Deck 17: Nursing Care of the Child With a Life-Threatening Illness or Injury

Question 1

A six-year-old child is in the pediatric intensive care unit (PICU) with a fractured femur and head trauma. The child was not wearing a helmet while riding his new bicycle on the highway, and he collided with a car. The parents appear lost and unable to take in the medical discussion. Which nursing diagnosis is most appropriate for the parents of this child?

A)Parental role conflict related to child's wellness vs.illness
B)Guilt related to buying a bicycle for the child
C)Family coping: compromised, related to the critical injury of the child
D)Knowledge deficit home care of fractured femur

Answer 1

Family coping: compromised, related to the critical injury of the child

Question 2

The hospital recently changed its policy and now allows families members to be present during resuscitation of their child. The benefits expected from this policy change include: Standard Text: Select all that apply.

A)Positive patient outcomes increase due to the patient hearing family voices during the resuscitation.
B)Parents are reassured that everything possible is being done.
C)Professional behavior by the healthcare team improves.
D)Parental feelings of helplessness decrease.
E)Grieving and closure are facilitated.

Answer 2

Parents are reassured that everything possible is being done.
Professional behavior by the healthcare team improves.
Parental feelings of helplessness decrease.
Grieving and closure are facilitated.

Question 3

A young child is admitted to the hospital following a serious injury while on a field trip with his school class. When the parents arrive at the emergency room, the nurse recognizes that the parents have only limited English. The nurse will:

A)Speak slowly and clearly so the parents can understand.
B)Have a translator/interpreter present when the nurse and physician describe the child's condition to the parents.
C)Have a family member who speaks English translate for the family
D)Give the parents a pamphlet written in their primary language that describes the hospital routine.

Answer 3

Have a translator/interpreter present when the nurse and physician describe the child's condition to the parents.

Question 4

An adolescent with a gunshot wound presents to the emergency department with his distraught parents. He states that he saw a classmate shoot his teacher and several other students. As a result of the shooting incident, the nurse expects this adolescent to be at risk for which disorder?

A)Conduct disorder
B)Depression
C)Post-traumatic stress disorder
D)School phobia

Question 5

A new pediatric hospital is under development. A suggestion that has been shown to improve the psychological comfort of children in the Pediatric Intensive Care Unit would be:

A)Limiting the number of visitors to allow the child to rest.
B)Allowing the parents to visit every two hours for 10 to 15 minutes.
C)Planning all rooms to be two-patient rooms so each child will have another child for comfort and support.
D)Providing a bed for a parent to stay with the child in the PICU.

Question 6

An adolescent with cystic fibrosis is intubated with an endotracheal tube. Which is the most appropriate nursing diagnosis for the adolescent?

A)Impaired social interaction related to hospitalization and separation from peers
B)Delayed growth and development related to prolonged hospitalization and life-threatening condition
C)Powerlessness (moderate) related to inability to speak to or communicate
D)Potential for imbalanced nutrition, more than body requirements related to inactivity

Question 7

The nurse is caring for an eight-year-old child who has been in a car accident, has a head injury, and is in the ICU. The nurse sees the child pulling on the IV line. What action should the nurse take?

A)Sedate the child as needed.
B)Place soft wrist restraints on the child.
C)Ask the parents to watch the child closely at all times.
D)Tell the child not to pull on the IV line.

Question 8

A child has been comatose in the PICU for three days. The parents have been at the child's bedside or in the waiting room the entire time. Which statement by the nurse would be most helpful in promoting the parents to take a break?

A)"You've been here three days.It is time for you to go home and take a shower."
B)"Your child isn't aware you are here anyway, so why don't you take a break?"
C)"I'll be with your child, so go home and get a good nap."
D)"I know you are concerned and afraid to leave.If you'd like to take a short walk, you can leave me your cell phone number and I'll call you if there are any changes."

Question 9

In which settings is the nurse most likely to work with parents experiencing shock and disbelief related to the sudden onset of a life-threatening illness for their child? Standard Text: Select all that apply.

A)Emergency departments
B)Pediatric Intensive Care Unit
C)Operating room
D)Neonatal Intensive Care Unit
E)Pediatric cancer clinics

Question 10

Complementary activities that may reduce stress for the child and parents in the Pediatric Intensive Care Unit include: Standard Text: Select all that apply.

