Download Cognitive Development and Hospitalized Children and more Exams Nursing in PDF only on Docsity! CLC CERTIFICATION EXAM ACTUAL EXAM 2024-2025 TEST BANK COMPLETE 400 QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+ 1)A 3-year-old child dies in the emergency room and the parents are experiencing shock and disbelief. Which of the following should be the NEXT step for the child life specialist? (A) Ask the parents to go to the waiting room while the child is bathed and dressed (B) Create an opportunity for parents to be with their child to say goodbye (C) Ask the parents if they would like to see a social worker to help them with funeral arrangements (D) Leave the parents along to grieve and wait for them to request support Correct Answer (B) Create an opportunity for parents to be with their child to say goodbye 2) Due to improved pediatric policies and family involvement, which stage of attachment is most seldom observed in the hospital setting? (A) Detachment (B) Despair (C) Protest (D) Withdrawal Correct Answer (A) Detachment 3) Which are some suggested and age appropriate coping techniques used for infants: A. Hand held games, guided imagery B. Counting, deep breathing exercises C. Pacifiers, touch, music and comfort item D. Pop-up books, hand holding Correct Answer C. Pacifiers, touch, music and comfort item 4) Which statement is true about non-directive medical play? A. Medical play and preparation are synonymous B. The adult should follow the child's lead C. The play is accompanied by positive affect and is not intense or aggressive D. The child should be the only one to initiate it Correct Answer B. The adult should follow the child's lead 5) When preparing a child for a medical procedure, a CLS should select which of the following age-appropriate materials: A. Photographs B. Dolls C. Actual medical equipment D. Diagrams E. All of the above Correct Answer E. All of the above 6) Volunteer performance standards should be based on which of the following? (A) Style of the supervisor (B) Objectives of the program (C) Volunteer's preference (D) Needs of the individual child Correct Answer (B) Objectives of the program 8) Which of the following is the most effective educational strategy for teaching techniques and benefits of play to a caregiver? (A) Using videos and music as instructional aids (B) Enlisting the help of an experienced caregiver (C) Modeling play interactions by engaging the caregiver and child (C) Rehearsal (D) Modeling Correct Answer (D) Modeling 17) Which of the following would be most useful in helping a child work through a just- completed medical procedure? A. A visit to the activity center B. Separation play C. Interacting with peers D. Medical play Correct Answer D. Medical play 18) A primary goal of advocacy training for family members is to empower them in (A) acquiring a particular service for their child.(B) facilitating a hospital policy change. (C) becoming more aggressive with medical personnel. (D) communicating their needs. Correct Answer (D) communicating their needs. 19) A 6-year-old is going to have a procedure in 30 minutes. How should the child life specialist respond? (A) Make an assessment and follow up with the appropriate interventions (B) Gather materials and provide healthcare play (C) Collect distraction items to use during the procedure (D) Prepare the child about the procedure and ways to cope Correct Answer (A) Make an assessment and follow up with the appropriate interventions 20) After three months in a newborn intensive care nursery, a baby is discharged. How can the child life specialist assist the family with this transition? (A) Provide respite care for the family (B) Provide information about community resources (C) Participate in a recreational outing with the family (D) Give the family his/her telephone number Correct Answer (B) Provide information about community resources 21) Which of the following refers to the idea that a word or phrase can stimulate images and feelings so intense that they can replace reality? (A) Symbolic communication (B) Word-Thing confusion (C) Medical jargon (D) Fact inference confusion Correct Answer (B) Word-Thing confusion 22) When a child is trying to understand death, he/she may ask, "Do children and animals die, too?" Which concept of death is the child trying to grasp by asking this question? (A) Irreversibility (B) Causality (C) Non-functionality (D) Universality Correct Answer (D) Universality 23) A child is having a difficult time with a procedure. What should the child life specialist do to promote coping? (A) Offer choices about what the child will do during the procedure (B) Choose the child's favorite nurse to do the procedure (C) Arrange for the procedure to be performed in the child's room for comfort (D) Suggest parents leave the room until the child calms down Correct Answer (A) Offer choices about what the child will do during the procedure 24) A child life specialist encourages children ages 6-11 to participate in their own care, continue schoolwork, and communicate with family and peers while in the hospital. Why is this approach important to development? (A) To increase feelings of inclusion (B) To increase feelings of initiative (C) To decrease development of preoperational cognition (D) To decrease development of abstract cognition Correct Answer (A) To increase feelings of inclusion 25) Which of the following are considered normal grief responses for a 16-year-old sibling? (A) Suicidal thoughts, low self-esteem, and academic failure (B) Sleep problems, isolation from friends and family, and fighting (C) Egocentricism and an increase in moodiness and sexual awareness (D) Chronic depression, dramatic changes in attitude, and eating disorders Correct Answer (C) Egocentricism and an increase in moodiness and sexual awareness 26) What should a family expect with the implementation of a patient- and family-centered care plan? (A) The family participates in decision making regarding their child's care. (B) All extended family must be involved in the care of the child. (C) The healthcare team will provide necessary medical care to the immediate family. (D) Family situations are similar, and standard care plans are incorporated. Correct Answer (A) The family participates in decision making regarding their child's care. 27) Which of the following is the most important strategy when working with families in any healthcare setting? (A) Communication (B) Support (C) Family-centered care (D) Cultural sensitivity Correct Answer (A) Communication 28) What should be the first step when using anticipatory guidance as a supportive technique with a new volunteer? 36) What action should the child life specialist take when preparing children for healthcare experiences? (A) Provide information even if the child seems reluctant to hear it because it will benefit the child later (B) Omit descriptions that may be stressful for a child to listen to, even if the child will experience the sensation (C) Use medical terminology so that children can become accustomed to this language (D) Provide honest, accurate information using developmentally- appropriate language Correct Answer (D) Provide honest, accurate information using developmentally-appropriate language 38) When working with a child who is on a ventilator, what approach should a child life specialist take? (A) Engage the child in nonverbal play (B) Place the child as a low priority due to limited capacity to interact (C) Do not provide play because it is medically threatening (D) Engage the child in sand tray play at the bedside Correct Answer (A) Engage the child in nonverbal play 39) An individual who continues to self-assess and respect differences is at what stage on the cultural competence continuum? (A) Basic cultural competence (B) Cultural blindness (C) Cultural pre-competence (D) Advanced cultural competence Correct Answer (A) Basic cultural competence 40) Which of the following best describes a child who has had repeated experiences of ineffective coping? (A) Anticipatory grief (B) Anticipatory anxiety (C) Learned helplessness (D) Oppositional defiance Correct Answer (C) Learned helplessness 1. When should a child life specialist initiate a referral to an interdisciplinary member of the health care team? A. When a child life specialist learns the patient does not have any siblings to support during hospitalization. B. Once the health care team asks about a child life specialist's observations, assessments and recommendations. C. When professional limits and boundaries of the child life scope of practice have been recognized. D. Once the patient has been assessed as developmentally delayed and non-verbal. Correct Answer C. When professional limits and boundaries of the child life scope of practice have been recognized. 2. A physician enters a room alone to obtain informed consent for an upcoming procedure from a family who, in handoff, has been reported to understand English but is primarily Spanish speaking. What should the child life specialist do next? A. The child life specialist speaks to the physician afterwards questioning the family's comprehension and is satisfied when told, "they're fine with it". B. The child life specialist contacts interpretation services, in advocacy, to alert them that the family is currently meeting with the physician and is questioning their full comprehension of the consent. C. The child life specialist inquires and is told that the physician speaks Spanish therefore no additional support or resources are needed. D. The child life specialist discovers in the patient's medical record that the family has consented in the past with assistance from an interpreter and therefore does not need to repeat Correct Answer B. The child life specialist contacts interpretation services, in advocacy, to alert them that the family is currently meeting with the physician and is questioning their full comprehension of the consent. 