Practice Test 2

Question 1

When should a child life specialist initiate a referral to an interdisciplinary member of the health care team?
a) When a child life specialist learns the patient does not have any siblings to support during hospitalization.
b)Once the health care team asks about a child life specialist’s observations, assessments and recommendations.
c) When professional limits and boundaries of the child life scope of practice have been recognized.
d) Once the patient has been assessed as developmentally delayed and non-verbal.

Answer 1

c) When professional limits and boundaries of the child life scope of practice have been recognized.

Question 2

A physician enters a room alone to obtain informed consent for an upcoming procedure from a family who, in handoff, has been reported to understand English but is primarily Spanish speaking. What should the child life specialist do next?
a) The child life specialist speaks to the physician afterwards questioning the family’s comprehension and is satisfied when told, “they’re fine with it”.
b) The child life specialist contacts interpretation services, in advocacy, to alert them that the family is currently meeting with the physician and is questioning their full comprehension of the consent.
c) The child life specialist inquires and is told that the physician speaks Spanish therefore no additional support or resources are needed.
d) The child life specialist discovers in the patient’s medical record that the family has consented in the past with assistance from an interpreter and therefore does not need to repeat the process.

Answer 2

b) The child life specialist contacts interpretation services, in advocacy, to alert them that the family is currently meeting with the physician and is questioning their full comprehension of the consent.

Question 3

Upon discharge from the hospital, a patient invites a child life specialist to come to his upcoming birthday party. The child life specialist explains why they cannot have a relationship with the patient outside of the hospital. The child life specialist is maintaining what type of relationship with the patient?
a) A casual professional relationship
b) A friendship
c) A therapeutic relationship
d) An over-involved relationship

Answer 3

c) A therapeutic relationship

Question 4

A child life specialist engages a patient in a therapeutic activity. During this activity, the child expresses fears about their upcoming surgery. Which of the following is the most appropriate way for a child life specialist to effectively communicate this child’s concerns to the care team?
a) Chart in the patient’s medical record
b) Inform the child life team
c) Encourage the patient to advocate for themselves
d) Consult the pediatric psychologist

Answer 4

a) Chart in the patient’s medical record

Question 5

Which of the following describes a child life specialist’s obligation to maintain confidentiality?
a) to be fair, impartial and equitable
b) to avoid or minimize harm and burden
c) to respect and protect the privacy of others
d) to recognize an individual as having unique worth

Answer 5

c) to respect and protect the privacy of others

Question 6

How long after a child is no longer a patient must a child life specialist wait until they can begin a personal relationship with the mother?
a) six months
b) one year
c) two years
d) three years

Answer 6

c) 2 years

Question 7

To ensure documentation about the intervention provided to a patient is comprehensive the chart note written by the child life specialist should contain
a) a diagnosis of a patient as being developmentally delayed.
b) a list of the family members t who were present engaged in the intervention.
c) details of the referrals to other disciplines made.
d) assessment information, plan of care and outcomes of care.

Answer 7

d) assessment information, plan of care and outcomes of care.

Question 8

Being a mandated reporter means that a child life specialist is required to
a) investigate the suspected abuse or neglect.
b) discuss parental responsibilities with the parent to ensure they understand their cultural expectations as a caregiver.
c) report the suspected abuse or neglect following hospital protocol, including documenting those steps taken.
d) tell your supervisor and allow them to report the suspected abuse or neglect.

Answer 8

c) report the suspected abuse or neglect following hospital protocol, including documenting those steps taken.

Question 9

A principal of evidence based practice is
a) incorporating cultural influences and spiritual preferences of patients and families.
b) including multidisciplinary members of the healthcare team.
c) conducting research to study the efficacy of new interventions.
d) integrating evidence from current research with professional expertise and patient preferences.

Answer 9

d) integrating evidence from current research with professional expertise and patient preferences.

Question 10

Which of the following behaviors may alert child life specialists that they may not be maintaining professional boundaries?
a) Feeling an exaggerated sense of responsibility for things beyond one’s control.
b) Setting realistic expectations of oneself.
c) Putting personal needs above the needs of others.
d) Embracing conflict and confrontation in a respectful manner.

Answer 10

a) Feeling an exaggerated sense of responsibility for things beyond one’s control.

Question 11

A child is separated briefly from a parent and upon return, the child is hesitant to interact with the parent. According to John Bowlby’s attachment theory, this is an example of
a) despair.
b) denial.
c) protest.
d) detachment.

Answer 11

d) detachment.

