the dying child

The nurse is caring for a terminally ill male child who is unconscious. Which statement by the nurse is most beneficial when counseling the family?

"Go ahead and speak to him as hearing remains intact."

A child who has been diagnosed with a terminal brain tumor states, "I'm dying." What is the best response by the nurse?

"Tell me more."

The parents of a child diagnosed with a terminal illness tell the nurse, "This isn't fair!" What is the most therapeutic nursing response?

"This must be very difficult for your child and family."

The intravenous infusion line infiltrates on a child who is terminally ill, and the child's mother tells the nurse that the nursing care in this hospital is the worst she has ever seen. What is the nurse's best response to her?

"You seem angrier today than before. Is something going on?"

The parents of a dying child have expressed the desire to have hospice care at home. What is the nurse's priority responsibility at this time?

Provide names of area hospices.

A 16-year-old client suffering from alopecia related to chemotherapy treatment is refusing to let friends visit. Which action by the nurse is most appropriate?

Provide opportunities for the child to discuss their body image changes.

A terminally ill school-age child is awake at 2 AM and continues to put on the call light. What should the nurse do regarding this child's behavior?

Sit with the child until sleep comes.

The nurse is administering 8 p.m. medications when a 9-year-old child expresses concern about dying sometime during the night. Which action by the nurse is most appropriate?

Stay with the child and encourage further discussion.

The nurse is caring for a preschool-age child who is aware of impending death. Based on the child's development, the nurse would incorporate an understanding of which concept into the child's plan of care?

The child has an underlying fear of being separated from parents

When caring for an adolescent client receiving palliative care treatment at home, which activity is most beneficial to encourage?

common activities, such as visiting with friends or playing a video game

The nurse is a guest speaker at a local pediatric palliative care support group. Which topic should the nurse consider the educational priority?

spending quality time with the child

The nurse is working with a support group for parents who have lost children. Which parent may have experienced anticipatory grief?

the parent of a child who had a near-drowning and died years later as a result of a complication

Which client characteristic is identified as normal behavior when demonstrated by a terminally ill 12-year-old client?

verbal or physical aggression

The best way to assist a preschool-aged child deal with death is to tell the child:

"Grandpa has died."

When communicating with a preschooler about his or her terminal illness, the nurse should recognize which statement as being a common misconception for this age?

"I ate my sister's candy so I got a tumor in my belly."

An 11-year-old child with a terminal cancer diagnosis tells the nurse "I know I will die soon. What will it feel like to die?" How should the nurse respond?

"I do not know what it feels like to die. Do you have any ideas about how it feels?"

The nurse is talking to a group of children who are 8 and 9-years-old and have lost someone close to them through death. Which of the following statements made by these children best characterizes the expected concept of death at this age?

"I guess we will all die sometime."

The parents of a 5-year-old boy who is very near death are at the bedside.The parents ask, "Can he hear what we are telling him?" Which response by the nurse would be most appropriate?

"Yes, he can hear what you are telling him and may be able to understand most of it."

A nurse is voicing concern to a peer about the first time caring for a child who is dying. What advice would the peer give the nurse to best help provide appropriate care?

"You will need to explore your feelings about death to provide good care." "You should attend a seminar with professionals who provide care to the dying." "To best help the family you need to demonstrate that you care for their child." "You can meet with the hospice care team to discuss your feelings."

The nurse has been providing support to a family facing the imminent death of their child. How does the nurse know this intervention has been successful?

The parents agree to donate their child's organs after passing away.

A hospice nurse has been preparing parents for the death of their child. How does the nurse recognize that the parents are dealing with anticipatory grief?

The parents have prepared a scrapbook of pictures of their child.

Put the following stages of grief response in the correct order:

denial anger bargaining depression acceptance

The nurse is instructing a parent group on a child's perception of death. Which factors are included in the teaching plan?

developmental age past experience with death of a pet family's attitude toward death

A 4-year-old child is hospitalized for a new diagnosis of type 1 diabetes. When the nurse enters the room to assess the blood glucose, the client yells "No needles, go away!" How should the nurse respond?

Use a calm and consistent approach with the child.

Which nursing consideration is most important when communicating with pediatric clients at the end of life?

client's developmental level

The nurse is caring for a 14-year-old client who has a gunshot wound and whose prognosis is poor. The client will have testing to determine if brain death has occurred. The parents ask if organ donation will be an option if the client is determined to be brain dead. How will the nurse reply?

"Organ donation may be an option; we can discuss this with your child's primary health care provider."

After the death of someone in the child's life, a child of which of the following ages may believe that they caused the death of the person because they were angry with the person?

4 ½ years old

An adolescent is admitted to the hospice unit as he is facing imminent death. How can the hospice nurse help the child cope with death?

Discuss how the adolescent has contributed to the family and community.

Which action should the nurse take first to effectively care for a dying child?

Evaluate personal views of death and dying.

When viewing grief in various age groups, death is viewed as which of the following by 5-year-old children?

They view death as reversible.

A 14-year-old adolescent admitted to the hospital is diagnosed with a terminal illness. Which nursing intervention would be most effective in fostering communication about the terminal illness?

encouraging the adolescent to attend a peer support group

Following the death of a grandparent, a child is heard saying, "Gramma died and she is in heaven." Twenty minutes later the same child is heard saying, "Let's go have supper at Gramma's house." These statements would most likely have been said by a child of which age?

