A nurse is reinforcing teaching to a newly hired nurse about the management of care for the terminal illness of a child. Which of the following statements by the newly hired nurse indicates an understanding of the teaching?

"Palliative care should be given separately from curative care."

"Clinicians should participate in the discussion with the family about the child's prognosis."

"Parents who express hope of their child surviving are less accepting of palliative care."

"Palliative care should be offered once a child has less than 6 months to live."

Answer and Explanation

The Correct Answer is B

A. "Palliative care should be given separately from curative care." Palliative care can be provided alongside curative treatments to enhance comfort and quality of life. It is not limited to end-of-life care but focuses on symptom management and emotional support throughout the illness.

B. "Clinicians should participate in the discussion with the family about the child's prognosis." Open, honest, and compassionate communication between healthcare providers and families is crucial. Clinicians help families understand the prognosis, treatment options, and goals of care, ensuring informed decision-making.

C. "Parents who express hope of their child surviving are less accepting of palliative care." Parents can hope for a cure while still accepting palliative care to improve their child's comfort and quality of life. Hope and palliative care are not mutually exclusive.

D. "Palliative care should be offered once a child has less than 6 months to live." Palliative care is not limited to a specific timeframe. It can begin at diagnosis of a serious illness and continue throughout treatment, rather than being restricted to end-of-life care.

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Correct Answer is B

Explanation

A. Administering the insulin injection quickly to minimize discomfort. Administering an injection quickly may reduce discomfort, but it does not address the emotional and psychological aspects of atraumatic care. The goal is to minimize fear and distress, not just physical pain.

B. Explaining the procedure in simple terms to the client before administering the insulin. Providing a clear, age-appropriate explanation helps reduce anxiety and fosters trust between the child and the nurse. Understanding what to expect allows the child to feel a sense of control, which is a key principle of atraumatic care.

C. Asking the client to look away during the injection to reduce anxiety. While looking away may help some children, it does not promote understanding or involvement in their care. Instead, explaining the procedure allows the child to develop coping strategies and feel more secure.

D. Using a larger needle to ensure accurate insulin delivery. Insulin is administered using a small-gauge needle to minimize pain. A larger needle is unnecessary and could increase discomfort, contradicting the principles of atraumatic care.

A. “Fragile X syndrome follows an autosomal recessive pattern, so both genetic parents must carry the gene mutation for a child to be affected." 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." C. “Fragile X syndrome is inherited in a mitochondrial pattern which means it is passed from the pregnant individual to child through the mitochondrial DNA.” 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."

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.

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A nurse is reinforcing teaching to a newly hired nurse about the management of care for the terminal illness of a child. Which of the following statements by the newly hired nurse indicates an understanding of the teaching?

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Correct Answer is B

Explanation

A nurse is reinforcing education about the inheritance patterns of fragile X syndrome to a couple who have a family history of the disorder. Which of the following statements should the nurse make?

Correct Answer is D

Explanation

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