Question 12

Which theory best illustrates how a new diagnosis affects not only the patient, but also the entire family?
a) family systems theory
b) attachment theory
c) coping theory
d) psychosocial theory

Answer 12

a) family systems theory

Question 13

According to the Stress Potential Assessment Process, which health care variables would warrant the rating of a 5?
a) four-year-old nearing the end of his first admission for asthma who was a direct admit from the physician’s office with no ICU stay
b) A nine-year-old admitted the previous day for an elective surgery who has been provided preparation
c) A ten-year-old admitted to the Intensive Care Unit with Guillain-Barre Syndrome who is angry and rejecting everyone who enters the room
d) A six-year-old with cystic fibrosis who has been hospitalized in the past

Answer 13

c) A ten-year-old admitted to the Intensive Care Unit with Guillain-Barre Syndrome who is angry and rejecting everyone who enters the room

Question 14

Which model of assessment assigns a risk level score using eight variables that correlates with the potential risk of negative patient behaviors or outcomes during healthcare encounters?
a) Stress Potential Assessment Process
b) Psychosocial Risk Assessment in Pediatrics
c) Child Life Assessment Intervention Plan
d) Hawaii Early Learning Profile

Answer 14

b) Psychosocial Risk Assessment in Pediatrics (PRAP)

Question 15

How can a child life specialist promote positive coping and best practice for siblings of a child in the hospital?
a) Encourage parents to leave siblings at home.
b) Have siblings step out of the room during education/preparation done with the patient.
c) Allow siblings to participate in the patient’s care, including: attending playroom and being involved in education and coping plans made.
d) Provide brochures about sibling coping to parents to take home.

Answer 15

c) Allow siblings to participate in the patient’s care, including: attending playroom and being involved in education and coping plans made.

Question 16

While having a blood draw, a child elects to play iSpy with a child life specialist rather than watching the procedure. Which type of coping strategy is the child using?
a) sensory
b) cognitive
c) behavioral
d) reflexive

Answer 16

b) cognitive

Question 17

A child is observed to be playing “house” in the playroom. According to Jean Piaget’s cognitive theory, this child is demonstrating which developmental stage?
a) concrete operational
b) formal operational
c) sensorimotor
d) preoperational

Answer 17

d) Preoperational

Question 18

Using the Bronfenbrenner model of ecological systems, which layer represents community support to the patient and family?
a) microsystem
b) exosystem
c) mesosystem
d) macrosystem

Answer 18

c) mesosystem

Question 19

Applying the Stress Potential Assessment Process, a child life specialist would rate a patient who has a new leukemia diagnosis and bone marrow biopsy at what stress potential level?
a) 0
b) 1
c) 2
d) 3-5

Answer 19

d) 3-5

Question 20

According to Erik Erikson’s Theory of Psychosocial Development, what should a child life specialist consider during assessment and intervention planning for an 8-year-old patient with a new leg cast?
a) patient’s need for privacy
b) patient’s need for activities that allows for success
c) patient’s need for exploration of the environment
d) patient’s need for parent to meet physical needs

Answer 20

b) patient’s need for activities that allows for success

Question 21

Which of the following best describes an emotion-based coping strategy used in child life practice?
a)promote deep breathing
b) advocate for use of procedure/treatment room
c)provide developmentally appropriate information
d)promote problem solving strategies

Answer 21

a) promote deep breathing

Question 22

A child life specialist advocates for patient and family-centered care practices when considering this factor during assessment?
a) identify patient’s pain level
b) identify the caregiver responsible for decision-making
c) identify patient’s hobbies
d) identify patient and family’s cultural background

Answer 22

d) identify patient and family’s cultural background

Question 23

Adaptability, irritability, activity level, and approachability are characteristics of
a) emotions
b) temperament
c) conditions
d) self-awareness

Answer 23

b) temperament

Question 24

In clinical practice, a child life specialist who encourages patients and families to be the experts of their own family practices is building the foundation for what?
a) integration of theories into practice
b) culturally competent and spiritually supportive care
c) knowledge competencies and building rapport
d) planning interventions

Answer 24

b) culturally competent and spiritually supportive care

Question 25

The steps of cyclical child life process are the framework for quality and applying child life service delivery. These steps are
a) assessment, introduction, intervention, and evaluation.
b) evaluation, assessment, plan, and intervention.
c) assessment, plan, interventions, and evaluation.
d) introduction, plan, assess, and intervention.

Answer 25

c) assessment, plan, interventions, and evaluation.

