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PEDS - EXAM #3 (CH. 17, 18, 24) WONG 10TH EDITION
QUESTIONS COMPREHENSIVE 2026 QUESTIONS EXAM
LATEST VERSION SOLVED QUESTIONS & ANSWERS
VERIFIED 100 %
Ch. 17 Impact of Chronic Illness, Disability, or End-of-Life Care on the Child &
Family
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 childs care
d. Primary care physician and key health professionals involved in the childs
care
C
A multidisciplinary conference is necessary for coordination of care for children with
complex health needs. The family is included, along with key health professionals
who are involved in the childs care. The nursing staff can address the childs nursing
care needs with the family, but other involved disciplines must be included. The
family must be included in the discharge conferences, which allows them to
determine what education they will require and the resources needed at home. A
member of the nursing staff must be included to review the childs nursing needs.
Which represents a common best practice in the provision of services to
children with special needs?
a. Care is now being focused on the childs 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.
B
Normalization refers to behaviors and interventions for the disabled to integrate into
society by living life as persons without a disability would. For children, normalization
includes attending school and being integrated into regular classrooms. This affords
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the child the advantages of learning with a wide group of peers. Care is necessarily
focused on the childs developmental age. Home care by the family is considered
best practice. The nurse can assist families by assessing social support systems,
coping strategies, family cohesiveness, and family and community resources.
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.
B
Parenting a child with a chronic illness can be stressful for parents. There are
anticipated times that parental stress increases. One of these identified times is
when the child begins school. Nurses can help parents recognize and plan
interventions to work through these stressful periods. The parents are not in denial;
they are responding to the childs placement in school. The parents are not exhibiting
signs of a knowledge deficit; this is their first interaction with the school system with
this child.
Approach behaviors are those coping mechanisms that result in a familys
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 childs condition despite physical evidence
B
The parents who anticipate future problems and seek guidance and answers are
demonstrating approach behaviors. They are demonstrating positive actions in
caring for their child. Being unable to adjust to a progression of the disease or
condition, looking for new cures without a perspective toward possible benefit, and
failing to recognize seriousness of childs condition despite physical evidence are
avoidance behaviors. The parents are moving away from adjustment (and toward
maladaptation) in the crisis of a child with chronic illness or disability.
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 childs limitations
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B
For most families, the adjustment phase is accompanied by several responses. Guilt,
self-accusation, bitterness, and anger are common reactions. The initial diagnosis of
a chronic illness or disability often is met with intense emotion, characterized by
shock and denial. Social reintegration and acceptance of the childs limitations are
the culmination of the adjustment process.
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.
C
Guilt may be associated with cultural or religious beliefs. Some parents are
convinced that they are being punished for some previous misdeed. Others may see
the disorder as a sacrifice sent by God to test their religious beliefs. The nurse can
help the parents explore their religious beliefs. The parents may not be able to
identify the feelings of guilt. It would be appropriate for the nurse to explore their
adjustment responses. Overprotectiveness is a parental response during the
adjustment phase. The parents fear letting the child achieve any new skill and avoid
all discipline.
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.
C
The nurse should be particularly alert to the child who passively accepts all painful
procedures. This child may believe that such acts are inflicted as deserved
punishment. The child who is hopeful is mobilized into goal- directed actions. This
child would actively participate in care. Chronic sorrow is the feeling of sorrow and
loss that recurs in waves over time. It is usually evident in the parents, not in the
child. A child who believes that procedures are an important part of care would
actively participate in care. Nursing interventions should be used to minimize the
pain.
The nurse comes into the room of a child who was just diagnosed with a
chronic disability. The childs parents begin to yell at the nurse about a variety
of concerns. Which is the nurses 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.
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B
Parental anger after the diagnosis of a child with a chronic disability is a common
response. One of the most common targets for parental anger is members of the
staff. The nurse should recognize the common response of anger to the diagnosis
and allow the family to ventilate. What is really wrong?Yelling at me will not change
things/I will come back when you settle down will place the parents on the defensive
and not facilitate communication
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 childs level
of capability.
A
Parental overprotection is manifested by the parents fear of letting the child achieve
any new skill; they allow the child to avoid all discipline and cater to every desire to
prevent frustration. Overprotective parents: do not set limits and or institute
discipline; prefer to remain in the role of total caregiver; do not allow the child to
perform self-care; and do not encourage the child to participate in social and
educational activities.
Most parents of children with special needs tend to experience chronic
sorrow. This is characterized by:
a. lack of acceptance of childs 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.
D
Chronic sorrow is manifested by feelings of sorrow and loss that recur in waves over
time. The sorrow is in response to the recognition of the childs limitations. The family
should be assessed in an ongoing manner to provide appropriate support as the
needs of the family change. The sorrow is not preventable. The chronic sorrow
occurs during the reintegration and acknowledgment stage.
Which intervention will encourage a sense of autonomy in a toddler with
disabilities?
a. Avoid separation from family during hospitalizations.
b. Encourage independence in as many areas as possible.
c. Expose child to pleasurable experiences as much as possible.
d. Help parents learn special care needs of their child.
