CHAPTER 17: CHRONIC CONDITIONS My Nursing Test Banks

CHAPTER 17: CHRONIC CONDITIONS

MULTIPLE CHOICE

1.Which of the following best describes the term disability?

a.

unable to work at 100% of the ability of the average person in the society

b.

functional limitation preventing or interfering with the ability to perform age-expected activities

c.

a condition in which a person is prevented by limitations from doing the work he or she needs to do

d.

having a part of the body that functions at 75% or less of its ability

ANS: B

Feedback

A

Incorrect: Disability is not defined as being unable to work at 100% of the ability of the average person in the society.

B

Correct: Disability is best defined as a functional limitation that prevents or interferes with a persons ability to perform age-expected activities.

C

Incorrect: Disability is not defined as a condition in which a person is prevented by limitations from doing the work he or she needs to do.

D

Incorrect: Disability is not defined as having a part of the body that functions at 75% or less of its ability.

PTS: 1 REF: p. 556 Chronic Conditions OBJ: Cognitive Level: Knowledge

2.The term chronic condition typically refers to a medical state or degree of health that exists for a minimum of how many months?

a.

3

c.

9

b.

6

d.

12

ANS: A

Feedback

A

Correct: A chronic condition typically refers to a medical state or degree of health that exists for a minimum of 3 months.

B

Incorrect: A chronic condition typically does not refer to a medical state or degree of health that exists for a minimum of 6 months.

C

Incorrect: A chronic condition typically does not refer to a medical state or degree of health that exists for a minimum of 9 months.

D

Incorrect: A chronic condition typically does not refer to a medical state or degree of health that exists for a minimum of 12 months.

PTS: 1 REF: p. 556 Chronic Conditions OBJ: Cognitive Level: Knowledge

3.The nurse assessing a child with a chronic illness evaluates the trajectory. The nurse is trying to find out:

a.

how fast the child can move

b.

how long the child has had the illness

c.

whether the condition will get better, worse, or stay the same

d.

who else in the family has this condition

ANS: C

Feedback

A

Incorrect: The trajectory does not refer to how fast the child can move.

B

Incorrect: The trajectory does not refer to how long the child has had the illness.

C

Correct: The trajectory refers to the progression of the condition, i.e., whether it will get better, worse, or stay the same.

D

Incorrect: The trajectory does not refer to who else in the family has this condition.

PTS:1REF:p. 556 Chronic Conditions

OBJ: Cognitive Level: Comprehension

4.A child has a disability that is not visible to others. Research has shown that children with a condition that is less visible to others will:

a.

frequently have more difficulty adjusting to the condition than those with a more visible disability

b.

have the same amount of difficulty adjusting to the condition as people with a visible disability

c.

often forget for long periods of time that they have a disability since it is not visible

d.

seek more attention from significant others compared to people with a more visible disability

ANS: A

Feedback

A

Correct: Research has shown that children with a condition that is less visible to others will frequently have more difficulty adjusting to the condition than those with a more visible disability.

B

Incorrect: Research has not shown that children with a condition that is less visible to others will have the same amount of difficulty adjusting to the condition as people with a visible disability.

C

Incorrect: Research has not shown that children with a condition that is less visible to others often forget for long periods of time that they have a disability since it is not visible.

D

Incorrect: Research has not shown that children with a condition that is less visible to others seek more attention from significant others compared to people with a more visible disability.

PTS: 1 REF: p. 557 Dimensions of Childhood Chronic Conditions

OBJ: Cognitive Level: Comprehension

5.The deficit-orientation model of chronic conditions assumes that people with chronic conditions are:

a.

lacking important aspects of life

b.

lacking in sufficient finances to receive adequate medical services

c.

intellectually impaired

d.

unable to function in society

ANS: A

Feedback

A

Correct: The deficit-orientation model of chronic conditions assumes that people with chronic conditions are lacking important aspects of life.

B

Incorrect: The deficit-orientation model of chronic conditions does not assume that people with chronic conditions are lacking in sufficient finances to receive adequate medical services.

C

Incorrect: The deficit-orientation model of chronic conditions does not assume that people with chronic conditions are intellectually impaired.

D

Incorrect: The deficit-orientation model of chronic conditions does not assume that people with chronic conditions are unable to function in society.

PTS: 1 REF: p. 557 Dimensions of Childhood Chronic Conditions

OBJ: Cognitive Level: Comprehension

6.Using the deficit-orientation model of chronic conditions, clinicians assessing the client would look for:

a.

unusual strengths and talents

c.

abnormalities and problems

b.

personality traits

d.

financial problems and debts

ANS: C

Feedback

A

Incorrect: Using the deficit-orientation model of chronic conditions, clinicians assessing the client would not look for unusual strengths and talents.

B

Incorrect: Using the deficit-orientation model of chronic conditions, clinicians assessing the client would not look for personality traits.

C

Correct: Using the deficit-orientation model of chronic conditions, clinicians assessing the client would look for abnormalities and problems.

D

Incorrect: Using the deficit-orientation model of chronic conditions, clinicians assessing the client would not look for financial problems and debts.

