Chapter 19: Family-Centered Care of the Child with Chronic Illness or Disability Test Bank for Wong's Nursing Care of Infants And Children 11th Edition by Hockenberry

TEST BANK FOR WONG'S NURSING CARE OF INFANTS AND CHILDREN 11TH EDITION BY HOCKENBERRY Chapter 19: Family-Centered Care of the Child with Chronic Illness or Disability MULTIPLE CHOICE 1. What is the major health concern of children in the United States? a. Acute illness b. Chronic illness c. Congenital disabilities d. Nervous system disorders ANS: B An estimated 18% of children in the United States have a chronic illness or disability that warrants health care services beyond those usually required by children. Chronic illness has surpassed acute illness as the major health concern for children. Congenital disabilities exist from birth but may not be hereditary. These represent a portion of the number of children with chronic illnesses. Mental and nervous system disorders account for approximately 17% of chronic illnesses in children. DIF: Cognitive Level: Understanding MSC: Client Needs: Health Promotion and Maintenance 2. What is a major premise of family-centered care? a. The child is the focus of all interventions. b. Nurses are the authorities in the childs care. c. Parents are the experts in caring for their child. d. Decisions are made for the family to reduce stress. ANS: C As parents become increasingly responsible for their children, they are the experts. It is essential that the health care team recognize the familys expertise. In family-centered care, consistent attention is given to the effects of the childs chronic illness on all family members, not just the child. Nurses are adjuncts in the childs care. The nurse builds alliances with parents. Family members are involved in decision making about the childs physical care. DIF: Cognitive Level: Analyzing TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 3. What should the nurse determine to be the priority intervention for a family with an infant who has a disability? a. Focus on the childs disabilities to understand care needs. b. Institute age-appropriate discipline and limit setting. c. Enforce visiting hours to allow parents to have respite care. d. Foster feelings of competency by helping parents learn the special care needs of the infant. ANS: D It is important that the parents learn how to care for their infant so they feel competent. The nurse facilitates this by teaching special holding techniques, supporting breastfeeding, and encouraging frequent visiting and rooming in. The focus should be on the infants capabilities and positive features. Infants do not usually require discipline. As the child gets older, this is necessary, but it is not a priority intervention at this time. The nursing staff negotiates with the family about the need for respite care. DIF: Cognitive Level: Analyzing TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 4. The potential effects of chronic illness or disability on a childs development vary at different ages. What developmental alteration is a threat to a toddlers normal development? a. Hindered mobility b. Limited opportunities for socialization c. Childs sense of guilt that he or she caused the illness or disability d. Limited opportunities for success in mastering toilet training ANS: A Toddlers are acquiring a sense of autonomy, developing self-control, and forming symbolic representation through language acquisition. Mobility is the primary tool used by toddlers to experiment with maintaining control. Loss of mobility can create a sense of helplessness. Toddlers do not socialize. They are sensitive to changes in family routines. A sense of guilt is more likely to occur in a preschooler. Toilet training is not usually mastered until the end of the toddler period. DIF: Cognitive Level: Understanding MSC: Client Needs: Health Promotion and Maintenance 5. A feeling of guilt that the child caused the disability or illness is especially common in which age group? a. Toddler b. Preschooler c. School-age child d. Adolescent ANS: B Preschoolers are most likely to be affected by feelings of guilt that they caused the illness or disability or are being punished for wrongdoings. Toddlers are focused on establishing their autonomy. The illness fosters dependency. School-age children have limited opportunities for achievement and may not be able to understand limitations. Adolescents face the task of incorporating their disabilities into their changing self- concept. DIF: Cognitive Level: Understanding TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 6. What intervention is most appropriate for fostering the development of a school-age child with disabilities associated with cerebral palsy? a. Provide sensory experiences. b. Help develop abstract thinking. c. Encourage socialization with peers. d. Give choices to allow for feeling of control. ANS: C Peer interaction is especially important in relation to cognitive development, social development, and maturation. Cognitive development is facilitated by interaction with peers, parents, and teachers. The identification with those outside the family helps the child fulfill the striving for independence. Sensory experiences are beneficial, especially for younger children. School-age children are too young for abstract thinking. Giving school-age children choices is always an important intervention. Providing structured choices allows for a feeling of control. DIF: Cognitive Level: Applying TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity 7. A 16-year-old boy with a chronic illness has recently become rebellious and is taking risks such as missing doses of his medication. What should the nurse explain to his parents?