Nokea
The nurse correctly explains that the behavior the preschooler is demonstrating is based on a need to feel what?
- A. Powerful
- B. Secure
- C. Confident
- D. Dependent
Correct Answer: B
Rationale: Preschoolers seek security in stressful situations.
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When the nurse documents this incident, which wording is most appropriate?
- A. Became angry for no reason and an assault occurred.
- B. Hit caregiver unexpectedly even though not provoked.
- C. Struck nursing assistant when being helped from bed.
- D. Attacked nursing assistant without prior warning.
Correct Answer: C
Rationale: Objective language like 'struck' accurately describes the incident without bias.
Which nursing action is most appropriate in this situation?
- A. Asking the client why he or she is so suspicious
- B. Putting the chart away
- C. Handing the client the form to read
- D. Telling the client that it is illegal to read the client record
Correct Answer: B
Rationale: Putting the chart away maintains privacy without escalating suspicion.
Which assessment finding differentiates bulimia from anorexia nervosa in an adolescent with a suspected eating disorder?
- A. Body image distortion
- B. Purging after meals
- C. Decreased self-esteem
- D. Binge eating
Correct Answer: B
Rationale: Purging after meals is characteristic of bulimia, not always present in anorexia.
The nurse recognizes that methylphenidate hydrochloride (Ritalin) is classified as which type of drug?
- A. Central nervous system depressant
- B. Central nervous system stimulant
- C. Antidepressant
- D. Tranquilizer
Correct Answer: B
Rationale: Methylphenidate is a CNS stimulant used for ADHD.
Which response by the nurse to the parents is most appropriate at this time?
- A. The physicians here are very well qualified.
- B. This diagnosis is difficult for you to accept.
- C. Why do you feel you need a second opinion?
- D. It's not as bad as it may seem right now.
Correct Answer: B
Rationale: Acknowledging the difficulty of accepting the diagnosis validates the parents' emotions and opens communication without being confrontational.