Question 1

The nurse is caring for an infant born with a congenital anomaly. Which of the following factors is likely to have the most influence on the mother's ability to cope with the infant's handicap?&#10;A) The mother's age&#10;B) The gender of the infant&#10;C) The parent's amount of support&#10;D) The fact that this is a mental and not a physical challenge

Accepted Answer

Availability of support people to help the mother cope with the infant's handicap will have a major influence. A family that has few close friends and lives some distance from relatives is apt to have more difficulty adjusting to illness in a child than a family that has close support people. People who can locate secondary support systems in their community usually do better than parents who are without these resources. The mother's age, gender of the infant, and type of handicap will not have the most influence on the mother's ability to cope with the infant's needs.

Question 2

The hospice nurse is planning a community program that emphasizes the 2020 National Health Goals to reduce long-term illness and early death in children. Which information should the nurse include in this program? (Select all that apply.)

A) Strategies to prevent unintentional injury
B) Seeking early prenatal care when pregnant
C) Following recommended immunization schedules
D) Supporting childhood physical activity expectations
E) Following recommended dietary intake requirements

Strategies to prevent unintentional injury
Seeking early prenatal care when pregnant
Following recommended immunization schedules

Accepted Answer

Nurses can help the nation achieve the 2020 National Health Goals to reduce long-term illness and early death in children by educating women to seek care during pregnancy so that congenital anomalies are less frequent and to teach unintentional injury prevention and the importance of immunizations so unintentional injuries and infectious diseases that can lead to long-term illness can be reduced. Physical activity expectations and dietary intake requirements are not strategies to achieve the 2020 National Health Goals to reduce long-term illness and early death in children.

Question 3

The community nurse is caring for a family who has a child with a long-term illness. At which point in life should the nurse anticipate the parents having the least difficult time accepting the child's condition?

A) On the child's first birthday
B) The day the child starts kindergarten
C) The day the child is toilet trained
D) The day the child would have graduated college

The day the child would have graduated college

Accepted Answer

A child's illness usually appears to be more acute at times when the child would normally reach developmental milestones. When the child does not reach these traditional milestones, it reminds parents about their child's illness in a particularly painful way. The first birthday, starting kindergarten, and being toilet trained are momentous occasions for families raising children. The family may or may not view attending college as a priority.

Question 4

The parents of a school-age child are informed that their child has muscular dystrophy and will be wheelchair bound going forward. Which nursing diagnosis should the nurse identify as appropriate for the parents at this time?

A) Hopelessness related to steady progression of child's disease
B) Interrupted family processes related to recent diagnosis of chronic illness in a child
C) Decisional conflict related to treatment options and choice of setting for child's final care
D) Risk for delayed growth and development related to lack of age-appropriate stimulation because of disability

Accepted Answer

Because the parents are just learning of the diagnosis of muscular dystrophy, this news will interrupt family processes. There is no enough information to determine if the parents are hopeless. The child is not diagnosed with a terminal illness. There is no enough information to determine if the child is at risk for delayed growth and development.

Question 5

The parents of a 6-year-old have just been told that their child will die shortly. At which age does the nurse realize that children are capable of understanding death?&#10;A) 3 years&#10;B) 6 years&#10;C) 9 years&#10;D) 12 years

Accepted Answer

As children near 8 or 9 years of age, they begin to appreciate that death is permanent. Younger children are not able to conceptualize the permanence of death. A 12-year-old child is able to conceptualize the permanence of death.

Question 6

A child who knows about a terminal disease tells the nurse of plans to recover and become a doctor to cure everyone in the whole world. What is the child demonstrating to the nurse?&#10;A) Anxiety about the illness&#10;B) Bargaining stage of grief&#10;C) Immature magical thinking&#10;D) Poor opinion of the care received

Accepted Answer

Bargaining, a stage of the grief process, is attempting to work out a deal to prevent death from occurring. This child is not demonstrating anxiety, immature thinking, or a poor opinion of the care that has been received.

Question 7

A terminally ill child is awake at 2 AM and continues to put on the call light. What should the nurse do regarding this child's behavior?&#10;A) Provide with a sleeping aid.&#10;B) Encourage the child to sleep.&#10;C) Sit with the child until sleep comes.&#10;D) Put on the television and dim the lights.

Accepted Answer

Many children assume that they will die at night. A child may talk more freely at night about fears or an unfulfilled life ambition than during the day. Children may also be more frightened at night and enjoy having someone sit beside them until they fall asleep. The nurse should not provide with a sleeping aid. Encouraging the child to sleep will not meet the child's needs at this time. Putting on the television with dim lights in the room will not meet the child's needs at this time.

