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Of the following suggestions, which one would best prevent nursing personnel from becoming injured when providing the adolescent with care?
- A. Apply soft wrist restraints before ambulating the client.
- B. Ask a parent to care for the client.
- C. Explain steps involved in care before touching the client.
- D. Medicate the client immediately before ambulation.
Correct Answer: C
Rationale: Explaining steps reduces fear and potential for aggressive reactions.
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The nurse correctly explains that this is normal behavior for toddlers who are developing which psychosocial characteristic?
- A. Integrity
- B. Identity
- C. Autonomy
- D. Generativity
Correct Answer: C
Rationale: The 'no' phase reflects toddlers asserting autonomy, per Erikson's stages.
The nurse is correct in assuming that without adequate nurturing during infancy, the child of the teenage mother is at risk for developing which psychosocial characteristic?
- A. Inferiority
- B. Mistrust
- C. Doubt
- D. Isolation
Correct Answer: B
Rationale: Lack of nurturing can lead to mistrust, per Erikson's developmental stages.
When discussing the home environment with the parents, the nurse should explain that which one of the following is the most appropriate environment for an autistic child?
- A. Stimulating, with a variety of sensory experiences
- B. Consistent, with a minimum of physical change
- C. Flexible, with the freedom to initiate activity
- D. Strict, with narrow limits for acceptable behavior
Correct Answer: B
Rationale: Consistency minimizes anxiety and supports routine.
What information is most helpful for the nurse to obtain next?
- A. The mother's expectations of an infant's behavior
- B. If the mother plans to finish high school
- C. The kinds of toys the mother has for the baby
- D. None of the above
Correct Answer: A
Rationale: Understanding the mother's expectations helps identify misconceptions contributing to the concern.
If the admitting nurse documents all of the following parental behaviors, which behavior is most likely to suppress this child's ability to reach the maximum potential for development?
- A. The parent dresses and undresses the teen.
- B. The parent answers all the medical questions.
- C. The parent exaggerates the teen's abilities.
- D. The parent assumes blame for the teen's condition.
Correct Answer: A
Rationale: Over-involvement like dressing the teen hinders independence.