PTS: 1 REF: p. 557 Dimensions of Childhood Chronic Conditions

OBJ: Cognitive Level: Application

7.The deficit-orientation model of chronic conditions tends to see which of the following as the expert?

a.

the client

c.

the professional(s)

b.

the clients family

d.

the evidence-based literature

ANS: C

Feedback

A

Incorrect: The deficit-orientation model of chronic conditions does not tend to see the client as the expert.

B

Incorrect: The deficit-orientation model of chronic conditions does not tend to see the clients family as the expert.

C

Correct: The deficit-orientation model of chronic conditions tends to see the professional(s) as the expert.

D

Incorrect: The deficit-orientation model of chronic conditions does not tend to see the evidence-based literature as the expert.

PTS: 1 REF: p. 557 Dimensions of Childhood Chronic Conditions

OBJ: Cognitive Level: Comprehension

8.The health-orientation model of disability tends to be critical of:

a.

people who are disabled

b.

professionals making negative appraisals

c.

the family of the person who is disabled

d.

healthy persons who ignore people who are disabled

ANS: B

Feedback

A

Incorrect: The health-orientation model of disability does not tend to be critical of people who are disabled.

B

Correct: The health-orientation model of disability tends to be critical of professionals who make negative appraisals of those with chronic conditions, such as saying the individual is in denial.

C

Incorrect: The health-orientation model of disability does not tend to be critical of the family of the person who is disabled.

D

Incorrect: The health-orientation model of disability does not tend to be critical of healthy persons who ignore people who are disabled.

PTS: 1 REF: p. 557 Dimensions of Childhood Chronic Conditions

OBJ: Cognitive Level: Comprehension

9.The ordinary model of chronic conditions differs from other models because in this model, people with chronic conditions view themselves as:

a.

leading ordinary lifestyles

b.

wanting to be more ordinary

c.

somewhat extraordinary compared to others

d.

experiencing conditions similar to those experienced by many other individuals

ANS: A

Feedback

A

Correct: The ordinary model of chronic conditions differs from other models because in this model, people with chronic conditions view themselves as leading ordinary lifestyles. The chronic condition does not assume a central role in the development of identity or in the activities of daily living.

B

Incorrect: The ordinary model of chronic conditions differs from other models because in this model, people with chronic conditions do not view themselves as wanting to be more ordinary.

C

Incorrect: The ordinary model of chronic conditions differs from other models because in this model, people with chronic conditions do not view themselves as somewhat extraordinary compared to others.

D

Incorrect: The ordinary model of chronic conditions differs from other models because in this model, people with chronic conditions do not view themselves as experiencing conditions similar to those experienced by many other individuals.

PTS: 1 REF: p. 557 Dimensions of Childhood Chronic Conditions

OBJ: Cognitive Level: Comprehension

10.The health-orientation model of chronic conditions portrays the relationship between client and professional as a:

a.

partnership

c.

patient-client relationship

b.

contract

d.

teacher-learner relationship

ANS: A

Feedback

A

Correct: The health-orientation model of chronic conditions portrays the relationship between client and professional as a partnership, with each individual bringing a different type of expertise to the situation.

B

Incorrect: The health-orientation model of chronic conditions does not portray the relationship between client and professional as a contract.

C

Incorrect: The health-orientation model of chronic conditions does not portray the relationship between client and professional as a patient-client relationship.

D

Incorrect: The health-orientation model of chronic conditions does not portray the relationship between client and professional as a teacher-learner relationship.

PTS: 1 REF: p. 557 Dimensions of Childhood Chronic Conditions

OBJ: Cognitive Level: Comprehension

11.Children with a chronic condition must learn to manage the symptoms. The other priority, time-consuming thing they must manage is which of the following aspects of their lives?

a.

their emotions

c.

their interaction with peers

b.

the treatments

d.

their success in academics

ANS: B

Feedback

A

Incorrect: Children with a chronic condition must learn to manage the symptoms. The other priority, time-consuming thing they do not need to manage are their emotions.

B

Correct: Children with a chronic condition must learn to manage the symptoms. The other priority, time-consuming thing they must manage are the treatments associated with the condition.

C

Incorrect: Children with a chronic condition must learn to manage the symptoms. The other priority, time-consuming thing they do not need to manage is their interaction with peers.

D

Incorrect: Children with a chronic condition must learn to manage the symptoms. The other priority, time-consuming thing they do not need to manage is their success in academics.

PTS:1REF:p. 559 Living with Chronic Conditions

OBJ: Cognitive Level: Comprehension

12.A mother complains to the nurse that her school-aged child with a disability does not readily comply with treatments and wants to do them differently or at a later time. Select the best response for the nurse.

a.

I suggest you have some form of punishment for not responding positively to the treatments.

b.

School-aged children often respond to treatments with manipulative behavior or boundary testing.

c.

You must remember that she has a disability and deserves that you accept some deviance from normal behavior.

d.

Your child should be allowed to participate in planning her care, thus requiring you to be flexible in planning treatments.

ANS: B

Feedback

A

Incorrect: When a mother complains to the nurse that her school-aged child with a disability does not readily comply with treatments and wants to do them differently or at a later time, your best response would not be: I suggest you have some form of punishment for not responding positively to the treatments.

B

Correct: When a mother complains to the nurse that her school-aged child with a disability does not readily comply with treatments and wants to do them differently or at a later time, your best response would be: School-aged children often respond to treatments with manipulative behavior or boundary testing.

