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In a community pediatric health clinic, which developmental task should you apply into your practice?
- A. You should apply the principles of initiative when caring for preschool children.
- B. You should apply the principles of sensorimotor thought when caring for preschool children.
- C. You should apply the principles of intimacy when caring for the adolescent.
- D. You should apply the principles of concrete operations when caring for the adolescent.
Correct Answer: A
Rationale: When working in a community pediatric health clinic, applying the principles of initiative is crucial when caring for preschool children. According to Erik Erikson's psychosocial theory, the developmental task for preschool children is initiative. Preschool children are in the stage where they are eager to initiate activities and carry out tasks. This stage is characterized by a balance between initiative and guilt. By encouraging children to explore and take the initiative in a supportive environment, healthcare providers can foster their sense of independence and creativity.
The other choices are incorrect because:
- Sensorimotor thought is a term associated with Jean Piaget's cognitive development theory, not Erikson's psychosocial theory.
- Intimacy is a developmental task associated with young adults, not adolescents, in Erikson's theory.
- Concrete operations is a term linked to Piaget's theory of cognitive development and is not a developmental task according to Erikson's psychosocial theory.
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The LPN is caring for a client taking Lipitor (Atorvastatin). Which of these statements would indicate that the client may need reinforced teaching?
- A. "I take my Lipitor with a glass of milk after my breakfast."?
- B. "I take my Lipitor and wait 30 minutes before taking my other medications."?
- C. "I take my Lipitor 30 minutes after I eat something."?
- D. "I take my Lipitor and my other morning medications with my grapefruit juice at breakfast."?
Correct Answer: D
Rationale: The correct answer is, 'I take my Lipitor and my other morning medications with my grapefruit juice at breakfast.' This statement indicates a need for reinforced teaching because grapefruit juice should be avoided when taking Lipitor. Grapefruit juice blocks the enzymes needed to break down the drug, which leads to excessive amounts of the drug in the body. Choices A, B, and C show appropriate timing and administration of Lipitor, whereas choice D poses a potential risk due to the interaction between grapefruit juice and Lipitor.
Which of the following would likely not impede learning?
- A. a client who took Ambien® an hour ago
- B. a bipolar client currently in a manic phase
- C. a client who states they are not interested
- D. a client with dysphagia
Correct Answer: C
Rationale: The correct answer is a client who states they are not interested. While lack of interest can hinder learning motivation, it is not a physical or mental barrier that directly impacts the learning process. On the other hand, a client who took Ambien® an hour ago may experience drowsiness or impaired cognitive function, affecting their ability to learn. A bipolar client in a manic phase may exhibit symptoms such as racing thoughts, distractibility, and impulsivity, making it challenging for them to focus and engage in the learning process. A client with dysphagia may have difficulty swallowing, which can interfere with their ability to take oral medications or participate in activities that involve swallowing.
Which of the following is least appropriate when caring for a stable postpartum client?
- A. Assess the location and height of the fundus.
- B. Conduct a family assessment, including the mother's future plans for returning to work, if applicable.
- C. Monitor the client for bleeding.
- D. Provide perineal care.
Correct Answer: D
Rationale: Providing perineal care is not the least appropriate when caring for a stable postpartum client. Perineal care is essential for maintaining hygiene and preventing infection after delivery. Assessing the location and height of the fundus helps in monitoring postpartum uterine involution, which is crucial for assessing the recovery progress. Conducting a family assessment, including the mother's future plans for returning to work, is important for understanding the support system available for the mother during the postpartum period. Monitoring the client for bleeding is critical to promptly identify and address any postpartum hemorrhage. Therefore, providing perineal care is the least appropriate option among the choices provided as it is a fundamental aspect of postpartum care.
When a nurse asks a client to repeat the word 'ninety-nine' while listening through the stethoscope and is able to hear the word clearly, which assessment finding is being documented?
- A. Normal egophony
- B. Abnormal vesicular breath sounds
- C. Abnormal bronchophony
- D. Normal whispered pectoriloquy
Correct Answer: C
Rationale: The nurse is documenting an abnormal bronchophony assessment finding. Bronchophony is a technique where the nurse asks the client to repeat a specific word, such as 'ninety-nine,' while listening through the stethoscope. Normally, the voice transmission is soft, muffled, and indistinct. However, if there is a pathologic condition increasing lung density, the nurse will hear the word clearly, indicating an abnormality. Vesicular breath sounds are normal sounds heard over peripheral lung fields and are not related to vocal resonance assessment. Egophony involves the client phonating a long 'ee-ee-ee-ee' sound, not repeating a specific word. Whispered pectoriloquy involves whispering a phrase like 'one-two-three,' not repeating a specific word. In these cases, normal findings are 'eeeeee' for egophony and a muffled, almost inaudible sound for whispered pectoriloquy.
When inspecting the ears for cerumen impaction, the nurse checks for which finding?
- A. Redness and swelling of the tympanic membrane
- B. An external auditory canal that is longer than normal
- C. The presence of edema in the external auditory canal
- D. A yellowish or brownish waxy material in the external auditory canal
Correct Answer: D
Rationale: When inspecting the ears for cerumen impaction, the nurse should look for a yellowish or brownish waxy material in the external auditory canal. Cerumen, also known as ear wax, is a secretion that can become impacted due to various reasons. It is produced by the vestigial apocrine sweat glands in the external ear canal. Cerumen may partially obscure the eardrum or totally occlude the ear canal. The other options, redness and swelling of the tympanic membrane, an external auditory canal that is longer than normal, and the presence of edema in the external auditory canal, are not indicative findings of cerumen impaction.