3. Upon discharge from the hospital, a patient invites a child life specialist to come to his upcoming birthday party. The child life specialist explains why they cannot have a relationship with the patient outside of the hospital. The child life specialist is maintaining what type of relationship with the patient? A. A casual professional relationship B. A friendship C. A therapeutic relationship D. An over-involved relationship Correct Answer C. A therapeutic relationship 4. A child life specialist engages a patient in a therapeutic activity. During this activity, the child expresses fears about their upcoming surgery. Which of the following is the most appropriate way for a child life specialist to effectively communicate this child's concerns to the care team? A. Chart in the patient's medical record B. Inform the child life team C. Encourage the patient to advocate for themselves D. Consult the pediatric psychologist Correct Answer A. Chart in the patient's medical record 5. Which of the following describes a child life specialist's obligation to maintain confidentiality? A. to be fair, impartial and equitable B. to avoid or minimize harm and burden C. to respect and protect the privacy of others D. to recognize an individual as having unique worth Correct Answer C. to respect and protect the privacy of others A. four-year-old nearing the end of his first admission for asthma who was a direct admit from the physician's office with no ICU stay B. A nine-year-old admitted the previous day for an elective surgery who has been provided preparation C. A ten-year-old admitted to the Intensive Care Unit with Guillain- Barre Syndrome who is angry and rejecting everyone who enters the room D. A six-year-old with cystic fibrosis who has been hospitalized in the past Correct Answer C. A ten-year-old admitted to the Intensive Care Unit with Guillain-Barre Syndrome who is angry and rejecting everyone who enters the room 14. Which model of assessment assigns a risk level score using eight variables that correlates with the potential risk of negative patient behaviors or outcomes during healthcare encounters? A. Stress Potential Assessment Process B. Psychosocial Risk Assessment in Pediatrics C. Child Life Assessment Intervention Plan D.Hawaii Early Learning Profile Correct Answer B. Psychosocial Risk Assessment in Pediatrics 15. How can a child life specialist promote positive coping and best practice for siblings of a child in the hospital? A. Encourage parents to leave siblings at home. B. Have siblings step out of the room during education/preparation done with the patient. C. Allow siblings to participate in the patient's care, including: attending playroom and being involved in education and coping plans made. D.Provide brochures about sibling coping to parents to take home. Correct Answer C. Allow siblings to participate in the patient's care, including: attending playroom and being involved in education and coping plans made. 16. While having a blood draw, a child elects to play iSpy with a child life specialist rather than watching the procedure. Which type of coping strategy is the child using? A. sensory B. cognitive C. behavioral D. reflexive Correct Answer B. cognitive 17. A child is observed to be playing "house" in the playroom. According to Jean Piaget's cognitive theory, this child is demonstrating which developmental stage? A. concrete operational B. formal operational C. sensorimotor D. preoperational Correct Answer D. preoperational 18. Using the Bronfenbrenner model of ecological systems, which layer represents community support to the patient and family? A. microsystem B. exosystem C. mesosystem D. macrosystem Correct Answer C. mesosystem 19. Applying the Stress Potential Assessment Process, a child life specialist would rate a patient who has a new leukemia diagnosis and bone marrow biopsy at what stress potential level? A. 0 B. 1 C. 2 D. 3-5 Correct Answer D. 3-5 20. According to Erik Erikson's Theory of Psychosocial Development, what should a child life specialist consider during assessment and intervention planning for an 8-year-old patient with a new leg cast? A. patient's need for privacy B. patient's need for activities that allows for success C. patient's need for exploration of the environment D. patient's need for parent to meet physical needs Correct Answer B. patient's need for activities that allows for success 21. Which of the following best describes an emotion-based coping strategy used in child life practice? A. promote deep breathing B. advocate for use of procedure/treatment room C. provide developmentally appropriate information D. promote problem solving strategies Correct Answer A. promote deep breathing 22. A child life specialist advocates for patient and family-centered care practices when considering this factor during assessment? A. identify patient's pain level B. identify the caregiver responsible for decision-making C. identify patient's hobbies D. identify patient and family's cultural background Correct Answer D. identify patient and family's cultural background 23. Adaptability, irritability, activity level, and approachability are characteristics of A. emotions B. temperament C. conditions D. self-awareness Correct Answer B. temperament 24. In clinical practice, a child life specialist who encourages patients and families to be the experts of their own family practices is building the foundation for what? A. integration of theories into practice B. culturally competent and spiritually supportive care C. knowledge competencies and building rapport B. Attachment Theory C. Psychosocial Theory D. Temperament Theory Correct Answer A. Family Systems Theory 33. When a person is internally having thoughts and feelings regarding a death, what are they experiencing? A. bereavement B. grief C. mourning D. shock Correct Answer B. grief 34. A child life specialist is working with two siblings of a patient dying. The family clearly communicates traditions and cultural beliefs of child presence surrounding end of life processes. The siblings briefly visit their brother at the bedside, and then go home with mother. The child life specialist should A. Discuss with the parents that the siblings may cope better if they are allowed to stay with the family at the hospital. B. Acknowledge and accept the family's cultural beliefs of who should be present for the death of a child. C. Contact the hospital ethics department for guidance. D. Ask the hospital chaplain to come up with a way for the family to be able to be present together for the child's death. Correct Answer B. Acknowledge and accept the family's cultural beliefs of who should be present for the death of a child. 35. The child life specialist has scheduled a game of Uno for adolescent patients with similar diagnoses to encourage socialization among the group. This activity would be an example of A. therapeutic play. B. normalizing play. C. parallel play. D. onlooker play. Correct Answer A. therapeutic play. 36. What is the most effective age range for utilizing oral sucrose when doing a heel stick? A. Approximately three months old and disappears after six months of age. B. Two days old and disappears over the first six months of age. C. Two days old and disappears around two years of age. D. Approximately three months old and disappears around 18 months of age. Correct Answer B. Two days old and disappears over the first six months of age. 37. When is palliative care shown to be most effective? A. When the patient is thought to have less than six months to live. B. When the patient has been given a terminal diagnosis. C. When the patient and family does not want death to occur at home. D. When the patient has a life-limiting or ultimately terminal condition. Correct Answer D. When the patient has a life-limiting or ultimately terminal condition. 38. A child's understanding that all living things eventually die is known as A. causality. B. non-functionality. C. universality. D. irreversibility. Correct Answer C. universality. 39. To provide emotional support and increase a sense of connection and between parent(s), sibling(s), and the patient, the child life specialist may provide technology-based communication resources. This intervention applies which theory into child life practice? A. Psychosocial development theory B. Social learning theory C. Cognitive development theory D. Family systems theory Correct Answer D. Family systems theory 40. When a child life specialist is assessing coping on a 4-year- old patient with a newer port, the parent states "We just have to hold him down and get it done." What is the most appropriate way for a child life specialist to proceed? A. Respect the mother's assessment and try to support the child as best as possible. B. Wait outside of room until procedure is done, returning to help child de-escalate. C. Stay in the room when port is accessed and observe the process and behaviors. D. Discuss with mother benefits of comfort positions and uses of distraction. Correct Answer D. Discuss with mother benefits of comfort positions and uses of distraction. 