Question 8

The nurse is caring for a preschool-age child who is aware of impending death. What behavior should the nurse expect the child to demonstrate at this time?&#10;A) Outbreaks of anger&#10;B) Verbalization of feelings&#10;C) Bargaining for another chance&#10;D) Fear of being separated from parents

Accepted Answer

Preschoolers fear separation. If able to grasp the concept of dying, this child's major worry is being alone and separated. These children may need someone to stay with them constantly to reassure them that they are loved and people are caring for them. Anger, verbalization of feelings, and bargaining are not behaviors typically associated with a preschool age-child who is facing death.

Question 9

The mother of a terminally ill child stays with the child day and night. Which statement indicates that the mother is in the chronic sorrow of depression stage?&#10;A) &#34;I will never accept that my child is dying.&#34;&#10;B) &#34;I know that there is nothing that can be done for my child.&#34;&#10;C) &#34;There must be another doctor somewhere than can help my child.&#34;&#10;D) &#34;I will go to church every week if this will keep my child from dying.&#34;

Accepted Answer

In the stage of depression, parents begin to face what is happening. They feel sad and unprotected. Some parents never reach the stage of acceptance and will always remain in the chronic sorrow of the depression stage. Saying that the child's dying will never be accepted indicates the chronic sorrow of depression stage. Knowing that nothing can be done for the child is acceptance. Looking for another doctor to help the child is the stage of anger. Going to church every week to prevent the child from dying is bargaining.

Question 10

The nurse is planning care to help young parents adjust to their newborn's long-term illness. Which assessment findings about the parents will help the nurse plan for their care? (Select all that apply.)

A) Parents belong to a local church.
B) Parents have strong ties with their parents and siblings.
C) Parents are strong in their marriage and frequently hold hands.
D) Parents state issues with having to spend time at the hospital instead of working.
E) Parents are overheard discussing the cost of the medical care and if insurance will cover it.

Accepted Answer

Factors that ease parental adjustment to a child's long-term illness include having a strong religious faith, having a good relationship with their parents, having support people available such as siblings, and having a good marital bond. Having concerns about missing work and having enough money for medical care are not findings that will help the parents adjust to their newborn's long-term illness.

Question 11

During a child's last stage of dying, the parents ask if the child is able to hear. What should the nurse respond to the parents?&#10;A) &#34;No, now that she is semicomatose, she is unable to hear you.&#34;&#10;B) &#34;No one really knows, so it is a good idea not to speak too loudly.&#34;&#10;C) &#34;Yes, she is able to hear and fully comprehend everything that is said.&#34;&#10;D) &#34;Yes, she can hear and may also understand most of what is being said.&#34;

Accepted Answer

The answer of During a child's last stage of dying,...

Question 12

The nurse notes that a chronically ill child has not been seeing the health care provider for several months, although monthly checkups and blood work are needed to help maintain the illness. What should the nurse realize as a reason for the child missing appointments?

A) The parents have been too busy to bring the child.
B) The family does not have the money to pay for multiple visits.
C) The child is afraid of having the blood drawn, so the parents do not bring him.
D) The parents are having a difficult time grieving with the idea of the child's illness.

Accepted Answer

The answer of The nurse notes that a chronically ill...

Question 13

The parents of a terminally ill child do not want the child dying in the hospital. What can the nurse suggest to help these parent's needs?&#10;A) Admit to a long-term care facility.&#10;B) Have hospice provided through home care.&#10;C) Discharge the child to home right before death.&#10;D) Have family stay with the child around-the-clock in the hospital.

Accepted Answer

The answer of The parents of a terminally ill child...

Question 14

During a home visit with a family, the nurse learns that the oldest adolescent son has been arrested for shoplifting and has been skipping school for months. Which information within the family's health history could help explain this child's behavior?

A) Father works out of the home.
B) Mother works out of the home.
C) Adolescent did not die as expected as a child.
D) Parents have other children that need time and attention.

Accepted Answer

The answer of During a home visit with a family,...

Question 15

The nurse caring for children on a pediatric oncology care area delays entering some of the children's rooms unless to provide medication or perform a procedure. Which stage of the grieving process is influencing this nurse's ability to provide patient care?

A) Anger
B) Denial
C) Bargaining
D) Depression

Accepted Answer

The answer of The nurse caring for children on a...

Deck 56: Nursing Care of a Family When a Child Has a Long-Term or Terminal Illness