Question 1

What characterizes a school-aged child's concept of death?

Accepted Answer

A)  Have a mature understanding of death 
B)  Can respond to logical explanations of death 
C)  Personify death as the devil or the bogeyman 
D)  Have a deeper understanding of death in a concrete sense 
E)  Fear the mutilation and punishment associated with death 
A)  Have a mature understanding of death 
B)  Can respond to logical explanations of death 
C)  Personify death as the devil or the bogeyman 
D)  Have a deeper understanding of death in a concrete sense 
E)  Fear the mutilation and punishment associated with death B,C,D,E

Question 2

What statement is most descriptive of a school-age child's reaction to death?

Accepted Answer

A)  Very interested in funerals and burials 
B)  Little understanding of words such as "forever" 
C)  Imagine the deceased person to be still alive 
D)  Can explain death from a religious or spiritual point of view 
A)  Very interested in funerals and burials 
B)  Little understanding of words such as "forever" 
C)  Imagine the deceased person to be still alive 
D)  Can explain death from a religious or spiritual point of view A

Question 3

The family and child have decided that hospice care best meets their needs during the terminal phase of illness.The nurse recognizes that the parents understand the principles of this care when they make which statement?

Accepted Answer

A)  "It will be good to be at home and care for our child." 
B)  "What a relief it will be not to need any more medicines." 
C)  "We are going to miss the support of the hospice team when our child dies." 
D)  "We know that once hospice care starts, we will not be able to return to the hospital if the care is difficult." 
A)  "It will be good to be at home and care for our child." 
B)  "What a relief it will be not to need any more medicines." 
C)  "We are going to miss the support of the hospice team when our child dies." 
D)  "We know that once hospice care starts, we will not be able to return to the hospital if the care is difficult." A

Question 4

The nurse is often the individual who is in the optimum position to suggest tissue donation to a family (after consultation with the practitioner).What will occur if a family chooses organ or tissue donation?

Accepted Answer

A)  The funeral will be delayed. 
B)  Cremation is the preferred method of burial. 
C)  Written consent is required for tissue or organ donation. 
D)  An open casket cannot be used subsequent to this procedure. 
A)  The funeral will be delayed. 
B)  Cremation is the preferred method of burial. 
C)  Written consent is required for tissue or organ donation. 
D)  An open casket cannot be used subsequent to this procedure.

Question 5

The nurse has attended a professional development program about palliative care for the pediatric population.What statement by the nurse should indicate a correct understanding of the program?

Accepted Answer

A)  "Palliative care provides interventions that hasten death." 
B)  "Palliative care promotes the optimal functioning and quality of life." 
C)  "Palliative care does not provide pain and symptom management like hospice care." 
D)  "Palliative care is not well received in hospitals that provide end-of-life care for children." 
A)  "Palliative care provides interventions that hasten death." 
B)  "Palliative care promotes the optimal functioning and quality of life." 
C)  "Palliative care does not provide pain and symptom management like hospice care." 
D)  "Palliative care is not well received in hospitals that provide end-of-life care for children."

Question 6

What explanation best describes how preschoolers react to the death of a loved one?

Accepted Answer

A)  Grief is acute but does not last long at this age. 
B)  Children this age are too young to have a concept of death. 
C)  Preschoolers may feel guilty and responsible for the death. 
D)  They express grief in the same way that the adults in the preschoolers' life are expressing grief. 
A)  Grief is acute but does not last long at this age. 
B)  Children this age are too young to have a concept of death. 
C)  Preschoolers may feel guilty and responsible for the death. 
D)  They express grief in the same way that the adults in the preschoolers' life are expressing grief.

Question 7

At which age do most children have an adult concept of death as being inevitable,universal,and irreversible?

Accepted Answer

A)  4 to 5 years 
B)  6 to 8 years 
C)  9 to 11 years 
D)  12 to 16 years 
A)  4 to 5 years 
B)  6 to 8 years 
C)  9 to 11 years 
D)  12 to 16 years

Question 8

What characterizes a preschooler's concept of death?

Accepted Answer

A)  Belief their thoughts can cause death. 
B)  They have a concrete understanding of death. 
C)  Death is seen as temporary and gradual. 
D)  Death is seen as a departure, a kind of sleep. 
E)  They usually have some sense of the meaning of death. 
A)  Belief their thoughts can cause death. 
B)  They have a concrete understanding of death. 
C)  Death is seen as temporary and gradual. 
D)  Death is seen as a departure, a kind of sleep. 
E)  They usually have some sense of the meaning of death.

Question 9

How might the quality of life for a terminally ill child and his family be enhanced by nurses?

