Talk to some of the peers to find out what their thinking is in regard to their friend with a chronic illness.

Question 15

The nurse is working with a teenager who has insulin-dependent diabetes. This adolescent has returned to the hospital after being discharged a month ago. Both hospitalizations are because of the blood sugar getting out of control. The nurse suspects the teen is not open about the diabetes then interacting with peers. Select the statement that would be most helpful for the nurse to say.

A) "Some teenagers who have diabetes don't like friends to know about it. How has it been for you?"
B) "Have you told your friends and classmates about your diabetes and the need to eat in a healthier way?"
C) "You really need to tell your friends and classmates about your diabetes and let them help you manage it."
D) "I suspect you postpone testing your blood sugar and taking your insulin then you are with friends. Am I right?"

Question 16

The father of a 15-month-old child with a chronic health condition asks the nurse if his child will experience the "terrible twos." The nurse will base the answer on which of the following beliefs?

A) Children with chronic illness use all their energy coping with the illness and do not tend to go through these age-related stages.
B) Developmental stages tend to be delayed, if experienced at all.
C) Children with chronic illnesses demonstrate similar age-dependent behaviors as any other child their age.
D) Children with chronic illness are often so protected by caregivers that they don't experience the terrible twos.

Question 17

Public Law 94-142, Education for All Handicapped Children Act of 1975, requires which of the following for children with a disability?

A) a special classroom there they don't have to interact with children who are not disabled
B) education in the least restrictive environment that is appropriate for the child
C) specific teachers who are familiar with the disease process
D) training of the caregivers, or a caretaker designated by the caregivers, in homeschooling the child

Question 18

The placement of children with chronic illnesses or multiple disabilities in a regular classroom is based on which of the following concepts?

A) saving tax dollars
B) maximizing available teachers
C) integrating students to enhance diversity
D) mainstreaming

Question 19

Individuals with Disabilities Education Act (Part H of Public Law 102-119, formerly Education for the Handicapped Amendments of 1986) provides coverage for which of the following groups of children who are handicapped or at risk for later delay?

A) newborn to 21 years
B) newborn to 18 years
C) 4 to 16 years
D) 3 to 21 years

Question 20

The nurse is working with the caregivers of a toddler who is HIV positive. The caregivers want to enroll the toddler into a preschool program but express a concern that no preschool program will accept their child. The nurse will advise the caregivers that under the Americans with Disabilities Act of 1990:

A) children with disabilities, including HIV, must be offered a program that is separate and equal to the programs for nondisabled children
B) preschool programs must accept children with chronic conditions, including those who are HIV positive
C) preschool programs were granted the right to refuse admission to any child who is contagious
D) if the child is less than 50% disabled, the school has to accept the child

Question 21

You are the nurse working with a child who has a chronic illness and is confined to a wheelchair. This child is being placed in a new classroom with children she does not know. Which of the following initial actions by the nurse would be most helpful in assisting the child to adjust to this change?

A) Provide classroom instruction on disabilities for all students.
B) Listen to and explore the child's concerns about this change.
C) Visit the classroom and talk with the children about how they need to interact with the child who is disabled.
D) Talk with the teacher about how important it is that teachers model acceptance of the child who is disabled.

Question 22

A child with cerebral palsy tells the school nurse that he feels all right in his own classroom, but then he is out on the playground, other children stare at him and he does not know what to do about it. The nurse decides to teach the child to use a frontal approach. Which of the following activities would be most helpful to a child learning to use a frontal approach?

A) role-play with the nurse, ignoring other people by staring or being rude
B) a talk by the nurse on what other children say to stop people from staring
C) role-play with the nurse staring and the child asking, "Do you have a question?"
D) teaching the child to ask the person what they are staring at

Question 23

An older child is having difficulty coping with a chronic condition. Talking with which of the following people is one of the best coping strategies available?

A) the child's health care practitioner
B) a nurse practitioner
C) another child with the same condition
D) a nursing student who is near the child's age

Question 24

Adolescents with terminal illnesses usually acknowledge the terminal nature of the illness and:

A) plan optimistically for the future
B) begin a chronic stage of denial
C) worry about who will get their favorite belongings
D) go into a state of depression for a period of time

Question 25

The effect of the challenges and demands of caring for a child with a chronic condition has been given which of the following terms?

