Question 1

What is a priority nursing diagnosis for the preschool child with chronic illness?
A) Risk for delayed growth and development related to chronic illness or disability
B) Chronic pain related to frequent injections
C) Anticipatory grieving related to impending death
D) Anxiety related to frequent hospitalizations

Accepted Answer

For a preschool child with chronic illness, the priority nursing diagnosis would be related to the potential for delayed growth and development as a result of the illness or disability. This is a critical concern that should be monitored and addressed through appropriate interventions. While chronic pain, anticipatory grieving, and anxiety may also be concerns for the child, they are not necessarily the top priority in this context.

Question 2

The parents of a school-age child are told that their child is diagnosed with leukemia.As the nurse caring for this child,what is the expected first response of the parents to the diagnosis of chronic illness in their child?
A) Anger and resentment
B) Sorrow and depression
C) Shock and disbelief
D) Acceptance and adjustment

Accepted Answer

Shock and disbelief are commonly the first response of parents when their child is diagnosed with a chronic illness. This is a normal reaction to unexpected news and can lead to further emotional responses such as sadness, anger, and acceptance.

Question 3

What is the priority goal for the child with a chronic illness?
A) To maintain the intactness of the family
B) To eliminate all stressors
C) To achieve complete wellness
D) To obtain the highest level of wellness

Accepted Answer

The priority goal for a child with a chronic illness is to obtain the highest level of wellness possible. While maintaining intactness of the family and eliminating stressors are important, they are not the primary goal. Complete wellness may not be possible for a child with a chronic illness, but reaching the highest level of wellness is achievable and should be the focus of their care.

Question 4

What is the primary concern for the parents of a dying child?
A) Pain
B) Safety
C) Food intake
D) Fluid intake.

Accepted Answer

Pain management is a primary concern for parents of a dying child. It is important for the child's comfort and quality of life in their final moments.

Question 5

Identify the most appropriate nursing response to a parent who tells the nurse,"I don't want my child to know she is dying."
A) "I shall respect your decision. I won't say anything to your child."
B) "Don't you think she has a right to know about her condition?"
C) "Would you like me to arrange for the physician to speak with your child?"
D) "I'll answer any questions she asks me as honestly as I can."

Accepted Answer

The answer of Identify the most appropriate nursing response to...

Question 6

Families progress through various stages of reactions when a child is diagnosed with a chronic illness or disability.After the shock phase,a period of adjustment usually follows.This is often characterized by which response?
A) Denial
B) Guilt and anger
C) Social reintegration
D) Acceptance of child's limitations

Accepted Answer

After the shock phase, families often experience a period of adjustment characterized by emotions such as guilt and anger as they come to terms with the diagnosis.

Question 7

You are counseling the family of a 12-month-old child who has lost his mother in a car accident.How should you explain to the father what the child's understanding of death is,related to theories of growth and development?
A) Temporary
B) Permanent
C) Loss of caretaker
D) Punishment

Accepted Answer

The answer of You are counseling the family of a...

Question 8

What corresponds to a 5-year-old child's understanding of death?
A) Loss of a caretaker
B) Reversible and temporary
C) Permanent
D) Inevitable

Accepted Answer

Children in early childhood (2 to 7 years old)view death as reversible and temporary.Loss of a caretaker corresponds to the infant/toddler understanding of death.The school-age child and adolescent understand that death is permanent.The adolescent understands death not only as permanent but also inevitable.

Question 9

Which activity should the nurse implement for the toddler hospitalized with a chronic illness to promote autonomy?
A) Playing with a push-pull toy
B) Putting together a puzzle
C) Playing a simple card game
D) Watching cartoons on television

Accepted Answer

Giving the toddler a push-pull toy to play with encourages exploration and independence in movement, which promotes autonomy. Puzzle play and card games may require adult assistance, and watching television is a passive activity that does not encourage autonomy.

Question 10

The nurse comes into the room of a child who was just diagnosed with a chronic disability.The child's parents begin to yell at the nurse about a variety of concerns.The nurse's best response is
A) "What is really wrong?"
B) "Being angry is only natural."
C) "Yelling at me will not change things."
D) "I will come back when you settle down."

