Nokea
What is a major premise of family-centered care?
- A. The child is the focus of all interventions.
- B. Nurses are the authorities in the childs care.
- C. Parents are the experts in caring for their child.
- D. Decisions are made for the family to reduce stress.
Correct Answer: C
Rationale: Family-centered care recognizes parents as experts in their child's care, emphasizing their role in decision-making and care provision. It considers the impact of the child's illness on all family members, not just the child. Nurses act as collaborators, not authorities, and decisions are made with the family, not for them, to promote empowerment and reduce stress.
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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.
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.
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.
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.
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.