The parents of a 2-year-old child ask the nurse how they can teach their child to quit taking toys away from other children. Which of the following statements by the nurse offers the parents the best explanation of their child's behavior?
- A. Your child is egocentric. Egocentricity is normal for 2-year-old children. He believes other children want him to have their toys.
- B. Your child is showing negativity. He doesn't want other children to have the toys he wants.
- C. Your child is demonstrating magical thinking. He believes he can make the other children want him to play with their toys.
- D. Your child is engaging in domestic imitation. He is doing what he has seen other children do.
Correct Answer: A
Rationale: Two-year-old children are very egocentric. They believe everything and everyone is concerned about them. They believe other children want them to have their toys. This is different than believing they can make other children want them to have all the toys, as in magical thinking, which normally occurs in preschool-age children. Toddlers are very negative, but this is expressed by refusal of requests made to them. Domestic imitation does occur in preschool-age children, but it refers to the imitation of household chores and roles performed by adults, not the imitation of other children.
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Mr. Lee comes to the clinic with thick green drainage around his eyelids. The nurse examiner takes his history and performs a physical examination, beginning with an eye history. General information the nurse should seek is:
- A. type of employment.
- B. burning or itchy sensation in the eyes.
- C. position of the eyelids.
- D. existence of floaters.
Correct Answer: A
Rationale: Data belonging in a general health history of the eye includes employment, activities, allergies, medications, lenses, and protective devices used.
Which of the following vaccines is a live virus?
- A. varicella
- B. IPV
- C. DTaP
- D. hepatitis B
Correct Answer: A
Rationale: Varicella is a live virus, as is OPV. IPV is an inactivated polio vaccine.
Medication bound to protein can have which of the following effects?
- A. enhancement of drug availability
- B. rapid distribution of the drug to receptor sites
- C. less availability to produce desired medicinal effects
- D. increased metabolism of the drug by the liver
Correct Answer: C
Rationale: Protein-bound drugs are inactive and less available for therapeutic effects until unbound. This does not enhance availability, speed distribution, or increase metabolism.
If a client has chronic renal failure, which of the following sexual complications is the client at risk of developing?
- A. retrograde ejaculation
- B. decreased plasma testosterone
- C. hypertrophy of testicles
- D. state of euphoria
Correct Answer: B
Rationale: Untreated chronic renal failure causes decreased testosterone levels, atrophy of testicles, and decreased spermatogenesis. Retrograde ejaculation is not a complication of chronic renal failure. It is a complication of transurethral resection of the prostate. In chronic renal failure, the testicles atrophy; they do not hypertrophy. Chronic renal failure produces a state of depression, not euphoria.
A client can receive the mumps, measles, rubella (MMR) vaccine if he or she:
- A. is pregnant.
- B. is immunocompromised.
- C. is allergic to neomycin.
- D. has a cold.
Correct Answer: D
Rationale: A simple cold without fever does not preclude vaccination. Choices 1 and 2 are incorrect because pregnant women and immunocompromised individuals cannot have the MMR vaccine because the rubella component is a live virus and might cause birth defects and/or disease. Choice 3 is incorrect because the American Academy of Pediatrics states, 'Persons who have experienced anaphylactic reactions to topically or systemically administered neomycin should not receive measles vaccine.'
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