Nokea
While caring for a family who lost a 10-year-old son in a car accident, the nurse should instruct the parents to tell the 4-year-old sister which of the following about her brother?
- A. He died and is not coming back.
- B. He passed on to the other side.
- C. He departed on a long journey.
- D. He has gone to see the Lord above.
Correct Answer: A
Rationale: For a 4-year-old, clear, simple language like 'He died and is not coming back' is appropriate to help them understand death without confusion. Euphemisms like 'passed on,' 'long journey,' or 'seeing the Lord' may confuse young children who think concretely and may expect the person to return.
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A nurse is working with a child for which an out-of-home placement has occurred. Which of the following would the nurse anticipate as the child?s initial response?
- A. Despair
- B. Withdrawal
- C. Protest
- D. Detachment
Correct Answer: C
Rationale: Protest is the initial response in children experiencing out-of-home placement, often manifesting as anger or resistance due to separation. Withdrawal, despair, or detachment may follow later as part of the grief process, per Bowlby?s attachment theory.
A 3-year-old child has been admitted to the hospital after an automobile accident. Which statement by the nurse would be most appropriate when discussing the type of behavior the parents can expect their child to display while hospitalized?
- A. Your child may not be able to accept how the injury has changed your child?s appearance.
- B. Your child may seem unduly anxious in the presence of strangers.
- C. Your child may experience some guilt feelings associated with the accident.
- D. Your child will exhibit intermittent periodic mood swings, but these should be brief.
Correct Answer: B
Rationale: A 3-year-old is likely to exhibit stranger anxiety, especially in a stressful hospital setting, as they are developmentally prone to fear of unfamiliar people. Appearance concerns, guilt, or mood swings are more typical in older children with greater cognitive awareness.
A home-health nurse is working with a poverty-stricken family that has two small children, ages 2 and 3 years. The family lives in an isolated rural area. The family?s home has a dirt floor, and there are chickens living in the house with the family. Because of a recent wind storm, there is a sizeable hole in the roof that lets rain and snow into the house. Which nursing intervention would be the highest priority in this situation?
- A. Make immunization appointments for the children in a nearby town?s public health clinic.
- B. Help the family find funding and manpower to patch and repair the roof of their home.
- C. Determine the educational readiness of the two children.
- D. Report the family for child abuse because of neglect.
Correct Answer: B
Rationale: Repairing the roof is the highest priority to ensure a safe, habitable environment, protecting the children from health risks due to exposure. Immunizations are important but less urgent, educational readiness is secondary, and reporting neglect is premature without assessing intent or resources.
A nurse is providing care to several chronically ill children. Which of the following would the nurse identify as having the greatest risk for developing a psychiatric problem?
- A. 12 year-old with diabetes mellitus
- B. 5 year-old with cerebral palsy
- C. 8 year-old who has chronic renal disease
- D. 10 year-old with a heart murmur
Correct Answer: C
Rationale: Chronic renal disease in an 8-year-old poses significant physical and emotional stress, including frequent medical interventions and lifestyle restrictions, increasing psychiatric risk. Diabetes and cerebral palsy also carry risks, but renal disease is more invasive, and a heart murmur is typically less severe.
A nurse is developing a plan of care for a family who is experiencing problems related to their child?s chronic illness. The nurse plans to have the family read a group of short stories written by parents of children with chronic illnesses. The nurse will be using which technique?
- A. Psychoeducation
- B. Social skills training
- C. Bibliotherapy
- D. Assertiveness training
Correct Answer: C
Rationale: Using stories written by parents of chronically ill children is bibliotherapy, which promotes insight and coping through reading relevant materials. Psychoeducation involves direct teaching, social skills training targets interpersonal behaviors, and assertiveness training focuses on communication skills.