C

Incorrect: When a mother complains to the nurse that her school-aged child with a disability does not readily comply with treatments and wants to do them differently or at a later time, your best response would not be: You must remember that she has a disability and deserves that you accept some deviance from normal behavior.

D

Incorrect: When a mother complains to the nurse that her school-aged child with a disability does not readily comply with treatments and wants to do them differently or at a later time, your best response would not be: Your child should be allowed to participate in planning her care, thus requiring you to be flexible in planning treatments.

PTS:1REF:p. 559 Living with Chronic Conditions

OBJ: Cognitive Level: Application

13.The nurse is administering treatments to a school-aged child with a disability. This child is in a state of remission and nearly symptom-free. He tries to talk his caregivers into not bringing him to treatments and wants to stop as soon as he starts the treatment, saying he really does not need it. After assessing for the need, the nurse would begin work to get him to accept his treatments by:

a.

offering him some positive reinforcements, such as candy or a food treat that is allowed in his diet in return for doing the treatments

b.

asking his caregivers to talk with him and offer some consequences if he does not do the treatments as prescribed

c.

listening to the child, then explaining and discussing why treatments are necessary during periods of lessened or no symptoms

d.

telling the child about other children his age who have continued their treatments despite being in remission

ANS: C

Feedback

A

Incorrect: After assessing for the need, the nurse would not begin work to get him to accept his treatments by offering him some positive reinforcements, such as candy or a food treat that is allowed in his diet in return for doing the treatments.

B

Incorrect: After assessing for the need, the nurse would not begin work to get him to accept his treatments by asking his caregivers to talk with him and offer some consequences if he does not do the treatments as prescribed.

C

Correct: After assessing for the need, the nurse would begin work to get him to accept his treatments by listening to the child, then explaining and discussing why treatments are necessary during periods of lessened or no symptoms. His view is partially due to his concrete thought processes and limited ability to understand disease processes.

D

Incorrect: After assessing for the need, the nurse would not begin work to get him to accept his treatments by telling the child about other children his age who have continued their treatments despite being in remission.

PTS:1REF:p. 559 Living with Chronic Conditions

OBJ: Cognitive Level: Application

14.A mother tells the school nurse that she thinks her son, who has a chronic illness, is upset about what other children may think about his disability. Which course of action would be best for the nurse to take initially?

a.

Ask the child what is bothering him, to see if it is what the other children are thinking.

b.

Teach the mother to ask open-ended, age-appropriate questions to find out what is of concern to the child.

c.

Include child in organized sporting events and other social activities

d.

Talk to some of the peers to find out what their thinking is in regard to their friend with a chronic illness.

ANS: B

Feedback

A

Incorrect: When a mother tells the school nurse that she thinks her son, who has a chronic illness, is upset about what other children may think about his disability, your best course of action initially would not be to ask the child what is bothering him, to see if it is what the other children are thinking.

B

Correct: When a mother tells the school nurse that she thinks her son, who has a chronic illness, is upset about what other children may think about his disability, your best course of action initially would be to teach the mother to ask open-ended, age-appropriate questions to find out what is of concern to the child.

C

Incorrect: When a mother tells the school nurse that she thinks her son, who has a chronic illness, is upset about what other children may think about his disability, your best course of action initially would not be to include him in organized sporting events and other social activities.

D

Incorrect: When a mother tells the school nurse that she thinks her son, who has a chronic illness, is upset about what other children may think about his disability, your best course of action initially would not be to talk to some of his peers to find out what their thinking is in regard to their friend with a chronic illness.

PTS:1REF:p. 559 Living with Chronic Conditions

OBJ: Cognitive Level: Application

15.The nurse is working with a teenager who has insulin-dependent diabetes. This adolescent has returned to the hospital after being discharged a month ago. Both hospitalizations are because of the blood sugar getting out of control. The nurse suspects the teen is not open about the diabetes then interacting with peers. Select the statement that would be most helpful for the nurse to say.

a.

Some teenagers who have diabetes dont like friends to know about it. How has it been for you?

b.

Have you told your friends and classmates about your diabetes and the need to eat in a healthier way?

c.

You really need to tell your friends and classmates about your diabetes and let them help you manage it.

d.

I suspect you postpone testing your blood sugar and taking your insulin then you are with friends. Am I right?

ANS: A

Feedback

A

Correct: The statement that would be most helpful for the nurse to say would be: Some teenagers who have diabetes dont like friends to know about it. How has it been for you? Use of open-ended, nonjudgmental questions gives the child permission to talk about how he or she is managing the condition and feelings related to the diabetes.

B

Incorrect: The statement Have you told your friends and classmates about your diabetes and the need to eat in a healthier way? would not be the most helpful for the nurse to say.

C

Incorrect: The statement You really need to tell your friends and classmates about your diabetes and let them help you manage it would not be the most helpful for the nurse to say.

D

Incorrect: The statement I suspect you postpone testing your blood sugar and taking your insulin then you are with friends. Am I right? would not be the most helpful for the nurse to say.

PTS:1REF:p. 559 Living with Chronic Conditions

OBJ: Cognitive Level: Application

16.The father of a 15-month-old child with a chronic health condition asks the nurse if his child will experience the terrible twos. The nurse will base the answer on which of the following beliefs?

a.

