Deck 12: The Child With a Chronic Condition

Question 1

The nurse can instruct parents to expect children in which age group to begin to assume more independent responsibility for their own management of a chronic condition, such as blood-glucose monitoring, insulin administration, intermittent self-catheterization, and appropriate inhaler use?
1) Toddlers
2) Preschool-age
3) School-age
4) Adolescents

Answer 1

3

Question 2

In working with parents of children with chronic diseases, the nurse is concerned with helping the parents to protect themselves from compassion fatigue. Which activities are appropriate for the nurse to encourage? Select all that apply.
1) Sleeping more than 9 hours per 24-hour period
2) Exercising
3) Fostering social relationships
4) Developing a hobby
5) Moving away

Answer 2

2, 3, 4

Question 3

The nurse is planning care for a preschool-age client who has cerebral palsy (CP). Which interventions are appropriate for this client? Select all that apply.
1) Providing heath supervision
2) Collaborating with physical therapy
3) Assisting with planning educational services
4) Prescribing medication for spasticity
5) Promoting growth and development

Answer 3

1, 2, 3, 5

Question 4

The school nurse completes an assessment of a school-age client to determine the services this child will need in the classroom. The client is a newly diagnosed with type I diabetes mellitus. Based on this information, which special healthcare need category is the most appropriate?
1) Dependent on medication or special diet
2) Dependent on medical technology
3) Increase use of healthcare services
4) Functional limitations

Question 5

The nurse is working with a group of parents who have children with chronic conditions. Which statement by a parent would indicate a risk for a caregiver burden that could become overwhelming?
1) "My mother moved in and helped us take our quadruplets home."
2) "Our health insurance sent us a rejection letter for my child's brand-name medication, and we must fill out forms to get the generic."
3) "I chose to quit my job to be home with my child, and my husband helps in the evening when he can."
4) "I have to care for my child day and night, which leaves little time for me."

Question 6

At the conclusion of teaching parents about cerebral palsy, the nurse asks, "What is your hope for your toddler with cerebral palsy?" Which reply from a parent best indicates an understanding of a realistic achievement for the child?
1) "I hope my child qualifies for the Winter Olympics like I did."
2) "I hope my child just enjoys life."
3) "I hope my child will attend our neighborhood school."
4) "I hope my child is liked and accepted by other children."

Question 7

The nurse is working with a child with a chronic condition. The nurse observes that over time, the parents have experienced a pattern of periodic grieving alternating with denial. What are the parents currently experiencing based on this assessment finding?
1) Chronic sorrow
2) Compassion fatigue
3) Dysfunctional parenting
4) Pathological grieving

Question 8

The clinic nurse is working with a child with multiple disabilities. The parents have asked the nurse to help them in meeting with the school board to develop an Individualized Education Plan (IEP) and an Individualized Health Plan (IHP). Which nursing intervention is most appropriate?
1) Providing a written list of the child's medical diagnoses for the IEP meeting.
2) Offering to wait with the child while the parents attend the IEP meeting.
3) Listening to the parents' concerns and complaints about the school district.
4) Presenting verbally the child's cognitive, physical, and social skills to school officials at the IEP meeting.

Question 9

Which stressor is common in the hospitalized toddler with a chronic disorder? Select all that apply.
1) Fear of painful procedures
2) Self-concept
3) Interruption of normal routines
4) Unfamiliarity of caregivers
5) Isolation

Question 10

There are many healthcare needs of children with chronic conditions. What nursing strategy would best help parents with continuity of care?
1) Include the family and older child in decision making.
2) Assist the family in gaining transportation to healthcare appointments.
3) Provide the family with resources such as social services.
4) Recognize and respect the cultural needs of the family.

Question 11

The nurse is planning activities for a toddler with a birth injury of a torn brachial plexus that resulted in muscle atrophy and weakness of his right arm. Which nursing intervention is most appropriate for this client?
1) Offering the toddler a choice of clothing
2) Asking the toddler if he would like to take his medicine
3) Dressing the toddler
4) Feeding the toddler

Question 12

A family actively participates in school functions. One of the children is paraplegic and requires a wheelchair for mobility. Which process does the nurse determine the family is working on based on these assessment findings?
1) Stagnation
2) Normalization
3) Isolation
4) Interaction

Question 13

The nurse has set up a group discussion for several families with chronically ill children. The nurse informs these parents that they may face which ethical issue?
1) Normalization
2) Withholding and refusal of treatment
3) Repeated hospital admissions
4) Lack of proper dietary needs

Question 14

The nurse in the long-term care clinic is reviewing the charts of a group of children with chronic physical, psychological, functional, and social limitations. Which conditions are most likely to lead to chronic limitations? Select all that apply.
1) Near drowning
2) Congenital heart defect
3) Sinusitis
4) Fetal insult when the mother contracted rubella in the first trimester of pregnancy
5) Sepsis contracted as a neonate

Question 15

A 5-year-old sibling of a 9-year-old child with cystic fibrosis tells the nurse, "I wish I had a breathing disease, too." The nurse knows the parents strive to spend quality time with each child and with both children together. What is the sibling currently experiencing?
1) Jealousy
2) Isolation
3) Loneliness
4) Anger

Question 16

The nurse is working in an adolescent medical clinic. What can the nurse anticipate when comparing adolescents in the clinic with chronic conditions to their peers?
1) A high level self-esteem
2) A concern for their parents
3) An altered body image
4) A decreased concern about their appearance

Question 17

It is important that parents of adolescents with special needs transition care of the adolescent so they can learn to make good decisions on their own. Which items are considered transitional needs? Select all that apply.
1) Attending school
2) Discussing sexual matters
3) Letting most friends know of the medical condition
4) Socialization beyond the family
5) To write his or her own individualized healthcare plan