Nokea
The nurse is talking with the parent of a 22-month-old client. The parent states, 'I am worried about my child's thumb-sucking and its effects on tooth alignment.' Which of the following responses would be appropriate for the nurse to make? Select all that apply.
- A. Newer research demonstrates that thumb-sucking has little effect on a child's dentition.'
- B. Offer a security item such as a blanket to help your child self-soothe without thumb-sucking.'
- C. Provide positive reinforcement such as a sticker chart when your child avoids thumb-sucking.'
- D. The likelihood of needing braces because of thumb-sucking is significant when the behavior persists beyond 12 months of age.'
- E. The risk of malocclusion increases when thumb-sucking persists beyond the eruption of permanent teeth.'
Correct Answer: B, C, E
Rationale: Offering a security item (B), positive reinforcement (C), and noting malocclusion risk after permanent teeth erupt (E) are appropriate. Thumb-sucking has minimal effect before permanent teeth (A), and braces after 12 months (D) is exaggerated.
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The nurse is reinforcing teaching about home administration of sublingual nitroglycerin tablets to a client with stable angina. Which client statement indicates the need for further teaching?
- A. I can take 1 tablet every 5 minutes, up to 3 times, for chest pain.'
- B. I should call 911 if my chest pain isn't relieved by nitroglycerin.'
- C. I will call my doctor's office if I start experiencing chest pain at rest.'
- D. I will keep one bottle of nitroglycerin in the house and one in the car.'
Correct Answer: D
Rationale: Keeping nitroglycerin in a car (D) risks exposure to heat, reducing efficacy, requiring further teaching. Other statements (A, B, C) are correct.
The nurse is providing care to a client with posttraumatic stress disorder following a terrorist attack at the client's place of worship. The client says, 'I'm just so worried all the time. I will never be safe again!' What is the priority nursing action?
- A. Acknowledge the client's feelings
- B. Assess the client's support system
- C. Encourage the client to talk about the trauma
- D. Offer the client a PRN sleep medication
Correct Answer: A
Rationale: Acknowledging feelings (A) builds trust and validates the client's experience, making it the priority. Assessing support (B), discussing trauma (C), or offering medication (D) are secondary.
A woman has recently been diagnosed with multiple sclerosis. Which comment by the client indicates that she understands the nature of the disease process?
- A. I understand that recovery will be slow.'
- B. I am faithfully taking the medicines so the symptoms should disappear soon.'
- C. I will avoid being close to my grandchildren until I have been on medication for several months.'
- D. I bought a pretty cane to help me with balance when I am walking.'
Correct Answer: D
Rationale: Using a cane for balance shows understanding of multiple sclerosis' chronic, progressive nature causing mobility issues, unlike expecting full recovery or avoiding grandchildren.
The nurse is reinforcing medication instructions for the parents of a child prescribed amoxicillin/clavulanate (liquid) twice a day for acute sinusitis. Which instructions are most important for the parents to remember? Select all that apply.
- A. Administer the medication with food if nausea or diarrhea develops
- B. Complete the medication course even if the child is better
- C. Rash is a normal, expected side effect
- D. Shake the medicine well before use
- E. Use a household spoon to measure the dose
Correct Answer: A, B, D
Rationale: Taking with food (A) reduces GI upset, completing the course (B) prevents resistance, and shaking well (D) ensures proper dosing. Rash (C) is not normal and requires evaluation, and household spoons (E) are inaccurate.
The nurse is talking to a client with rheumatoid arthritis who is reporting increased pain and stiffness of the joints in the morning. The nurse should encourage the client to
- A. apply a heating pad to the affected joints for a minimum of 30 minutes every morning
- B. consume a meal that is high in calories and carbohydrates every morning
- C. take a warm shower and perform range-of-motion exercises every morning
- D. take nonsteroidal anti-inflammatory medication before breakfast every morning
Correct Answer: C
Rationale: A warm shower and range-of-motion exercises (C) reduce morning stiffness and improve mobility. Heating pads (A) may help but are less comprehensive, high-calorie meals (B) are irrelevant, and NSAIDs (D) may not address stiffness immediately.