A school nurse is preparing to support children who have a chronic illness in a middle school setting. The nurse should be aware of which of the following challenges chronically a children may face? (Select All that Apply)
Bullying
Absenteeism
Decreased intelligence quotient score
Behavioral issues towards other students
Mental health concerns
Correct Answer : A,B,E
A. Bullying. Children with chronic illnesses may be at higher risk of bullying due to visible symptoms, medical devices (e.g., insulin pumps, braces), or frequent absences. Bullying can negatively impact their self-esteem and emotional well-being.
B. Absenteeism. Chronic illnesses often require frequent medical appointments, hospitalizations, or rest periods, leading to increased school absences. This can affect academic performance and social integration.
C. Decreased intelligence quotient (IQ) score. While chronic illness can affect cognitive function in some cases (e.g., severe epilepsy, untreated hypothyroidism), most children with chronic illnesses do not inherently have lower IQ scores. Learning difficulties are more often linked to fatigue, medication side effects, or missed instruction time rather than a direct decrease in intelligence.
D. Behavioral issues toward other students. While some children may struggle with frustration or emotional distress due to their illness, chronic illness does not inherently cause aggressive behavior toward peers. However, emotional regulation difficulties may arise due to stress or anxiety related to their condition.
E. Mental health concerns. Anxiety, depression, and feelings of isolation are common among children with chronic illnesses. They may struggle with self-identity, fear of medical procedures, and social exclusion, increasing the risk of mental health disorders.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","D"]
Explanation
A. Provide frequent and routine verbal updates with the parents. Regular updates help reduce parental anxiety and build trust between the healthcare team and the family. Keeping parents informed reassures them that their child is receiving appropriate care.
B. Encourage the parents to participate in the toddler's plan of care when appropriate. Involving parents in simple caregiving tasks (e.g., soothing the child, assisting with feedings) fosters a sense of control and connection, easing their distress.
C. Perform more frequent health care rounds on the toddler. Increased monitoring ensures early detection of respiratory complications and reassures parents that their child's condition is being closely managed.
D. Conduct interprofessional rounds at the child's bedside so the parents can be included. Including parents in bedside rounds allows them to hear updates from multiple specialists, ask questions, and feel more engaged in decision-making regarding their child's care.
E. Reinforce education to the parents on all nursing interventions to alleviate added anxiety about tasks they are unfamiliar with. While educating parents is important, overwhelming them with detailed explanations of every intervention may actually increase anxiety rather than alleviate it. Teaching should be concise and tailored to what the parents need to know at the moment.
F. Provide the parents with the nurse's personal cell phone number to contact if they have questions while they are away from the hospital. Personal phone numbers should not be given out for professional and ethical reasons. Instead, parents should be provided with the hospital unit’s contact information for any concerns.
Correct Answer is C
Explanation
A. Print out a copy of the asthma action plan and thoroughly review it with the child and the school nurse prior to discharge. While an asthma action plan is essential, it is not sufficient if the parent is not actively engaged. The parent also needs education and support to properly manage the child's condition at home.
B. Write out a detailed schedule of the child's medications and a list of their healthcare providers’ addresses and phone numbers in case they should need it. Providing a medication schedule is helpful, but it does not address the root issue—parental disengagement. Simply handing out information does not ensure the parent understands or feels empowered to manage the child's asthma.
C. Empower the child's parent to help manage the asthma by offering comprehensive education on the condition, treatment plan, and managing potential complications at home. Parental education and engagement are crucial for managing uncontrolled asthma. Offering clear explanations, demonstrating medication use (such as inhalers and spacers), and discussing signs of worsening asthma can help the parent feel more confident and involved in their child’s care.
D. Contact child protective services to intervene in the family since the child's parent does not seem adequately prepared to manage the client's illness at home. CPS involvement is not appropriate unless there are signs of medical neglect (e.g., refusal to seek care, persistent non-adherence). In this case, the best first step is education and support to encourage parental involvement.
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