Question 1

What characterizes an infant's concept of death? (Select all that apply.)

Accepted Answer

A)  Death is seen as temporary. 
B)  Death is seen as a departure, a kind of sleep. 
C)  Death has no significance before 6 months of age. 
D)  They believe that death is a consequence of their thoughts. 
E)  Anxiety is not created by death but by loss, even temporary, of the parent.

Question 2

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.

Question 3

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

Question 4

What characterizes a toddler's concept of death? (Select all that apply.)

Accepted Answer

A)  They are unable to comprehend an absence of life. 
B)  They may recognize the fact of physical death. 
C)  They understand the universality and inevitability of death. 
D)  The are affected more by the change in lifestyle than the concept of death. 
E)  They can only think about events in terms of their own frame of reference-living.

Question 5

What characterizes a school-aged child's concept of death? (Select all that apply.)

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

Question 6

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

Question 7

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

The answer of A terminally ill child is receiving morphine...

Question 8

What is a principle of palliative care that can be included in the care of children?

Accepted Answer

A)  Maintenance of curative therapy 
B)  Child and family as the unit of care 
C)  Exclusive focus on the spiritual issues the family faces 
D)  Extensive use of opiates to ensure total pain control

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.

Question 10

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."

Question 11

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.

Question 12

Parents ask the nurse, "When should palliative care be initiated?" What is the best response by the nurse?

Accepted Answer

A)  "When curative care is not feasible." 
B)  "When the child's prognosis is uncertain." 
C)  "It should be included along the continuum of care." 
D)  "It should begin when curative treatments are no longer appropriate."

Question 13

A health care provider prescribes morphine sulfate, 0.2 mg/kg IV every 2 to 4 h as needed for pain for a child with a terminal illness. The child weighs 10 kg. The medication label states: "Morphine sulfate 5 mg/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

The answer of A health care provider prescribes morphine sulfate,...

Question 14

What does the nurse recognize as physical signs of approaching death? (Select all that apply.)

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

Question 15

When is an autopsy required?

Accepted Answer

A)  In the case of a suspected suicide 
B)  When a person has a known terminal illness 
C)  With a hospice patient who dies at home 
D)  With the victim of a motor vehicle collision

Question 16

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.

Question 17

Parents tell the nurse they do not want to let their school-age child know his illness is terminal. What response should the nurse make to the parents?

Accepted Answer

A)  "Have you discussed this with your health care provider?" 
B)  "I would do the same thing in your position; it is better the child doesn't know." 
C)  "I understand you want to protect your child, but often children realize the seriousness of their illness." 
D)  "I praise you for that decision; it can be so difficult to be truthful about the seriousness of your son's illness."

Question 18

A school-age child is diagnosed with a life-threatening illness. The parents want to protect their child from knowing the seriousness of the illness. The nurse should provide which explanation?

Accepted Answer

A)  This attitude is helpful to give parents time to cope. 
B)  This will help the child cope effectively by denial. 
C)  Terminally ill children know when they are seriously ill. 
D)  Terminally ill children usually choose not to discuss the seriousness of their illness.

Exam 20: Family-Centered Palliative Care