41. Through her research in the late 1960's, Elisabeth Kubler- Ross developed the widely accepted stages of grief. Dying adults tend to progress through the stages in what order? A. anger, depression, bargaining, denial, acceptance B. denial, depression, anger, bargaining, acceptance C. denial, anger, bargaining, depression, acceptance D. depression, bargaining, anger, denial, acceptance Correct Answer C. denial, anger, bargaining, depression, acceptance 42. A member of the multidisciplinary team calls a child life specialist to discuss an 8-year-old patient newly diagnosed with diabetes that is exhibiting uncooperative behavior at the time of insulin injections. Which healthcare play example best supports the patient's coping needs? A. onlooker B. dramatic C. group casts on the paws of a stuffed animal. The type of play that is most likely to happen is A. parallel play. B. age appropriate play. C. child-directed play. D. spontaneous play. Correct Answer D. spontaneous play. 49. A pediatric resident enters the playroom to assess a preschool-age patient's pain and listen to their lungs. The child life specialist should A. allow the resident to make their assessment, as they are not doing anything invasive. B. request the resident to come back after the play session has finished to not disrupt the play. C. explain to the resident that the playroom is a 'safe space' and if an assessment must occur immediately the child would have to return to their room. D. tell the resident that doctors are not allowed in the playroom, and ask them to leave. Correct Answer C. explain to the resident that the playroom is a 'safe space' and if an assessment must occur immediately the child would have to return to their room. 50. A 10-year-old patient is having an IV placed. Which would be a developmentally appropriate coping strategy to offer the patient during the procedure? A. playroom B. imagery C. preparation D. education Correct Answer B. imagery A child repeatedly asks questions during a blood draw. According to Lazarus, this behavior is best identified as: A. Primary appraisal B. Problem-focused coping C. Emotion-focused coping D. Secondary appraisal Correct Answer B. Problem-focused coping Which of the following is an accurate statement about the sequence of physiological development of motor skills? A. Motor development begins when the child reaches age 6 months B. The development sequence is disordered in children with cerebral palsy C. Motor development proceeds from the head downward to the lower body, and from the center of the body outward to the extremities D. The development sequence is determined by which of the child's hands will eventually be dominant Correct Answer C. Motor development proceeds from the head downward to the lower body, and from the center of the body outward to the extremities After working on an individual school project for weeks, a patient learns that hospitalization will prevent its completion. According to the work of Erikson, at which stage is a child most likely to be distressed by this situation? A. Autonomy vs. shame and doubt B. Industry vs. inferiority C. Identity vs. role diffusion D. Initiative vs. guilt Correct Answer B. Industry vs. inferiority According to theories related to body image, at what age would female patients be expected to be most distressed upon learning that required chemotherapy is likely to cause hair loss? A. 7 years B. 10 years C. 14 years D. 20 years Correct Answer C. 14 years Knowledge of the child's temperament provided by the parents generally: A. May reflect the child's behavior when healthy, but is likely to have little or no relation to behavior in the hospital B. Offers helpful information about preschool children but little help for understanding children at other ages C. Must be viewed with caution, as parents are biased and subjective to their comments D. Can provide child life specialists with valuable clues as to how to interact with the child Correct Answer D. Can provide child life specialists with valuable clues as to how to interact with the child 6. When talking to parents in a health care setting, the child life specialist should: A. Be accepting of silence B. Refrain from asking questions C. Talk about one's own experience D. Give advice and offer suggestions Correct Answer A. Be accepting of silence The most critical factor associated with a child's vulnerability to the stresses of hospitalization is the: A. Age of the patient B. Level of family support C. Medical condition D. Length of hospitalization Correct Answer A. Age of the patient As accurate statement about emotional stress is that it is: A. Experienced by fewer hospitalized children today than in the past B. Seen frequently in the hospital but rarely observed after discharge C. Common during the period of hospitalization and following discharge B. Document interactions with patient and peers C. Maximize communication opportunities D. Organize a medical team conference Correct Answer C. Maximize communication opportunities Filmed modeling is believed to be an effective way of preparing children for health care experiences primarily based on: A. Pavlov's model for classical conditioning B. Skinner's theory of behavior shaping C. Erikson's psychosocial theory D. Bandura's social learning theory Correct Answer D. Bandura's social learning theory When a child is hospitalized and she/he has several siblings that would like to visit the hospital, the CLS should: A. Tell them they can only visit on weekends B. Be available by phone only C. Provide preparation D. Facilitate the visit, assess their understanding and provide education Correct Answer D. Facilitate the visit, assess their understanding and provide education A primary benefit of the development of a supportive relationship is that it enhances the CLS's ability to: A. Engage in therapeutic interactions with the patient B. Elicit cooperative behavior from the patient C. Plan activities for the child D. Provide parents with time away from the children Correct Answer A. Engage in therapeutic interactions with the patient The structure of individual programs varies according to many factors. All programs are guided by the following objective: A. To help educate about the profession B. To develop preparation materials C. To help children cope with the stress and anxiety of the hospital experience D. To provide easy working hours Correct Answer C. To help children cope with the stress and anxiety of the hospital experience A correct statement about the use of health care teams to meet the needs of children is that the: A. Family is a critical member of the team B. Professions represented on the team are consistent from patient to patient C. Composition of the team remains the same throughout the patient's care D. Team leader is the patient's attending physician Correct Answer A. Family is a critical member of the team The role of the CLS is to be: A. An advocate for the entire family B. The only member of the health care team to provide information C. Healthy and good spirited D. Available 24 hours to the family Correct Answer A. An advocate for the entire family Which approach is most appropriate for evaluating the effectiveness of an intervention designed to reduce fear, stress and anxiety in a selected group of patients? A. Anecdotal reports B. Critical pathway note C. Behavioral rating scale D. Cost/benefit analysis Correct Answer C. Behavioral rating scale In 1967 the first organization was founded and the first to engage in child life work was: A. NACHRI (National Association of Children's Hospitals and Related Institutions) B. Zero to Three C. ACCH (Association for the Care of Children's Health) D. NASW (National Association for Social Work) Correct Answer C. ACCH (Association for the Care of Children's Health) The following statement best describes the theory of which theorist?: This Swiss philosopher made an enormous contribution to our understanding of cognitive development, the capacity to understand and use phenomena in the world around us. A. Bowlby B. Skinner C. Piaget D. Mahler Correct Answer C. Piaget A child has been prepared for a procedure during which the parent will not be present. During the procedure, the child cries softly. This response: A. Demonstrates that the preparation was successful since the child maintained control B. Gives little information by itself about the child's emotional state or the effectiveness of the preparation C. Indicates that the preparation was less than optimally successful D. Shows the importance of the parent's presence Correct Answer B. Gives little information by itself about the child's emotional state or the effectiveness of the preparation Which of the following is a major component of the Official Documents of the Child Life Council? A. Child Life Competencies B. Vision-to-Action Statement C. Articles of Incorporation D. By-laws Correct Answer A. Child Life Competencies A. Change the subject and refocus the play on a lighter topic to avoid further upsetting the child B. Assure the child that he/she will not die and that the health care team will keep him/her safe C. Continue to support the child in play, trusting that the child will open up to others only to the extent they feel safe in doing so. D. Redirect the play to a less emotional level and request that the child be seen by a psychologist. Correct Answer C. Continue to support the child in play, trusting that the child will open up to others only to the extent they feel safe in doing so. Preparing parents for a child's hospitalization ideally should begin A. During the pre-admission assessment visit to the hospital B. Through a private phone call to the parents initiated by a designated pediatric staff member C. During a scheduled pre-admission tour which includes the entire family D. In the physicians office as soon as the admission is scheduled Correct Answer D. In the physicians office as soon as the admission is scheduled Alexander Thomas and Stella Chess were two psychiatrists who research findings determined nine identifiable traits in newborns that remain intact for life. These traits are the basis of: A. Temperament B. Verbal Skills C. Cognitive Development D. Gross Motor Skills Correct Answer A. Temperament The MOST beneficial play activities for children in health care settings are: A. Emotionally charged B. Highly structured C. Open-ended D. Passive Correct Answer C. Open-ended To prepare orientation activities for students and volunteers, it is advisable to minimize the use of: A. Handouts B. Audio-visual format C. Active-involvement format D. Lecture format Correct Answer D. Lecture format A definitive sign of ataxia in a child would be: A. Difficulty breathing B. Refusal to eat