Accepted Answer

A)  Tell the family what is best. 
B)  Leave the family alone to deal with their tragedy. 
C)  Remain objective and uninvolved with family grieving. 
D)  Advocate for and implement pain and symptom relief measures. 
A)  Tell the family what is best. 
B)  Leave the family alone to deal with their tragedy. 
C)  Remain objective and uninvolved with family grieving. 
D)  Advocate for and implement pain and symptom relief measures.

Question 10

The nurse understands that a school-age child may react to death with what reaction?

Accepted Answer

A)  Joking 
B)  Having no reaction 
C)  Fearing the unknown 
D)  Seeing it as a distant event 
A)  Joking 
B)  Having no reaction 
C)  Fearing the unknown 
D)  Seeing it as a distant event

Question 11

A 12-year-old boy is in the final phase of dying from leukemia.He tells the nurse who is giving him opiates for pain that his grandfather is waiting for him.How should the nurse interpret this situation?

Accepted Answer

A)  The boy is experiencing side effects of the opiates. 
B)  The boy is making an attempt to comfort his parents. 
C)  He is experiencing hallucinations resulting from brain anoxia. 
D)  He is demonstrating readiness and acceptance that death is near. 
A)  The boy is experiencing side effects of the opiates. 
B)  The boy is making an attempt to comfort his parents. 
C)  He is experiencing hallucinations resulting from brain anoxia. 
D)  He is demonstrating readiness and acceptance that death is near.

Question 12

A health care provider prescribes OxyContin (oxycodone),3 mg PO every 4 to 6 h as needed for pain for a child with a terminal illness.The medication label states: "OxyContin 5 mg/1 ml." The nurse prepares to administer one dose.How many milliliters will the nurse prepare to administer one dose? Fill in the blank.Record your answer using one decimal place.
________________

Accepted Answer

0.6
Follow the formula for dos

Question 13

A child in the terminal stage of cancer has frequent breakthrough pain.Nonpharmacologic methods are not helpful,and the child is exceeding the maximum safe dose for opiate administration.What approach should the nurse implement?

Accepted Answer

A)  Add acetaminophen for the breakthrough pain. 
B)  Titrate the opioid medications to control the child's pain as specified in the protocol. 
C)  Notify the practitioner that immediate hospitalization is indicated for pain management. 
D)  Help the parents and child understand that no additional medication can be given because of the risk of respiratory depression. 
A)  Add acetaminophen for the breakthrough pain. 
B)  Titrate the opioid medications to control the child's pain as specified in the protocol. 
C)  Notify the practitioner that immediate hospitalization is indicated for pain management. 
D)  Help the parents and child understand that no additional medication can be given because of the risk of respiratory depression.

Question 14

A health care provider prescribes morphine sulfate (Roxanol),10 mg PO every 4 h as needed for pain for a child with a terminal illness.The medication label states: "Morphine sulfate (Roxanol)20 mg/1 ml." The nurse prepares to administer one dose.How many milliliters will the nurse prepare to administer one dose? Fill in the blank.Record your answer using one decimal place.
________________

Accepted Answer

0.5
Follow the formula for dos

Question 15

A critically injured child has died and is being removed from a ventilator in the pediatric intensive care unit.What is a priority nursing intervention for the family at this time?

Accepted Answer

A)  Ensure that parents are in the waiting room while the ventilator is removed. 
B)  Help the parents understand that the child is already dead and no further interventions are necessary. 
C)  Control the environment around the child and family to provide privacy. 
D)  Encourage them to wait to see their child until the funeral home has prepared the body. 
A)  Ensure that parents are in the waiting room while the ventilator is removed. 
B)  Help the parents understand that the child is already dead and no further interventions are necessary. 
C)  Control the environment around the child and family to provide privacy. 
D)  Encourage them to wait to see their child until the funeral home has prepared the body.

Question 16

When communicating with dying children,what should the nurse remember?

Accepted Answer

A)  Adolescent children tend to be concrete thinkers. 
B)  Games, art, and play provide a good means of expression. 
C)  When children can recite facts, they understand the implications of those facts. 
D)  If children's questions direct the conversation, the assessment will be incomplete. 
A)  Adolescent children tend to be concrete thinkers. 
B)  Games, art, and play provide a good means of expression. 
C)  When children can recite facts, they understand the implications of those facts. 
D)  If children's questions direct the conversation, the assessment will be incomplete.

Question 17

The nurse is providing support to a family that is experiencing anticipatory grief related to their child's imminent death.What statement by the nurse is therapeutic?

Accepted Answer

A)  "Your other children need you to be strong." 
B)  "You have been through a very tough time." 
C)  "His suffering is over; you should be happy." 
D)  "God never gives us more than we can handle." 
A)  "Your other children need you to be strong." 
B)  "You have been through a very tough time." 
C)  "His suffering is over; you should be happy." 
D)  "God never gives us more than we can handle."

