Chapter 17: Quality of Life for Children Living with Chronic and Complex Diseases Hockenberry: Wong’s Essentials of Pediatric Nursing, 10th Edition ALL ANSWERS 100% SOLVED 2022/2023 EDITION RATED GRADE 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. 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 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 NURSINGTB.COM 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 future 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 NURSINGTB.COM 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 TOP: Integrated Process: Nursing Process: Implementation MSC: Area of Client Needs: Psychosocial Integrity 7. The nurse obse