Nokea
The nurse is assisting low-income families to access health care. The nurse is aware that, in today's society, this most accurately defines the diversity of a modern family.
- A. A family consists of parents and their offspring living together.
- B. A family is whatever the child and family say it is.
- C. A family is two or more people related or unrelated who are living together.
- D. A family is two or more genetically related persons living together with separate roles.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
You may also like to solve these questions
A nurse is developing a teaching plan for an 8-year-old child who has recently been diagnosed with type 1 diabetes. What developmental characteristic of a child this age should the nurse consider?
- A. Child is in the concrete operational stage of cognition.
- B. Child's dependence on peer influence is increasing.
- C. Child will welcome opportunities for participation in self-care.
- D. Child's developmental stage involves achieving a sense of autonomy.
Correct Answer: C
Rationale: The correct answer is C. At the age of 8, children are typically in the stage of industry vs. inferiority according to Erikson's psychosocial theory. This stage is characterized by a desire to engage in productive activities and take on responsibilities. Thus, the child will likely welcome opportunities for participation in self-care related to their diabetes management. Choices A, B, and D are incorrect. Choice A is inaccurate as children at this age are usually in the concrete operational stage of cognitive development, not abstract. Choice B is incorrect because while peer influence is significant, it has not reached its peak at this age. Choice D is wrong as achieving a sense of identity is a developmental task more commonly associated with adolescence, not 8-year-old children.
What information would the nurse include in the preoperative plan of care for an infant with myelomeningocele?
- A. Positioning the infant supine with a pillow under the buttocks
- B. Covering the sac with saline-soaked nonadhesive gauze
- C. Wrapping the infant snugly in a blanket
- D. Applying a diaper to prevent fecal soiling of the sac
Correct Answer: B
Rationale: The correct answer is B: Covering the sac with saline-soaked nonadhesive gauze. This intervention is essential in caring for an infant with myelomeningocele as it helps prevent infection and maintains a moist environment around the sac before surgical repair. Positioning the infant supine with a pillow under the buttocks (Choice A) may be suitable for comfort but is not directly related to managing the myelomeningocele. Wrapping the infant snugly in a blanket (Choice C) and applying a diaper (Choice D) are not recommended as they can increase the risk of infection and damage to the sac.
The nurse is assessing a 9-year-old girl with a history of tuberculosis at age 6 years. She has been losing weight and has no appetite. The nurse suspects Addison disease based on which assessment findings?
- A. Arrested height and increased weight
- B. Thin, fragile skin and multiple bruises
- C. Hyperpigmentation and hypotension
- D. Blurred vision and enuresis
Correct Answer: C
Rationale: In a child with suspected Addison disease, the presence of hyperpigmentation (bronzing of the skin) and hypotension are key clinical findings. Hyperpigmentation is due to increased ACTH stimulation, resulting in melanocyte stimulation. Hypotension occurs due to decreased aldosterone production and subsequent sodium loss. Choices A, B, and D are incorrect. Arrested height and increased weight are not typical of Addison disease; thin, fragile skin and multiple bruises are more indicative of conditions like Cushing's syndrome; blurred vision and enuresis are not typically associated with Addison disease.
A parent tells the nurse, "My 9-month-old baby no longer has the same strong grasp that was present at birth and no longer acts startled by loud noises." How should the nurse explain these changes in behavior?
- A. "I will check these responses before deciding how to proceed."
- B. "Failure of these responses may be related to a developmental delay."
- C. "Additional sensory stimulation is needed to aid in the return of these responses."
- D. "These responses are replaced by voluntary activity at about five months of age."
Correct Answer: D
Rationale: The correct answer is D: "These responses are replaced by voluntary activity at about five months of age." The grasp reflex and startle reflex (Moro reflex) are normal in newborns but typically disappear as the infant's nervous system matures and voluntary control develops. Choice A is incorrect because checking the responses before deciding a course of action does not address the developmental milestone related to the reflexes. Choice B is incorrect as it jumps to a conclusion of developmental delay without considering the normal developmental process. Choice C is incorrect as additional sensory stimulation is not necessary for the return of these reflexes, as they are expected to naturally diminish as part of normal development.
Why should the nurse closely monitor the IV flow rate for a 5-month-old infant with severe diarrhea receiving IV fluids?
- A. Limiting output
- B. Replacing lost fluids
- C. Avoiding IV infiltration
- D. Preventing cardiac overload
Correct Answer: D
Rationale: The correct answer is D: Preventing cardiac overload. Infants are highly vulnerable to fluid overload, making it essential to carefully monitor IV flow rates to prevent complications such as cardiac overload. Rapid administration of IV fluids can lead to an excessive increase in circulating volume, potentially causing cardiac strain or heart failure in infants. Choices A, B, and C are incorrect. Monitoring the IV flow rate is not primarily aimed at limiting output, replacing lost fluids, or avoiding IV infiltration in this scenario. The key concern is to prevent the risk of cardiac overload due to the infant's susceptibility to fluid imbalances.