The nurse is caring for a child with a developmental disability who is starting kindergarten this year. The mother is tearful and doesn’t want the child to go to school. What is the best response by the nurse?
“Do you need some time alone to collect yourself?”
“You’ve known for a while this time would come.”
“Can I call your husband or a friend for you?”
“It is normal to feel stressed or sad at this time.”
The Correct Answer is D
Supporting families of children with developmental disabilities requires empathy, validation, and encouragement. Starting school can be an emotional milestone for any parent, and even more so when additional needs are involved. The nurse’s best response is one that normalizes the mother’s feelings, showing understanding and compassion without judgment.
Rationale for correct answer:
D. “It is normal to feel stressed or sad at this time.” This statement validates the mother’s emotions, reassures her that her reaction is expected, and opens the door for further supportive discussion. It reflects therapeutic communication, which acknowledges feelings without dismissing or minimizing them.
Rationale for incorrect answers:
A. “Do you need some time alone to collect yourself?” This may come across as dismissive and does not directly validate her emotions. It could shut down communication instead of fostering support.
B. “You’ve known for a while this time would come.” This response is non-therapeutic, potentially judgmental, and invalidates her feelings by suggesting she should be prepared.
C. “Can I call your husband or a friend for you?” While offering support is helpful, this bypasses the opportunity for the nurse to provide direct emotional support and validation. It shifts responsibility away instead of first acknowledging her feelings.
Take home points
- Therapeutic communication involves validating emotions, showing empathy, and encouraging expression.
- Parents of children with disabilities often experience added stress during developmental milestones, nurses should provide reassurance and support.
- Avoid dismissive, judgmental, or minimizing statements; instead, acknowledge feelings as normal and offer continued guidance.
- Validation builds trust and strengthens the nurse-family relationship.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Support from other parents of children with special health care needs is a powerful coping mechanism. Shared experiences foster understanding, reduce isolation, and help families adapt to challenges more effectively than professional advice alone at times.
Rationale for correct answer:
C. Support between parents of special children is extremely valuable. Parents often find strength, comfort, and practical advice from those who have experienced similar challenges. These peer connections promote resilience, normalize feelings, and provide ongoing emotional support.
Rationale for incorrect answers:
A. Assuming the nurse has not provided enough support is inaccurate. While professional support is important, peer support adds a unique dimension that nurses cannot replace.
B. Viewing the relationship as potentially unhealthy is incorrect. Unless it becomes exclusive or fosters dependency, peer support is beneficial, not harmful.
D. Confidentiality is not a concern here as long as families willingly share their own experiences. The nurse must only safeguard protected health information.
Take home points
- Parent-to-parent support is highly effective in managing stress and promoting coping for families of children with special needs.
- Nurses should encourage peer connections through support groups or networking opportunities.
- Professional support and peer support complement each other, ensuring holistic family care.
- Confidentiality concerns arise only if health professionals disclose private information, not when parents voluntarily share.
Correct Answer is A
Explanation
Down syndrome is a genetic condition caused by the presence of an extra copy of chromosome 21, which is why it's also called trisomy 2A. This additional genetic material affects how the body and brain develop, leading to a range of physical, cognitive, and developmental differences.
Rationale for correct answer:
A. A single transverse palmar crease is a common finding in infants with Down syndrome. While it can also appear in healthy infants, its presence along with other physical characteristics supports the diagnosis of trisomy 2A.
Rationale for incorrect answers:
B. The presence of extra digits is associated more with trisomy 13 (Patau syndrome), not trisomy 2A.
C. A transient skin color change (half red, half pale) due to immature blood vessel regulation in newborns. It is a benign and temporary finding, not specific to Down syndrome.
D. Benign bluish pigmentation commonly found on the sacral area of infants with darker skin tones. These are unrelated to chromosomal abnormalities.
Take home points
- Simian crease is a key physical finding in Down syndrome, though not diagnostic on its own.
- Other common Down syndrome features: hypotonia, upslanting palpebral fissures, epicanthal folds, flat nasal bridge, and small ears.
- Distinguish Down syndrome features from findings related to other syndromes (e.g., polydactyly in trisomy 13).
- Early recognition allows prompt evaluation for associated conditions (e.g., congenital heart disease, GI anomalies).
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