Nokea
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.
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What nursing intervention is especially helpful in assessing feelings of parental guilt when a disability or chronic illness is diagnosed?
- A. Ask the parents if they feel guilty.
- B. Observe for signs of overprotectiveness.
- C. Talk about guilt only after the parents mention it.
- D. Discuss the meaning of the parents religious and cultural background.
Correct Answer: D
Rationale: Discussing the parents? religious and cultural background can reveal beliefs contributing to guilt, such as viewing the illness as punishment. Direct questioning may not elicit honest responses, overprotectiveness is a separate adjustment issue, and waiting for parents to mention guilt may miss underlying feelings.
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.
Parents ask for help for their other children to cope with the changes in the family resulting from the special needs of their sibling. What strategy does the nurse recommend?
- A. Explain to the siblings that embarrassment is unhealthy.
- B. Encourage the parents not to expect siblings to help them care for the child with special needs.
- C. Provide information to the siblings about the childs condition only as requested.
- D. Invite the siblings to attend meetings to develop plans for the child with special needs.
Correct Answer: D
Rationale: Inviting siblings to attend meetings, such as those for individualized education plans, involves them in the care process, fostering understanding and inclusion. Discouraging embarrassment ignores natural feelings, expecting no help may exclude siblings, and providing information only on request risks misinformation.
The potential effects of chronic illness or disability on a childs development vary at different ages. What developmental alteration is a threat to a toddlers normal development?
- A. Hindered mobility
- B. Limited opportunities for socialization
- C. Childs sense of guilt that he or she caused the illness or disability
- D. Limited opportunities for success in mastering toilet training
Correct Answer: A
Rationale: Toddlers develop autonomy and self-control through mobility, which allows them to explore and assert independence. Hindered mobility due to chronic illness can lead to feelings of helplessness, disrupting this developmental stage. Socialization is less critical for toddlers, guilt is more common in preschoolers, and toilet training is typically mastered later in toddlerhood.
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.