Children with chronic illness use all their energy coping with the illness and do not tend to go through these age-related stages.

b.

Developmental stages tend to be delayed, if experienced at all.

c.

Children with chronic illnesses demonstrate similar age-dependent behaviors as any other child their age.

d.

Children with chronic illness are often so protected by caregivers that they dont experience the terrible twos.

ANS: C

Feedback

A

Incorrect: The nurse will not base the answer on the belief that children with chronic illness use all their energy coping with the illness and do not tend to go through these age-related stages.

B

Incorrect: The nurse will not base the answer on the belief that developmental stages tend to be delayed, if experienced at all in children with chronic illnesses.

C

Correct: The nurse will base the answer on the belief that children with chronic illnesses demonstrate similar age-dependent behaviors as any other child their age. Children with chronic illnesses have the same developmental tasks as any other child. Therefore, this 15 month-old child will experience the terrible twos.

D

Incorrect: The nurse will not base the answer on the belief that children with chronic illness are often so protected by caregivers that they dont experience the terrible twos.

PTS:1REF:p. 560 Living with Chronic Conditions

OBJ: Cognitive Level: Application

17.Public Law 94-142, Education for All Handicapped Children Act of 1975, requires which of the following for children with a disability?

a.

a special classroom there they dont have to interact with children who are not disabled

b.

education in the least restrictive environment that is appropriate for the child

c.

specific teachers who are familiar with the disease process

d.

training of the caregivers, or a caretaker designated by the caregivers, in homeschooling the child

ANS: B

Feedback

A

Incorrect: Public Law 94-142, Education for All Handicapped Children Act of 1975, does not require a special classroom there they dont have to interact with children who are not disabled.

B

Correct: Public Law 94-142, Education for All Handicapped Children Act of 1975, requires a free, appropriate public education in the least restrictive environment that is appropriate for the child, for all children ages 5-18 years with a disability.

C

Incorrect: Public Law 94-142, Education for All Handicapped Children Act of 1975, does not require specific teachers who are familiar with the disease process.

D

Incorrect: Public Law 94-142, Education for All Handicapped Children Act of 1975, does not require training of the caregivers, or a caretaker designated by the caregivers, in homeschooling the child.

PTS:1REF:p. 561 Living with Chronic Conditions

OBJ: Cognitive Level: Comprehension

18.The placement of children with chronic illnesses or multiple disabilities in a regular classroom is based on which of the following concepts?

a.

saving tax dollars

c.

integrating students to enhance diversity

b.

maximizing available teachers

d.

mainstreaming

ANS: D

Feedback

A

Incorrect: The placement of children with chronic illnesses or multiple disabilities in a regular classroom is not based on the concept of saving tax dollars.

B

Incorrect: The placement of children with chronic illnesses or multiple disabilities in a regular classroom is not based on the concept of maximizing available teachers.

C

Incorrect: The placement of children with chronic illnesses or multiple disabilities in a regular classroom is not based on the concept of integrating students to enhance diversity.

D

Correct: The placement of children with chronic illnesses or multiple disabilities in a regular classroom is based on the concept mainstreaming. When children with chronic illnesses are included in regular classes, they become part of the class, without their disability being the most important characteristic.

PTS:1REF:p. 561 Living with Chronic Conditions

OBJ: Cognitive Level: Comprehension

19.Individuals with Disabilities Education Act (Part H of Public Law 102-119, formerly Education for the Handicapped Amendments of 1986) provides coverage for which of the following groups of children who are handicapped or at risk for later delay?

a.

newborn to 21 years

c.

4 to 16 years

b.

newborn to 18 years

d.

3 to 21 years

ANS: A

Feedback

A

Correct: Individuals with Disabilities Education Act (Part H of Public Law 102-119, formerly Education for the Handicapped Amendments of 1986) provides coverage for children in the age period from newborn to 21 years who are handicapped or at risk for later delay.

B

Incorrect: Individuals with Disabilities Education Act (Part H of Public Law 102-119, formerly Education for the Handicapped Amendments of 1986) does not provide coverage for children in the age period from newborn to 18 years who are handicapped or at risk for later delay.

C

Incorrect: Individuals with Disabilities Education Act (Part H of Public Law 102-119, formerly Education for the Handicapped Amendments of 1986) does not provide coverage for children in the age period from 4 to 16 years who are handicapped or at risk for later delay.

D

Incorrect: Individuals with Disabilities Education Act (Part H of Public Law 102-119, formerly Education for the Handicapped Amendments of 1986) does not provide coverage for children in the age period from 3 to 21 years who are handicapped or at risk for later delay.

PTS:1REF:p. 561 Living with Chronic Conditions

OBJ: Cognitive Level: Knowledge

20.The nurse is working with the caregivers of a toddler who is HIV positive. The caregivers want to enroll the toddler into a preschool program but express a concern that no preschool program will accept their child. The nurse will advise the caregivers that under the Americans with Disabilities Act of 1990:

a.

children with disabilities, including HIV, must be offered a program that is separate and equal to the programs for nondisabled children

b.

preschool programs must accept children with chronic conditions, including those who are HIV positive

c.

preschool programs were granted the right to refuse admission to any child who is contagious

d.

if the child is less than 50% disabled, the school has to accept the child

ANS: B

Feedback

A

Incorrect: The nurse will not advise the caregivers that under the Americans with Disabilities Act of 1990 children with disabilities, including HIV, must be offered a program that is separate and equal to the programs for nondisabled children.

