The nurse is speaking with the parents of a 4 year old child following a family discussion with the health care provider about the child's terminal condition and the possibility to transition to end-of-life care. The parents state, "We don't think we can make this decision right now. What would you do? Choose the nurse's BEST response.

You seem overwhelmed, I'll contact the chaplain to come and talk with you about the options

I find it helpful to investigate the options. I will get you a pamphlet about end-of-life care

Its hard to say what the best decision is, but I know the end-of-life team provides wonderful care

These decisions are challenging. Tell me about your beliefs and understanding about end-of life

Answer and Explanation

The Correct Answer is D

A. You seem overwhelmed, I'll contact the chaplain to come and talk with you about the options: While offering chaplain support is valuable, it's essential to engage in a conversation with the parents first to understand their needs and concerns.

B. I find it helpful to investigate the options. I will get you a pamphlet about end-of-life care: Providing information is valuable, but in this case, the parents are expressing their emotional distress, and they may need a more empathetic and personalized approach.

C. It's hard to say what the best decision is, but I know the end-of-life team provides wonderful care: While reassuring, this response doesn't actively engage with the parents or explore their feelings and beliefs, which are crucial for making this challenging decision.

D. These decisions are challenging. Tell me about your beliefs and understanding about end-of-life.

This response acknowledges the parents' difficulty with the decision and opens the door for a deeper conversation. It allows the nurse to understand the parents' perspectives, values, and concerns, which is crucial in providing holistic and patient-centered care. This information will help the nurse support the family and guide them through the decision-making process, addressing their specific needs and preferences.

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Correct Answer is A

Explanation

A white glow of the pupil, often referred to as "cat's eye reflex" or "leukocoria," is a significant and characteristic sign of retinoblastoma. It occurs when the tumor within the eye reflects light, resulting in a white or yellowish glow in the pupil when light is shined into it. This can be seen in flash photographs or in certain lighting conditions. It's a crucial sign that may indicate the presence of retinoblastoma, a rare eye cancer that primarily affects young children.

The other options, B (ptosis of the eye), C (fixed and dilated pupil), and D (purulent eye discharge), are not typically associated with retinoblastoma. Ptosis is the drooping of the upper eyelid, a fixed and dilated pupil is usually a sign of neurological issues, and purulent eye discharge is often associated with eye infections rather than retinoblastoma.

A. Explain to the teenager that he is lucky to receive such good care at a specialty hospital and he just needs to be patient B. Arrange for the teenager to have a video conference with his teacher and ensure he has his school work available C. Ask the child-life specialist to help find activities to distract the teenager D. Arrange a multi-disciplinary team meeting, including the teenager and his family to discuss the situation and set goals together

Correct Answer is D

Explanation

A. Explaining to the teenager that he is lucky to receive good care does not address his emotional and social needs adequately and may minimize his feelings.

B. Arranging for a video conference with his teacher and ensuring schoolwork is available is important but does not address his desire to be with friends or his emotional needs.

C. Asking the child-life specialist to help find activities to distract the teenager can be helpful for providing emotional support but may not address his concerns about being with friends and feeling frustrated.

D. Arrange a multi-disciplinary team meeting, including the teenager and his family, to discuss the situation and set goals together.

In this challenging situation, it's important to involve the patient and their family in decision-making and goal-setting. Advanced osteosarcoma with metastasis to the lungs is a serious and potentially terminal illness. The teenager's feelings and wishes should be respected and taken into consideration. A multi-disciplinary team meeting allows for open communication, including the patient, family, healthcare providers, and specialists, to discuss the situation, the patient's preferences, and the overall care plan.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A 1-year-old is being screened for retinoblastoma based on family history of the disease. The nurse recognizes which sign as being most characteristic of the disease?

Correct Answer is A

Explanation

Correct Answer is D

Explanation

The nurse is planning care for an 18 month-old child. Which of the following should be included in the child's care?

A nurse is assisting with a routine physical examination of an adolescent. The provider observes a lateral curvature of the spine. The nurse should expect the provider to document which of the following disorders?

The parent of a child being evaluated for cellac disease asks the nurse why it is important maka dietary changes. What is the user's best response?

The nurse is caring for a 2-year-old who is lethargic and irritable after brain tumor surgery. She is noted to have dry mucous membranes and high urinary output. She has had 2 generalized seizures in the past hour. Which of the following is likely causing these symptoms?

The new mother of a 2-day-old neonate who weighed 8 pounds at birth is distressed that the baby has lost one-half pound. The home health nurse's response is one of:

The nervous parent asks when the big "soft spot" (anterior fontanel) will be closed. The nurse's most informative response would be

Which intervention is a priority for a hemophilic child who has fallen and badly bruised his leg?

The nurse devices a teaching plan for the patient with aplastic anemia. Which of the following is the most important concept to teach for health maintenance?