1. A 7-year-old child has been diagnosed with a chronic condition. Which of the following should the nurse prioritize to support the family during this time?

   a) Focus on curing the condition
   b) Assist the family in finding long-term resources and coping strategies
   c) Provide emotional support only to the child
   d) Limit the amount of information shared with the family

2. Parents of a child with a chronic illness express feelings of grief and hopelessness. What should be the nurse’s initial response?

   a) Refer them to a counselor immediately
   b) Encourage them to stay positive
   c) Acknowledge their feelings and explore their concerns
   d) Distract them from their worries

3. Which of the following statements is true regarding the impact of chronic illness on a child’s development?

   a) Chronic illness has little effect on psychosocial development
   b) Most children with chronic illness reach developmental milestones on time
   c) The child’s ability to achieve developmental milestones may be delayed
   d) Chronic illness only affects physical development, not emotional development

4. A family is coping with the anticipated death of their child from a life-threatening illness. The nurse can best support the family by:

   a) Avoiding discussions about the child's death
   b) Encouraging the family to hope for a miracle
   c) Helping them create realistic expectations and a care plan
   d) Suggesting that they prepare emotionally but avoid legal matters

5. What is the nurse’s priority intervention when caring for a child with a chronic illness and significant respiratory distress?

   a) Apply mechanical ventilation immediately
   b) Administer antibiotics
   c) Provide oxygen and monitor saturation levels
   d) Begin chest compressions

6. A child with cystic fibrosis is admitted to the hospital with a respiratory infection. Which collaborative management strategy should be implemented?

   a) Strict bed rest
   b) Aggressive pulmonary management and infection control
   c) Decrease fluid intake
   d) Immediate transfer to intensive care

7. When working with a child with a chronic condition, how can the nurse ensure continuity of care?

   a) Encourage the parents to switch providers regularly
   b) Establish a care plan that involves all healthcare providers
   c) Refer the family to multiple specialists without coordination
   d) Suggest care from multiple unlinked providers

8. A 10-year-old child is diagnosed with diabetes mellitus. What should the nurse prioritize in the teaching plan?

   a) Avoid discussing insulin injections
   b) Focus on long-term complications first
   c) Teach the child and family how to manage blood sugar levels
   d) Tell the child to avoid all carbohydrates

9. Which of the following is an appropriate goal for a family coping with a child’s chronic condition?

   a) The family will rely solely on hospital resources
   b) The family will develop effective coping mechanisms and support networks
   c) The family will avoid discussing the child’s condition with others
   d) The family will focus on finding a cure

10. A child with severe asthma is dependent on inhaled corticosteroids and bronchodilators. What should the nurse emphasize in discharge teaching?

    a) Only use the inhalers when symptoms are severe
    b) Skip doses if the child feels better
    c) Maintain consistent medication usage to prevent exacerbations
    d) Increase the dose of bronchodilators when needed without consulting the provider

11. Which of the following nursing diagnoses is most appropriate for a child with a newly diagnosed terminal illness?

    a) Risk for infection
    b) Risk for impaired parent-child attachment
    c) Anticipatory grieving
    d) Fluid volume deficit

12. Which of the following is a primary ethical consideration when caring for a child with a life-threatening condition?

    a) Respecting the child’s autonomy in all decisions
    b) Prioritizing the wishes of the healthcare team over the family’s
    c) Discussing Do Not Resuscitate (DNR) orders with the family
    d) Encouraging the family to avoid making end-of-life decisions

13. When working with families of children who have chronic illnesses, the nurse must recognize the potential for caregiver strain. Which strategy would help prevent this? a) Encourage the family to handle all care without outside help
    b) Teach the family to manage all treatments without any breaks
    c) Encourage respite care and support systems for the family
    d) Advise the family to prioritize the child's needs over their own well-being

14. A parent is refusing life-saving treatment for their child with a terminal illness. What is the best initial action for the nurse?

    a) Immediately contact legal authorities
    b) Respect the parent's decision without question
    c) Explore the parent’s concerns and provide information on treatment options
    d) Proceed with treatment without consent

15. A 4-year-old with cerebral palsy has limited mobility and frequent respiratory infections. What should be the nurse’s priority intervention?

    a) Encourage bed rest to prevent fatigue
    b) Promote mobility through physical therapy
    c) Limit fluid intake to prevent pneumonia
    d) Administer antibiotics as a preventive measure

