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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 what response?
- A. Denial
- B. Guilt and anger
- C. Social reintegration
- D. Acceptance of the childs limitations
Correct Answer: B
Rationale: The adjustment phase after a chronic illness diagnosis is often marked by guilt, self-accusation, bitterness, and anger as families grapple with the reality. Denial characterizes the initial shock phase, while social reintegration and acceptance occur later in the adjustment process.
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The nurse is talking to the parent of a child with special needs. The parent has expressed worry about how to support the siblings at home. What suggestion is appropriate for the nurse to give to the parent?
- A. You should help the siblings see the similarities and differences between themselves and your child with special needs.
- B. You should explain that your child with special needs should be included in all activities that the siblings participate in even if they are reluctant.
- C. You should give the siblings many caregiving tasks for your child with special needs so the siblings feel involved.
- D. You should intervene when there are differences between your child with special needs and the siblings.
Correct Answer: A
Rationale: Helping siblings recognize similarities and differences with their special needs sibling fosters understanding and empathy, supporting family dynamics. Forcing inclusion in all activities, assigning excessive caregiving, or intervening in sibling differences can create resentment or hinder independence.
What should the nurse determine to be the priority intervention for a family with an infant who has a disability?
- A. Focus on the childs disabilities to understand care needs.
- B. Institute age-appropriate discipline and limit setting.
- C. Enforce visiting hours to allow parents to have respite care.
- D. Foster feelings of competency by helping parents learn the special care needs of the infant.
Correct Answer: D
Rationale: Helping parents learn the special care needs of their infant fosters feelings of competency, enabling them to care confidently. This includes teaching techniques like special holding or breastfeeding support. Focusing solely on disabilities overlooks strengths, discipline is not a priority for infants, and rigid visiting hours may hinder family bonding.
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 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.
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.