21. Which term best describes a multidisciplinary approach to the management of a terminal illness that focuses on symptom control and support?

a. Dying care

b. Curative care

c. Restorative care

d. Palliative care

22. Which best describes how preschoolers react to the death of a loved one?

a. Preschooler is too young to have a concept of death.

b. Preschooler may feel guilty and responsible for the death.

c. Grief is acute but does not last long at this age.

d. Grief is usually expressed in the same way in which the adults in the preschooler’s life are expressing grief.

23. A preschooler is found digging up a pet bird that was recently buried after it died. The best explanation for this behavior is that:

a. he has a morbid preoccupation with death.

b. he is looking to see whether a ghost took it away.

c. the loss is not yet resolved, and professional counseling is needed.

d. reassurance is needed that the pet has not gone somewhere else.

24. At what age do most children have an adult concept of death as being inevitable, universal, and irreversible?

a. 4 to 5 years

b. 6 to 8 years

c. 9 to 11 years

d. 12 to 16 years

25. Which is most descriptive of a school-age child’s reaction to death?

a. Is very interested in funerals and burials

b. Has little understanding of words such as forever

c. Imagines the deceased person to be still alive

d. Has an idealistic view of world and criticizes funerals as barbaric

26. At what developmental period do children have the most difficulty coping with death, particularly if it is their own?

a. Toddlerhood

b. Preschool

c. School-age

d. Adolescence

27. A school-age child is diagnosed with a life-threatening illness. The parents want to protect their child from knowing the seriousness of the illness. The nurse should explain that:

a. this will help the child cope effectively by denial.

b. this attitude is helpful to give parents time to cope.

c. terminally ill children know when they are seriously ill.

d. terminally ill children usually choose not to discuss the seriousness of their illness.

28. A cure is no longer possible for a young child with cancer. The nursing staff recognizes that the goal of treatment must shift from cure to palliation. Which is an important consideration at this time?

a. The family is included in the decision to shift the goals of treatment.

b. The decision must be made by the health professionals involved in the child’s care.

c. The family needs to understand that palliative care takes place in the home.

d. The decision should not be communicated to the family because it will encourage a sense of hopelessness.

29. The nurse is caring for a child who has just died. The parents ask to be left alone so that they can rock their child one more time. The nurse’s most appropriate response is to:

a. grant their request.

b. assess why they feel this is necessary.

c. discourage this because it will only prolong their grief.

d. kindly explain that they need to say good-bye to their child now and leave.

30. The nurse is talking with the parents of a child who died 6 months ago. They sometimes still “hear” the child’s voice and have trouble sleeping. They describe feeling “empty” and depressed. The nurse should recognize that:

a. these are normal grief responses.

b. the pain of the loss is usually less by this time.

c. these grief responses are more typical of the early stages of grief.

d. this grieving is essential until the pain is gone and the child is gradually forgotten.