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?

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.

A. Complete a screening test for autism spectrum disorder (ASD). By 18 months, most toddlers have said their first word, and a lack of speech development can be an early sign of ASD or other developmental delays. The M-CHAT (Modified Checklist for Autism in Toddlers) is a common screening tool used at this age to assess for autism. Early identification allows for timely interventions.

B. Ask the parent about recent immunizations. While immunization history is important for overall health, there is no connection between vaccines and delayed speech development. This question does not directly address the developmental concern at hand.

C. Educate the parent that toddlers do not typically say their first word until 18-20 months of age. This is incorrect. Most toddlers say their first word around 12 months, and by 18 months, they typically have a vocabulary of several words. A lack of speech at this age warrants further assessment.

D. Ask the parent if the toddler has a history of hospitalizations or surgeries. While medical history is important, hospitalizations or surgeries are not the most common causes of delayed speech. Developmental screening is the most appropriate next step in evaluating speech delays.