B
Encouraging the toddler to be independent encourages a sense of autonomy. The
child can be given choices about feeding, dressing, and diversional activities, which
PEDS - EXAM #3 (CH. 17, 18, 24) WONG 10TH EDITION
QUESTIONS COMPREHENSIVE 2026 QUESTIONS EXAM
LATEST VERSION SOLVED QUESTIONS & ANSWERS
VERIFIED 100 %
Ch. 17 Impact of Chronic Illness, Disability, or End-of-Life Care on the Child &
Family
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 childs care
d. Primary care physician and key health professionals involved in the childs
care
C
A multidisciplinary conference is necessary for coordination of care for children with
complex health needs. The family is included, along with key health professionals
who are involved in the childs care. The nursing staff can address the childs nursing
care needs with the family, but other involved disciplines must be included. The
family must be included in the discharge conferences, which allows them to
determine what education they will require and the resources needed at home. A
member of the nursing staff must be included to review the childs nursing needs.
Which represents a common best practice in the provision of services to
children with special needs?
a. Care is now being focused on the childs 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.
B
Normalization refers to behaviors and interventions for the disabled to integrate into
society by living life as persons without a disability would. For children, normalization
includes attending school and being integrated into regular classrooms. This affords
, Page 2 of 40
the child the advantages of learning with a wide group of peers. Care is necessarily
focused on the childs developmental age. Home care by the family is considered
best practice. The nurse can assist families by assessing social support systems,
coping strategies, family cohesiveness, and family and community resources.
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.
B
Parenting a child with a chronic illness can be stressful for parents. There are
anticipated times that parental stress increases. One of these identified times is
when the child begins school. Nurses can help parents recognize and plan
interventions to work through these stressful periods. The parents are not in denial;
they are responding to the childs placement in school. The parents are not exhibiting
signs of a knowledge deficit; this is their first interaction with the school system with
this child.
Approach behaviors are those coping mechanisms that result in a familys
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 childs condition despite physical evidence
B
The parents who anticipate future problems and seek guidance and answers are
demonstrating approach behaviors. They are demonstrating positive actions in
caring for their child. Being unable to adjust to a progression of the disease or
condition, looking for new cures without a perspective toward possible benefit, and
failing to recognize seriousness of childs condition despite physical evidence are
avoidance behaviors. The parents are moving away from adjustment (and toward
maladaptation) in the crisis of a child with chronic illness or disability.
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 childs limitations
, Page 3 of 40
B
For most families, the adjustment phase is accompanied by several responses. Guilt,
self-accusation, bitterness, and anger are common reactions. The initial diagnosis of
a chronic illness or disability often is met with intense emotion, characterized by
shock and denial. Social reintegration and acceptance of the childs limitations are
the culmination of the adjustment process.
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.
C
Guilt may be associated with cultural or religious beliefs. Some parents are
convinced that they are being punished for some previous misdeed. Others may see
the disorder as a sacrifice sent by God to test their religious beliefs. The nurse can
help the parents explore their religious beliefs. The parents may not be able to
identify the feelings of guilt. It would be appropriate for the nurse to explore their
adjustment responses. Overprotectiveness is a parental response during the
adjustment phase. The parents fear letting the child achieve any new skill and avoid
all discipline.
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.
C
The nurse should be particularly alert to the child who passively accepts all painful
procedures. This child may believe that such acts are inflicted as deserved
punishment. The child who is hopeful is mobilized into goal- directed actions. This
child would actively participate in care. Chronic sorrow is the feeling of sorrow and
loss that recurs in waves over time. It is usually evident in the parents, not in the
child. A child who believes that procedures are an important part of care would
actively participate in care. Nursing interventions should be used to minimize the
pain.
The nurse comes into the room of a child who was just diagnosed with a
chronic disability. The childs parents begin to yell at the nurse about a variety
of concerns. Which is the nurses 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.
, Page 4 of 40
B
Parental anger after the diagnosis of a child with a chronic disability is a common
response. One of the most common targets for parental anger is members of the
staff. The nurse should recognize the common response of anger to the diagnosis
and allow the family to ventilate. What is really wrong?Yelling at me will not change
things/I will come back when you settle down will place the parents on the defensive
and not facilitate communication
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 childs level
of capability.
A
Parental overprotection is manifested by the parents fear of letting the child achieve
any new skill; they allow the child to avoid all discipline and cater to every desire to
prevent frustration. Overprotective parents: do not set limits and or institute
discipline; prefer to remain in the role of total caregiver; do not allow the child to
perform self-care; and do not encourage the child to participate in social and
educational activities.
Most parents of children with special needs tend to experience chronic
sorrow. This is characterized by:
a. lack of acceptance of childs 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.
D
Chronic sorrow is manifested by feelings of sorrow and loss that recur in waves over
time. The sorrow is in response to the recognition of the childs limitations. The family
should be assessed in an ongoing manner to provide appropriate support as the
needs of the family change. The sorrow is not preventable. The chronic sorrow
occurs during the reintegration and acknowledgment stage.
Which intervention will encourage a sense of autonomy in a toddler with
disabilities?
a. Avoid separation from family during hospitalizations.
b. Encourage independence in as many areas as possible.
c. Expose child to pleasurable experiences as much as possible.
d. Help parents learn special care needs of their child.
B
Encouraging the toddler to be independent encourages a sense of autonomy. The
child can be given choices about feeding, dressing, and diversional activities, which
