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?

"Siblings may feel as if they have lost a parent, which can lead to poor mental health."

"Most negative feelings regarding losing a child should diminish within a year."

"Parents are less likely to rely on hospice care services if their child has terminal illness."

"Parents who feel hopeful are less equipped to make decisions that limit end-of-life interventions."

Answer and Explanation

The Correct Answer is A

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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Correct Answer is D

Explanation

A. “Fragile X syndrome follows an autosomal recessive pattern, so both genetic parents must carry the gene mutation for a child to be affected.” Fragile X syndrome is not autosomal recessive; it is X-linked dominant, meaning it is associated with mutations in the FMR1 gene on the X chromosome. Only one copy of the mutated gene is needed to express the condition.

B. "Since your child has fragile X syndrome, all of your future sons will also have the condition, but your daughters will not be affected." This is incorrect because not all sons will necessarily inherit the condition, and daughters can also be affected, though they often have milder symptoms due to having two X chromosomes.

C. “Fragile X syndrome is inherited in a mitochondrial pattern which means it is passed from the pregnant individual to the child through mitochondrial DNA.” Mitochondrial inheritance involves genes from the mother’s mitochondria, but fragile X syndrome is not inherited this way—it is an X-linked disorder passed down through the X chromosome.

D. “Fragile X syndrome is inherited in an X-linked dominant pattern, which means that if a pregnant client carries the gene mutation, each child has a 50% chance of inheriting the condition.” This is correct. Fragile X syndrome is X-linked dominant, and a parent who carries the full mutation has a 50% chance of passing it to each child. Males typically have more severe symptoms than females due to having only one X chromosome.

A. "My family should use separate serving utensils for gluten-free foods." B. "I can still enjoy oatmeal for breakfast.” C. “I need to avoid foods like bread, pasta, and cereal." D. "I need to check food labels for hidden sources of gluten, like barley and rye."

Correct Answer is B

Explanation

A. "My family should use separate serving utensils for gluten-free foods." Cross-contamination is a serious concern for individuals with celiac disease. Using separate utensils and cookware helps prevent exposure to gluten and reduces the risk of intestinal damage.

B. "I can still enjoy oatmeal for breakfast." Regular oats are often contaminated with gluten due to cross-contact with wheat, barley, or rye during processing. Only certified gluten-free oats are considered safe for individuals with celiac disease, but even then, some people may still react due to the protein avenin found in oats.

C. "I need to avoid foods like bread, pasta, and cereal." Many traditional bread, pasta, and cereals contain wheat, barley, or rye, which must be strictly avoided in a gluten-free diet.

D. "I need to check food labels for hidden sources of gluten, like barley and rye." Gluten can be found in processed foods, sauces, seasonings, and even medications. Reading labels carefully is essential for managing celiac disease.

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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?

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