C. Problems with speech D. An unsteady gait Correct Answer D. An unsteady gait Preparation of a preschool child for a medical procedure is MOST effective when performed: A. Immediately before the procedure B. A few hours before the procedure C. A few days before the procedure D. A few weeks before the procedure Correct Answer B. A few hours before the procedure Qualitative methods of research A. Are seldom used due to the medical community's preference for quantative data for complete statistical analysis B. Are considered to be of limited value to child life specialists. C. Refer to research procedures which produce descriptive data D. Refer to research procedures in which statistical analysis of data in inherent in the design. Correct Answer C. Refer to research procedures which produce descriptive data All of the following, defined by James Robertson (1958) and John Bowlby (1960), describe a young child's response to separation EXCEPT: A. Protest B. Denial C. Despair D. Detachment Correct Answer B. Denial 15.) Which of the following statement(s) is/are accurate for school-age siblings? I. Sibling presence often enables play for the hospitalized child II. School-age siblings who are developing normally are no longer vulnerable to the use of fantasy to explain the unknown III. School-age siblings usually can be incorporated into a playroom activity alongside patients IV. Separate sibling play areas are less then optimal because they keep family members apart. A. III only B. I and II only C. I and III only D. II and IV only Correct Answer C. I and III only 16.) All of the following areas are essential when orienting students and volunteers EXCEPT: A. Summarizing the philosophy and goals of a program B. Presenting the needs and roles of the child and family during the hospital stay C. Discussing the disadvantages of getting attached to the patient emotionally D. Explaining children's development concepts of grief and death Correct Answer D. Explaining children's development concepts of grief and death 17.) Which age group is MOST likely to think that death is reversible? A. Infants (0-1) B. Toddlers (1-3) 26.) All of the following are principles from the Code of Ethical Responsibility for the Child Life Council members EXCEPT: A. Recognizing when personal needs are interfering with professional duties B. Demonstrating respect for all healthcare professionals C. Sharing patient information with hospital staff on the unit D. Making referrals when a service needed is beyond the child life professional's qualifications. Correct Answer B. Demonstrating respect for all healthcare professionals 27.) An accurate statement about coping strategies employed by hospitalized children is that they A. Can be acquired, changed, or eliminated through personal experiences B. Are innate and stimulated by traumatic events C. Have limited value for preschool children D. Remain constant from infancy through pre-adolescence. Correct Answer A. Can be acquired, changed, or eliminated through personal experiences 28.) A job description for volunteers should A. Clarify expectations and responsibilities B. List expectations for volunteer experiences and talents C. Identify names of individuals to whom volunteers report D. Clarify terms of termination Correct Answer A. Clarify expectations and responsibilities 29.) The BEST method for preventing separation anxiety during a procedure is A. Having the parents present B. Having a child life specialist present C. Consistently having the same physician perform all procedures D. Having the parents leave a transitional item with the child Correct Answer A. Having the parents present 30.) According to Bowlby what are the 3 phases of separation anxiety? A. Distress, ambivalence, and depression B. Trust, mistrust, and guilt C. Protest, despair, and depression D. Protest, despair, and detachment Correct Answer D. Protest, despair, and detachment 31.) Characteristics of a preschool child that would used while preparing him/her for medical procedures would include A. A sense of autonomy B. Animism C. Limited Language skills D. A sense of industry Correct Answer B. Animism 32.) All of the following contribute to an assessment of a child's potential vulnerability in a stressful situation EXCEPT A. Chronological age B. Response to similar situations in the past C. Performance level in school D. Parental Stressors Correct Answer C. Performance level in school 33.) Health care providers facilitating preparation for health care experiences should first and foremost consider the child's A. Family structure B. Developmental level C. Medical condition D. Personality Correct Answer B. Developmental level The age range of children MOST vulnerable to psychological upset related to hospitalization is A. Birth to two and one-half years B. Six months to four years C. Two years to three years D. Three years to six years Correct Answer B. Six months to four years 35.) A child being prepared for a hernia repair. Which age group would MOST likely need to be assured that their condition in not the result of thoughts or actions? A. 1-3 years B. 3-7 years C. 7-9 years D. 9-11 years Correct Answer B. 3-7 years 36.) Children who use passive or avoidant coping strategies to deal with a venipuncture are MOST likely to benefit from A. Comprehensive information about the procedure B. Sedation during the procedure C. Cognitive-behavioral therapies D. Distraction strategies Correct Answer D. Distraction strategies 37.) To be comprehensive, the child life specialists developmental assessment should include physical, cognitive, affective, and which of the following other domains? A. Medical B. Play C. Social D. Environmental Correct Answer C. Social 38.) Which of the following activities would be MOST effective in helping a toddler address the issues of autonomy and separation/ A. Reading a book on separation B. Discussing separation C. Playing "hide and seek" D. Playing "house" Correct Answer C. Playing "hide and seek" 39.) Problem-solving behaviors directed towards changing something in the environment are referred to as 45.) One characteristic of good volunteer supervisors in the ability to A. Coach his/her volunteers B. Give feedback only at scheduled meetings C. Problem solve for volunteers D. Allow volunteers to interact with children by trial and error Correct Answer A. Coach his/her volunteers 46.) A child with neutropenia has which of the following? A. Decreased blood flow to the lings B. An enlarged liver and spleen C. Calcification of the joints D. A decrease in the number of circulating white blood cells Correct Answer D. A decrease in the number of circulating white blood cells 47.) When engaging in medical play with a child, the child life specialist should do all of the following EXCEPT A. Provide realistic materials B. Allow the child the choice of avoiding play C. Correct any apparent misconceptions as they are revealed D. Monitor misconceptions revealed through play Correct Answer D. Monitor misconceptions revealed through play 48.) The coping effort in which one's behavior is directed towards dealing with the distressing thoughts and feelings that accompany stressful situations is A. Problem focused coping B. Emotion focused coping C. Resolution focused coping D. Equilibrium focused coping Correct Answer B. Emotion focused coping 49.) The child life program must have written policies and procedures to meet the requirements of accrediting agencies and to A. Ensure a level of quality and consistency of care and practice within the program B. Ensure equal status with other disciplines in the health care environment C. Effectively recruit volunteers and students for the child life program D. Effectively present the program to business in the community for grant funding. Correct Answer A. Ensure a level of quality and consistency of care and practice within the program 50.) Which of the following is an appropriate guideline to follow when preparing a child for potential stress inducing events? A. Young children need to have their preparation accompanied with appropriate audio-visuals while adolescents prefer verbal explanations B. Two and three year old children need preparation at least 2 weeks in advance so they have ample time to develop appropriate coping skills C. All children should be prepared except for those who show no interest or whose parents request no preparation be given D. Preparation of each individual child should be the responsibility of one person should be supported by other staff members Correct Answer D. Preparation of each individual child should be the responsibility of one person should be supported by other staff members 1.) Of a 6-year old who announces " I'm here for my methotrexate, " it can accurately be stated that the child: A. Knows the technical name for the medication B. Is not fearful of the treatment and has accepted the illness C. Knows what to do to get through the treatment D. Is comfortable with the treatment and coping well Correct Answer A. Knows the technical name for the medication 3.) A 3-year old child brought into an emergency department assumes that the unfamiliar items in a tray on a counter are to be used in her treatment. Piaget would explain this behavior as an example of: A. Disequilibrium B. Accommodation C. Conservation D. Egocentrism Correct Answer D. Egocentrism 4.) A child repeatedly asks questions during a blow draw. According to Lazarus, this behavior is best identified as A. Primary appraisal B. Problem-focused coping C. Emotion-focused coping D. Secondary Appraisal Correct Answer B. Problem-focused coping 5.) According to theories related to body image, at which age would female patients be expected to become most distressed about learning that chemotherapy is likely to cause hair loss? A. 7 years B. 10 years C. 14 years D. 20 years Correct Answer C. 14 years 6.) The child life specialist should observe a child's intensity of