Question 1

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 of the following is an important consideration at this time?

Accepted Answer

Including the family in the decision-making process is crucial when shifting the focus of treatment from cure to palliation, ensuring that their values, preferences, and concerns are considered.

Question 2

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

Accepted Answer

School-age children often show a keen interest in the rituals surrounding death, such as funerals and burials, as part of their process of understanding and coping with death.

Question 3

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

Terminally ill children often have an intrinsic understanding of the severity of their condition, even if not explicitly told. It's important for caregivers and healthcare professionals to acknowledge this awareness and provide appropriate support and information tailored to the child's level of understanding and emotional readiness.

Question 4

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

Being available to the family offers emotional support and a sense of security during a difficult time, acknowledging their need for presence and understanding without imposing any specific way of coping or grieving.

Question 5

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 should do which of the following?

Accepted Answer

Allowing parents to spend time with their child after death is an important part of the grieving process. It helps them to begin to accept the reality of the loss.

Question 6

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

Accepted Answer

Limiting care to essentials minimizes unnecessary disturbances, allowing the child to rest more comfortably and reducing stress for both the child and family during the final moments.

Question 7

A 16-year-old boy with a chronic illness has recently become rebellious and is taking risks such as missing doses of his medication. The nurse should explain to his parents that:

Accepted Answer

This behavior can be part of normal adolescence, where teenagers often test boundaries and assert their independence, even in the context of managing a chronic illness.

Question 8

A preschooler is found digging up a pet bird that was recently buried after it died. The best explanation for this behavior is which of the following?

Accepted Answer

This behavior is typical of a preschooler's understanding of death, which is often not fully comprehended. They may think of death as temporary or reversible, hence the child might be checking if the pet might come back or has gone somewhere else. Reassurance about the permanence of death in a gentle, age-appropriate manner is often needed rather than assuming a pathological issue or misunderstanding about ghosts.

Question 9

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 doing which of the following?

Accepted Answer

The nurse's statement, "We will miss him so much," is an expression of personal feelings of loss, indicating empathy and shared sorrow with the mother over the child's death. This helps in validating the mother's feelings and shows that the healthcare staff also cared for the child.

Question 10

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

Accepted Answer

Palliative care is a multidisciplinary approach focusing on providing patients with relief from the symptoms, pain, and stress of a serious illness, regardless of the diagnosis. It aims to improve quality of life for both the patient and the family, emphasizing symptom control and support rather than curative treatments.

Question 11

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

Accepted Answer

The answer of At what developmental period do children have...

Question 12

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

Accepted Answer

By the ages of 9 to 11, most children have developed an adult concept of death, understanding that it is inevitable, universal, and irreversible.

Question 13

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

Accepted Answer

Preschoolers may feel guilty and responsible for the death due to their egocentric thinking, believing their thoughts or actions might have caused it.

Question 14

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 which of the following?

Accepted Answer

These symptoms are normal grief responses, indicating that the parents are experiencing a natural reaction to the loss of their child. Grief can manifest in various ways, including auditory hallucinations of the deceased's voice, sleep disturbances, feelings of emptiness, and depression. The process and duration of grief vary greatly among individuals, and there is no standard timeline for when one should start feeling better.

Quiz 18: Chronic Illness, Disability, or End-Of-Life Care for the Child and Family