A) caregiver burden
B) burnout
C) plus four stress
D) runaway caregivers

Question 26

The nurse is working with the family of a child with a chronic condition. The family seems to be overwhelmed with the care and in need of a periodic break from the care. The nurse is most likely to talk with the family about which of the following solutions to this problem?

A) devising a rotation of family coverage
B) scheduling respite care
C) using friends to give the family a rest
D) getting a babysitter

Question 27

The caregivers of a child with a chronic condition are believed to go through an adjustment period known by which of the following names?

A) grieving
B) chronic (cyclic) sorrow
C) yo-yo syndrome
D) honeymoon phase

Question 28

The nurse working with the caregivers of a child with a chronic illness is aware that the family will:

A) have likely completed the grieving process
B) experience recurring grief and adjustment at predictable times during the child's life
C) be consistently maladjusted as long as they are responsible for the child's care
D) burn out early but regain their strength then working with the professional team

Question 29

A family caring for a child with a chronic health condition has rearranged and continues to rearrange their life schedule and routine. This is an attempt to make life better for the child and the family and to keep important aspects of the pre-illness lifestyle. The strategies used by the family are referred to as:

A) resorting
B) management
C) organization
D) normalization

Question 30

Ideally the role of the caregiver caring for a child with a chronic condition can be described as:

A) staying stable as caregiver
B) moving from caregiver to careful and systematic observer to behavior modifier
C) changing in a planned way from provider to manager to supervisor to consultant
D) lifelong companion and advocate

Question 31

The caregivers of a child with a chronic health condition say they are feeling frustrated and like professionals are discounting their expertise. The nurse will help them resolve this problem by teaching them to:

A) directly express frustration and confront the discounting of their expertise with "I" statements such as, "When you (do a specific thing or say a specific thing) I feel like
. . ."
B) change health care providers until they find a health care team that will treat them as experts and partners in the care of their child
C) ignore these feelings, as the health care team does not mean to discount their expertise and knows that they are experts in the care of their child
D) listen to the health care professionals, say nothing, and do whatever they (the caregivers) feel is best regardless of what the health care professionals suggest

Question 32

When caregivers of a child with a chronic health care condition look for meaning in their situation, they most often:

A) feel small, helpless, and hopeless in the face of such a long-term responsibility
B) find they have little or nothing to be thankful for and drop out of their religion
C) give up and adopt a martyr-like existence because any meaning is depressing or demeaning
D) find positive outcomes, such as family relationships being strengthened due to working together

Question 33

When networking with other families who also have a child with a chronic illness, the caregivers of a chronically ill child often engage in a process of downward comparison, which means that:

A) comparisons are frequent at first, but diminish with time as exhaustion sets in
B) caregivers comparing themselves with other caregivers find that there are situations worse than their own
C) their perception of other caregivers being better off is periodically proven to be true
D) they feel that their situation only gets worse and that the other caregivers' situations get better over time

Question 34

The sibling of a child with a chronic health condition comes to the attention of the school nurse. The sibling is worried about the child's illness and is experiencing some negative feelings about all the attention that the child who is disabled is receiving. The sibling will likely benefit most from:

A) saturation and ongoing attention from the nurse during the school year and beyond
B) the caregivers being made aware of the sibling's problems
C) a support group there they can gain knowledge, share feelings, and get help in coping
D) their minister or priest being notified so the church can provide help to the child

Question 35

The nurse working with the family of a child with a chronic health condition is aware that the siblings:

A) are relatively unaffected by having a brother or sister with a chronic health condition
B) may experience and share some of the stigma faced by the ill child
C) often overcompensate for activities the sibling cannot do
D) overlook much of what goes on with the child who has the chronic health problem

Question 36

The nurse is working with a family who is from a different country and who carries their 11-month-old child with a chronic illness everywhere. The child is not allowed to touch the ground. The nurse's initial action will be to:

A) get someone from the family's culture to explain that the child needs to walk
B) provide the caregivers with education on growth and developmental needs of children
C) assess the culture to see if carrying the child has something to do with culture
D) get an orthopedic specialist to screen the child for orthopedic problems

Question 37

The nurse who wants to effectively care for people from other cultures needs to examine his or her own:

A) language skills
B) ethnocentrism
C) cultural ability
D) access to the culture

Question 38

Which of the following treatments may pose a threat to the school-aged child's compliance with the regimen? Select all that apply.

A) time-consuming treatments
B) treatment regimens that are visible to others
C) treatments that interfere with daily activities
D) perception that condition is worse