NSG 434: Exam 3 Topics 5 and 6
questions and correct answers rated
A+
1. The nurse case manager is planning a care conference about a young child who has complex
health care needs and will soon be discharged home. Whom should the nurse invite to the
conference?
a. Family and nursing staff
b.Social worker, nursing staff, and primary care physician
c. Family and key health professionals involved in childs care
d.Primary care physician and key health professionals involved in childs care - correct answer
✔✔ ANS: C
A multidisciplinary conference is necessary for coordination of care for children with complex
health needs. The family and key health professionals who are involved in the childs care are
included. The nursing staff can address the nursing care needs of the child with the family, but
other involved disciplines must be included. The family must be included in the discharge
conferences, which allow them to determine what education they will require and the resources
needed at home. A member of the nursing staff must be included to review the nursing needs
of the child.
2. Lindsey, age 5 years, 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 that her disability
was so severe. The best interpretation of this situation is that:
a. This is a sign that 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 are used to having expectations that are too high. - correct answer ✔✔ ANS: B
,Parenting a child with a chronic illness can be very stressful for parents. There are anticipated
times that parental stress increases. One of these identified times is when the child begins
school. Nurses can help parents recognize and plan interventions to work through these
stressful periods. The parents are not in denial; they are responding to the childs placement in
school. The parents are not exhibiting signs of a knowledge deficit or expectations that are too
high; this is their first interaction with the school system with this child.
3. Approach behaviors are coping mechanisms that result in a familys movement toward
adjustment and resolution of the crisis of having a child with a chronic illness or disability. What
is considered an approach behavior in parents?
a. Are unable to adjust to a progression of the disease or condition
b.Anticipate future problems and seek guidance and answers
c. Look for new cures without a perspective toward possible benefit
d.Fail to recognize seriousness of childs condition despite physical evidence - correct answer
✔✔ ANS: B
The parents who anticipate future problems and seek guidance and answers are demonstrating
approach behaviors. They are demonstrating positive actions in caring for their child. Avoidance
behaviors include being unable to adjust to a progression of the disease or condition, looking
for new cures without a perspective toward possible benefit, and failing to recognize the
seriousness of the childs condition despite physical evidence. These behaviors would suggest
that the parents are moving away from adjustment or adaptation in the crisis of a child with
chronic illness or disability.
4. 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:
a. Denial.
b.Guilt and anger.
c. Social reintegration
d. Acceptance of childs limitations. - correct answer ✔✔ ANS: B
For most families, the adjustment phase is accompanied by several responses that are normally
part of the adjustment process. Guilt, self-accusation, bitterness, and anger are common
,reactions. The initial diagnosis of a chronic illness or disability often is often met with intense
emotion and characterized by shock and denial. Social reintegration and acceptance of the
childs limitations is the culmination of the adjustment process.
5. The nurse comes into the room of a child who was just diagnosed with a chronic disability.
The childs parents begin to yell at the nurse about a variety of concerns. The nurses best
response is:
a. What is really wrong?
b.Being angry is only natural.
c. Yelling at me will not change things.
d.I will come back when you settle down. - correct answer ✔✔ ANS: B
Parental anger after the diagnosis of a child with a chronic disability is a common response. One
of the most common targets for parental anger is members of the staff. The nurse should
recognize the common response of anger to the diagnosis and allow the family to ventilate.
What is really wrong? Yelling at me will not change things, and I will come back when you settle
down are all possible responses, but they are not the likely reasons for this anger.
6. A common parental reaction to a child with special needs is parental overprotection. Parental
behavior suggestive of this includes:
a. Giving inconsistent discipline.
b.Providing consistent, strict discipline.
c. Forcing child to help self, even when not capable.
d.Encouraging social and educational activities not appropriate to childs level of capability. -
correct answer ✔✔ ANS: A
Parental overprotection is manifested by the parents fear of letting the child achieve any new
skill, avoiding all discipline, and catering to the childs every desire to prevent frustration. The
overprotective parents usually do not set limits and or institute discipline, and they usually
prefer to remain in the role of total caregiver. They do not allow the child to perform self-care or
encourage the child to try new activities.
, 7. Most parents of children with special needs tend to experience chronic sorrow. This is
characterized by:
a. Lack of acceptance of the 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 and loss that occur in waves over time. - correct answer ✔✔
ANS: D
Chronic sorrow is manifested by feelings of sorrow and loss that recur in waves over time. The
sorrow is in response to the recognition of the childs limitations. The family should be assessed
in an ongoing manner to provide appropriate support as the needs of the family change. The
sorrow is not preventable. The chronic sorrow occurs during the reintegration and
acknowledgment stage.
8. Which intervention will encourage a sense of autonomy in a toddler with disabilities?
a. Avoiding separation from family during hospitalizations
b.Encouraging independence in as many areas as possible
c.Exposing child to pleasurable experiences as much as possible
d.Helping parents learn special care needs of their child - correct answer ✔✔ ANS: B
Encouraging the toddler to be independent encourages a sense of autonomy. The child can be
given choices about feeding, dressing, and diversional activities, which will provide a sense of
control. Avoiding separation from family during hospitalizations and helping parents learn
special care needs of their child should be practiced as part of family-centered care. They do not
particularly foster autonomy. Exposing the child to pleasurable experiences, especially sensory
ones, is a supportive intervention. It does not particularly support autonomy.