B

Correct: The nurse will advise the caregivers that under the Americans with Disabilities Act of 1990 preschool programs must accept children with chronic conditions, including those who are HIV positive.

C

Incorrect: The nurse will not advise the caregivers that under the Americans with Disabilities Act of 1990 preschool programs were granted the right to refuse admission to any child who is contagious.

D

Incorrect: The nurse will not advise the caregivers that under the Americans with Disabilities Act of 1990 if the child is less than 50% disabled, the school has to accept the child.

PTS:1REF:p. 562 Living with Chronic Conditions

OBJ: Cognitive Level: Comprehension

21.You are the nurse working with a child who has a chronic illness and is confined to a wheelchair. This child is being placed in a new classroom with children she does not know. Which of the following initial actions by the nurse would be most helpful in assisting the child to adjust to this change?

a.

Provide classroom instruction on disabilities for all students.

b.

Listen to and explore the childs concerns about this change.

c.

Visit the classroom and talk with the children about how they need to interact with the child who is disabled.

d.

Talk with the teacher about how important it is that teachers model acceptance of the child who is disabled.

ANS: B

Feedback

A

Incorrect: The initial actions by the nurse in assisting the child to adjust to this change that would not be most helpful include providing classroom instruction on disabilities for all students.

B

Correct: The initial actions by the nurse in assisting the child to adjust to this change that would be most helpful include listening to and exploring the childs concerns about this change.

C

Incorrect: The initial actions by the nurse in assisting the child to adjust to this change that would not be most helpful include visiting the classroom and talking with the children about how they need to interact with the child who is disabled.

D

Incorrect: The initial actions by the nurse in assisting the child to adjust to this change that would not be most helpful include talk with the teacher about how important it is that teachers model acceptance of the child who is disabled.

PTS:1REF:p. 564 Living with Chronic Conditions

OBJ: Cognitive Level: Application

22.A child with cerebral palsy tells the school nurse that he feels all right in his own classroom, but then he is out on the playground, other children stare at him and he does not know what to do about it. The nurse decides to teach the child to use a frontal approach. Which of the following activities would be most helpful to a child learning to use a frontal approach?

a.

role-play with the nurse, ignoring other people by staring or being rude

b.

a talk by the nurse on what other children say to stop people from staring

c.

role-play with the nurse staring and the child asking, Do you have a question?

d.

teaching the child to ask the person what they are staring at

ANS: C

Feedback

A

Incorrect: Role-playing with the nurse, ignoring other people by staring or being rude would not be most helpful to a child learning to use a frontal approach.

B

Incorrect: A talk by the nurse on what other children say to stop people from staring would not be most helpful to a child learning to use a frontal approach.

C

Correct: Role-playing with the nurse staring and the child asking, Do you have a question? would be most helpful to a child learning to use a frontal approach.

D

Incorrect: Teaching the child to ask the person what they are staring at would not be most helpful to a child learning to use a frontal approach.

PTS:1REF:p. 569 Living with Chronic Conditions

OBJ: Cognitive Level: Application

23.An older child is having difficulty coping with a chronic condition. Talking with which of the following people is one of the best coping strategies available?

a.

the childs health care practitioner

b.

a nurse practitioner

c.

another child with the same condition

d.

a nursing student who is near the childs age

ANS: C

Feedback

A

Incorrect: For an older child having difficulty coping with a chronic condition, talking with the childs health care practitioner is not one of the best coping strategies available.

B

Incorrect: For an older child having difficulty coping with a chronic condition, talking with a nurse practitioner is not one of the best coping strategies available.

C

Correct: For an older child having difficulty coping with a chronic condition, talking with another child with the same condition is one of the best coping strategies available.

D

Incorrect: For an older child having difficulty coping with a chronic condition, talking with a nursing student who is near the childs age is not one of the best coping strategies available.

PTS:1REF:p. 563 Living with Chronic Conditions

OBJ: Cognitive Level: Comprehension

24.Adolescents with terminal illnesses usually acknowledge the terminal nature of the illness and:

a.

plan optimistically for the future

b.

begin a chronic stage of denial

c.

worry about who will get their favorite belongings

d.

go into a state of depression for a period of time

ANS: A

Feedback

A

Correct: Adolescents with terminal illnesses usually acknowledge the terminal nature of the illness and plan optimistically for the future.

B

Incorrect: Adolescents with terminal illnesses usually acknowledge the terminal nature of the illness; however, they do not begin a chronic stage of denial.

C

Incorrect: Adolescents with terminal illnesses usually acknowledge the terminal nature of the illness; however, they do not worry about who will get their favorite belongings.

D

Incorrect: Adolescents with terminal illnesses usually acknowledge the terminal nature of the illness; however, they do not go into a state of depression for a period of time.

PTS:1REF:p. 564 Living with Chronic Conditions

OBJ: Cognitive Level: Comprehension

25.The effect of the challenges and demands of caring for a child with a chronic condition has been given which of the following terms?

a.

caregiver burden

c.

plus four stress

b.

burnout

d.

runaway caregivers

ANS: A

Feedback

A

Correct: The effect of the challenges and demands of caring for a child with a chronic condition has been called caregiver burden.

