Capstone VATI nursing care of Children Health Promotion and Maintenance Already Passed

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.,/Capstone VATI Nursing care of Children Health Promotion and Maintenance quiz 1 3-26-19 The parent of a two-year-old child reports feeling frustrated with the fact that her son is saying no to eve... rything. The nurse should teach the parent that this behavior is a normal expression of the child’s desire to accomplish which of the following? Select one: a. Gratify their oral fixation. b. Develop their sense of trust. c. Finish a project they set out to do. d. Increase their independence. CORRECT. The drive for independence is expressed by the toddler opposing the desires of those in authority (tantrums) and attempting to do everything for themselves. The Erickson developmental stage for this age is “Autonomy vs. Shame and Doubt.” Feedback The correct answer is: Increase their independence. At a well-child visit, the parents report that their toddler occasionally touches and fondles her genital area. The parents ask the nurse if this behavior is something to be concerned about. Which of the following is a correct response? Select one: a. This is a possible infection or irritation in the genital area b. Your child is probably imitating behaviors that she has observed c. Awareness of body structures and sensations is normal and expected CORRECT. Genital self-stimulation by the toddler is normal and expected. It is a new area to explore, similar to exploring the toes at an earlier age, but it has pleasurable sensations too! It should be ignored unless the behavior becomes pervasive, and then it should still be ignored and the child should be distracted to come and do some fun and exciting activity d. This is an early emergence of sexual expression that should be discouraged Feedback The correct answer is: Awareness of body structures and sensations is normal and expected A nurse is taking the health history of a school-age girl. Which statement by the client’s mother indicates a need for further teaching regarding the client’s nutritional status? Select one: a. “She eats a large breakfast every morning.” b. "She enjoys helping to prepare her snacks in the kitchen.” c. “We allow her to pick out a treat at the grocery store for good behavior.” CORRECT. This statement indicates a need for further teaching. This client’s mother should be educated about the importance of praising the client’s abilities and skills rather than using food as a reward, which may lead to an increased risk for obesity. d. “We increase her protein intake when she’s playing sports.” Feedback The correct answer is: “We allow her to pick out a treat at the grocery store for good behavior.” A nurse correctly understands which of the following characteristics is a possible developmental delay for a 3-month-old client? Select one: a. The infant demonstrates stranger anxiety b. The infant is unable to point to objects c. The infant is unable to sit with support d. The infant does not raise his head when placed on his abdomen CORRECT. When placed on the abdomen the 3 month old should attempt to raise his head. Some sources refer to this as “tummy time” which provides the infant with the stimulation to strengthen upper body and neck muscles in preparation for good head control when sitting upright and the some of the muscles required for crawling. Feedback The correct answer is: The infant does not raise his head when placed on his abdomen A nurse has administered the first DTaP (diphtheria toxoid, tetanus and pertussis) immunization to a two-month-old infant. For which of the following symptoms should the nurse teach the parents to seek immediate medical attention? Select one: a. The baby is crying inconsolably for more than three hours CORRECT. Inconsolable crying lasting more than three hours and/or seizures within 48 hours of vaccination is a sign of encephalopathy that must be treated immediately. b. The baby develops swelling or redness at the injection site c. The baby has an axillary temperature of 100.4oF. (38o C) d. The baby develops a localized or generalized rash Feedback The correct answer is: The baby is crying inconsolably for more than three hours A nurse is educating the parents of an infant about symptoms that should be reported to the provider. What finding should be immediately reported? Select one: a. Mild diarrhea b. Decreased urine output CORRECT. Decreased urine output indicates dehydration and should be reported immediately to the provider. Listlessness, sunken eyes, decreased tears, and dry mucous membranes are other symptoms of dehydration that should be immediately reported. c. Difficulty evacuating bowels d. Abdominal distension Feedback The correct answer is: Decreased urine output A nurse is changing a dressing on a preschool-aged child who has a healing wound on a lower extremity. Which of the following nonpharmacologic comfort measures would be most appropriate for this child? Select one: a. Assisting the child to take deep breaths and focus on relaxing. b. Promising the child a special treat in exchange for cooperation. c. Teaching the child how to go ‘to a different place’ using their imagination. d. Encouraging the child to watch a favorite cartoon on television. CORRECT. Cartoons would be a very attractive distraction, and distraction is a powerful nonpharmacologic comfort intervention which works well with this developmental age. Feedback The correct answer is: Encouraging the child to watch a favorite cartoon on television. A nurse is planning community education focusing on the principles of first aid. Which of the following strategies is likely to be most effective with adolescent learners? Select one: a. Actively involve the participants in practice of techniques. Adolescent learners will learn best when actively involved in participation and use of psychomotor skills. b. Divide the planned program into several sessions over several weeks. c. Teach the most crucial content early in the session. d. Simple lecture format. Feedback The correct answer is: Actively involve the participants in practice of techniques. A nurse is providing education to the mother of a 10-year-old child about to undergo scoliosis screening. Which of the following statements by the mother indicates a need for further teaching? Select one: a. “The examiner will be looking for asymmetry of the ribs and flanks.” b. “The examiner will be looking for symmetry in alignment of shoulders or hips.” c. “My child should be undressed down to her under wear.” d. “My child will be asked to stand upright, arms stretched above the head.” The adolescent client should be leaning forward at the waist with arms hanging down; upright with arms stretched above the head would not allow proper screening. Feedback The correct answer is: “My child will be asked to stand upright, arms stretched above the head.” A nurse is collecting data on a 5-month-old infant. Which of the following is an expected finding? Select one: a. Pulse rate 70 to 80/min b. Stepping reflex present c. Babinski reflex present The Babinski reflex is present for the first year of life. The reflex is elicited by stroking the outer edge of the sole of an infant’s foot up toward the toes. The infant’s toes fan upward and out. d. Respirations 21 to 24/min Feedback The correct answer is: Babinski reflex present [Show More]

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