Child Life Certification Exam- Practice Test

When should a child life specialist initiate a referral to an interdisciplinary member of the health care team?

When professional limits and boundaries of the child life scope of practice have been recognized.

A physician enters a room alone to obtain informed consent for an upcoming procedure from a family who, in hand off, has been reported to understand English but is primarily Spanish speaking. What should the child life specialist do next?

The child life specialist contacts interpretation services, in advocacy, to alert them that the family is currently meeting with the physician and is questioning their full comprehension of the consent.

Upon discharge from the hospital, a patient invites a child life specialist to come to his upcoming birthday party. The child life specialist explains why they cannot have a relationship with the patient outside of the hospital. The child life specialist is maintaining what type of relationship with the patient?

A therapeutic relationship

A child life specialist engages a patient in a therapeutic activity. During this activity, the child expresses fears about their upcoming surgery. Which of the following is the most appropriate way for a child life specialist to effectively communicate this child's concerns to the care team?

Chart in the patient's medical record

Which of the following describes a child life specialist's obligation to maintain confidentiality?

to respect and protect the privacy of others

How long after a child is no longer a patient must a child life specialist wait until they can begin a personal relationship with the mother?

2 years

To ensure documentation about the intervention provided to a patient is comprehensive the chart note written by the child life specialist should contain

assessment information, plan of care and outcomes of care

Being a mandated reporter means that a child life specialist is required to

report the suspected abuse or neglect following hospital protocol, including documenting those steps taken.

A principle of evidence based practice is

integrating evidence from current research with professional expertise and patient preferences.

Which of the following behaviors may alert child life specialists that they may not be maintaining professional boundaries?

Feeling an exaggerated sense of responsibility for things beyond one's control.

A child is separated briefly from a parent and upon return, the child is hesitant to interact with the parent. According to John Bowlby's attachment theory, this is an example of

detatchment

Which theory best illustrates how a new diagnosis affects not only the patient, but also the entire family?

family systems theory

According to the Stress Potential Assessment Process, which health care variables would warrant the rating of a 5?

A ten-year-old admitted to the Intensive Care Unit with Guillain-Barre Syndrome who is angry and rejecting everyone who enters the room

What is the most effective age range for utilizing oral sucrose when doing a heel stick?

Two days old and disappears over the first six months of age.

When is palliative care shown to be most effective?

When the patient has a life-limiting or ultimately terminal condition.

A child's understanding that all living things eventually die is known as

universality

What is the difference between palliative care and hospice?

Palliative care extends the concept of care beyond connotation of hospice to include a longer time frame and broadens the scope to apply to other illnesses that are life limiting

A child life specialist provides a variety of medical supplies. A 10-year-old child that has both hands in casts chooses to place casts on the paws of a stuffed animal. The type of play that is most likely to happen is

spontaneous play

A pediatric resident enters the playroom to assess a preschool-age patient's pain and listen to their lungs. The child life specialist should

explain to the resident that the playroom is a 'safe space' and if an assessment must occur immediately the child would have to return to their room.

A 10-year-old patient is having an IV placed. Which would be a developmentally appropriate coping strategy to offer the patient during the procedure?

imagery

Which of the following best describes an emotion-based coping strategy used in child life practice?

advocate for use of the procedure/treatment room

overt or active response

crying, screaming, whining, clinging to parents, resisting medicine, being self-destructive, being destructive of the environment, fighting

passive response

excessive sleeping

decreased communication

decreased activity

decreased eating

regressive behavior

alterations in sleeping patterns

eating too much or too little

being tense, anxious, restless

manifesting fears (of hospitals, needles, death, etc)

being overly concerned with one's body

displaying compulsive behavior

Contagion hypothesis

Transmission of anxiety from parent to child.

During this period of acute distress, children cry, scream and kick, all the while eagerly looking for signs of their parent's return

protest

If parents do not return, children may enter a period characterized by "increased hopelessness"

despair

In this phase, children appear to be making a recovery, as they once again become active and interested in their surroundings

detachment

unoccupied behavior

children demonstrating this behavior seem not to be playing-watching, instead, whatever strikes them as interesting

microsystem

immediate environment

mesosytem

describes how different parts of a child's microsystem work together for the sake of the child

research indicates that children in this age group are most vulnerable to psychological stress when hospitalized

7 months-4 years

3 elements of preparation for the child

1) imparting information to the child

2) encouraging emotional expression

3) establishing trusting relationships with the hospital staff

predominant pattern of functioning

the child life specialist should observe a child's intensity of response, distractibility, adaptability to changes in routine, persistence and attention span, in order to determine this...

The essential elements of a psychosocial assessment include

affect, mood and temperament, capacity of communication and interaction, prior physical health and medical history, personal and family stressors, coping skills and predisposed strategies/patterns, preferred defense mechanisms and frequency of common situations of use, history of any self-esteem issues, recent events

CL service model

APIE

P- plan of CL service model

care plans must target specific goal outcomes and identify an anticipated benefit

I- intervention of CL service model

begin by establishing rapport and trust, interventions should be consistent, timed and sequenced, adapted to availability of CLS and child's needs

E- evaluation of CL service model

Pt. describing their experience and understanding of a diagnosis or finally talking about their feelings

Identifying need- risk potential scores/vulnerability ratings

Child age (6mo-4 years most vulnerable)

Parent/family unavailability

Stress points

Illness severity

Concept of caring

developing true and honest empathy and care about others is vital to health care professionals.

newborn-3 years understanding of death

does not comprehend death, aware of constant buzz of activity, aware of Mom & Dad looking sad, aware that someone in home is missing

3 to 5 years understanding of death

death is temporary and reversible, feel ambivalent, magical thinking or responsibility for death

6 to 9 years understanding of death

understand concept of death, understand that death happens to others, superstitions about death, uncomfortable explaining feelings, worried other important people will die

9 to 12 years understanding of death

accepts death as final, personal fear of death, morbidly interested, concerned with practical matters

Adolescents (12-18 years) understanding of death

adult concept of death, ability to cope based on prior experience, thrill of recklessness, focuses on present, questions afterlife

3 child life categories of care

Direct care, indirect care, non-direct care

One person CL programs

account for 25% CL programs today

-single person programs often report to nurse managers, physician admin, or family service directors