Question 26

A family recently came to the United States for healthcare for their child from a country where fathers are the primary decision makers. The father is unable to be present during daily medical rounds. How can a child life specialist assess the family’s cultural needs and ensure they are being met?
a) Offer to provide teleconferencing services on rounds to allow the father to participate
b) Empower mother to make decisions about patient’s care
c) Encourage the team to push forward with their own plans for the patient
d) Call the patient advocate to serve as primary decision maker for family

Answer 26

a) Offer to provide teleconferencing services on rounds to allow the father to participate

Question 27

A 14- year old patient is struggling with the possible outcomes of the medical diagnosis and treatment plan affecting the future. This patient is experiencing an age appropriate response for Piaget’s stage of development known as
a) preoperational.
b) concrete operations.
c) formal operations.
d) initiative vs. guilt.

Answer 27

c) formal operations.

Question 28

As members of the healthcare team, how do child life specialists accurately and consistently share assessment information and care plans with other healthcare team members?
a) verbal report
b) secure text
c) documentation
d) voicemail

Answer 28

c) documentation

Question 29

A child’s stable pattern of behavior that does not change across time, activity type, and context is defined as
a) coping style.
b) temperament.
c) anxiety trait.
d) behavior pattern.

Answer 29

b) temperament

Question 30

Information from the family, information from the child and information from the healthcare team are all components of
a) development.
b) assessment.
c) therapeutic relationships.
d) communication styles.

Answer 30

b) assessment

Question 31

When a child pretends, imitates objects, or recreates events, they are exhibiting behaviors typically seen during what stage of Jean Piaget’s cognitive theory?
a) preoperational
b) trust vs. mistrust
c) mastery
d) associative play

Answer 31

a) Preoperational

Question 33

A child life specialist provides educational resources and collaborates with both the patient and caregiver to develop a daily medicine chart to support adherence. Which theory is applied in this child life intervention?
a) Family Systems Theory
b) Attachment Theory
c) Psychosocial Theory
d) Temperament Theory

Answer 33

a) Family Systems Theory

Question 34

When a person is internally having thoughts and feelings regarding a death, what are they experiencing?
a) bereavement
b) grief
c) mourning
d) shock

Answer 34

b) grief

Question 35

A child life specialist is working with two siblings of a patient dying. The family clearly communicates traditions and cultural beliefs of child presence surrounding end of life processes. The siblings briefly visit their brother at the bedside, and then go home with mother. The child life specialist should
a) Discuss with the parents that the siblings may cope better if they are allowed to stay with the family at the hospital.
b) Acknowledge and accept the family’s cultural beliefs of who should be present for the death of a child.
c) Contact the hospital ethics department for guidance.
d) Ask the hospital chaplain to come up with a way for the family to be able to be present together for the child’s death.

Answer 35

b) Acknowledge and accept the family’s cultural beliefs of who should be present for the death of a child.

Question 36

The child life specialist has scheduled a game of Uno for adolescent patients with similar diagnoses to encourage socialization among the group. This activity would be an example of
a) therapeutic play.
b) normalizing play.
c) parallel play.
d) onlooker play.

Answer 36

a) therapeutic play.

Question 37

What is the most effective age range for utilizing oral sucrose when doing a heel stick?
a) Approximately three months old and disappears after six months of age.
b) Two days old and disappears over the first six months of age.
c) Two days old and disappears around two years of age.
d) Approximately three months old and disappears around 18 months of age.

Answer 37

b) Two days old and disappears over the first six months of age.

Question 38

When is palliative care shown to be most effective?
a) When the patient is thought to have less than six months to live.
b) When the patient has been given a terminal diagnosis.
c) When the patient and family does not want death to occur at home.
d) When the patient has a life-limiting or ultimately terminal condition.

Answer 38

d) When the patient has a life-limiting or ultimately terminal condition.

Question 39

A child’s understanding that all living things eventually die is known as
a) causality.
b) non-functionality.
c) universality.
d) irreversibility.

Answer 39

c) universality

Question 40

To provide emotional support and increase a sense of connection and between parent(s), sibling(s), and the patient, the child life specialist may provide technology-based communication resources. This intervention applies which theory into child life practice?
a) Psychosocial development theory
b) Social learning theory
c) Cognitive development theory
d) Family systems theory

Answer 40

d) Family Systems Theory

Question 41

When a child life specialist is assessing coping on a 4-year-old patient with a newer port, the parent states “We just have to hold him down and get it done.” What is the most appropriate way for a child life specialist to proceed?
a) Respect the mother’s assessment and try to support the child as best as possible.
b) Wait outside of room until procedure is done, returning to help child de-escalate.
c) Stay in the room when port is accessed and observe the process and behaviors.
d) Discuss with mother benefits of comfort positions and uses of distraction.

