Chapter 36: The Child with a Chronic Condition or Terminal Illness
Test Bank
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
Feedback
A Feelings of anger and resentment are part of the grieving process, although not
usually the initial response.
B Feelings of sadness and depression are part of the grieving process, although not
usually the initial response.
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.
D Acceptance is the final stage of the grieving process, not the first response.
PTS: 1 DIF: Cognitive Level: Application REF: p. 896
OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
2. What is the primary concern for the parents of a dying child?
a. Pain
b. Safety
c. Food intake
d. Fluid intake
ANS: A
Feedback
A The primary concern of all parents of dying children is the possibility of their
child feeling pain.
B Although safety is a concern of all parents, it is not the priority concern.
C Although eating is important, it is not the priority concern.
D Although hydration is a concern, it is not the priority concern.
PTS: 1 DIF: Cognitive Level: Application REF: p. 909
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
,3. An important nursing goal in caring for the hospitalized child is to minimize the negative
effects of illness and hospitalization. On what should the nurse focus while caring for a
hospitalized infant?
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
Feedback
A Bodily injury and pain are fears of preschool and school-age children.
B The major fear of infants during illness and hospitalization are separation from
caregivers and fear of strangers.
C Loss of control is a fear of children from the preschool period through
adolescence. Altered body image applies to adolescents.
D Fear of the unknown and being left alone are applicable to preschoolers.
PTS: 1 DIF: Cognitive Level: Application REF: p. 898 | 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
Feedback
A This is the infant/toddler understanding of death.
B Children in early childhood (2 to 7 years old) view death as reversible and
temporary.
C The school-age child and adolescent understand that death is permanent.
D The adolescent understands death not only as permanent, but also inevitable.
PTS: 1 DIF: Cognitive Level: Application REF: p. 905 | Table 36-1
OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
5. You are 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
, Feedback
A The preschool-age child views death as temporary.
B The school-age child and adolescent understand the permanence of death.
C This is the infant/toddler understanding of death.
D The preschool-age child facing impending death may view his or her condition
as punishment for behaviors or thoughts.
PTS: 1 DIF: Cognitive Level: Application REF: p. 905 | Table 36-1
OBJ: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity
6. How can chronic illness and frequent hospitalizations affect the psychosocial development of
a toddler?
a. They can create a distortion or differentiation of self from parent.
b. They can interfere with the development of autonomy.
c. They can interfere with the acquisition of language, fine motor, and self-care skills.
d. They can create feelings of inadequacy.
ANS: B
Feedback
A The infant with a chronic illness may have distortion of differentiation of self
from parents.
B Chronic illness may interfere in the development of autonomy, which is the
major psychosocial task of the toddler.
C Chronic illness with frequent hospitalizations can inhibit the acquisition of
language, motor, and self-care skills in the preschool-age child.
D Feelings of inadequacy and inferiority can occur if independence is
compromised by chronic illness in the school-age child.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 898 | Box 36-2
OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
7. How can chronic illness and frequent hospitalizations affect the psychosocial development of
an adolescent?
a. They can lead to feelings of inadequacy.
b. They can interfere with parental attachment.
c. They can block the development of identity.
d. They can prevent the development of imagination.
ANS: C
Feedback
A Inadequacy and inferiority refer to the school-age period.
B Parental attachment is a task of the infant.
C Development of identity is the task of the adolescent.
D Development of imagination occurs in the preschool period.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 898 | Box 36-2
Test Bank
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
Feedback
A Feelings of anger and resentment are part of the grieving process, although not
usually the initial response.
B Feelings of sadness and depression are part of the grieving process, although not
usually the initial response.
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.
D Acceptance is the final stage of the grieving process, not the first response.
PTS: 1 DIF: Cognitive Level: Application REF: p. 896
OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
2. What is the primary concern for the parents of a dying child?
a. Pain
b. Safety
c. Food intake
d. Fluid intake
ANS: A
Feedback
A The primary concern of all parents of dying children is the possibility of their
child feeling pain.
B Although safety is a concern of all parents, it is not the priority concern.
C Although eating is important, it is not the priority concern.
D Although hydration is a concern, it is not the priority concern.
PTS: 1 DIF: Cognitive Level: Application REF: p. 909
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
,3. An important nursing goal in caring for the hospitalized child is to minimize the negative
effects of illness and hospitalization. On what should the nurse focus while caring for a
hospitalized infant?
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
Feedback
A Bodily injury and pain are fears of preschool and school-age children.
B The major fear of infants during illness and hospitalization are separation from
caregivers and fear of strangers.
C Loss of control is a fear of children from the preschool period through
adolescence. Altered body image applies to adolescents.
D Fear of the unknown and being left alone are applicable to preschoolers.
PTS: 1 DIF: Cognitive Level: Application REF: p. 898 | 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
Feedback
A This is the infant/toddler understanding of death.
B Children in early childhood (2 to 7 years old) view death as reversible and
temporary.
C The school-age child and adolescent understand that death is permanent.
D The adolescent understands death not only as permanent, but also inevitable.
PTS: 1 DIF: Cognitive Level: Application REF: p. 905 | Table 36-1
OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
5. You are 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
, Feedback
A The preschool-age child views death as temporary.
B The school-age child and adolescent understand the permanence of death.
C This is the infant/toddler understanding of death.
D The preschool-age child facing impending death may view his or her condition
as punishment for behaviors or thoughts.
PTS: 1 DIF: Cognitive Level: Application REF: p. 905 | Table 36-1
OBJ: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity
6. How can chronic illness and frequent hospitalizations affect the psychosocial development of
a toddler?
a. They can create a distortion or differentiation of self from parent.
b. They can interfere with the development of autonomy.
c. They can interfere with the acquisition of language, fine motor, and self-care skills.
d. They can create feelings of inadequacy.
ANS: B
Feedback
A The infant with a chronic illness may have distortion of differentiation of self
from parents.
B Chronic illness may interfere in the development of autonomy, which is the
major psychosocial task of the toddler.
C Chronic illness with frequent hospitalizations can inhibit the acquisition of
language, motor, and self-care skills in the preschool-age child.
D Feelings of inadequacy and inferiority can occur if independence is
compromised by chronic illness in the school-age child.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 898 | Box 36-2
OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
7. How can chronic illness and frequent hospitalizations affect the psychosocial development of
an adolescent?
a. They can lead to feelings of inadequacy.
b. They can interfere with parental attachment.
c. They can block the development of identity.
d. They can prevent the development of imagination.
ANS: C
Feedback
A Inadequacy and inferiority refer to the school-age period.
B Parental attachment is a task of the infant.
C Development of identity is the task of the adolescent.
D Development of imagination occurs in the preschool period.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 898 | Box 36-2