Accepted Answer

Parental anger after the diagnosis of a child with a chronic disability is a common response.One of the most common targets for parental anger is members of the staff.The nurse should recognize the common response of anger to the diagnosis and allow the family to ventilate.The other responses do not validate the parents' feelings and concerns and may hamper a therapeutic nurse-family relationship.

Question 11

How can chronic illness and frequent hospitalizations affect the psychosocial development of an adolescent?
A) They can lead to feelings of inadequacy.
B) They can interfere with parental attachment.
C) They can block the development of identity.
D) They can prevent the development of imagination.

Accepted Answer

Development of identity is the task of the adolescent.Inadequacy and inferiority refer to the school-age period.Parental attachment is a task of the infant.Development of imagination occurs in the preschool period.

Question 12

The nurse case manager is planning a care conference about a young child who has complex health care needs and will soon be discharged home.Who should the nurse invite to the conference?
A) Family and nursing staff
B) Social worker, nursing staff, and primary care physician
C) Family and key health professionals involved in the child's care
D) Primary care physician and key health professionals involved in the child's care

Accepted Answer

The family and key health professionals involved in the child's care should be invited to the care conference in order to ensure that everyone is on the same page and has a clear understanding of the child's care needs and plan for discharge. This would include the child's primary care physician, any specialists involved in their care, as well as nursing staff and any other relevant professionals. The social worker may also be invited if they have been involved in the child's care and can provide valuable input.

Question 13

What is the most appropriate response to a school-age child who asks if she can talk to her dying sister?
A) "You need to talk loudly so she can hear you."
B) "Holding her hand would be better because at this point she can't hear you."
C) "Although she can't hear you, she can feel your presence so sit close to her."
D) "Even though she will probably not answer you, she can still hear what you say to her."

Accepted Answer

Hearing is the last sense to cease before death.Talking to the dying child is important both for the child and the family.The sense of hearing is intact before death and there is no need to speak loudly.The sibling should be encouraged to speak to the child,as well as hold the child's hand.The sibling should be encouraged to sit close and speak to the dying child.

Question 14

What is an important focus of nursing care for the dying child and his or her family?
A) Nursing care should be organized to minimize contact with the child.
B) Adequate oral intake is crucial to the dying child.
C) Families should be made aware that hearing is the last sense to stop functioning before death.
D) It is best for the family if nursing care takes place during periods when the child is alert.

Accepted Answer

It is important for nursing care to address the holistic needs of the dying child and their family, which includes psychosocial, spiritual, and emotional support. A key aspect of this support is recognizing that hearing is often the last sense to go before death, so it is important to be mindful of what is said in the child's presence and to provide emotional support through verbal communication. Minimizing contact with the child, focusing solely on oral intake, or limiting nursing care to times when the child is alert are not appropriate or effective approaches to caring for a dying child and their family.

Question 15

How can chronic illness and frequent hospitalizations affect the psychosocial development of a toddler?
A) They can create a distortion or differentiation of self from parent.
B) They can interfere with the development of autonomy.
C) They can interfere with the acquisition of language, fine motor, and self-care skills.
D) They can create feelings of inadequacy.

Accepted Answer

Chronic illness may interfere in the development of autonomy,which is the major psychosocial task of the toddler.The infant with a chronic illness may have distortion of differentiation of self from parents.Chronic illness with frequent hospitalizations can inhibit the acquisition of language,motor,and self-care skills in the preschool-age child.Feelings of inadequacy and inferiority can occur if independence is compromised by chronic illness in the school-age child.

Question 16

Many parents who have children diagnosed with a chronic illness experience recurrent feelings of grief,loss,and fear related to the child's condition and loss of the ideal healthy child.The nurse recognizes this process as
A) Anticipatory grieving
B) Chronic sorrow
C) Bereavement
D) Illness trajectory

Accepted Answer

Chronic sorrow is a concept that describes the ongoing feelings of grief, loss, and fear experienced by parents of children diagnosed with chronic illnesses. It is different from anticipatory grieving, which refers to the process of grieving for a loss that has not yet occurred, and bereavement, which refers to the process of grieving after a death has occurred. Illness trajectory refers to the predicted course of a particular illness.

