MULTIPLE CHOICE

1. The nurse case manager is planning a care conference about a young child who has complex health care needs and will soon be discharged home. Who should the nurse invite to the conference?

a. Family and nursing staff

b. Social worker, nursing staff, and primary care physician

c. Family and key health professionals involved in child’s care

d. Primary care physician and key health professionals involved in the child’s care

2. Which represents a common best practice in the provision of services to children with special needs?

a. Care is now being focused on the child’s chronologic age.

b. Children with special needs are being integrated into regular classrooms.

c. Children with special needs no longer have to be cared for by their families.

d. Children with special needs are being separated into residential treatment facilities.

3. Lindsey, age 5 years, will be starting kindergarten next month. She has cerebral palsy, and it has been determined that she needs to be in a special education classroom. Her parents are tearful when telling the nurse about this and state that they did not realize her disability was so severe. The best interpretation of this situation is that:

a. this is a sign parents are in denial.

b. this is a normal anticipated time of parental stress.

c. the parents need to learn more about cerebral palsy.

d. the parents are used to having expectations that are too high.

4. Approach behaviors are those coping mechanisms that result in a family’s movement toward adjustment and resolution of the crisis of having a child with a chronic illness or disability. Which is considered an approach behavior?

a. Is unable to adjust to a progression of the disease or condition

b. Anticipates future problems and seeks guidance and answers

c. Looks for new cures without a perspective toward possible benefit

d. Fails to recognize seriousness of child’s condition despite physical evidence

5. Families progress through various stages of reactions when a child is diagnosed with a chronic illness or disability. After the shock phase, a period of adjustment usually follows. This is often characterized by which of the following responses?

a. Denial

b. Guilt and anger

c. Social reintegration

d. Acceptance of child’s limitations

6. Which nursing intervention is especially helpful in assessing parental guilt when a disability or chronic illness is diagnosed?

a. Ask the parents if they feel guilty.

b. Discuss guilt only after the parents mention it.

c. Discuss the meaning of the parents’ religious and cultural background.

d. Observe for signs of overprotectiveness.

7. 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 a:

a. sense of hopefulness.

b. sense of chronic sorrow.

c. belief that procedures are a deserved punishment.

d. belief that procedures are an important part of care.

8. The nurse comes into the room of a child who was just diagnosed with a chronic disability. The child’s parents begin to yell at the nurse about a variety of concerns. Which is the nurse’s best response?

a. “What is really wrong?”

b. “Being angry is only natural.”

c. “Yelling at me will not change things.”

d. “I will come back when you settle down.”

9. A common parental reaction to a child with special needs is parental overprotection. Parental behavior suggestive of this includes:

a. giving inconsistent discipline.

b. providing consistent, strict discipline.

c. forcing child to help self, even when not capable.

d. encouraging social and educational activities not appropriate to child’s level of capability.

10. Most parents of children with special needs tend to experience chronic sorrow. This is characterized by:

a. lack of acceptance of child’s limitation.

b. lack of available support to prevent sorrow.

c. periods of intensified sorrow when experiencing anger and guilt.

d. periods of intensified sorrow and loss that occur in waves over time.