9. The feeling of guilt that the child caused the disability or illness is especially critical in which
child?
a. Toddler
b.Preschooler
c.School-age child
questions and correct answers rated
A+
1. The nurse case manager is planning a care conference about a young child who has complex
health care needs and will soon be discharged home. Whom should the nurse invite to the
conference?
a. Family and nursing staff
b.Social worker, nursing staff, and primary care physician
c. Family and key health professionals involved in childs care
d.Primary care physician and key health professionals involved in childs care - correct answer
✔✔ ANS: C
A multidisciplinary conference is necessary for coordination of care for children with complex
health needs. The family and key health professionals who are involved in the childs care are
included. The nursing staff can address the nursing care needs of the child with the family, but
other involved disciplines must be included. The family must be included in the discharge
conferences, which allow them to determine what education they will require and the resources
needed at home. A member of the nursing staff must be included to review the nursing needs
of the child.
2. Lindsey, age 5 years, 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 that her disability
was so severe. The best interpretation of this situation is that:
a. This is a sign that 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 are used to having expectations that are too high. - correct answer ✔✔ ANS: B
,Parenting a child with a chronic illness can be very stressful for parents. There are anticipated
times that parental stress increases. One of these identified times is when the child begins
school. Nurses can help parents recognize and plan interventions to work through these
stressful periods. The parents are not in denial; they are responding to the childs placement in
school. The parents are not exhibiting signs of a knowledge deficit or expectations that are too
high; this is their first interaction with the school system with this child.
3. Approach behaviors are coping mechanisms that result in a familys movement toward
adjustment and resolution of the crisis of having a child with a chronic illness or disability. What
is considered an approach behavior in parents?
a. Are unable to adjust to a progression of the disease or condition
b.Anticipate future problems and seek guidance and answers
c. Look for new cures without a perspective toward possible benefit
d.Fail to recognize seriousness of childs condition despite physical evidence - correct answer
✔✔ ANS: B
The parents who anticipate future problems and seek guidance and answers are demonstrating
approach behaviors. They are demonstrating positive actions in caring for their child. Avoidance
behaviors include being unable to adjust to a progression of the disease or condition, looking
for new cures without a perspective toward possible benefit, and failing to recognize the
seriousness of the childs condition despite physical evidence. These behaviors would suggest
that the parents are moving away from adjustment or adaptation in the crisis of a child with
chronic illness or disability.
4. 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:
a. Denial.
b.Guilt and anger.
c. Social reintegration
d. Acceptance of childs limitations. - correct answer ✔✔ ANS: B
For most families, the adjustment phase is accompanied by several responses that are normally
part of the adjustment process. Guilt, self-accusation, bitterness, and anger are common
,reactions. The initial diagnosis of a chronic illness or disability often is often met with intense
emotion and characterized by shock and denial. Social reintegration and acceptance of the
childs limitations is the culmination of the adjustment process.
5. The nurse comes into the room of a child who was just diagnosed with a chronic disability.
The childs parents begin to yell at the nurse about a variety of concerns. The nurses best
response is:
a. What is really wrong?
b.Being angry is only natural.
c. Yelling at me will not change things.
d.I will come back when you settle down. - correct answer ✔✔ ANS: B
Parental anger after the diagnosis of a child with a chronic disability is a common response. One
of the most common targets for parental anger is members of the staff. The nurse should
recognize the common response of anger to the diagnosis and allow the family to ventilate.
What is really wrong? Yelling at me will not change things, and I will come back when you settle
down are all possible responses, but they are not the likely reasons for this anger.
6. A common parental reaction to a child with special needs is parental overprotection. Parental
behavior suggestive of this includes:
a. Giving inconsistent discipline.
b.Providing consistent, strict discipline.
c. Forcing child to help self, even when not capable.
d.Encouraging social and educational activities not appropriate to childs level of capability. -
correct answer ✔✔ ANS: A
Parental overprotection is manifested by the parents fear of letting the child achieve any new
skill, avoiding all discipline, and catering to the childs every desire to prevent frustration. The
overprotective parents usually do not set limits and or institute discipline, and they usually
prefer to remain in the role of total caregiver. They do not allow the child to perform self-care or
encourage the child to try new activities.
, 7. Most parents of children with special needs tend to experience chronic sorrow. This is
characterized by:
a. Lack of acceptance of the 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 and loss that occur in waves over time. - correct answer ✔✔
ANS: D
Chronic sorrow is manifested by feelings of sorrow and loss that recur in waves over time. The
sorrow is in response to the recognition of the childs limitations. The family should be assessed
in an ongoing manner to provide appropriate support as the needs of the family change. The
sorrow is not preventable. The chronic sorrow occurs during the reintegration and
acknowledgment stage.
8. Which intervention will encourage a sense of autonomy in a toddler with disabilities?
a. Avoiding separation from family during hospitalizations
b.Encouraging independence in as many areas as possible
c.Exposing child to pleasurable experiences as much as possible
d.Helping parents learn special care needs of their child - correct answer ✔✔ ANS: B
Encouraging the toddler to be independent encourages a sense of autonomy. The child can be
given choices about feeding, dressing, and diversional activities, which will provide a sense of
control. Avoiding separation from family during hospitalizations and helping parents learn
special care needs of their child should be practiced as part of family-centered care. They do not
particularly foster autonomy. Exposing the child to pleasurable experiences, especially sensory
ones, is a supportive intervention. It does not particularly support autonomy.
9. The feeling of guilt that the child caused the disability or illness is especially critical in which
child?
a. Toddler
b.Preschooler
c.School-age child