response, distractibility, adaptability to changes in routine, persistence, and attention span, in order to determine the child's: A. Predominant pattern of behaving B. Developmental level C. Social Maturity 14.) Children who have experienced trauma or loss require continuous assessment of which behavior? A. Changes in interactions with siblings B. Parent-child interactions C. Responses to peer pressure D. Self-blame Correct Answer D. Self-blame 16.) An accurate statement about emotional stress is that it is: A. Experienced by fewer hospitalized children today than in the past B. Seen frequently in the hospital but rarely observed after discharge C. Common during the period of hospitalization and following discharge D. Most severe in chronically ill children Correct Answer C. Common during the period of hospitalization and following discharge 17.) Which of the following statements most supports the use of temperament theory and its dimensions in child life assessments A. The child life specialist should consider a cognitive-affective approach with an angry child B. A temperamental child requires focused behavioral interventions C. Interventions consistent with the child's temperament are more likely to have a successful outcome D. Behaviors and anxieties of parents are transmitted to their child and must be considered Correct Answer C. Interventions consistent with the child's temperament are more likely to have a successful outcome 18.) Which statement is true about nondirective medical play? A. Medical play and preparation are synonymous B. The adult should follow the child's lead C. The play is accompanied by positive affect and is not intense or aggressive D. The child should be the only one to initiate it Correct Answer B. The adult should follow the child's lead 19.) When families can visit hospitalized children only occasionally and the children exhibit difficulty coping with the separation, the most helpful action is to A. Encourage staff and volunteers to assume parental roles B. Avoid upsetting the child by talking about or looking at pictures of family members C. Talk about what family members are doing at home or work and when they will return D. Inform the family of the child's distress and encourage them to visit more frequently. Correct Answer C. Talk about what family members are doing at home or work and when they will return 20.) Which of the following would be most useful in helping a child work through a just completed medical procedure? A. A visit to the activity center B. Separation play C. Interacting with peers D. Medical Play Correct Answer D. Medical Play 21.) Which of the following determines priority goals in planning therapeutic play interventions for a child? A. Health care team's treatment plan B. Child Life Specialist's observations C. Child's needs and milieu D. Parent's concerns Correct Answer C. Child's needs and milieu 22.) A child life specialist should play for a child when the child: A. Is either to ill, physically unable, or withdrawn to engage in play B. Has exhibited inappropriate play behavior C. Expresses feeling so inadequacy about performance on a game or project D. Has limited social skills and refuses to interact with others Correct Answer A. Is either to ill, physically unable, or withdrawn to engage in play 23.) The effect of a child life specialist using a standardized plan to prepare a 5-year old for different types of medical procedures is that: A. The child's individual needs may not be met B. Preparation standards are consistently reinforced C. The specialists clinical preparation skills are enhanced D. The child's coping skills are enhanced Correct Answer A. The child's individual needs may not be met 24.) When working with an adolescent struggling with lack of trust issues, the child life specialist should: A. Encourage patient journal writing B. Document interactions with patient and peers C. Maximize communication opportunities D. Organize a medical team conference Correct Answer C. Maximize communication opportunities 26.) A researcher is designing a study to investigate whether reduced anxiety in children is associated with preparation before a medical procedure. To ensure confidence in the results, the most appropriate research design would be to: A. Randomly select a group of children whose parents report preparation and compare to a randomly selected group whose parents report no preparation B. Provide preparation to a randomly selected group of children and compare to a second randomly selected group who receive no preparation 33.) A female child is mature and willingly compliant in managing the frequent treatments associated with her chronic illness. At 14 years of age however, she begins to skip medications and misses other treatments and appointments. She does not exhibit signs of depression, and is very happy about her new boyfriend. After establishing a comfortable dialogue, the child life specialist's best starting point for discussing the patient's behavior and feelings is to: A. Ask how school and peer relations are going B. Reinforce the dangers of treatment non-compliance C. Ask what the patient thinks about when the time for her treatment arrives D. Determine how the patient manages her treatment needs when others are present Correct Answer C. Ask what the patient thinks about when the time for her treatment arrives 34.) Which of the following chart notes is appropriate for a child life documentation in a medical record? A. Provide mother with ongoing psychotherapy B. Provide consistent emotional support to reduce child's depression C. This child must have anesthesia induction by mask D. Provide expressive play activities to reduce child's anxiety regarding family separation Correct Answer D. Provide expressive play activities to reduce child's anxiety regarding family separation 35.) A child has not been prepared for a procedure during which the parent will not be present. During the procedure, the child cries softly. This response: A. Demonstrates that the preparation was successful since the child maintained control. B. Gives little information by itself about the child's emotional state or the effectiveness of the preparation C. Indicates that the preparation was less than optimally successful. D. Shows the importance of the parent's presence. Correct Answer B. Gives little information by itself about the child's emotional state or the effectiveness of the preparation 36.) When developing a child life care plan, theoretical assumptions: A. Guide the goals, choices of interventions, and conclusions of all child life specialists B. Affect the process of care indirectly, and have little direct relevance to care plans C. Are of limited use, since theory is an abstract phenomenon and care plans deal with actual, concrete experiences D. Should be explicitly written in chart notes next to goals and interventions Correct Answer A. Guide the goals, choices of interventions, and conclusions of all child life specialists 37.) An effective supervisor of child life volunteers will do which of the following? A. Minimize directive feedback in order to facilitate use of the volunteer's natural abilities B. Make performance expectations clear and provide continuing feedback C. Provide positive feedback about all behaviors, to avoid discouraging volunteers D. Allow volunteers to self-select patient assignments Correct Answer B. Make performance expectations clear and provide continuing feedback 38.) A child life specialist notes in a patients chart that the patient "is very depressed today." A primary problem concerning this entry is that it: A. It ignores the fact that depression is a common state among hospitalized children B. Fails to say why the patient is depressed C. Omits a plan for addressing the patients condition D. Calls for clinical judgment beyond the expertise of the child life specialist. Correct Answer D. Calls for clinical judgment beyond the expertise of the child life specialist. 39.) Which of the following statements best describes the purpose of the Child Life Council Standards of clinical practice? A. To establish the authencity and validity of child life interventions as they related to larger service delivery systems B. To assure staffing requirements that meet the minimum professional standards necessary to facilitate therapeutic relationships C. To establish criteria for the creation, maintentence, and development of child life programs and practices to ensure professional service delivery D. To standardize theoretical foundations and educational requirements across all clinical and academic child life programs Correct Answer D. To standardize theoretical foundations and educational requirements across all clinical and academic child life programs 40.) A non- child life staff member consistently fails to collaborate with the child life specialist's best efforts to work with a certain patient and family. The most effective starting point for resolving this issue is to: A. Speak with the staff member about shared goals and priorities concerning the child and family B. Involve an ally or supervisor as a mediator C. Discuss the issue with the family D. Address the issue with the staff member during rounds Correct Answer A. Speak with the staff member about shared goals and priorities concerning the child and family 7.) Which of the following is the primary reason for the child life specialist to conduct an initial assessment of the patient's and family's needs? A. Plan interventions based on the patient's and family's interests B. Formulate realistic patient and family treatment goals C. Understand the patients and family's reactions to the environment D. Increase patient and family satisfaction with services Correct Answer B. Formulate realistic patient and family treatment goals 8.) The child life specialist may achieve which of the following through observing a child's play? A. An assessment of the child's