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A home health nurse is providing care to a child who has cerebral palsy and notes that the child's parent seems withdrawn. The nurse asks the parent how they are doing, and the parent begins crying and states that taking care of their child is “so hard sometimes" and they are not sure how much more stress they can take. Which of the following statements made by the nurse's the most appropriate response?

“I will give you the names and contact information of a few good counselors. Talking to a professional is very helpful."

“Taking care of anyone with complex medical needs can be very overwhelming. What has your healthcare team told you about respite care?”

"You seem to be under a lot of stress. Have you tried reading self-help books on coping with stress?"

"Has something changed with your child's health condition? You can usually handle taking care of them. I will schedule a follow-up appointment with their provider to see what is going on.”

Answer and Explanation

The Correct Answer is B

A. “I will give you the names and contact information of a few good counselors. Talking to a professional is very helpful." While counseling can be beneficial, immediately directing the parent to therapy may feel dismissive of their immediate distress. A more supportive and solution-focused approach, such as discussing respite care, directly addresses the caregiver's burden.

B. “Taking care of anyone with complex medical needs can be very overwhelming. What has your healthcare team told you about respite care?” This response validates the parent's feelings while offering a practical solution. Respite care can provide temporary relief for caregivers, allowing them time to rest and recover, which can reduce burnout.

C. "You seem to be under a lot of stress. Have you tried reading self-help books on coping with stress?" While self-help books may provide general coping strategies, this suggestion does not acknowledge the immediate emotional burden the parent is experiencing or offer direct assistance.

D. "Has something changed with your child's health condition? You can usually handle taking care of them. I will schedule a follow-up appointment with their provider to see what is going on.” Assuming the parent can "usually handle" caregiving may invalidate their struggle. Additionally, suggesting a medical follow-up for the child rather than addressing the caregiver’s needs misses the core issue of caregiver stress.

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Naxlex Comprehensive Predictor Exams

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Correct Answer is ["3.8"]

Explanation

Convert the child's weight from pounds to kilograms:

Formula:

kg = lb / 2.2

= 22 lb / 2.2 lb/kg

= 10 kg

Calculate the total daily dose of dexamethasone:

Total daily dose (mg) = Dose (mg/kg/day) × Weight (kg)

= 1.5 mg/kg/day × 10 kg

= 15 mg/day

Calculate the dose to be administered every 6 hours:

Dose per interval (mg/dose) = Total daily dose (mg/day) / Number of doses per day

= 15 mg/day / 4 doses/day

= 3.75 mg/dose

Calculate the volume of dexamethasone oral solution to administer:

Volume (mL) = Dose (mg) / Concentration (mg/mL)

= 3.75 mg / 1 mg/mL

= 3.75 mL

Round to the nearest tenth:

3.75 mL rounded to the nearest tenth is 3.8 mL.

The nurse should administer 3.8 mL per dose.

A. "Siblings may feel as if they have lost a parent, which can lead to poor mental health." B. "Most negative feelings regarding losing a child should diminish within a year." C. "Parents are less likely to rely on hospice care services if their child has terminal illness." D. "Parents who feel hopeful are less equipped to make decisions that limit end-of-life interventions."

Correct Answer is A

Explanation

A. "Siblings may feel as if they have lost a parent, which can lead to poor mental health." When a child is diagnosed with a terminal illness, parents often focus most of their attention on the sick child, which can make siblings feel neglected or emotionally abandoned. This can lead to anxiety, depression, or behavioral issues, requiring additional support and reassurance.

B. "Most negative feelings regarding losing a child should diminish within a year." Grieving the loss of a child is a lifelong process, and emotions do not follow a set timeline. Many parents continue to experience profound grief for years, though their coping mechanisms may improve over time.

C. "Parents are less likely to rely on hospice care services if their child has a terminal illness." Hospice care is often recommended for children with terminal illnesses, as it provides pain management, emotional support, and quality-of-life care for both the child and family. Many parents seek hospice services to ensure their child is comfortable in their final days.

D. "Parents who feel hopeful are less equipped to make decisions that limit end-of-life interventions." Hope does not prevent parents from making informed medical decisions. Parents can hope for a miracle while still making practical choices about palliative care and limiting invasive interventions when necessary.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer a dexamethasone 1.5 mg/kg/day PO to divide equally every 6 hr to a preschool-age child who weighs 22 lb. Available is dexamethasone oral solution 1 mg/mL. How many mL should the nurse administer per dose?

Correct Answer is ["3.8"]

Explanation

A nurse is reinforcing teaching to a newly hired nurse about how family members are affected by the terminal diagnosis of a child. Which of the following statements by the new nurse indicates an understanding of the teaching?

Correct Answer is A

Explanation

A nurse is reinforcing education about nutrition for a patient who has HIV and has a newborn. Which of the following statements should the nurse provide in the teaching?

A hospice nurse is reinforcing teaching to a parent about how age affects how their child experiences a terminal illness. Which of the following statements should the nurse include?

A nurse is reinforcing education with a caregiver of a pediatric client about diaper dermatitis. Which of the following statements should the nurse make?

A nurse is assisting in the care of a client who has a long-term suprapubic catheter in place and is eager to learn how to care for the catheter. The nurse recognizes that a child in which of the following psychosocial developmental stages may be ready for this education?

A home health nurse is collecting data on an adolescent who has cystic fibrosis. The child expresses concern about experiencing increasing episodes of respiratory distress and asks the nurse for insight into the possible reasons. Which of the following responses should the nurse make?

A nurse is assisting in the care of a toddler whose caregivers have questions about allergies. Which of the following should the nurse identify as the most common allergic reaction in children?

A nurse is preparing to administer dextrose 5% in water (DSW) 100 mL to infuse over 1 hr. The drop factor of the manual IV tubing is 15 gtt/ml. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number.)