Nokea
According to Erickson's stage of growth and development, the developmental task associated with middle childhood is:
- A. Trust
- B. Initiative
- C. Independence
- D. Industry
Correct Answer: D
Rationale: Middle childhood (ages 6-12) is associated with the developmental task of industry, where children focus on competence and achievement.
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A 3-year-old girl with complaints of dysuria. The physician orders a catheterization to obtain a urine specimen.
The nurse should
- A. describe the procedure to the child in short, concrete terms while talking calmly.
- B. let the child play with the equipment during the procedure.
- C. involve the girl's older sister in explaining the procedure.
- D. show the child a diagram of the urinary system.
Correct Answer: A
Rationale: Strategy: All answers are implementations. Determine the outcome of each answer choice. Is it desired? (1) correct-children this age need simple explanations (2) might contaminate the equipment, must be a sterile procedure (3) not likely to listen to sister (4) not appropriate for this age
The nurse is caring for a person who has a nasogastric tube attached to drainage. Which complaint by the client needs to be reported to the charge nurse?
- A. Dry mouth
- B. Weak muscles
- C. Sore throat
- D. Irritated nose
Correct Answer: C
Rationale: A sore throat may indicate nasogastric tube complications like erosion or infection, requiring evaluation. Dry mouth, weakness, or nasal irritation are expected.
Which of the following should be included in the discharge teaching of a client with a unilateral adrenalectomy?
- A. The client's need to pay close attention to skin care
- B. The client's need to restrict dietary intake of sodium and protein
- C. The client's need to recognize signs of hypoglycemia
- D. The client's need for daily steroid medication
Correct Answer: D
Rationale: Unilateral adrenalectomy may impair cortisol production, requiring lifelong steroid replacement. Skin care, dietary restrictions, and hypoglycemia are not primary concerns.
The nurse has just returned to the desk and has four phone messages to return.
Which of the following messages should the nurse return FIRST?
- A. A man with swelling of his left wrist following a fall from a ladder two hours ago.
- B. A woman who had a cholecystectomy one week ago and now complains of redness and tenderness at the incision site.
- C. A mother of a child reports that her son's lips are swollen following a fire ant bite.
- D. A man with COPD reports he is coughing up large amounts of green-tinged sputum and has a temperature of 101.2°F (38.4°C).
Correct Answer: C
Rationale: Strategy: Remember the ABCs. (1) wrist needs to be x-rayed, not a priority (2) indicates infection, treated with antibiotic (3) correct-potential anaphylactic reaction, administer epinephrine, corticosteroids; treat for shock (4) indicates infection, treat with an antibiotic
A newly admitted elderly client is severely dehydrated. When planning care for this client, which task is appropriate to assign to an unlicensed assistive personnel (UAP)?
- A. Converse with the client to determine if the mucous membranes are impaired
- B. Report output of less than 30 ml/hr
- C. Provide oral fluids every hour
- D. Check skin turgor every 4 hours
Correct Answer: C
Rationale: Providing oral fluids is a routine task with predictable outcomes, suitable for a UAP, while the other tasks require clinical judgment or assessment skills.