regression to earlier levels of development B. An ability to interject parts of the child's play that are missing due to distress C. Diagnosis psychopathological responses of the child to hospitalization D. Analyze family system information to uncover sibling issues Correct Answer A. An assessment of the child's regression to earlier levels of development 9.) What is the sequence of reactions of young children to separation from primary caregivers? A. Sadness, anger, and depression B. Protest, despair, and detachment C. Regression, rage, and sadness D. Anger, longing, and hopelessness Correct Answer B. Protest, despair, and detachment 10.) Children in which age group typically believe that a person who has died will come back to life? A. 3-5 B. 6-9 C. 10-12 D. 13-18 Correct Answer A. 3-5 11.) What is an example of egocentrism in a 16-year old who is in a health care setting? A. Believing others are preoccupied with their appearance B. Rejecting attention from staff C. Displaying a lack of empathy for other patients D. Inquiring about personal lives of staff Correct Answer A. Believing others are preoccupied with their appearance 12.) What should a child life specialist look for when assessing a child and family? A. A wide range of variables and systems that influence the successful management of stressors B. Adaptive behaviors and how the child reacted to past medical experiences and stressors C. The impact of parenting style on the child's ability to adjust to stressful situations D. The child's mastery of stressful situations and changes in thinking Correct Answer A. A wide range of variables and systems that influence the successful management of stressors 13.) A family's level of coping is most directly related to which of the following? A. Social class B. Support system C. Level of education D. Religious denomination Correct Answer B. Support system 14.) Which of the following child life practices is a key element of family-centered care? A. Establishing a pediatric playroom B. Developing a sibling support group C. Working in partnership with families D. Providing for rooming-in Correct Answer C. Working in partnership with families 15.) Which of the following examples demonstrates effective cross-cultural communication? A. Being open and respectful to differences B. Learning new gestures and facial expressions C. Speaking in a loud voice with clear articulation D. Paraphrasing everything the other person is saying Correct Answer A. Being open and respectful to differences 16.) When a parent does not want to tell his/her 9-year old child the diagnosis and prognosis of a life-threatening illness, which of the following is likely to occur? A. Shielding from the truth may decrease anxiety B. At this age the child is not able to understand the disease C. The relationship between the parent and child will be strengthened D. The child will be unsure of who to trust Correct Answer D. The child will be unsure of who to trust 17.) Hospital policies which encourage on-going peer relationships demonstrate responsiveness to which developmental group? A. 11months-2 years B. 3-5 years C. 6-11 years D. 12-18 years Correct Answer D. 12-18 years 18.) When parents are provided information and emotional support, which of the following is most likely to happen A. Children will regress B. Fears will disappear C. Anxiety will decrease C. Explore the mother's feelings and reasons, and discuss the concept of consent/assent D. Respect the mothers wishes and provide developmentally appropriate activities Correct Answer C. Explore the mother's feelings and reasons, and discuss the concept of consent/assent 26.) What is an important guideline to follow when providing support to children and families? A. Highlight the area's of weaknesses in the parent/child relationship B. Add to, but does not detract from the parent/child relationship C. Center interventions around the child's immediate needs D. Center interventions around the parents immediate needs Correct Answer B. Add to, but does not detract from the parent/child relationship 27.) Which of the following is a guideline for supportive listening? A. Give constructive feedback B. Provide gentle guidance C. Minimize periods of silence D. Use open ended questions Correct Answer D. Use open ended questions 28.) Which of the following best describes interactions that help children and families learn health care information? A. Individualized, accurate, and age appropriate B. Integrated with playful techniques and humor C. Focused on being positive and minimizing stressful information D. Included information that the patient and family wanted to learn Correct Answer A. Individualized, accurate, and age appropriate 29.) What is the purpose for providing opportunities for children to engage in health care play? A. To normalize the environment B. To provide opportunities for role identity C. To distract patients from expressing feelings D. To avoid the use of real medical equipment Correct Answer A. To normalize the environment 30.) In preparing a 4-year old for surgery, which of the following should be included? A. Sensory information B. Abstract Ideas C. Privacy Issues D. Detailed pictures Correct Answer A. Sensory information 31.) What should the child life specialist do when preparing children for healthcare experiences? A. Provide honest, accurate information using age-appropriate language B. Use medical terminology so that children can become accustomed to this language C. Omit descriptions that may be stressful for a child to listen to even if the child will experience the sensation D. Provide information even if the child seems reluctant to hear it, because it will benefit the child later. Correct Answer A. Provide honest, accurate information using age-appropriate language 32.) What is an outcome of providing psychological preparation? A. Decrease in crying and protesting B. Healthcare provider is seen as less threatening C. Decrease in anxiety and stress D. Patient does not move during procedure Correct Answer C. Decrease in anxiety and stress 33.) Which of the following is an important strategy found to be helpful when preparing 3-4 year old children for surgery? A. Offer appropriate choices to secure a sense of control B. Prepare them one week before surgery C. Provide preparation over the phone with the parent D. Invite their friends to attend a hospital tour Correct Answer A. Offer appropriate choices to secure a sense of control 34.) What is the purpose of encouraging patients who are 13-18 years old to dress in their own clothes and maintain personal grooming and hygiene during hospitalization? A. Maintain hospital cost containment measures B. Encourage independence and self responsibility C. Facilitate adjustment by normalizing the hospital environment D. Facilitate healthy relationships among peers Correct Answer C. Facilitate adjustment by normalizing the hospital environment 35.) What should be considered when evaluating a child life plan of care? A. Goal of achievement B. Available resources C. Patient satisfaction scores D. Results of formal questionnaire Correct Answer A. Goal of achievement 36.) In addition to child oriented atmosphere creative materials, hospital objects, and meaningful play for children in healthcare also requires which of the following? A. Private space to get away from others when desired B. Other hospitalized children for playmates C. A permission-giving responsive adult D. A limit-setting, directive adult Correct Answer C. A permission- giving responsive adult 37.) Which of the following is theoretical basis in support of the play behavior in hospitalized children? A. Children are under stress and thus require adult guidance during play. B. Directed play activities are most therapeutic D. The telephone numbers of the child life staff Correct Answer B. A school reentry program for the teens classmates and teachers 46.) Which of the following represents the effective process for problem solving? A. Problem identification, implementation, problem analysis, and idea generation B. Self evaluation, professional boundaries, respecting diversity, and problem analysis C. Problem identification, problem analysis, idea generation, and implementation D. Problem analysis, self-evaluation, professional boundaries, and respecting diversity Correct Answer C. Problem identification, problem analysis, idea generation, and implementation 47.) Other than salary, what is the largest expense when hiring a new child life specialist? A. Consumable supplies B. Tuition reimbursement C. Travel/ conference fees D. Employee Benefits Correct Answer D. Employee Benefits 48.) How should the use of statistics, numerical analysis, and databases be beneficial to a child life program? A. Assist in the evaluation and program development B. Provide standards for rewriting job descriptions C. Provide framework for evaluating competency D. Assist in creating staff development programs Correct Answer D. Assist in creating staff development programs 49.) Members of the child life team are aware of hospital wide staff reductions in the next fiscal year. The staff seeks to maximize efficiency in their department. How should the staff begin? A. Collect data to show how many children and families are receiving child life services and the outcomes B. Document the number of chart notes written in a weekly log C. Write and instructional annual report and use it orientation for the staff D. Review the policy and procedures in the department on a monthly basis Correct Answer A. Collect data to show how many children and families are receiving child life services and the outcomes 50.) What is the primary research technique in a co-relational study? A. Perform experimental manipulations of independent variables to assess their effects on dependent variables B. Perform simultaneously comparisons of a cohort in terms of age of subjects and time measurements C. Describe the