B

Incorrect: The effect of the challenges and demands of caring for a child with a chronic condition has not been called burnout.

C

Incorrect: The effect of the challenges and demands of caring for a child with a chronic condition has not been called plus four stress.

D

Incorrect: The effect of the challenges and demands of caring for a child with a chronic condition has not been called runaway caregivers.

PTS:1REF:p. 566 Living with Chronic Conditions

OBJ: Cognitive Level: Comprehension

26.The nurse is working with the family of a child with a chronic condition. The family seems to be overwhelmed with the care and in need of a periodic break from the care. The nurse is most likely to talk with the family about which of the following solutions to this problem?

a.

devising a rotation of family coverage

c.

using friends to give the family a rest

b.

scheduling respite care

d.

getting a babysitter

ANS: B

Feedback

A

Incorrect: The nurse is not most likely to talk with the family of a child with a chronic condition about devising a rotation of family coverage as a solution to their being overwhelmed with the care and in need of a periodic break from the care.

B

Correct: The nurse is most likely to talk with the family of a child with a chronic condition about scheduling respite care as a solution to their being overwhelmed with the care and in need of a periodic break from the care. Respite care involves having a person relieve the usual caregiver of caregiving responsibilities for a period of time.

C

Incorrect: The nurse is not most likely to talk with the family of a child with a chronic condition about using friends to give the family a rest as a solution to their being overwhelmed with the care and in need of a periodic break from the care.

D

Incorrect: The nurse is not most likely to talk with the family of a child with a chronic condition about getting a babysitter as a solution to their being overwhelmed with the care and in need of a periodic break from the care. Some children with a chronic illness require too complex a level of care for a babysitter.

PTS:1REF:p. 566 Living with Chronic Conditions

OBJ: Cognitive Level: Application

27.The caregivers of a child with a chronic condition are believed to go through an adjustment period known by which of the following names?

a.

grieving

c.

yo-yo syndrome

b.

chronic (cyclic) sorrow

d.

honeymoon phase

ANS: B

Feedback

A

Incorrect: The caregivers of a child with a chronic condition do go through an adjustment period similar to the grief process. However, the adjustment process does not happen just once with a final resolution as suggested by the stage perspective as seen in the grieving process.

B

Correct: The caregivers of a child with a chronic condition are believed to go through an adjustment period known as chronic (cyclic) sorrow. The notion is that the adjustment process does not happen just once with a final resolution. Instead chronic sorrow reoccurs at often predictable times, and perhaps with increasing intensity during the childs life. Examples include then developmental milestones are unmet or delayed, such as walking, talking, etc.

C

Incorrect: The caregivers of a child with a chronic condition are believed to go through an adjustment period. However, it is not known as a yo-yo syndrome.

D

Incorrect: The caregivers of a child with a chronic condition are believed to go through an adjustment period. However, it is not known as the honeymoon phase.

PTS:1REF:p. 567 Living with Chronic Conditions

OBJ: Cognitive Level: Comprehension

28.The nurse working with the caregivers of a child with a chronic illness is aware that the family will:

a.

have likely completed the grieving process

b.

experience recurring grief and adjustment at predictable times during the childs life

c.

be consistently maladjusted as long as they are responsible for the childs care

d.

burn out early but regain their strength then working with the professional team

ANS: B

Feedback

A

Incorrect: The family of a child with a chronic condition do go through an adjustment process similar to the grieving process. However, this process does not happen just once with a final resolution of acceptance as suggested by the stage perspective as seen in the grieving process.

B

Correct: The family of a child with a chronic condition do experience recurring grief and adjustment at predictable times during the childs life. This concept is called chronic (cyclic) sorrow.

C

Incorrect: The family of a child with a chronic condition are not consistently maladjusted as long as they are responsible for the childs care. This is the view of the deficit-orientation model. The health-oriented model proponents do not deny that the family may be maladjusted, but instead focus on positive aspects of life.

D

Incorrect: The family of a child with a chronic condition must learn to manage the illness and identify resources, and maintain the family unit for an extended period of time.

PTS:1REF:p. 567 Living with Chronic Conditions

OBJ: Cognitive Level: Application

29.A family caring for a child with a chronic health condition has rearranged and continues to rearrange their life schedule and routine. This is an attempt to make life better for the child and the family and to keep important aspects of the pre-illness lifestyle. The strategies used by the family are referred to as:

a.

resorting

c.

organization

b.

management

d.

normalization

ANS: D

Feedback

A

Incorrect: The strategies used by this family are not referred to as resorting.

B

Incorrect: The strategies used by this family are not referred to as management. Although the caregivers must learn management skills, this option is not an appropriate description of the strategies used by this family.

C

Incorrect: The strategies used by this family are not referred to as organization.

D

Correct: The strategies used by this family are referred to as normalization. This term is defined as cognitive and behavioral strategies used by the family in order to view itself as normal.

