A nurse is caring for a child who has terminal cancer. Which of the following responses by the child's school age brother should the nurse expect?

Believes that his brother's death will be reversible

Regresses to an earlier developmental level

Alienates himself from his peers

Believes his bad behavior is causing his brother's death

Answer and Explanation

The Correct Answer is D

A. This belief is more common in preschool-age children who may not fully understand the permanence of death. School-age children generally have a better grasp of the concept of death being final.

B. Regression can occur in children of any age dealing with significant stress or trauma, but it is more typically seen in younger children. Older children might exhibit other forms of stress responses.

C. While alienation can happen, it is not the most typical response for a school-age child. They are more likely to seek support from peers or blame themselves through magical thinking, as they are still developing their understanding of complex emotional and social dynamics.

D. This choice reflects the magical thinking common in school-age children, where they might believe that their actions or thoughts can influence events. This can lead to feelings of guilt and responsibility for their sibling's illness or death.

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Correct Answer is A

Explanation

The correct answer is choice a. Wear shoes with rubber soles.

Choice A rationale:

Wear shoes with rubber soles () - Quiet footwear minimizes noise disruption during sleep hours, promoting a better sleep environment.

Choice B rationale:

Conduct change of shift reports near the clients’ rooms () - Conducting reports near rooms creates noise and disrupts sleep. It’s best done in designated areas away from patients.

Choice C rationale:

Open curtains between clients in semi-private rooms () - Privacy and individual light control are crucial for sleep. Open curtains can disrupt a client’s sleep cycle.

Choice D rationale:

Turn on overhead lights briefly when checking IV lines () - Bright lights suppress melatonin production, a hormone vital for sleep. Using alternative light sources or dimmed lighting minimizes sleep disruption.

A. "I will take two 325 milligram aspirin tablets at the same time." B. "I will stop what I am doing and lie down." C. "I will call the provider after taking one dose of nitroglycerin." D. "I will hold my breath and bear down."

Correct Answer is B

Explanation

A. "I will take two 325 milligram aspirin tablets at the same time.": While aspirin is often recommended for heart attack prevention, taking two 325 mg tablets at the same time is not the standard recommendation for managing stable angina. The client should focus on using nitroglycerin as prescribed and seeking immediate medical attention if symptoms persist.

B. "I will stop what I am doing and lie down.": When chest pain occurs, the client should stop all activity and rest, preferably lying down. Resting can help reduce the heart's workload and alleviate the pain associated with stable angina.

C. "I will call the provider after taking one dose of nitroglycerin.": The correct action is to take one dose of nitroglycerin and wait five minutes. If the pain is not relieved, the client should take another dose and wait another five minutes. If the pain persists after three doses, the client should seek emergency medical help immediately rather than waiting to call the provider.

D. "I will hold my breath and bear down.": Holding the breath and bearing down (the Valsalva maneuver) is not recommended for relieving chest pain. This action can actually decrease venous return to the heart and increase strain on the heart, potentially worsening the situation.

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A nurse is caring for a child who has terminal cancer. Which of the following responses by the child's school age brother should the nurse expect?

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Correct Answer is B

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