relationships between variables without experimental manipulations D. Compare the effects of different values of an independence variable on the same subjects Correct Answer C. Describe the relationships between variables without experimental manipulations 1) A 3-year-old child dies in the emergency room and the parents are experiencing shock and disbelief. Which of the following should be the NEXT step for the child life specialist? (A) Ask the parents to go to the waiting room while the child is bathed and dressed (B) Create an opportunity for parents to be with their child to say goodbye (C) Ask the parents if they would like to see a social worker to help them with funeral arrangements (D) Leave the parents along to grieve and wait for them to request support Correct Answer (B) Create an opportunity for parents to be with their child to say goodbye 2) Due to improved pediatric policies and family involvement, which stage of attachment is most seldom observed in the hospital setting? (A) Detachment (B) Despair (C) Protest (D) Withdrawal Correct Answer (A) Detachment 3) At what age may a patient believe that his/her diagnosis is a form of punishment? (A) 3-5 years (B) 6-11 years (C) 12-15 years (D) 16-20 years Correct Answer (A) 3-5 years 4) Which of the following interventions should the child life specialist encourage to help parents support siblings of a child with a life threatening illness? (A) Include siblings in indirect activities, such as phone calls, letters, etc., if siblings cannot be together (B) Encourage parents to focus energy towards the ill child while others provide support to siblings (C) Suggest parents redirect discussions surrounding the ill child if siblings exhibit stress and anxiety (D) Recommend parents directly involve resistant siblings in participating in their ill sibling's care Correct Answer (A) Include siblings in indirect activities, such as phone calls, letters, etc., if siblings cannot be together (D) To minimize the mother's statement regarding the twin at home due to the severity of the patient's condition Correct Answer (B) To support parental presence and facilitate family and professional collaboration 12) Humor can be utilized to relieve which of the following? (A) Pain (B) Emotional tension and grief (C) Missing out on social opportunities (D) Solitude Correct Answer (B) Emotional tension and grief 14) Which of the following behaviors demonstrates an active response to hospitalization and surgery after discharge? (A) Being restless (B) Refusing medication (C) Sleeping excessively (D) Talking less with friends Correct Answer (B) Refusing medication 15) Which of the following is a benefit of healthcare team meetings? (A) Resolving conflict around interpersonal issues (B) Identifying team members' roles in caring for the patient (C) Establishing child life priorities (D) Reviewing the medical record Correct Answer (D) Reviewing the medical record 16) In preparation for day surgery, an 8-year-old is shown a video depicting a child of similar age going through events associated with surgery. This approach to preparation is an example of which of the following? (A) Sensory information (B) Stress-point preparation (C) Rehearsal (D) Modeling Correct Answer (D) Modeling 17) Effective cross-cultural communication includes which of the following? (A) Limiting attempts to understand others points of view (B) Relying on verbal communication (C) Remembering that silence is not communication (D) Possessing the ability to tolerate ambiguity Correct Answer (D) Possessing the ability to tolerate ambiguity 18) A primary goal of advocacy training for family members is to empower them in (A) acquiring a particular service for their child. (B) facilitating a hospital policy change. (C) becoming more aggressive with medical personnel. (D) communicating their needs. Correct Answer (D) communicating their needs. 19) A 6-year-old is going to have a procedure in 30 minutes. How should the child life specialist respond? (A) Make an assessment and follow up with the appropriate interventions (B) Gather materials and provide healthcare play (C) Collect distraction items to use during the procedure (D) Prepare the child about the procedure and ways to cope Correct Answer (A) Make an assessment and follow up with the appropriate interventions 20) After three months in a newborn intensive care nursery, a baby is discharged. How can the child life specialist assist the family with this transition? (A) Provide respite care for the family (B) Provide information about community resources (C) Participate in a recreational outing with the family (D) Give the family his/her telephone number Correct Answer (B) Provide information about community resources 21) Which of the following refers to the idea that a word or phrase can stimulate images and feelings so intense that they can replace reality? (A) Symbolic communication (B) Word-Thing confusion (C) Medical jargon (D) Fact inference confusion Correct Answer (B) Word-Thing confusion 22) When a child is trying to understand death, he/she may ask, "Do children and animals die, too?" Which concept of death is the child trying to grasp by asking this question? (A) Irreversibility (B) Causality (C) Non-functionality (D) Universality Correct Answer (D) Universality 23) A child is having a difficult time with a procedure. What should the child life specialist do to promote coping? (A) Offer choices about what the child will do during the procedure (B) Choose the child's favorite nurse to do the procedure 30) In the healthcare setting, the creation of a well-defined role in relationship to others is integral to which of the following concepts? (A) Scope of practice (B) Standards of care (C) Cultural competency (D) Professional boundaries Correct Answer (D) Professional boundaries 31) What is the primary function of structured play for children in healthcare settings? (A) To minimize feelings of loneliness and isolation (B) To make and find new friends going through similar situations (C) To obtain mastery with objects and roles associated with healthcare experiences (D) To distract the child from discomfort and pain after surgery Correct Answer (C) To obtain mastery with objects and roles associated with healthcare experiences 32) Which of the following strategies should be used first when teaching a child about coping with a procedure? (A) Tell the child to look away during the procedure (B) Tell the child that you will describe the procedure as it is happening (C) Ask the physician to count before starting the procedure (D) Offer the child a choice of several techniques Correct Answer (D) Offer the child a choice of several techniques 33) The duty of promoting the welfare of an individual is known as which of the following? (A) Beneficence (B) Fidelity (C) Veracity (D) Justice Correct Answer (A) Beneficence 34) A 4-year-old recovering from a ruptured appendix is having a difficult time expressing his level of pain. Which of these tools would be MOST appropriate for his age level? (A) Pain diary (B) FACES scale (C) Pain thermometer (D) Parent assessment Correct Answer (B) FACES scale 35) Which of the following describes measures that monitor the efficacy of behavioral interventions in helping children cope with painful or threatening procedures? (A) FACES scale and visual analog scale (B) Child questionnaire and parent report (C) Pulse rates prior to and after a medical procedure (D) Emotional distress and coping effectiveness Correct Answer (D) Emotional distress and coping effectiveness 36) What action should the child life specialist take when preparing children for healthcare experiences? (A) Provide information even if the child seems reluctant to hear it because it will benefit the child later (B) Omit descriptions that may be stressful for a child to listen to, even if the child will experience the sensation (C) Use medical terminology so that children can become accustomed to this language (D) Provide honest, accurate information using developmentally- appropriate language Correct Answer (D) Provide honest, accurate information using developmentally-appropriate language 37) According to Bolig, what type of child life program aims to provide socialization experiences, normalize the environment, facilitate the expression of feelings, and involve the family? (A) Diversionary (B) Therapeutic (C) Child developmental (D) Comprehensive Correct Answer (D) Comprehensive 38) When working with a child who is on a ventilator, what approach should a child life specialist take? (A) Engage the child in nonverbal play (B) Place the child as a low priority due to limited capacity to interact (C) Do not provide play because it is medically threatening (D) Engage the child in sand tray play at the bedside Correct Answer (A) Engage the child in nonverbal play 39) An individual who continues to self-assess and respect differences is at what stage on the cultural competence continuum? (A) Basic cultural competence (B) Cultural blindness (C) Cultural pre-competence (D) Advanced cultural competence Correct Answer (A) Basic cultural competence 40) Which of the following best describes a child who has had repeated experiences of ineffective coping? B. Locke: Tabula Rasa C. Konrad Lorenz: Imprinting D. Bandura: Social Learning Theory Correct Answer D. Bandura: Social Learning Theory 9. Which theorist purports that all humans progress through 8 stages of psychological development wherein their needs must be met in order for them to function effectively as adults? A. Piaget B. Erikson C. Skinner D. Freud Correct Answer B. Erikson 10. What are the 4 consecutive steps of practice that CLS typically follow? A. Play, communicate, advocate, support B. Assess, intervene, document, plan C. Plan, communicate, collaborate, document D. Assess, plan, intervene, evaluate Correct Answer D. Assess, plan, intervene, evaluate 11. The developmental theorists, Giott, Garvey and