16. How should a nurse best assess the psychosocial needs of a family dealing with a child’s life-threatening illness?

    a) Assume the family is coping well unless they express concerns
    b) Focus only on the child’s physical symptoms
    c) Conduct an in-depth family assessment of coping mechanisms and support
    d) Provide information only on the child’s medical condition

17. Which of the following factors can contribute to compromised family coping in families with a chronically ill child?

    a) Strong social support
    b) Adequate financial resources
    c) Limited access to healthcare
    d) Established coping strategies

18. When a child with a terminal illness expresses feelings of anger, the nurse should: a) Discourage the child from showing negative emotions
    b) Explore the reasons for the anger and validate the child’s feelings
    c) Ignore the anger and continue with medical care
    d) Suggest the child focus on positive thinking

19. Which of the following is a critical component of collaborative care for a child with a chronic illness?

    a) Focusing solely on medical interventions
    b) Involving a multidisciplinary team in the care plan
    c) Avoiding discussion of home care with the family
    d) Prioritizing physician orders over family input

20. A nurse is discussing end-of-life care with the family of a child with a terminal illness. What is the most appropriate nursing action?

    a) Avoid discussing difficult topics like death
    b) Provide the family with clear information about the child’s condition and treatment options
    c) Encourage the family to make all decisions without guidance
    d) Withhold information about the child’s prognosis to prevent distress

21. A child with brain injury is dependent on medical technology for survival. What is a priority for the nurse in this situation?

    a) Avoiding any discussions about future planning with the family
    b) Providing education on the use and maintenance of medical devices
    c) Limiting the family’s involvement in the child’s care
    d) Discontinuing life support without family consent

22. The parents of a child with a chronic illness are finding it difficult to maintain their own social life. What advice should the nurse offer?

    a) Suggest they focus entirely on their child’s needs
    b) Encourage them to prioritize self-care and maintain a balance
    c) Advise them to limit their social interactions for now
    d) Recommend they avoid discussing their child’s condition with friends

23. A child with leukemia is receiving chemotherapy. What should the nurse include in the care plan to prevent infection?

    a) Strict hand hygiene and monitoring for signs of infection
    b) Limiting the child's fluid intake
    c) Avoiding all outdoor activities
    d) Administering prophylactic antibiotics daily

24. A child with a chronic condition requires extensive at-home care. How can the nurse best support the family in managing this care?

    a) Provide the family with a long list of tasks to complete
    b) Offer ongoing education and emotional support
    c) Expect the family to manage care independently
    d) Avoid overwhelming the family with detailed instructions

25. When planning care for a child with a life-threatening condition, what outcome should the nurse prioritize?

    a) The child will recover fully
    b) The family will adapt to the child’s condition and develop effective coping mechanisms
    c) The child will experience no symptoms
    d) The family will rely only on hospital care

26. A nurse notices that a family of a chronically ill child is showing signs of stress and burnout. What should the nurse do?

    a) Suggest they continue without seeking help
    b) Refer the family to support groups and respite care
    c) Advise them to focus only on medical treatments
    d) Provide more detailed instructions for care

27. A child with a severe illness has a Do Not Resuscitate (DNR) order. What is the nurse’s role in this situation?

    a) Ignore the DNR order and resuscitate the child if needed
    b) Discuss the DNR order with the healthcare team and ensure it is followed
    c) Encourage the family to change their mind
    d) Avoid providing any medical care for the child

28. What is the priority nursing intervention for a child with phenylketonuria?

    a) Administer insulin
    b) Provide a diet low in phenylalanine
    c) Administer corticosteroids
    d) Encourage high protein intake

29. Which of the following strategies would most effectively reduce anxiety in a family dealing with a child’s terminal illness?

    a) Avoid discussing the illness
    b) Provide clear information and emotional support
    c) Encourage the family to focus on other children
    d) Avoid discussing the prognosis

30. A child with renal failure is dependent on dialysis. The nurse should prioritize which of the following interventions?

    a) Provide detailed information on dialysis management
    b) Focus only on the child’s emotional needs
    c) Avoid discussing future complications
    d) Encourage the family to pursue alternative treatments

Answer Key:

1. b

2. c

3. c

4. c

5. c

6. b

7. b

8. c

9. b

10. c

11. c

12. c

13. c

14. c

15. b

16. c

17. c

18. b

19. b

20. b

21. b

22. b

23. a

24. b

25. b

26. b

27. b

28. b

29. b

30. a