3 years old

Parents tell the nurse that they will do anything to help their child with leukemia get well, even donating everything they have to charity. How does the nurse respond to this situation?

Acknowledge that this must be very difficult for them.

What is the priority nursing intervention for the sibling of a child who has died?

Assess the child's feelings about the sibling's death.

Jill is 20 weeks' gestation, and the fetus is diagnosed with anencephaly. Jill has decided to continue the pregnancy and donate the fetus's organs. Which action by the nurse would be most appropriate?

Document the information on Jill's electronic health record and alert the health care provider about Jill's decision.

A terminally ill client and family are choosing experimental therapies as a last resort. The nurse recognizes anticipatory grieving in the actions and statements of the family. In which way can anticipatory grieving be beneficial?

It can help a family progress in the grief process.

The parents of a dying child have opted for organ transplantation. What is the nurse's responsibility in this situation?

Maintain the child's body on life support.

The nurse is caring for a terminally ill 14-year-old adolescent. What nursing intervention is most important ?

Promote open communication to the adolescent about what to expect.

A full-term infant is born with suspected trisomy 21 based on physical examination. The parents had declined prenatal genetic screening. What approach by the health care team will best allow the parents to adjust to the potential long-term illness?

Provide information about the physical findings and potential diagnosis.

The nurse caring for a dying pediatric client notices that the parents are sitting at the bedside sobbing. Which nursing action is most appropriate in meeting the parents' immediate needs?

Support the parents by appropriately using therapeutic touch.

How would a nurse best advise the family to discuss the seriousness of the diagnosis with their terminally ill 6-year-old?

Tell the child, because the nurse and family are able to help the child with fears.

A new nurse is caring for a child in the final stages of dying. Which nursing action would require the nurse mentor to intervene?

administering oral pain medications for pain relief

The nurse is caring for an infant born at 24 weeks' gestation in the neonatal intensive care unit. At 3 weeks of life, the infant has many complications of prematurity and an uncertain prognosis in the neonatal intensive care unit. The parents have been visiting the infant less frequently and have been less interested in participating in care. The parents ask the nurse when they can start trying again for another pregnancy. What does the nurse think is the cause of the parents' behaviors?

anticipatory grief

A 6-year-old is dealing with the death of a sibling. Which action should the nurse suggest to the family to best support the child with the grieving process?

assisting the child in drawing a picture to be placed in the sibling's casket

After several weeks of caring for a child who is dying, a nurse finds herself hoping that the child will die on the weekend she is scheduled to be off work. This behavior is consistent with which stage of grief?

bargaining

A pediatric client who has two school-aged siblings is dying. Which final act by the siblings should the nurse identify as most important to the siblings' emotional health?

giving the client a hug and kiss and saying "I love you."

To be an effective nurse with a female child who is dying, it is first necessary to:

identify your own reactions and feelings about death.

Which nursing action best promotes a sense of security during the final weeks in the life of a toddler?

maintaining routines and rituals

A nurse admits an 8-year-old child to the hospital. The client is usually cared for at home by the parents with a gastrostomy tube feeds and ventilator. What is the most important source of information in developing the plan of care for the client?

parents' usual routines and care

The nurse should be aware that the preschooler thinks of death as:

punishment for thoughts and actions.

The nurse is caring for a child who is in the dying process. What intervention should the nurse prioritize?

relieving the child's pain and discomfort

The nurse is admitting an 8-year-old client diagnosed with a metastatic brain tumor. When the client's 5-year-old sibling becomes loud and distracting, the nurse identifies this behavior as:

sibling jealousy.

The parents of a 6-year-old have just been told that their child will die shortly. At which age does the nurse realize that children are capable of understanding death?

9 years

The parents of a child with a malignancy disagree with each other about the treatment plan, then express frustration at the staff for not answering call lights quickly enough. Which nursing intervention will best address their needs?

Accept the parents' anger and respond with empathy and acceptance.

A terminally ill 14-year-old is nearing death. The nurse is preparing to provide hygiene and comfort care to the child. The parent asks to give the bed bath. What is the best response by the nurse?

Allow the parent to provide the care.

The adolescent shares that she is afraid to tell her parents she wants to delay cancer treatment until after she attends the prom. Which action by the nurse is best?

Encourage the adolescent to speak with her parents and offer to be present.

A 4-year-old child is facing death and cries frequently for the parents. What is the nurse's most therapeutic action?

Encourage the parents to remain with their child.

The parent of a dying 10-year-old states she is unable to handle watching her child die and starts to leave the unit. What is the priority intervention by the nurse?

Ensure that the child has support during the dying process.

The nurse is caring for a preschooler with a terminal illness. Which intervention would facilitate the child to address feelings about the illness?

Have the child draw a picture about the illness.

The family of a terminally ill client is asking about the benefits of hospice care. Which statement by the nurse provides accurate information?

Hospice is designed to meet the individual client's needs.

The nurse notes that a chronically ill child has not been seeing the health care provider for several months, although monthly checkups and blood work are needed to help maintain the illness. What should the nurse suspect as a reason for the child missing appointments?

The parents are having a difficult time grieving with the idea of the child's illness.

A child who knows his disease is terminal tells you that when he gets better he is going to be a doctor and cure everyone in the whole world. This statement is most likely a manifestation of:

a bargaining stage of grief.

The parent of a terminally ill pediatric client reports crying, not being able to sleep at night, and an intense longing to hold the client. The parent also states not eating due to nausea. Based on these behaviors, what condition does the nurse suspect?

anticipatory grief