Chapter 17 - Chronic Illness

Question 1

What is the major health concern of children in the United States?

a. Acute illness
b. Chronic illness
c. Congenital disabilities
d. Nervous system disorders

Answer 1

b. Chronic illness

Question 2

What is a major premise of family-centered care?

a. The child is the focus of all interventions.
b. Nurses are the authorities in the childs care.
c. Parents are the experts in caring for their child.
d. Decisions are made for the family to reduce stress.

Answer 2

c. Parents are the experts in caring for their child.

Question 3

What should the nurse determine to be the priority intervention for a family with an infant who has a disability?

a. Focus on the childs disabilities to understand care needs.
b. Institute age-appropriate discipline and limit setting.
c. Enforce visiting hours to allow parents to have respite care.
d. Foster feelings of competency by helping parents learn the special care needs of the infant

Answer 3

d. Foster feelings of competency by helping parents learn the special care needs of the infant

Question 4

The potential effects of chronic illness or disability on a childs development vary at different ages. What developmental alteration is a threat to a toddlers normal development?

a. Hindered mobility
b. Limited opportunities for socialization
c. Childs sense of guilt that he or she caused the illness or disability
d. Limited opportunities for success in mastering toilet training

Answer 4

a. Hindered mobility

Question 5

A feeling of guilt that the child caused the disability or illness is especially common in which age group?

a. Toddler
b. Preschooler
c. School-age child
d. Adolescent

Answer 5

b. Preschooler

Question 6

What intervention is most appropriate for fostering the development of a school-age child with disabilities associated with cerebral palsy?

a. Provide sensory experiences.
b. Help develop abstract thinking.
c. Encourage socialization with peers.
d. Give choices to allow for feeling of control.

Answer 6

c. Encourage socialization with peers.

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. What should the nurse explain to his parents?

a. That he needs more discipline
b. That this is a normal part of adolescence
c. That he needs more socialization with peers
d. That this is how he is asking for more parental control

Answer 7

b. That this is a normal part of adolescence

Question 8

What nursing intervention is most appropriate in promoting normalization in a school-age child with a chronic illness?

a. Give the child as much control as possible.
b. Ask the childs peer to make the child feel normal.
c. Convince the child that nothing is wrong with him or her.
d. Explain to parents that family rules for the child do not need to be the same as for healthy siblings.

Answer 8

a. Give the child as much control as possible.

Question 9

The nurse observes that a seriously ill child passively accepts all painful procedures. The nurse should recognize that this is most likely an indication that the child is experiencing what emotional response?

a. Hopefulness
b. Chronic sorrow
c. Belief that procedures are a deserved punishment
d. Understanding that procedures indicate impending death

Answer 9

c. Belief that procedures are a deserved punishment

Question 10

The parents of a child born with disabilities ask the nurse for advice about discipline. The nurses response should be based on remembering that discipline is which?

a. Essential for the child
b. Not needed unless the childs behavior becomes problematic
c. Best achieved with punishment for misbehavior
d. Too difficult to implement with a special needs child

Answer 10

a. Essential for the child

Question 11

Parents ask for help for their other children to cope with the changes in the family resulting from the special needs of their sibling. What strategy does the nurse recommend?

a. Explain to the siblings that embarrassment is unhealthy.
b. Encourage the parents not to expect siblings to help them care for the child with special needs.
c. Provide information to the siblings about the childs condition only as requested.
d. Invite the siblings to attend meetings to develop plans for the child with special needs.

Answer 11

d. Invite the siblings to attend meetings to develop plans for the child with special needs.

Question 12

What nursing intervention is especially helpful in assessing feelings of parental guilt when a disability or chronic illness is diagnosed?

a. Ask the parents if they feel guilty.
b. Observe for signs of overprotectiveness.
c. Talk about guilt only after the parents mention it.
d. Discuss the meaning of the parents religious and cultural background.

Answer 12

d. Discuss the meaning of the parents religious and cultural background.

Question 13

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 what response?

a. Denial
b. Guilt and anger
c. Social reintegration
d. Acceptance of the childs limitations

Answer 13

b. Guilt and anger

Question 14

What manifestation observed by the nurse is suggestive of parental overprotective?

a. Gives inconsistent discipline
b. Facilitates the childs responsibility for self-care of illness
c. Persuades the child to take on activities of daily living even when not able
d. Encourages social and educational activities not appropriate to the childs level of capability

Answer 14

a. Gives inconsistent discipline

Question 15

What finding by the nurse is most characteristic of chronic sorrow?

a. Lack of acceptance of childs limitation
b. Lack of available support to prevent sorrow
c. Periods of intensified sorrow when experiencing anger and guilt
d. Periods of intensified sorrow at certain landmarks of the childs development

Answer 15

d. Periods of intensified sorrow at certain landmarks of the childs development

Question 16

A 5-year-old child will be starting kindergarten next month. She has cerebral palsy, and it has been determined that she needs to be in a special education classroom. Her parents are tearful when telling the nurse about this and state that they did not realize her disability was so severe. What is the best interpretation of this situation?

a. This is a sign the parents are in denial.
b. This is a normal anticipated time of parental stress.
c. The parents need to learn more about cerebral palsy.
d. The parents expectations are too high.

Answer 16

b. This is a normal anticipated time of parental stress.

Question 17

The nurse notes that the parents of a critically ill child spend a large amount of time talking with the parents of another child who is also seriously ill. They talk with these parents more than with the nurses. How should the nurse interpret this situation?

a. Parent-to-parent support is valuable.
b. Dependence on other parents in crisis is unhealthy.
c. This is occurring because the nurses are unresponsive to the parents.
d. This has the potential to increase friction between the parents and nursing staff.

Answer 17

a. Parent-to-parent support is valuable.

Question 18

The nurse is talking to the parent of a child with special needs. The parent has expressed worry about how to support the siblings at home. What suggestion is appropriate for the nurse to
give to the parent?

a. You should help the siblings see the similarities and differences between themselves and your child with special needs.

b. You should explain that your child with special needs should be included in all activities that the siblings participate in even if they are reluctant.

c. You should give the siblings many caregiving tasks for your child with special needs so the siblings feel involved.

d. You should intervene when there are differences between your child with special needs and the siblings.

Answer 18

a. You should help the siblings see the similarities and differences between themselves and your child with special needs.