Nokea
When discussing discipline with the mother of a 4-year-old child, which should the nurse include?
- A. Parental control should be consistent.
- B. Withdrawal of love and approval is effective at this age.
- C. Children as young as 4 years rarely need to be disciplined.
- D. One should expect rules to be followed rigidly and unquestioningly.
Correct Answer: A
Rationale: Consistent parental control is crucial for effective discipline, providing clear expectations and consequences for behavior.
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The nurse is using a bulb syringe to suction a neonate after delivery. What is an important consideration?
- A. Compress the bulb before insertion.
- B. Clear the mouth and pharynx before the nasal passages.
- C. Use two bulb syringes, one for the mouth and pharynx and one for the nasal passages.
- D. Continue using a bulb syringe until secretions are removed as mechanical suction is contraindicated.
Correct Answer: B
Rationale: The correct consideration when using a bulb syringe to suction a neonate after delivery is to clear the mouth and pharynx before the nasal passages to prevent aspiration of amniotic fluid. Compressing the bulb syringe before insertion is important to create suction. Using two bulb syringes is unnecessary, as one is sufficient for both the mouth/pharynx and nasal passages. It is not recommended to continue using a bulb syringe until all secretions are removed; instead, mechanical suction can be employed if more forceful removal of secretions is required.
Which best describes signs and symptoms as part of a nursing diagnosis?
- A. Description of potential risk factors
- B. Identification of actual health problems
- C. Human response to state of illness or health
- D. Cues and clusters derived from patient assessment
Correct Answer: D
Rationale: Signs and symptoms are cues and clusters derived from patient assessments that are used to form a nursing diagnosis, guiding the development of a care plan.
An adolescent patient wants to make decisions about treatment options, along with his parents. Which moral value is the nurse displaying when supporting the adolescent to make decisions?
- A. Justice
- B. Autonomy
- C. Beneficence
- D. Nonmaleficence
Correct Answer: B
Rationale: Supporting an adolescent in making decisions about their care reflects the moral value of autonomy, emphasizing the importance of respecting the patient's right to make informed choices.
A parent of a school-age child tells the school nurse that the parents are going through a divorce. The child has not been doing well in school and sometimes has trouble sleeping. The nurse should recognize this as what?
- A. Indicative of maladjustment
- B. A common reaction to divorce
- C. Suggestive of a lack of adequate parenting
- D. An unusual response that indicates a need for referral
Correct Answer: B
Rationale: Poor academic performance and sleep disturbances are common reactions in children going through their parents' divorce, reflecting stress and adjustment challenges.
The nurse is planning care for a hospitalized preschool-aged child. Which should the nurse plan to ensure atraumatic care?
- A. Limit explanation of procedures because the child is preschool-aged
- B. Ask that all family members leave the room when performing procedures
- C. Allow the child to choose the type of juice to drink with the administration of oral medications
- D. Explain that EMLA cream cannot be used for the morning lab draw because there is not time for it to be effective
Correct Answer: C
Rationale: Allowing the child to make choices, such as selecting the type of juice, helps to maintain a sense of control and reduce anxiety, ensuring atraumatic care.