Deck 43: The Child With a Life-Threatening Condition and End-Of-Life Care

Question 1

The nurse is working with a 3-year-old child in Bryant's traction for a fractured femur.A pain assessment scale,such as the Oucher scale,can be useful to the nurse caring for this child because the pain assessment scale:

A)Provides continuity and consistency in assessing and monitoring the child's pain.
B)Decreases anxiety in the child.
C)Increases the child's comfort level.
D)Reduces the child's fear of painful procedures.

Answer 1

Provides continuity and consistency in assessing and monitoring the child's pain.

Question 2

A 16-year-old boy has a stiff neck,headache,fever of 103ºF,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 psychological stressor to be the most significant for this adolescent?

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

Answer 2

Separation from friends and permanent changes in appearance

Question 3

The nurse must prepare parents to see their adolescent daughter in the Pediatric Intensive Care Unit (PICU).The child arrived by life flight after experiencing multiple traumas in a car accident involving a suspected drunk driver.At this time,which statement is most important for the nurse to make?

A)"Don't worry,everything will be okay.We will take excellent care of your child."
B)"You should press charges against the drunk driver."
C)"Your child's leg was crushed,and might have to be amputated."
D)"Your child's condition is very critical;her face is swollen,and she might not look like herself."

Answer 3

"Your child's condition is very critical;her face is swollen,and she might not look like herself."

Question 4

A 6-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 collided with a car.The nurse can expect which nursing diagnoses to apply to the parents of this child? Select all that apply.

A)Guilt related to lack of child supervision and safety precautions
B)Family coping: compromised,related to the critical injury of the child
C)Parental role conflict related to child's injuries and PICU policies
D)Knowledge deficit,home care of fractured femur
E)Anger related to feelings of helplessness

Question 5

The hospital nurses,after attending a conference on nursing burnout,discuss among themselves strategies to use when working with families of dying children.Which of the following would be helpful? Select all that apply.

A)Planning the child and family's care alone as the primary nurse
B)Participating in team decisions regarding the dying child's plan of care
C)Declining the family's invitation to attend the child's funeral
D)Participating in a mentoring relationship with experienced hospice nurses
E)Participating in support groups with mental health professionals

Question 6

The Emergency Department nurse is talking with a preschooler about the death of the child's parents in an airplane crash.The preschooler asks,"Can I talk to my mommy and daddy?" The nurse responds,"They were killed,and cannot talk to you anymore." However,the nurse realizes that preschoolers might:

A)Believe death is permanent.
B)Believe the parents will not come back home.
C)Engage in reality-based thinking.
D)Believe deaths are their fault.

Question 7

The parents of a 2-year-old child who sustained severe head trauma from falling out of a second-story window are arguing in the Pediatric Intensive Care Unit (PICU),and are blaming each other for the child's accident.Which is the best nursing diagnosis for this family?:

A)Parental role conflict related to protecting the child
B)Hopelessness related to the child's deteriorating condition
C)Anxiety related to the critical care unit environment
D)Family coping: compromised,related to the child's critical injury

Question 8

A school bus carrying children in grades K-12 crashed into a ravine.The critically injured children were transported by ambulance and admitted to the Pediatric Intensive Care Unit (PICU).The nurse is concerned about calming the frightened children.Which is the most effective nursing intervention to achieve this goal?

A)Tell the children that the physicians are competent.
B)Assure the children that the nurses are caring.
C)Explain that the PICU equipment is state-of-the-art.
D)Call the children's parents to come into the PICU.

Question 9

A 3-year-old child with severe head trauma is intubated and on a respirator.The child has three flat electroencephalograms (EEG)completed 24 hours apart.The electrocardiogram (EKG)shows a rate of 90 beats per minute in a normal sinus rhythm.Which of the following describes these findings?

A)Heart-lung death
B)Cerebral death
C)Imminent death
D)Natural death

Question 10

An adolescent experiencing status asthmaticus was rushed to the Emergency Department by ambulance.The parents arrive and ask to see their child.The triage nurse at the reception desk knows that the adolescent was pronounced dead on arrival.At this moment,the triage nurse's best intervention is to do which of the following?

A)Tell the parents that they must wait because only the doctor can talk with them.
B)Ask the parents to please take a seat in the waiting room.
C)Immediately escort the parents to a quiet,private room.
D)Immediately tell the parents,"I'm sorry,but your child didn't make it."

Question 11

The nurse caring for a child who is sedated,unconscious,and on a mechanical ventilator can expect to include which nursing intervention in the nursing care plan?

A)Active range-of-motion (ROM)exercises
B)Maintenance of intravenous (IV)hydration
C)Out-of-bed transfer to wheelchair
D)Whirlpool baths

Question 12

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

A)Potential for imbalanced nutrition,more than body requirements related to inactivity
B)Anxiety related to leaving chores undone at home
C)Potential for fear of future pain related to medical procedures
D)Powerlessness (moderate)related to inability to speak or communicate with friends

Question 13

A 12-year-old child with congenital heart block codes in the Emergency Department.The parents witness this and stare at the resuscitation scene unfolding before them.Which is the best nursing intervention in this situation?

A)Ask the parents to leave.
B)Ask the parents to help bag the child.
C)Ask the parents to sit near the child's face and hold his hand.
D)Ask the parents to stand at the foot of the cart to watch.

Question 14

The nurse is working with children in hospice care.The mother of a young child with cancer talks with the nurse about the future holiday celebrations she will miss with her child.The nurse assesses that the mother is experiencing:

A)Actual loss.
B)Anticipatory loss.
C)Perceived loss.
D)Loss.

Question 15

A 10-year-old child is transported to the Emergency Department by ambulance fro 3.His pulse,respirations,and blood pressure are stable,and his neck and back are immobilized on a backboard.The nurse sees no obvious bleeding.The child states," I can't move or feel my legs." What injury is most likely?m the scene of a car accident.He is alert and oriented ×

A)Traumatic brain injury
B)Ruptured spleen
C)Traumatic shock
D)Spinal cord injury