PTS:1REF:p. 567 Living with Chronic Conditions

OBJ: Cognitive Level: Comprehension

30.Ideally the role of the caregiver caring for a child with a chronic condition can be described as:

a.

staying stable as caregiver

b.

moving from caregiver to careful and systematic observer to behavior modifier

c.

changing in a planned way from provider to manager to supervisor to consultant

d.

lifelong companion and advocate

ANS: C

Feedback

A

Incorrect: Ideally the role of the caregiver caring for a child with a chronic condition is not described as staying stable as caregiver. Caregivers need to negotiate with the child regarding then and how to shift responsibility for care to the child. The goal is not for the caregiver to continue giving care to the child forever, but for the child to eventually be able to independently manage the condition.

B

Incorrect: Ideally the role of the caregiver caring for a child with a chronic condition is not described as moving from caregiver to careful and systematic observer to behavior modifier.

C

Correct: Ideally the role of the caregiver caring for a child with a chronic condition can be described as changing in a planned way from provider to manager to supervisor to consultant. At the same time, the childs role shifts from receiver to co-provider to manager to supervisor, and finally, chief executive officer.

D

Incorrect: Ideally the role of the caregiver caring for a child with a chronic condition is not described as a lifelong companion and advocate.

PTS:1REF:p. 568 Living with Chronic Conditions

OBJ: Cognitive Level: Application

31.The caregivers of a child with a chronic health condition say they are feeling frustrated and like professionals are discounting their expertise. The nurse will help them resolve this problem by teaching them to:

a.

directly express frustration and confront the discounting of their expertise with I statements such as, When you (do a specific thing or say a specific thing) I feel like

. . .

b.

change health care providers until they find a health care team that will treat them as experts and partners in the care of their child

c.

ignore these feelings, as the health care team does not mean to discount their expertise and knows that they are experts in the care of their child

d.

listen to the health care professionals, say nothing, and do whatever they (the caregivers) feel is best regardless of what the health care professionals suggest

ANS: A

Feedback

A

Correct: The nurse will help these caregivers resolve this problem by teaching them to directly express frustration and confront the discounting of their expertise with I statements such as, When you (do a specific thing or say a specific thing) I feel like . . . Caregivers report that relationships with professionals can be helpful and harmful. They are harmful then the professional disregards or discounts the caregivers knowledge and abilities.

B

Incorrect: The nurse will not help these caregivers resolve this problem by teaching them to change health care providers until they find a health care team that will treat them as experts and partners in the care of their child.

C

Incorrect: The nurse will not help these caregivers resolve this problem by teaching them to ignore these feelings, as the health care team does not mean to discount their expertise and knows that they are experts in the care of their child. Professionals need to be relational and validate caregivers feelings.

D

Incorrect: The nurse will not help these caregivers resolve this problem by teaching them to listen to the health care professionals, say nothing, and do whatever they (the caregivers) feel is best regardless of what the health care professionals suggest. Professionals need to establish a collaborative interaction style with caregivers by acknowledging their expertise, role, and concerns.

PTS:1REF:p. 568 Living with Chronic Conditions

OBJ: Cognitive Level: Application

32.When caregivers of a child with a chronic health care condition look for meaning in their situation, they most often:

a.

feel small, helpless, and hopeless in the face of such a long-term responsibility

b.

find they have little or nothing to be thankful for and drop out of their religion

c.

give up and adopt a martyr-like existence because any meaning is depressing or demeaning

d.

find positive outcomes, such as family relationships being strengthened due to working together

ANS: D

Feedback

A

Incorrect: When caregivers of a child with a chronic health care condition look for meaning in their situation, they will not most often feel small, helpless, and hopeless in the face of such a long-term responsibility.

B

Incorrect: When caregivers of a child with a chronic health care condition look for meaning in their situation, they will not most often find they have little or nothing to be thankful for and drop out of their religion.

C

Incorrect: When caregivers of a child with a chronic health care condition look for meaning in their situation, they will not most often give up and adopt a martyr-like existence because any meaning is depressing or demeaning.

D

Correct: When caregivers of a child with a chronic health care condition look for meaning in their situation, they most often find positive outcomes, such as family relationships being strengthened due to working together. Caregivers typically make sense of and find meaning in their situation.

PTS:1REF:p. 568 Living with Chronic Conditions

OBJ: Cognitive Level: Comprehension

33.When networking with other families who also have a child with a chronic illness, the caregivers of a chronically ill child often engage in a process of downward comparison, which means that:

a.

comparisons are frequent at first, but diminish with time as exhaustion sets in

b.

caregivers comparing themselves with other caregivers find that there are situations worse than their own

c.

their perception of other caregivers being better off is periodically proven to be true

d.

they feel that their situation only gets worse and that the other caregivers situations get better over time

ANS: B

Feedback

A

Incorrect: The process of downward comparison does not mean that comparisons are frequent at first, but diminish with time as exhaustion sets in.

B

Correct: When networking with other families who also have a child with a chronic illness, the caregivers of a chronically ill child often engage in a process of downward comparison. This means that caregivers comparing themselves with other caregivers find that there are situations worse than their own.

C

Incorrect: The process of downward comparison does not mean that their perception of other caregivers being better off is periodically proven to be true.

D

Incorrect: The process of downward comparison does not mean that they feel that their situation only gets worse and that the other caregivers situations get better over time.

