Nokea
What finding by the nurse is most characteristic of chronic sorrow?
- A. Lack of acceptance of childs limitation
- B. Lack of available support to prevent sorrow
- C. Periods of intensified sorrow when experiencing anger and guilt
- D. Periods of intensified sorrow at certain landmarks of the childs development
Correct Answer: D
Rationale: Chronic sorrow is characterized by recurring waves of sorrow and loss, particularly intensified at developmental milestones when the child?s limitations become more evident. Lack of acceptance or support relates to adjustment issues, and anger and guilt are more typical of the adjustment phase, not chronic sorrow.
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A 5-year-old child 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?
- A. This is a sign the 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 expectations are too high.
Correct Answer: B
Rationale: Parental stress often peaks at anticipated milestones like starting school, especially for a child with a disability like cerebral palsy, as it highlights the severity of limitations. This is a normal response, not denial, a knowledge deficit, or overly high expectations.
What nursing intervention is most appropriate in promoting normalization in a school-age child with a chronic illness?
- A. Give the child as much control as possible.
- B. Ask the childs peer to make the child feel normal.
- C. Convince the child that nothing is wrong with him or her.
- D. Explain to parents that family rules for the child do not need to be the same as for healthy siblings.
Correct Answer: A
Rationale: Giving the child as much control as possible fosters normalization by countering dependency caused by chronic illness, promoting independence. Peers cannot be tasked with making the child feel normal, denying the illness is unhelpful, and different family rules may cause resentment among siblings.
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.
A feeling of guilt that the child caused the disability or illness is especially common in which age group?
- A. Toddler
- B. Preschooler
- C. School-age child
- D. Adolescent
Correct Answer: B
Rationale: Preschoolers often experience guilt, believing they caused their illness or disability or that it is a punishment for misbehavior due to their egocentric thinking. Toddlers focus on autonomy, school-age children face achievement issues, and adolescents work on integrating disabilities into their self-concept, making guilt less prominent.
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.