Nokea
A school-age child is diagnosed with a life-threatening illness. The parents want to protect their child from knowing the seriousness of the illness. The nurse should provide which explanation?
- A. This attitude is helpful to give parents time to cope.
- B. This will help the child cope effectively by denial.
- C. Terminally ill children know when they are seriously ill.
- D. Terminally ill children usually choose not to discuss the seriousness of their illness.
Correct Answer: C
Rationale: Children, even young ones, sense the seriousness of their illness due to increased medical attention, making honesty essential. Denial is an ineffective coping mechanism, protecting the child does not primarily serve parental coping, and children may want to discuss their condition if given the opportunity.
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A critically injured child has died and is being removed from a ventilator in the pediatric intensive care unit. What is a priority nursing intervention for the family at this time?
- A. Ensure that parents are in the waiting room while the ventilator is removed.
- B. Help the parents understand that the child is already dead and no further interventions are necessary.
- C. Control the environment around the child and family to provide privacy.
- D. Encourage them to wait to see their child until the funeral home has prepared the body.
Correct Answer: C
Rationale: Controlling the environment to provide privacy respects the family?s need for dignity and space during this sensitive time. Forcing parents to the waiting room, stating no further interventions are needed, or delaying their time with the child disregards their emotional needs.
What explanation best describes how preschoolers react to the death of a loved one?
- A. Grief is acute but does not last long at this age.
- B. Children this age are too young to have a concept of death.
- C. Preschoolers may feel guilty and responsible for the death.
- D. They express grief in the same way that the adults in the preschoolers life are expressing grief.
Correct Answer: C
Rationale: Due to egocentric thinking, preschoolers may feel guilty, believing they caused the death. They have a limited concept of death as a temporary state, their grief may involve regression or joking, and their expressions differ from adults, reflecting their developmental stage.
A 7-year-old child is in the end stages of cancer. The parents ask you how they will know when death is imminent. What physical sign is indicative of approaching death?
- A. Hunger
- B. Tachycardia
- C. Increased thirst
- D. Difficulty swallowing
Correct Answer: D
Rationale: Difficulty swallowing is a physical sign of approaching death, reflecting declining bodily functions. Appetite and fluid intake decrease, and the pulse slows, not quickens, in the final stages.
A 12-year-old child has failed several courses of chemotherapy. An experimental drug is available that his parents want him to receive. He has told his parents and the oncologists that he is ready to die and does not want any more chemotherapy. The nurse recognizes what to be true?
- A. Parents and child both need support in the decision making.
- B. Twelve-year-olds are minors and cannot give consent or refuse treatments.
- C. The oncologists needs to make the decision because the parents and child disagree.
- D. The parents have the right and responsibility to make decisions for their children younger than age 18 years.
Correct Answer: A
Rationale: Supporting both parents and child in resolving this conflict respects the child?s autonomy, especially given the poor prognosis. Twelve-year-olds can assent or refuse under certain conditions, oncologists guide but don?t decide, and parental authority may be limited if the child?s decision is informed and verified.
What statement is most descriptive of a school-age childs reaction to death?
- A. Very interested in funerals and burials
- B. Little understanding of words such as forever
- C. Imagine the deceased person to be still alive
- D. Can explain death from a religious or spiritual point of view
Correct Answer: A
Rationale: School-age children are curious about the physiological and naturalistic aspects of death, such as funerals and burials. They understand concepts like ?forever,? do not typically imagine the deceased as alive, and spiritual explanations are more common in adolescents.