PTS:1REF:p. 568 Living with Chronic Conditions

OBJ: Cognitive Level: Comprehension

34.The sibling of a child with a chronic health condition comes to the attention of the school nurse. The sibling is worried about the childs illness and is experiencing some negative feelings about all the attention that the child who is disabled is receiving. The sibling will likely benefit most from:

a.

saturation and ongoing attention from the nurse during the school year and beyond

b.

the caregivers being made aware of the siblings problems

c.

a support group there they can gain knowledge, share feelings, and get help in coping

d.

their minister or priest being notified so the church can provide help to the child

ANS: C

Feedback

A

Incorrect: The sibling will not likely benefit most from saturation and ongoing attention from the nurse during the school year and beyond.

B

Incorrect: The sibling will not likely benefit most from the caregivers being made aware of the siblings problem.

C

Correct: The sibling will likely benefit most from a support group there they can gain knowledge, share feelings, and get help in coping with the siblings chronic condition.

D

Incorrect: The sibling will not likely benefit most from their minister or priest being notified so the church can provide help to the child.

PTS:1REF:p. 568 Living with Chronic Conditions

OBJ: Cognitive Level: Application

35.The nurse working with the family of a child with a chronic health condition is aware that the siblings:

a.

are relatively unaffected by having a brother or sister with a chronic health condition

b.

may experience and share some of the stigma faced by the ill child

c.

often overcompensate for activities the sibling cannot do

d.

overlook much of what goes on with the child who has the chronic health problem

ANS: B

Feedback

A

Incorrect: The nurse working with the family of a child with a chronic health condition is aware that the siblings are affected by having a brother or sister with a chronic health condition. The healthy sibling usually receives less attention because of increased demands on the caregivers. They often assume greater responsibilities such as for housework and caring for younger family members. Their participation in sports, school, or church activities may be limited because of the caregivers responsibilities.

B

Correct: The nurse working with the family of a child with a chronic health condition is aware that the siblings may experience and share some of the stigma faced by the ill child. Because of the close identification between siblings, characteristics of the chronically ill child may be associated with the siblings.

C

Incorrect: The nurse working with the family of a child with a chronic health condition is aware that the healthy siblings do not often overcompensate for activities the sibling cannot do.

D

Incorrect: The nurse working with the family of a child with a chronic health condition is aware that the siblings do not overlook much of what goes on with the ill child. In fact, siblings worry about the possible death of the brother or sister. In addition, they may worry about their own future if the ill child lives to adulthood but is unable to function independently.

PTS:1REF:p. 570 Living with Chronic Conditions

OBJ: Cognitive Level: Application

36.The nurse is working with a family who is from a different country and who carries their 11-month-old child with a chronic illness everywhere. The child is not allowed to touch the ground. The nurses initial action will be to:

a.

get someone from the familys culture to explain that the child needs to walk

b.

provide the caregivers with education on growth and developmental needs of children

c.

assess the culture to see if carrying the child has something to do with culture

d.

get an orthopedic specialist to screen the child for orthopedic problems

ANS: C

Feedback

A

Incorrect: The nurses initial action will not be to get someone from the familys culture to explain that the child needs to walk.

B

Incorrect: The nurses initial action will not be to provide the caregivers with education on growth and developmental needs of children.

C

Correct: The nurses initial action will be to assess the culture to see if carrying the child has something to do with culture. Professionals should take into account the differences in normal development or age-appropriate expectations between cultures. In some cultures a child is carried until approximately the age of 1 year.

D

Incorrect: The nurses initial action will not be to get an orthopedic specialist to screen the child for orthopedic problems.

PTS:1REF:p. 568 Living with Chronic Conditions

OBJ: Cognitive Level: Application

37.The nurse who wants to effectively care for people from other cultures needs to examine his or her own:

a.

language skills

c.

cultural ability

b.

ethnocentrism

d.

access to the culture

ANS: B

Feedback

A

Incorrect: The nurse who wants to effectively care for people from other cultures does not need to examine his or her own language skills.

B

Correct: The nurse who wants to effectively care for people from other cultures needs to examine his or her own ethnocentrism, particularly as it relates to health and illness. Ethnocentrism is the tendency for all individuals and cultures to believe their values are the best, the most correct. Ethnocentrism prevents professionals from learning from people of other cultures.

C

Incorrect: The nurse who wants to effectively care for people from other cultures does not need to examine his or her own cultural ability.

D

Incorrect: The nurse who wants to effectively care for people from other cultures does not need to examine his or her own access to the culture.

PTS:1REF:p. 570 Living with Chronic Conditions

OBJ: Cognitive Level: Comprehension

MULTIPLE RESPONSE

1.Which of the following treatments may pose a threat to the school-aged childs compliance with the regimen? Select all that apply.

a.

time-consuming treatments

b.

treatment regimens that are visible to others

c.

treatments that interfere with daily activities

d.

perception that condition is worse

ANS: A, B, C

Feedback

Correct

School-aged children may not perform treatments that are time-consuming, visible to others, or interfere with daily activities

Incorrect

The school-aged child may not comply with the treatment plan if the child perceives the benefits as not being immediate or may not understand why treatments are necessary during symptom-free periods.

PTS: 1 REF: p. 557 Dimensions of Childhood Chronic Conditions

OBJ: Cognitive Level: Application

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