Gottfried speak on the importance of _____ for a child's adjustment to hospitalization. A. Play B. Parental presence C. Temperament D. Opportunity for self expression Correct Answer A. Play 12. The mission of the child life profession: A. Provide comfort B. Reduce negative impact of stressful/traumatic events that affect the development, health and well being of children and families C. Prevent loss of self esteem for youth D. Communicate effectively with members of the health care community Correct Answer B. Reduce negative impact of stressful/traumatic events that affect the development, health and well being of children and families 13. Social participation during play was categorized by: A. Garvey/Gottfried B. Lazarus C. Parten Correct Answer C. Parten 14. Social learning theory was studied by: A. Parten B. Bandura C. Prugh Correct Answer B. Bandura 15. Revising an existing schema because of a new experience is called: A. Assimilation B. Accommodation C. Equilibrium Correct Answer B. Accommodation 16. Behavior directed toward trying to solve a problem by changing something in the environment is called: A. Stress point coping B. Problem-focused coping C. Emotion focused coping Correct Answer B. Problem-focused coping 17. Children find ways to vent their anger, overcome their fears or express saddness through becoming absorbed in certain activities. This can compensate for the stressful events, but other pleasures or family needs may be ignored. This is called: A. Replacement B. Sublimation C. Substitute distraction Correct Answer B. Sublimation According to the Child Life Ethical Code, a professional should not have a personal relationship with a patient or family member until the following time elapse: A. 6 months B. 12 months C. 24 months Correct Answer C. 24 months A 3 year old is struggling with potty training. Erikson would categorize this into which of his developmental groupings: A. Identity vs. Guilt B. Initiative vs. Guilt C. Autonomy vs. Shame and Doubt D. Industry vs. Shame and Doubt Correct Answer C. Autonomy vs. Shame and Doubt 20. The theorist whose philosophy is based on children beginning life as a blank slate is: A. Peller B. Kohlberg C. Lorenz D. Locke Correct Answer D. Locke 21. A study involving the collection of data over time is called: A. Correlational study B. Cross-sectional study C. Longitudinal study D. Hypothesis study Correct Answer C. Longitudinal study Preparation of parents and providing them with information and emotional support resulting in lowered parental anxiety and decreased psychological upset in their children is the findings of: A. Skipper & Leonard B. Peller C. Parten 34. Orientation of new child life employees should NOT include which of the following: A. Tour of the hospital B. Free lunch C. Review of job description D. Explanation of routines Correct Answer B. Free lunch 35. Prugh believes that the child of _____ is in the latter stage of the most vulnerable period for hospitalization. A. Birth - 12 months B. 7 - 9 years C. 3 - 4 years D. 12 - 15 years Correct Answer C. 3 - 4 years 36. Humans learn behavior based on a trial and error process whereby they remember which behaviors elicited positive or pleasurable responses and which negative ones, is the belief of: A. Pavlov: Classical conditioning B. Parten: Associative conditioning C. Skinner: Operant conditioning D. Wolfer & Visintainer: Focused conditioning Correct Answer A. Pavlov: Classical conditioning 37. Which is NOT one of Giott's 5 main functions of play? A. Catharsis B. Insight C. Sublimation D. Symbolism Correct Answer D. Symbolism 38. Children learn about the world around them through their own actions and explorations is the belief of: A. Piaget B. Erikson C. Peller D. Freud Correct Answer A. Piaget T or F: Erikson's theories of child development extending into age compared to Freud whose theory only extends into adolescence. Correct Answer True T or F: An authoritarian parenting style fails to provide any structure. Correct Answer False T or F: Vygotsky believed that all children move through the same sequence of stages. Correct Answer False Freud Kohlberg Erikson Bandura Piaget Skinner Lorenz Bronfenbrenner Lazarus J. Locke Vygotsky Ainsworth 1. ___________ Theory of moral development 2. ___________ Patterns of attachment 3. ___________ Cognitive Appraisal 4. ___________ Cognitive learning - "schemes" 5. ___________ Modeling - reciprocal determinism 6. ___________ "Neo Freudian" - conflicts resolved at each stage 7. ___________ Focused on environment - zone of proximal development 8. ___________ Psychosexual stages - Id, Ego, Superego 9. ___________ Ecological systems theory 10. ___________ Children are born with a clean/blank slate 11. ___________ Imprinting 12. ___________ Behaviorism - operant conditioning Correct Answer 1. Kohlberg 2. Ainsworth 3. Lazarus 4. Piaget 5. Bandura 6. Erikson 7. Vygotsky 8. Freud 9. Bronfenbrenner 10. J. Locke 11. K. Lorenz 12. Skinner 1. When children attempt to grasp the subconcept of universality in their understanding of death, they are challenged to comprehend that: A. All living things must eventually die B. The physical body of a living thing is dead, it can never be alive again C. The final ceasing of bodily functions D. What really does or can bring about the death of a living thing Correct Answer A. All living things must eventually die 2. Children who are striving to master the concept of causality ask themselves and others questions like the following: A. What caused the death of my pet dog? B. Do dead people continue to eat, play or go to the bathroom? C. How long do you stay dead after you die? D. Does everyone die? Correct Answer A. What caused the death of my pet dog? D. Suggest appropriate books to read Correct Answer C. Validate their feelings and allow them to talk about the death over and over if needed 11. Grieving reactions in children vary widely. Some regressive reactions may include: A. Bedwetting and thumb sucking B. Loss of appetite C. Nightmares D. Headaches Correct Answer A. Bedwetting and thumb sucking 12. The significance of death for children is based on many factors. Which factor is the most important to consider when helping a child grieve the loss of a loved one: A. Spiritual, cultural and religious influences B. Ritual and funeral experience C. Relationship to the deceased D. Child's previous experience with death Correct Answer C. Relationship to the deceased 13. The process of grieving is unique to every child. Children can begin their grief process when they: A. Know someone has died and find that they themselves are safe B. View the dead body C. Tell someone how they are feeling D. See a grief counselor Correct Answer C. Tell someone how they are feeling 14. Children have varying grief reactions. Some common grief reactions are: A. Regression, nightmares, separation anxiety B. Hunger, craving chocolate, missing meals C. Staying out late smoking, drinking excessively D. Severe anxiety, withdrawal, flashbacks Correct Answer A. Regression, nightmares, separation anxiety 15. When talk to children about the death of a loved one, a Child Life Specialist must: A. Encourage the child to talk openly about feelings B. Support expression of emotions C. Tell the child what to expect D. Provide simple and honest explanations E. All of the above Correct Answer E. All of the above 16. One of the most important interventions for bereaved siblings provided by a Child Life Specialist: A. Preparation for medical procedure B. Education about the illness C. Facilitating saying good-bye D. Play Correct Answer C. Facilitating saying good-bye 17. Understanding different cultures can be challenging. What is one of the most important considerations you should know in order to support a Latino family in the end of life care: A. Know the cultural background of the family B. Understand every culture represented in the work place C. Respect differences and accept a family's need to grieve in their own unique way D. Review your own history of losses Correct Answer C. Respect differences and accept a family's need to grieve in their own unique way 19. True / False: Between the ages of 5 and 9, children are better able to understand the meaning of physical death because of their developing life experiences Correct Answer True 20. True / False: By the time children are 9 or 10 and thereafter, they formulate more realistic concepts based on biological observations and wider experiences Correct Answer True 2. A toddler may react to the death of a family member by: A. Thinking s/he will get the illness as punishment for his/her thoughts or actions if s/ he becomes seriously ill B. Fearing s/he may contract the disease C. Acting as though the person is still alive D. Questioning what happens to the body Correct Answer C. Acting as though the person is still alive 3. According to Erikson, the BEST way to encourage a toddler in traction to develop autonomy is to: A. Ensure the child has TV B. Provide the child with choices in daily activities C. Encourage the child to look at picture books quietly in bed D. Provide only bedside activities Correct Answer B. Provide the child with choices in daily activities 5. According to the ACCH Child Life Research Project (Wolfer, Gaynard, et al.), hospitalized children who participate in child life activities were shown to: A. Experience less emotional stress and exhibit more coping mechanisms than children in the control group B. Take longer to void for the first time after surgery C. Be discharged four days earlier than the control group D. Have parents who experienced more stress and participated less frequently in their care Correct Answer A. Experience less emotional stress and exhibit more coping mechanisms than children in the control group 6. When observing reactions of young children to hospitalization, a child life specialist will notice that: A. Reactions always vary in both character and intensity