Nokea
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.
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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.
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 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.
A 16-year-old boy with a chronic illness has recently become rebellious and is taking risks such as missing doses of his medication. What should the nurse explain to his parents?
- A. That he needs more discipline
- B. That this is a normal part of adolescence
- C. That he needs more socialization with peers
- D. That this is how he is asking for more parental control
Correct Answer: B
Rationale: Rebelliousness and risk-taking, such as skipping medication, are normal adolescent behaviors as they seek independence. Increased discipline may escalate rebellion, socialization doesn?t directly address the behavior, and it?s not a request for more control but rather a push for autonomy.
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.