Answer 41

d) Discuss with mother benefits of comfort positions and uses of distraction.

Question 42

Through her research in the late 1960’s, Elisabeth Kubler-Ross developed the widely accepted stages of grief. Dying adults tend to progress through the stages in what order?
a) anger, depression, bargaining, denial, acceptance
b) denial, depression, anger, bargaining, acceptance
c) denial, anger, bargaining, depression, acceptance
d) depression, bargaining, anger, denial, acceptance

Answer 42

c) denial, anger, bargaining, depression, acceptance

Question 43

A member of the multidisciplinary team calls a child life specialist to discuss an 8-year-old patient newly diagnosed with diabetes that is exhibiting uncooperative behavior at the time of insulin injections. Which healthcare play example best supports the patient’s coping needs?
a) onlooker
b) dramatic
c) group
d) parallel

Answer 43

b) dramatic

Question 44

During assessment, a 10-year-old patient with a sickle cell pain crisis states that she does not know why she needs to be in the hospital for her pain. Which is the most appropriate intervention that supports the patient’s understanding?
a) let the child sleep since they are receiving a lot of pain medications.
b) introduce the child to other patients with the same disease to engage in activity.
c) provide diagnosis education to help increase understanding of the disease and possible triggers for pain.
d) refer the patient to an outside support group.

Answer 44

c) provide diagnosis education to help increase understanding of the disease and possible triggers for pain.

Question 45

A 15-year-old patient prefers to be referred to using ‘she/her/hers’ pronouns; however, the patient’s sex is listed as male in the chart. The patient’s parents continue to refer to the patient using ‘he/his/him’ pronouns. How should the child life specialist proceed?
a) Strictly refer to the patient by the name listed in the medical chart.
b) Follow the parents’ lead and refer to the patient using ‘he/his/him’ pronouns.
c) Ask patient and family’s preference on how best to address patient’s name and gender.
d) Tell the patient you must call them by the pronoun that correlates with the sex listed in the medical chart.

Answer 45

c) Ask patient and family’s preference on how best to address patient’s name and gender.

Question 46

What is the difference between palliative care and hospice?
a) Palliative care is a broad philosophy of total and compassionate care provided in the hospital whereas hospice is provided in the patient’s home when cure is no longer possible
b) Palliative care extends the concept of care beyond connotation of hospice to include a longer time frame and broadens the scope to apply to other illnesses that are life limiting
c) Palliative care focuses on stopping medical technology support while hospice focuses on end-of-life and quality of life care for patient’s family
d) Palliative care encompasses a comprehensive and compassionate care, exclusive of prenatal and neonates, that meets the physical, social, psychological, and spiritual needs of child, youth, and adult patients and family

Answer 46

b) Palliative care extends the concept of care beyond connotation of hospice to include a longer time frame and broadens the scope to apply to other illnesses that are life limiting

Question 47

To best support a family through the death of their child a child life specialist should
a) make decisions for the family.
b) limit the family’s time at the bedside.
c) encourage the family to minimize sibling involvement.
d) provide opportunities for memory making and legacy work.

Answer 47

d) provide opportunities for memory making and legacy work.

Question 48

The type of grief expressed in advance when loss is perceived as inevitable is called
a) preemptive grief.
b) anticipatory grief.
c) sudden grief.
d) pronounced grief

Answer 48

b) anticipatory grief

Question 49

A child life specialist provides a variety of medical supplies. A 10-year-old child that has both hands in casts chooses to place casts on the paws of a stuffed animal. The type of play that is most likely to happen is
a) parallel play.
b) age appropriate play.
c) child-directed play.
d) spontaneous play.

Answer 49

c) child-directed play

Question 50

A pediatric resident enters the playroom to assess a preschool-age patient’s pain and listen to their lungs. The child life specialist should
a) allow the resident to make their assessment, as they are not doing anything invasive.
b) request the resident to come back after the play session has finished to not disrupt the play.
c) explain to the resident that the playroom is a ‘safe space’ and if an assessment must occur immediately the child would have to return to their room.
d) tell the resident that doctors are not allowed in the playroom, and ask them to leave.

Answer 50

c) explain to the resident that the playroom is a ‘safe space’ and if an assessment must occur immediately the child would have to return to their room.