WONGS ESSENTIALS OF PEDIATRIC NURSING 10TH EDITION HOCKENBERRY TEST BANK
Chapter 17: Quality of Life for Children Living with Chronic and Complex Diseases
Hockenberry: Wong’s Essentials of Pediatric Nursing, 10th Edition
MULTIPLE CHOICE
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. Who 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 the child’s care
d. Primary care physician and key health professionals involved in the child’s care
ANS: C
A multidisciplinary conference is necessary for coordination of care for children with complex
health needs. The family is included, along with key health professionals who are involved in
the child’s care. The nursing staff can address the child’s nursing care needs with the family,
but other involved disciplines must be included. The family must be included in the discharge
conferences, which allows 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
child’s nursing needs.
DIF: Cognitive Level: Analyze REF: p. 501
TOP: Integrated Process: Nursing Process: Planning
MSC: Area of Client Needs: Safe and Effective Care Environment: Management of Care
NURSINGTB.COM
2. Which represents a common best practice in the provision of services to children with special
needs?
a. Care is now being focused on the child’s chronologic age.
b. Children with special needs are being integrated into regular classrooms.
c. Children with special needs no longer have to be cared for by their families.
d. Children with special needs are being separated into residential treatment facilities.
ANS: B
Normalization refers to behaviors and interventions for the disabled to integrate into society
by living life as persons without a disability would. For children, normalization includes
attending school and being integrated into regular classrooms. This affords the child the
advantages of learning with a wide group of peers. Care is necessarily focused on the child’s
developmental age. Home care by the family is considered best practice. The nurse can assist
families by assessing social support systems, coping strategies, family cohesiveness, and
family and community resources.
DIF: Cognitive Level: Understand REF: p. 502
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Safe and Effective Care Environment: Management of Care
3. 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 her disability was so
severe. What is the best interpretation of this situation?
NURSINGTB.COM
, WONGS ESSENTIALS OF PEDIATRIC NURSING 10TH EDITION HOCKENBERRY TEST BANK
a. This is a sign 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
ANS: B
Parenting a child with a chronic illness can be 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 child’s placement in
school. The parents are not exhibiting signs of a knowledge deficit; this is their first
interaction with the school system with this child.
DIF: Cognitive Level: Analyze REF: p. 517
TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Psychosocial Integrity
4. Approach behaviors are those coping mechanisms that result in a family’s movement toward
adjustment and resolution of the crisis of having a child with a chronic illness or disability.
Which is considered an approach behavior?
a. Is unable to adjust to a progression of the disease or condition
b. Anticipates future problems and seeks guidance and answers
c. Looks for new cures without a perspective toward possible benefit
d. Fails to recognize the seriousness of the child’s condition despite physical
evidence
ANS: B
The parents who anticipate futureNURSINGTB.COM
problems and seek guidance and answers are demonstrating
approach behaviors. They are demonstrating positive actions in caring for their child. 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 a child’s
condition despite physical evidence are avoidance behaviors. The parents are moving away
from adjustment (and toward maladaptation) in the crisis of a child with chronic illness or
disability.
DIF: Cognitive Level: Understand REF: p. 506
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Psychosocial Integrity
5. 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 which of the following responses?
a. Denial
b. Guilt and anger
c. Social reintegration
d. Acceptance of the child’s limitations
ANS: B
NURSINGTB.COM
, WONGS ESSENTIALS OF PEDIATRIC NURSING 10TH EDITION HOCKENBERRY TEST BANK
For most families, the adjustment phase is accompanied by several responses. Guilt,
self-accusation, bitterness, and anger are common reactions. The initial diagnosis of a chronic
illness or disability often is met with intense emotion, characterized by shock and denial.
Social reintegration and acceptance of the child’s limitations are the culmination of the
adjustment process.
DIF: Cognitive Level: Understand REF: p. 506
TOP: Integrated Process: Nursing Process: Planning
MSC: Area of Client Needs: Psychosocial Integrity
6. Which nursing intervention is especially helpful in assessing parental guilt when a disability
or chronic illness is diagnosed?
a. Ask the parents if they feel guilty.
b. Discuss guilt only after the parents mention it.
c. Discuss the meaning of the parents’ religious and cultural background.
d. Observe for signs of overprotectiveness.
ANS: C
Guilt may be associated with cultural or religious beliefs. Some parents are convinced that
they are being punished for some previous misdeed. Others may see the disorder as a sacrifice
sent by God to test their religious beliefs. The nurse can help the parents explore their
religious beliefs. The parents may not be able to identify the feelings of guilt. It would be
appropriate for the nurse to explore their adjustment responses. Overprotectiveness is a
parental response during the adjustment phase. The parents fear letting the child achieve any
new skill and avoid all discipline.
DIF: Cognitive Level: Apply REF: p. 506
NURSINGTB.COM
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Psychosocial Integrity
7. The nurse observes that a seriously ill child passively accepts all painful procedures. What
should the nurse recognize this child is most likely experiencing?
a. A sense of hopefulness
b. A sense of chronic sorrow
c. A belief that procedures are a deserved punishment
d. A belief that procedures are an important part of care
ANS: C
The nurse should be particularly alert to the child who passively accepts all painful
procedures. This child may believe that such acts are inflicted as deserved punishment. The
child who is hopeful is mobilized into goal-directed actions. This child would actively
participate in care. Chronic sorrow is the feeling of sorrow and loss that recurs in waves over
time. It is usually evident in the parents, not in the child. A child who believes that procedures
are an important part of care would actively participate in care. Nursing interventions should
be used to minimize the pain.