Question 18

A terminally ill child is receiving morphine sulfate (Morphine)and is experiencing respiratory depression.A health care provider prescribes naloxone (Narcan),0.5 mcg/kg IV in 2 minute increments until breathing improves.The medication label states: "Naloxone 400 mcg/1 ml." The child weighs 60 kg.The nurse prepares to administer one dose.How many milliliters will the nurse prepare to administer one dose? Fill in the blank.Record your answer using two decimal places.
________________

Accepted Answer

0.08 ml
Follow the formula for dosage ca

Question 19

What does the nurse recognize as physical signs of approaching death?

Accepted Answer

A)  Mottling of skin 
B)  Decreased sleeping 
C)  Cheyne-Stokes respirations 
D)  Loss of the sense of hearing 
E)  Decreased appetite and thirst 
A)  Mottling of skin 
B)  Decreased sleeping 
C)  Cheyne-Stokes respirations 
D)  Loss of the sense of hearing 
E)  Decreased appetite and thirst

Question 20

What factor is most important for parents implementing do not resuscitate (DNR)orders?

Accepted Answer

A)  Parents' beliefs about euthanasia 
B)  Presence of other children in the home 
C)  Experiences of the health care team with other children in this situation 
D)  Acknowledgment by health care team that child has no realistic chance for cure 
A)  Parents' beliefs about euthanasia 
B)  Presence of other children in the home 
C)  Experiences of the health care team with other children in this situation 
D)  Acknowledgment by health care team that child has no realistic chance for cure

Exam 20: Family-Centered Palliative Care

What characterizes a school-aged child's concept of death?

What statement is most descriptive of a school-age child's reaction to death?

The family and child have decided that hospice care best meets their needs during the terminal phase of illness.The nurse recognizes that the parents understand the principles of this care when they make which statement?

The nurse is often the individual who is in the optimum position to suggest tissue donation to a family (after consultation with the practitioner).What will occur if a family chooses organ or tissue donation?

The nurse has attended a professional development program about palliative care for the pediatric population.What statement by the nurse should indicate a correct understanding of the program?

What explanation best describes how preschoolers react to the death of a loved one?

At which age do most children have an adult concept of death as being inevitable,universal,and irreversible?

What characterizes a preschooler's concept of death?

How might the quality of life for a terminally ill child and his family be enhanced by nurses?

The nurse understands that a school-age child may react to death with what reaction?

A 12-year-old boy is in the final phase of dying from leukemia.He tells the nurse who is giving him opiates for pain that his grandfather is waiting for him.How should the nurse interpret this situation?

A child in the terminal stage of cancer has frequent breakthrough pain.Nonpharmacologic methods are not helpful,and the child is exceeding the maximum safe dose for opiate administration.What approach should the nurse implement?

A critically injured child has died and is being removed from a ventilator in the pediatric intensive care unit.What is a priority nursing intervention for the family at this time?

When communicating with dying children,what should the nurse remember?

The nurse is providing support to a family that is experiencing anticipatory grief related to their child's imminent death.What statement by the nurse is therapeutic?

What does the nurse recognize as physical signs of approaching death?

What factor is most important for parents implementing do not resuscitate (DNR)orders?

Perspectives of Pediatric Nursing

Social,cultural,religious,and Family Influences on Child Health Promotion

Hereditary Influences on Health Promotion of the Child and Family

Communication, physical, and Developmental Assessment

Pain Assessment and Management in Children

Childhood Communicable and Infectious Diseases

Health Promotion of the Newborn and Family

Health Problems of Newborns

The High-Risk Newborn and Family

Health Promotion of the Infant and Family

Health Problems of the Infant

Health Promotion of the Toddler and Family

Health Promotion of the Preschooler and Family

Health Problems of Early Childhood

Health Promotion of the School-Age Child and Family

Health Problems of the School-Age Child

Health Promotion of the Adolescent and Family

Health Problems of the Adolescent

Family-Centered Care of the Child With Chronic Illness or Disability

The Child With Cognitive, sensory, or Communication Impairment

Family-Centered Care of the Child During Illness and Hospitalization

Pediatric Nursing Interventions and Skills

The Child With Fluid and Electrolyte Imbalance

The Child With Renal Dysfunction

The Child With Gastrointestinal Dysfunction

Overview of Oxygen and Carbon Dioxide Exchange

The Child With Respiratory Dysfunction

The Child With Cardiovascular Dysfunction

The Child With Hematologic or Immunologic Dysfunction

The Child With Cancer

The Child With Cerebral Dysfunction

The Child With Endocrine Dysfunction

The Child With Musculoskeletal or Articular Dysfunction

The Child With Neuromuscular or Muscular Dysfunction

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