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What factor is most important for parents implementing do not resuscitate (DNR) orders?
- A. Parents beliefs about euthanasia
- B. Presence of other children in the home
- C. Experiences of the health care team with other children in this situation
- D. Acknowledgment by health care team that child has no realistic chance for cure
Correct Answer: D
Rationale: An honest appraisal by the health care team that the child has no realistic chance for cure facilitates earlier DNR orders and appropriate palliative care. DNR orders are distinct from euthanasia, the presence of other children is not directly relevant, and the health care team?s prior experiences inform discussions but are secondary to acknowledging prognosis.
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What is a principle of palliative care that can be included in the care of children?
- A. Maintenance of curative therapy
- B. Child and family as the unit of care
- C. Exclusive focus on the spiritual issues the family faces
- D. Extensive use of opiates to ensure total pain control
Correct Answer: B
Rationale: Palliative care for children emphasizes a multidisciplinary approach focusing on symptom control and support for the family as the unit of care, rather than cure when it is no longer possible. Curative therapy is transitioned away from, spiritual issues are one aspect among others, and opiate use is balanced to manage pain while minimizing side effects.
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.
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.
A 12-year-old boy is in the final phase of dying from leukemia. He tells the nurse who is giving him opiates for pain that his grandfather is waiting for him. How should the nurse interpret this situation?
- A. The boy is experiencing side effects of the opiates.
- B. The boy is making an attempt to comfort his parents.
- C. He is experiencing hallucinations resulting from brain anoxia.
- D. He is demonstrating readiness and acceptance that death is near.
Correct Answer: D
Rationale: Visions of loved ones, like the grandfather, are common near death and indicate the child?s acceptance and lack of fear. These are not opiate side effects, attempts to comfort parents, or due to brain anoxia, as there?s no evidence of hypoxia.
At which age do most children have an adult concept of death as being inevitable, universal, and irreversible?
- A. 4 to 5 years
- B. 6 to 8 years
- C. 9 to 11 years
- D. 12 to 16 years
Correct Answer: C
Rationale: By ages 9 to 11, children develop an adult-like understanding of death as inevitable, universal, and irreversible. Younger children have less mature concepts, and adolescents have a fully mature understanding.