Chapter 22: End-of-Life Care for Children and Their Families

Chapter 22: End-of-Life Care for Children and Their Families

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The nurse notes on the chart that a patient with Wilms tumor is to receive palliative care only. The nurse knows this means:

a.	The child will continue to receive treatment to cure the tumor
b.	The child will be kept sedated
c.	The parents will be relieved of the care of their child
d.	The child will achieve a comfortable and dignified death

 

 

ANS:   D

Palliative care provides a patient with a comfortable and dignified death. Palliative care focuses on relieving symptoms and comfort. All curative therapies are halted. A great deal of care is involved because the care also involves the family of the patient.

 

DIF:    Cognitive Level: Application             REF:    p. 416              OBJ:    3

TOP:    Palliative Care

KEY:   Nursing Process Step: Psychosocial Integrity

MSC:   NCLEX: Physiological Integrity: Basic Care and Comfort

 

2. The nurse caring for a child on palliative care would include in the plan of care to:

a.	Distract the child when the child begins to talk about the impending death
b.	Encourage the child to discuss the illness
c.	Reassure the child that death will not hurt
d.	Deny that the child is dying

 

 

ANS:   C

The child should be reassured that death will not hurt because this is a major fear. The child should not be overly encouraged to discuss his illness. The child should not be pressured to discuss anything. The child should be told that it is okay to die, because children often feel guilty. The nurse should be honest and not deny that death is imminent.

 

DIF:    Cognitive Level: Application             REF:    p. 416              OBJ:    3

TOP:    Palliative Care                                    KEY:   Nursing Process Step: Intervention

MSC:   NCLEX: Psychosocial Integrity: Coping and Adaptation

 

3. The nurse working with a 15-year-old patient who is dying understands that the adolescent’s concept of death is that:

a.	Death is not permanent
b.	Death may happen in the distant future
c.	Death can be understood in a logical manner
d.	Death is a form of punishment

 

 

ANS:   C

A teenager understands death in a logical manner.

 

DIF:    Cognitive Level: Application             REF:    p. 416              OBJ:    4

TOP:    Child’s Reaction to Death                 KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Psychosocial Integrity: Coping and Adaptation

 

4. The dying 16-year-old patient threw her food tray on the floor and yelled, “I can’t eat this slop! I want some real food!” The nurse’s best response to this episode would be:

a.	“Just calm down. We will get you another tray.”
b.	“I know you’re tired of bland food, but this kind of behavior doesn’t help anyone.”
c.	“I imagine you are pretty mad. Do you want to tell me what you might like?”
d.	“It is slop, but now someone has to clean this up.”

 

 

ANS:   C

The nurse understands that the teen is displacing her anger about dying on this situation. The nurse will show acceptance in recognizing the anger. The other three options cast guilt on the patient.

 

DIF:    Cognitive Level: Application             REF:    p. 418              OBJ:    4

TOP:    Child’s Reaction to Death                 KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Psychosocial Integrity: Coping and Adaptation

 

5. A dying child’s parents have told the nurse that they do not want their child to know that she is dying. The nurse reminds the parents that this choice might cause the child to feel:

a.	Isolated and suffering alone
b.	Free to express her fears
c.	Less anxiety
d.	Protected and loved

 

 

ANS:   A

This choice will force the child to suffer alone, because she will not be able to share or understand her fears and feelings. Children need clear, age-appropriate information about their illness.

 

DIF:    Cognitive Level: Analysis                  REF:    p. 418              OBJ:    5

TOP:    Child’s Awareness of Death              KEY:   Nursing Process Step: Intervention

MSC:   NCLEX: Psychosocial Integrity: Coping and Adaptation