Question 17

An important nursing goal in caring for the hospitalized child is to minimize the negative effects of illness and hospitalization.On what should the nurse focus while caring for a hospitalized infant?
A) Bodily injury and pain
B) Separation from caregivers and fear of strangers
C) Loss of control and altered body image
D) The unknown and being left alone

Accepted Answer

The nurse should focus on the infant's fear of separation from caregivers and fear of strangers. Infants are not able to verbalize their needs or communicate effectively, so the absence of familiar caregivers can be particularly distressing to them. The nurse should prioritize comforting the infant and providing a consistent routine that imitates home as much as possible.

Question 18

The feeling of guilt that the child "caused" the disability or illness is especially critical in which child?
A) Toddler
B) Preschooler
C) School-age child
D) Adolescent

Accepted Answer

The feeling of guilt is most critical in preschoolers because they tend to have an egocentric view of the world and may believe that their actions or thoughts caused the disability or illness. It is important to reassure these children that they are not responsible and that the disability or illness is not their fault.

Question 19

Identify the most appropriate response for the nurse when parents say,"Living with this disease is really hard; it's not fair."
A) "Tell me about what is hard for you."
B) "I know exactly how you must feel."
C) "I know a local support group for families."
D) "I am going to ask the grief counselor to meet with you."

Accepted Answer

This response shows empathy and allows the parents to express their feelings and concerns. It also opens up a dialogue for the nurse to identify areas of support needed for the family. The other responses may come across as dismissive or premature without further assessment of the parents' needs.

Question 20

What is the predominant trait of the resilient family associated with chronic illness?
A) Social separation
B) Family flexibility
C) Family cohesiveness
D) Clear family boundaries

Accepted Answer

Family cohesiveness is the predominant trait of the resilient family associated with chronic illness. This means that the family members are united and supportive of one another in dealing with the illness. They work together to provide emotional, physical, and financial support to the chronically ill family member. This cohesiveness helps the family to navigate the challenges and stressors that come with chronic illness. Social separation, inflexibility, and unclear boundaries can all contribute to family dysfunction and make it more difficult to cope with chronic illness.

Quiz 36: The Child With a Chronic Condition or Terminal Illness

What is a priority nursing diagnosis for the preschool child with chronic illness?

The parents of a school-age child are told that their child is diagnosed with leukemia.As the nurse caring for this child,what is the expected first response of the parents to the diagnosis of chronic illness in their child?

What is the priority goal for the child with a chronic illness?

What is the primary concern for the parents of a dying child?

Identify the most appropriate nursing response to a parent who tells the nurse,"I don't want my child to know she is dying."

Families progress through various stages of reactions when a child is diagnosed with a chronic illness or disability.After the shock phase,a period of adjustment usually follows.This is often characterized by which response?

You are counseling the family of a 12-month-old child who has lost his mother in a car accident.How should you explain to the father what the child's understanding of death is,related to theories of growth and development?

What corresponds to a 5-year-old child's understanding of death?

Which activity should the nurse implement for the toddler hospitalized with a chronic illness to promote autonomy?

The nurse comes into the room of a child who was just diagnosed with a chronic disability.The child's parents begin to yell at the nurse about a variety of concerns.The nurse's best response is

How can chronic illness and frequent hospitalizations affect the psychosocial development of an adolescent?

The nurse case manager is planning a care conference about a young child who has complex health care needs and will soon be discharged home.Who should the nurse invite to the conference?

What is the most appropriate response to a school-age child who asks if she can talk to her dying sister?

What is an important focus of nursing care for the dying child and his or her family?

How can chronic illness and frequent hospitalizations affect the psychosocial development of a toddler?

Many parents who have children diagnosed with a chronic illness experience recurrent feelings of grief,loss,and fear related to the child's condition and loss of the ideal healthy child.The nurse recognizes this process as

An important nursing goal in caring for the hospitalized child is to minimize the negative effects of illness and hospitalization.On what should the nurse focus while caring for a hospitalized infant?

The feeling of guilt that the child "caused" the disability or illness is especially critical in which child?

Identify the most appropriate response for the nurse when parents say,"Living with this disease is really hard; it's not fair."

What is the predominant trait of the resilient family associated with chronic illness?