DIF: Cognitive Level: Analyze REF: p. 507
TOP: Integrated Process: Nursing Process: Diagnosis
MSC: Area of Client Needs: Psychosocial Integrity
NURSINGTB.COM
Chapter 17: Quality of Life for Children Living with Chronic and Complex Diseases
Hockenberry: Wong’s Essentials of Pediatric Nursing, 10th Edition
MULTIPLE CHOICE
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. Who 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 the child’s care
d. Primary care physician and key health professionals involved in the child’s care
ANS: C
A multidisciplinary conference is necessary for coordination of care for children with complex
health needs. The family is included, along with key health professionals who are involved in
the child’s care. The nursing staff can address the child’s nursing care needs with the family,
but other involved disciplines must be included. The family must be included in the discharge
conferences, which allows 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
child’s nursing needs.
DIF: Cognitive Level: Analyze REF: p. 501
TOP: Integrated Process: Nursing Process: Planning
MSC: Area of Client Needs: Safe and Effective Care Environment: Management of Care
NURSINGTB.COM
2. Which represents a common best practice in the provision of services to children with special
needs?
a. Care is now being focused on the child’s chronologic age.
b. Children with special needs are being integrated into regular classrooms.
c. Children with special needs no longer have to be cared for by their families.
d. Children with special needs are being separated into residential treatment facilities.
ANS: B
Normalization refers to behaviors and interventions for the disabled to integrate into society
by living life as persons without a disability would. For children, normalization includes
attending school and being integrated into regular classrooms. This affords the child the
advantages of learning with a wide group of peers. Care is necessarily focused on the child’s
developmental age. Home care by the family is considered best practice. The nurse can assist
families by assessing social support systems, coping strategies, family cohesiveness, and
family and community resources.
DIF: Cognitive Level: Understand REF: p. 502
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Safe and Effective Care Environment: Management of Care
3. 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 her disability was so
severe. What is the best interpretation of this situation?
NURSINGTB.COM
, WONGS ESSENTIALS OF PEDIATRIC NURSING 10TH EDITION HOCKENBERRY TEST BANK
a. This is a sign 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
ANS: B
Parenting a child with a chronic illness can be 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 child’s placement in
school. The parents are not exhibiting signs of a knowledge deficit; this is their first
interaction with the school system with this child.
DIF: Cognitive Level: Analyze REF: p. 517
TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Psychosocial Integrity
4. Approach behaviors are those coping mechanisms that result in a family’s movement toward
adjustment and resolution of the crisis of having a child with a chronic illness or disability.
Which is considered an approach behavior?
a. Is unable to adjust to a progression of the disease or condition
b. Anticipates future problems and seeks guidance and answers
c. Looks for new cures without a perspective toward possible benefit
d. Fails to recognize the seriousness of the child’s condition despite physical
evidence
ANS: B
The parents who anticipate futureNURSINGTB.COM
problems and seek guidance and answers are demonstrating
approach behaviors. They are demonstrating positive actions in caring for their child. 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 a child’s
condition despite physical evidence are avoidance behaviors. The parents are moving away
from adjustment (and toward maladaptation) in the crisis of a child with chronic illness or
disability.
DIF: Cognitive Level: Understand REF: p. 506
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Psychosocial Integrity
5. 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 which of the following responses?
a. Denial
b. Guilt and anger
c. Social reintegration
d. Acceptance of the child’s limitations
ANS: B
NURSINGTB.COM
, WONGS ESSENTIALS OF PEDIATRIC NURSING 10TH EDITION HOCKENBERRY TEST BANK
For most families, the adjustment phase is accompanied by several responses. Guilt,
self-accusation, bitterness, and anger are common reactions. The initial diagnosis of a chronic
illness or disability often is met with intense emotion, characterized by shock and denial.
Social reintegration and acceptance of the child’s limitations are the culmination of the
adjustment process.
DIF: Cognitive Level: Understand REF: p. 506
TOP: Integrated Process: Nursing Process: Planning
MSC: Area of Client Needs: Psychosocial Integrity
6. Which nursing intervention is especially helpful in assessing parental guilt when a disability
or chronic illness is diagnosed?
a. Ask the parents if they feel guilty.
b. Discuss guilt only after the parents mention it.
c. Discuss the meaning of the parents’ religious and cultural background.
d. Observe for signs of overprotectiveness.
ANS: C
Guilt may be associated with cultural or religious beliefs. Some parents are convinced that
they are being punished for some previous misdeed. Others may see the disorder as a sacrifice
sent by God to test their religious beliefs. The nurse can help the parents explore their
religious beliefs. The parents may not be able to identify the feelings of guilt. It would be
appropriate for the nurse to explore their adjustment responses. Overprotectiveness is a
parental response during the adjustment phase. The parents fear letting the child achieve any
new skill and avoid all discipline.
DIF: Cognitive Level: Apply REF: p. 506
NURSINGTB.COM
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Psychosocial Integrity
7. The nurse observes that a seriously ill child passively accepts all painful procedures. What
should the nurse recognize this child is most likely experiencing?
a. A sense of hopefulness
b. A sense of chronic sorrow
c. A belief that procedures are a deserved punishment
d. A belief that procedures are an important part of care
ANS: C
The nurse should be particularly alert to the child who passively accepts all painful
procedures. This child may believe that such acts are inflicted as deserved punishment. The
child who is hopeful is mobilized into goal-directed actions. This child would actively
participate in care. Chronic sorrow is the feeling of sorrow and loss that recurs in waves over
time. It is usually evident in the parents, not in the child. A child who believes that procedures
are an important part of care would actively participate in care. Nursing interventions should
be used to minimize the pain.
DIF: Cognitive Level: Analyze REF: p. 507
TOP: Integrated Process: Nursing Process: Diagnosis
MSC: Area of Client Needs: Psychosocial Integrity
NURSINGTB.COM