A)Prayer.
B)Maintaining silence in the PICU.
C)Maintaining a sterile-appearing hospital room.
D)Music playing softly.
E)Encouraging the parents to read age-appropriate books to the child.

Question 11

Twenty-four hours after being transferred from the pediatric intensive care unit to the regular pediatrics floor, the seven-year-old child is asked about his experience in the PICU. The child says he was not in the PICU but came directly to the floor from the ambulance ride. The nurse recognizes this is a coping behavior for the child known as:

A)Repression.
B)Regression.
C)Amnesia.
D)Developmental delay.

Question 12

A child is admitted to the PICU following an accident. The parents ask the nurse about bringing the siblings to visit. The nurse will meet with the siblings and the parents and: Standard Text: Select all that apply.

A)Describe the sights, sounds, and smells of the pediatric intensive care unit.
B)Provide a simple explanation of the other children being cared for in the PICU.
C)Explain the child's injuries in ways that are appropriate to the ages of the siblings.
D)Describe how the child looks.
E)Explain why the siblings will not be able to visit until the child has stabilized and is progressing.

Question 13

A premature infant is admitted to the Neonatal Intensive Care Unit. The infant is in critical condition, and the outcome is questionable. Nursing behaviors that will promote visitation include:

A)Explaining to the parents that everything possible is being done for their infant.
B)Smiling at the parents and making them welcome when they come to visit.
C)Allowing alone time with their infant when they visit.
D)Introducing the parents to the other parents visiting their babies.

Question 14

A baby is born at 32 weeks' gestation and is admitted to the NICU. After 4 difficult weeks, the child's condition has improved and survival seems guaranteed. The mother comes every day to feed the infant. Between feedings, the mother sits alone in the waiting room. The mother tells the nurse that she feels her life is in a holding pattern, not yet being a parent but no longer anticipating the excitement of the planned delivery. The nurse recognizes that the mother's reaction could be defined as:

A)Shock and disbelief.
B)Anticipatory waiting.
C)Readjustment.
D)Mourning.

Question 15

Following a tornado destroying the family home and injuring all family members, the four-year-old child is admitted to the Pediatric Intensive Care Unit. All other family members are hospitalized at a different hospital. The nursing staff can provide the four-year-old with a sense of security by:

A)Providing new toys for the child.
B)Asking a hospital volunteer to visit the child daily and stay as long as possible.
C)Explaining to the child that mom and dad also are sick and cannot come to visit.
D)Keeping the child's security blanket with the child at all times.

Question 16

A 16-year-old boy has a stiff neck, a headache, a fever of 103° Fahrenheit, and purpuric lesions on his legs. He is admitted to the hospital for treatment of suspected meningococcemia. Although the adolescent's physical needs take priority at the present time, the nurse can expect which of the following to be the most significant psychological stressor for this adolescent?

A)Fear of getting behind in schoolwork
B)Fear of painful procedures and bodily mutilation
C)Separation from friends and permanent changes in appearance
D)Separation from parents and home

Question 17

The nurse is taking care of a school-age child with 50% burns to the head and upper part of the body. The nurse recognizes that the most significant stressors for school-age children with life-threatening illness are: Standard Text: Select all that apply.

A)Painful and invasive procedures.
B)Fear of the medical team.
C)Disfigurement.
D)Separation from family.
E)Loss of self-control.

Question 18

The nurse is preparing a seriously ill child for a procedure. Which age group of children benefits most from being talked to, soothed, and touched during and after the procedure?

A)Preschoolers
B)School-age children
C)Adolescents
D)Toddlers

Question 19

In caring for a child with a life-threatening illness, the nurse should anticipate the parent's reaction to the child illness. Which response should the nurse anticipate the parent will experience? Standard Text: Select all that apply.

A)Anticipatory waiting
B)Post-traumatic stress disorder
C)Deprivation and loss
D)Anger and guilt
E)Readjustment and mourning

Question 20

A newborn is admitted to the neonatal intensive care unit (NICU). The parents are concerned because they cannot stay for long hours to visit. Which statement made by the nurse is most appropriate?

A)"Why can't you visit after work every day?"
B)"One of you could take a leave of absence to be here more."
C)"Perhaps the grandparents can make the visits for you."
D)"Parents often feel this way; you can call any time to see how your baby is doing."