Chapter 36 The Child with a Chronic Condition or Terminal Illness

Chapter 36  The Child with a Chronic Condition or Terminal Illness

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. 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

ANS: C
According to Kübler-Ross, denial is the initial stage of the grieving process when an
individual reacts with shock and disbelief to the diagnosis of chronic illness. The other
responses are also part of the grieving process although not usually the initial response.

PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 803 OBJ: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity

2. A nurse is caring for a dying child. What action by the nurse best meets the the primary

concern of the parents?
a. Giving the child pain medication on a schedule
b. Placing the child on fall and safety precautions
c. Providing the child with favorite foods when requested
d. Ensuring the child gets the minimum fluid requirement

ANS: A
The primary concern of all parents of dying children is the possibility of their child feeling
pain. The nurse works vigilantly to assess and treat the child’s pain. The other options are
also important considerations but usually not the priority concern.

PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 815 OBJ: Nursing Process: Implementation
MSC: Client Needs: Physiologic Integrity

3. In order to minimize the negative effects of illness and hospitalization on an infant, the

nurse focuses care on which of the following?
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

ANS: B

The major fear of infants during illness and hospitalization are separation from caregivers
and fear of strangers. Bodily injury and pain are fears of preschool and school-age children.
Loss of control is a fear of children from the preschool period through adolescence. Altered
body image applies to adolescents. Fear of the unknown and being left alone are applicable
to preschoolers.

PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 805 | Box 36.2 OBJ: Nursing Process: Planning
MSC: Client Needs: Psychosocial Integrity

4. 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

ANS: B
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.

PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 811 | Table 36.1 OBJ: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity

5. The nurse is 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

ANS: C
Infants and toddlers view death as loss of a caretaker. The preschool-age child views death
as temporary. The school-age child and adolescent understand the permanence of death. The
preschool-age child facing impending death may view his or her condition as punishment
for behaviors or thoughts.

PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 811 | Table 36.1 OBJ: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity