peds week 2

A nurse is providing education to parents who have a child recently diagnosed with a chronic illness. Which statement made by the nurse should be helpful for this family trying to cope with the changes the family is experiencing? a. "Coping with a chronic illness is not easy, but can be done if the family works to achieve cohesiveness." b. "Coping with a chronic illness can be very difficult and unfortunately leads to a weakened family unit." c. "A chronic illness will impact the daily life of your family and will require a lot of change for everyone involved." d. "Change impedes the process of normalization. Achieving normalcy will not be possible while dealing with a chronic condition."

a. "Coping with a chronic illness is not easy, but can be done if the family works to achieve cohesiveness."

The parents of three children, including a toddler with hemophilia, are talking with the nurse and admit that the child with hemophilia is the center of attention in the family since they are more protective of the child who is ill. Which statements by the nurse should be an appropriate response to the parent's actions toward their child? (Select all that apply.) a. "Favoritism toward your toddler can negatively affect important boundaries and should be avoided." b. "Making the toddler the center of attention can actually cause some harm by decreasing age-appropriate development." c. "It is important for you as parents to spend time together to maintain your relationship as well so that the foundation of your family is strong." d. "Let's talk about ways to ensure that all of your children feel equal attention so that there are not negative feelings towards the ill child or parents." e. "The toddler needs extra support because of the chronic condition, so it is important to ensure that the toddler's required care is the focus of family activities."

a. "Favoritism toward your toddler can negatively affect important boundaries and should be avoided." b. "Making the toddler the center of attention can actually cause some harm by decreasing age-appropriate development." c. "It is important for you as parents to spend time together to maintain your relationship as well so that the foundation of your family is strong." d. "Let's talk about ways to ensure that all of your children feel equal attention so that there are not negative feelings towards the ill child or parents."

The parent of a school-aged child states, "I am so proud of my daughter. She was diagnosed with asthma and yet she still does everything she was doing before. She processed this diagnosis more quickly than I thought she would." How should the nurse respond? a. "Let's talk to your daughter and see how she is doing." b. "It is great to hear that your daughter is coping so well." c, "She might not be doing as well as you think. There is a chance she is in denial that there is a problem." d. "Your daughter might be hiding her feelings from you and should speak with a mental health specialist for support."

a. "Let's talk to your daughter and see how she is doing."

An adolescent going through cancer treatment lost her hair and missed prom six months ago. The teen is coming in for her usual check-up and starts crying. The nurse states, "All of your blood work looks good. You are fine." Which statement reflects how the nurse should have responded better? a. "Tell me what you are thinking about right now." b. "There is nothing to be concerned about right now. Everything looks good." c. "I think you are misunderstanding what your test results show. You are getting better." d. "I thought you had made it past your grief. You seemed so happy during your last appointment."

a. "Tell me what you are thinking about right now."

A child with a terminal illness has died following complications. The nurse is following-up with the child's parents. What can the nurse expect to observe in response to their child's death? (Select all that apply.) a. Any emotions that the parents are feeling may be expressed. b. The grief response will be different for each parent, and that is normal. c. The grief response could last months but should resolve within a year. d. Symptoms that might indicate one or both parents need a referral to a mental health care provider. e. A support group must be attended so that the parents can learn from other parents who have been in similar circumstances.

a. Any emotions that the parents are feeling may be expressed. b. The grief response will be different for each parent, and that is normal. d. Symptoms that might indicate one or both parents need a referral to a mental health care provider.

Which manifestation would alert the nurse that a teenaged patient may be experiencing a childhood disorder? a. Decrease in the ability to concentrate in class b. Increased involvement in drama club and basketball c. More time spent studying because of demanding academic work d. Shedding of considerable weight after joining the cross-country team

a. Decrease in the ability to concentrate in class

Which considerations are necessary when assessing a child for childhood disorders? (Select all that apply.) a. Inconsistent responses are expected. b. Child's first response is most accurate. c. Children typically provide predictable answers. d. Assessments must be repeated to determine a child's baseline developmental level. e. A wide range of cognitive ability should be expected as a result of variations in brain development.

a. Inconsistent responses are expected. d. Assessments must be repeated to determine a child's baseline developmental level. e. A wide range of cognitive ability should be expected as a result of variations in brain development.

The nurse is providing community education about definitions of developmental disability. Which information should the nurse provide? (Select all that apply.) a. Mental age is significantly lower than chronologic age. b. Physical impairment results in requirement of lifelong care. c. Physical disability results in limited economic self-sufficiency. d. Mental disability renders the patient unable to care for himself or herself. e. Physical disability renders the patient unable to perform activities of daily living.

a. Mental age is significantly lower than chronologic age. b. Physical impairment results in requirement of lifelong care. d. Mental disability renders the patient unable to care for himself or herself. e. Physical disability renders the patient unable to perform activities of daily living.

Which information, obtained from a patient's history, represents potential risk factors for the development of a childhood disorder? (Select all that apply.) a. Patient began speaking at 6 years of age. b. Patient sustained a head injury in late infancy. c. Mother has been diagnosed with a mental illness. d. Patient functions above the expected developmental level. e. Patient lives with mother, father, and maternal grandmother.

a. Patient began speaking at 6 years of age. b. Patient sustained a head injury in late infancy. c. Mother has been diagnosed with a mental illness.

The nurse is assessing a 10-year-old child with a developmental disorder. Which areas of impairment would the nurse anticipate in this patient? (Select all that apply.) a. Self-care b. Learning c. Language d. Economic e. Elimination

a. Self-care b. Learning c. Language d. Economic

A teenager with leukemia states, "I thought everything about this was going to be terrible, but at least my parents have stopped making me do chores and homework." The next time the nurse sees the parents, what should be the nurse's best response? a. "Your teen seems to be responding well to a decrease in stress at home from the elimination of the need to do homework and chores." b. "Let's talk about the importance of maintaining age-appropriate expectations with your teenager, even while your teen is battling leukemia." c. "Allowing your teen to neglect homework and chores is going to make it harder on going back to usual expectations after the battle with leukemia is over." d. "Decreasing expectations for a little while will minimize the behavioral and psychologic issues that often develop in children and teens experiencing a chronic health condition."

b. "Let's talk about the importance of maintaining age-appropriate expectations with your teenager, even while your teen is battling leukemia."

The parents of infant twins, both with developmental delays, ask the nurse about resources for caring for the children as they get a little older. Which information should the nurse share? a. "Your family will find a pattern of normalcy that will make caring for the children easier." b. "Medical homes can offer holistic and centralized care that include the patient and family as the primary focus." c. "There are support groups and community resources available to help cope with caring for children with special health care needs." d. "Having two children with developmental delays likely means that the children will need to be institutionalized to receive adequate care."

b. "Medical homes can offer holistic and centralized care that include the patient and family as the primary focus."

A husband and wife are speaking to the nurse about their infant who has cerebral palsy. The father seems anxious when interacting with the infant. What is the nurse's best response to this situation? a. Have both parents work together to care for the infant so that neither parent feels singled out b. Ask the father to assist the nurse with bathing the infant and encourage the father to ask questions c. Ensure that the father is not left alone with the child because the father seems uncomfortable and unsafe d. Address the education primarily to the mother because she seems to feel more comfortable caring for the infant

b. Ask the father to assist the nurse with bathing the infant and encourage the father to ask questions

Which assessments can the nurse use to evaluate the intellectual skills of a school-aged child? (Select all that apply.) a. Play catch with the child. b. Give the child a puzzle to solve. c. Provide a scenario and have the child explain cause/effect relationships. d. Present a story and then have the child determine the correct order of events. e. Ask the child to articulate his or her feelings; listen for tone, volume, and fluency.

b. Give the child a puzzle to solve. c. Provide a scenario and have the child explain cause/effect relationships. d. Present a story and then have the child determine the correct order of events.

Which common co-morbidities or risk factors would a nurse expect to observe in a child with developmental disability? (Select all that apply.) a. Heart disease b. Intellectual disability c. Increased risk for infections d. Decreased adaptive functioning e. Increased risk for other childhood disorders

b. Intellectual disability e. Increased risk for other childhood disorders

The parents of an adolescent with a newly diagnosed chronic illness state, "She was a little disrespectful and defiant before, but now things have gotten completely out of control. We feel like we really need some help coping with this." What can the nurse do to enhance coping in these parents? a. Instruct the parents on ways to maintain age-appropriate expectations and limitations on negative behaviors b. Provide education regarding support groups for families of children with special health care needs as a way to get emotional needs met c. Teach the parents ways to enhance the coping of the adolescent so that she is able to find more productive ways to work through her frustrations d. Have the parents ignore the behavior because the change in behavior is a normal adolescent reaction to the frustration of dealing with a chronic illness

b. Provide education regarding support groups for families of children with special health care needs as a way to get emotional needs met

Which statement describes the purpose of using an individualized education plan (IEP) for a child with a developmental disability? a. The child will begin to excel in the classroom as a result of the IEP provisions. b. The IEP will ensure that the child receives appropriate services and support. c. The child will receive individualized tutoring sessions to facilitate performance at grade level. d. The IEP will require the child to complete more daily homework to keep pace with the other students.

b. The IEP will ensure that the child receives appropriate services and support.

The nurse is working with a family that has two parents and three children. The oldest child was just diagnosed with diabetes mellitus. The parents want to know how they should schedule their health care provider's appointments. What information should the nurse provide? a. The child who is dealing with a chronic illness requires extra attention from the parents and siblings, so everyone should attend the appointments. b. The family should try to schedule health care appointments at times that do not interfere with any of the children's school or extracurricular activities. c. The child's medical needs are top priority. Cancelling other activities or engagements for the children is an acceptable adjustment for the oldest child's health. d. The family needs to maintain a balance, so some scheduled appointments may be missed to allow the parents and child not to miss any extracurricular or school activities.

b. The family should try to schedule health care appointments at times that do not interfere with any of the children's school or extracurricular activities.

A parent of a six- and four-year-old, the youngest one with juvenile arthritis, states, "I feel terrible when I have to discipline the youngest one." What is the nurse's best response? a. "A child with a chronic illness should not be disciplined because it causes unnecessary stress." b. "Permissive parenting of children with a chronic illness can cause long-term damage to the child." c. "Although disciplining a child with a chronic illness can be hard, it is important for the development of the child." d. "It is important that your older child sees that you still discipline the four-year-old so that there is not any resentment."

c. "Although disciplining a child with a chronic illness can be hard, it is important for the development of the child."

The parents of a toddler newly diagnosed with a chronic illness ask, "Will our little girl develop just like her peers?" How should the nurse respond? a. "Children with chronic illnesses often lag behind their peers developmentally." b. "Because your child was diagnosed with a chronic illness at such a young age, the outlook for the child is poor." c. "Development is unique to each child, but can be supported through consistency at home and community resources to help minimize any developmental delays." d. "A chronic illness does not usually impact the social or behavioral development, so your child might only struggle with physical development because of the chronic illness."

c. "Development is unique to each child, but can be supported through consistency at home and community resources to help minimize any developmental delays."

The parents of four children, one of which has a chronic illness, state, "My spouse and I spend as much time as we can with our sick child, but our family just seems to be stressed all the time." What should be the nurse's best response? a. "The children just need an outlet for their frustration. You could send them to a support group." b. "The other children are probably just reacting to the stress of having a sibling with a chronic illness." c. "It is possible to spend too much time with a child who is ill and not enough time with your other children." d. "Educate your other children on the need for you to spend extra time with the child who is ill to decrease their stress."

c. "It is possible to spend too much time with a child who is ill and not enough time with your other children."

A teenager is having an acute exacerbation of cystic fibrosis. The parents of the teen state, "We were doing so well coping before this episode. We don't even know what to do." What should the nurse do to help the parents? a. Discuss the need to remain consistent in their activities to maintain normalcy in the family b. Help the parents to determine why they are not able to cope with the teen's illness like they have in the past c. Assist the parents in identifying what usually helps the family to cope to see if that can be used during the exacerbation of the chronic illness d. Explain the illness trajectory of cystic fibrosis so that the parents know that they need to be prepared for the exacerbations to continue to happen

c. Assist the parents in identifying what usually helps the family to cope to see if that can be used during the exacerbation of the chronic illness

A nurse is preparing discharge instructions for a school-aged child newly diagnosed with an autoimmune disease. What information should the nurse provide to both the child and the parents to prevent behavioral problems at home? a. Be lenient, which will be helpful, while your child learns to cope with the autoimmune disorder. b. Remain firm in the expectations of your child and refrain from any modifications of those expectations. c. Maintain consistent discipline, which is important to help your child continue to develop socially and emotionally. d. Minimize the expectation that the child performs chores and understand that the child might struggle in school so allowing a decrease in grades is acceptable.

c. Maintain consistent discipline, which is important to help your child continue to develop socially and emotionally.

Which statement explains the prevalence of attention-deficit/hyperactivity disorder (ADHD) among all childhood disorders? a. Females have a stronger will to focus and manage stress than males. b. Females are more likely to be diagnosed with ADHD than male counterparts. c. Males are more likely to be diagnosed with ADHD than female counterparts. d. Males generally have more mental health disorders than females of the same age.

c. Males are more likely to be diagnosed with ADHD than female counterparts.

The 12-year-old sibling of an infant born with Down syndrome has been increasingly difficult and lashing out on family and friends. The parents are spending time with the 12-year-old child and do not understand why the child's behavior has changed so much. What information should the nurse provide? a. The family is likely spending too much time with the infant and not enough time with the 12-year-old. b. Regression is expected from a sibling when any new infant is brought into the family because the child feels jealous. c. The 12-year-old is likely experiencing anger as part of a grief response to the infant being born with a chronic illness. d. A 12-year-old does not understand that the infant has a chronic condition, so these behaviors are likely from a lack of discipline.

c. The 12-year-old is likely experiencing anger as part of a grief response to the infant being born with a chronic illness.

An adolescent who has had diabetes mellitus for ten years is able to check his blood glucose and maintain glucose levels while still participating in sports and maintaining a 'B' average. The adolescent tells the nurse, "I am so glad that I am finally able to deal with having diabetes." What is the nurse's best response? a. "You seem to be taking on a lot for someone with a chronic health care condition." b. "It seems that you have finally worked through your anger and frustration related to your illness. Keep up the good work." c. "You might be in denial that you have a chronic illness that requires you to make some changes in your life. This is common at your age." d. "It sounds like you feel as though you are coping well with diabetes and have reached acceptance of the illness. Just remember that at times you might struggle, and that it is OK to ask for help."

d. "It sounds like you feel as though you are coping well with diabetes and have reached acceptance of the illness. Just remember that at times you might struggle, and that it is OK to ask for help."

A single parent of a child with cancer comes into the care provider's office and states, "I am so frustrated. Lately the appointments are too much and my child's behavior has been terrible." Which statement by the nurse is appropriate? a. "Why exactly are you frustrated?" b. "You should be firmer when you discipline the child." c. "All the appointments are necessary for the child's health." d. "Let's talk about some helpful techniques that can assist you in working through the frustration you are having."

d. "Let's talk about some helpful techniques that can assist you in working through the frustration you are having."

What does it mean when a 7-year-old patient has the mental age of a 5-year-old? a. It is a child's level of adaptive function. b. It is an indicator of intellectual potential. c. It is a measure of the level of coping that a child has developed. d. It is a child's level of intellectual understanding, which can be independent of chronologic age.

d. It is a child's level of intellectual understanding, which can be independent of chronologic age.

Which activity would provide the most support for the family members of a child with a developmental disability? a. Social skills training b. Educational consultation c. Provision of respite care services d. Support of parental advocacy on child's behalf

d. Support of parental advocacy on child's behalf

The nurse is observing an 8-year-old child in the pediatric unit. The nurse notes that the child has been diagnosed with dyspraxia. Which findings would the nurse expect to observe in this patient? a. Difficulty swallowing tablets or capsules. b. The child is unable to focus on one task for more than a few minutes at a time. c. The child experiences difficulty when trying to share thoughts and feelings. d. The child has a hard time holding a pencil to draw and bumps into the walls when walking around the unit.

d. The child has a hard time holding a pencil to draw and bumps into the walls when walking around the unit.