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A 16-year-old boy with a chronic illness has recently become rebellious and is taking risks such as missing doses of his medication. What should the nurse explain to his parents?
- A. That he needs more discipline
- B. That this is a normal part of adolescence
- C. That he needs more socialization with peers
- D. That this is how he is asking for more parental control
Correct Answer: B
Rationale: Rebelliousness and risk-taking, such as skipping medication, are normal adolescent behaviors as they seek independence. Increased discipline may escalate rebellion, socialization doesn?t directly address the behavior, and it?s not a request for more control but rather a push for autonomy.
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What is the major health concern of children in the United States?
- A. Acute illness
- B. Chronic illness
- C. Congenital disabilities
- D. Nervous system disorders
Correct Answer: B
Rationale: An estimated 18% of children in the United States have a chronic illness or disability requiring health care services beyond typical needs. Chronic illness has surpassed acute illness as the primary health concern for children. Congenital disabilities contribute to chronic illnesses but are not the main concern, and nervous system disorders account for about 17% of chronic illnesses, a subset of the broader issue.
The nurse is assessing the coping behaviors of the parents of a child recently diagnosed with a chronic illness. What behavior should the nurse consider an approach behavior that results in movement toward adjustment?
- A. Being unable to adjust to a progression of the disease or condition
- B. Anticipating future problems and seeking guidance and answers
- C. Looking for new cures without a perspective toward possible benefit
- D. Failing to recognize the seriousness of the childs condition despite physical evidence
Correct Answer: B
Rationale: Anticipating future problems and seeking guidance are approach behaviors that promote adjustment by proactively addressing the child?s needs. Inability to adjust, seeking cures unrealistically, or denying severity are avoidance behaviors that hinder coping and adaptation.
The nurse notes that the parents of a critically ill child spend a large amount of time talking with the parents of another child who is also seriously ill. They talk with these parents more than with the nurses. How should the nurse interpret this situation?
- A. Parent-to-parent support is valuable.
- B. Dependence on other parents in crisis is unhealthy.
- C. This is occurring because the nurses are unresponsive to the parents.
- D. This has the potential to increase friction between the parents and nursing staff.
Correct Answer: A
Rationale: Parent-to-parent support is valuable, as parents who share similar experiences can offer unique emotional and practical support that nurses cannot provide. This is not unhealthy dependence, a sign of unresponsive nurses, or likely to cause friction, but rather a beneficial coping mechanism.
What manifestation observed by the nurse is suggestive of parental overprotection?
- A. Gives inconsistent discipline
- B. Facilitates the childs responsibility for self-care of illness
- C. Persuades the child to take on activities of daily living even when not able
- D. Encourages social and educational activities not appropriate to the childs level of capability
Correct Answer: A
Rationale: Inconsistent discipline, where parents avoid setting boundaries or cater to every desire, suggests overprotection, preventing the child from developing independence. Facilitating self-care or encouraging activities, even if challenging, promotes growth, while inappropriate activities reflect unrealistic expectations, not overprotection.
The nurse observes that a seriously ill child passively accepts all painful procedures. The nurse should recognize that this is most likely an indication that the child is experiencing what emotional response?
- A. Hopefulness
- B. Chronic sorrow
- C. Belief that procedures are a deserved punishment
- D. Understanding that procedures indicate impending death
Correct Answer: C
Rationale: Passive acceptance of painful procedures in a seriously ill child often indicates a belief that they are deserved punishment, reflecting feelings of unworthiness. Hopefulness leads to active participation, chronic sorrow is more typical in parents, and understanding procedures as linked to death is less common in children.