Nokea
Which developmental milestone would the nurse expect an 11-month-old infant to have achieved?
- A. Sitting independently
- B. Turning a doorknob
- C. Building a tower of four cubes
- D. Walking independently
Correct Answer: A
Rationale: The correct answer is A: Sitting independently. By 11 months, most infants can sit independently. This milestone usually precedes walking, which typically occurs closer to 12 months. Turning a doorknob and building a tower of four cubes involve more complex motor skills that are typically achieved later in development. Therefore, at 11 months, sitting independently is the milestone that the nurse would expect an infant to have achieved.
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Which disease would require strict isolation of the patient?
- A. Mumps
- B. Chickenpox
- C. Exanthema subitum (roseola)
- D. Erythema infectiosum (fifth disease)
Correct Answer: B
Rationale: The correct answer is B: Chickenpox. Chickenpox is highly infectious and is transmitted through direct contact, droplet spread, and contaminated objects. Due to its high communicability, strict isolation of the patient is necessary to prevent the spread of the disease. Mumps is primarily transmitted through direct contact with the infected person's saliva, with peak contagiousness before the onset of swelling. Exanthema subitum (roseola) has an unknown transmission source. Erythema infectiosum (fifth disease) is contagious before the appearance of symptoms. Therefore, these diseases do not require the same level of strict isolation as chickenpox.
When discussing discipline with the mother of a 4-year-old child, which should the nurse include?
- A. Parental control should be consistent.
- B. Withdrawal of love and approval is effective at this age.
- C. Children as young as 4 years rarely need to be disciplined.
- D. One should expect rules to be followed rigidly and unquestioningly.
Correct Answer: A
Rationale: Consistent parental control is crucial for effective discipline, providing clear expectations and consequences for behavior.
You are developing a plan of care for a hospitalized child. Which age group is most likely to view illness as a punishment for misdeeds?
- A. Adolescence
- B. Preschool age
- C. Infancy
- D. School age
Correct Answer: B
Rationale: Preschool-aged children often engage in magical thinking, where they may believe that illness is a punishment for misdeeds. This belief is related to their cognitive development stage, where they may attribute cause and effect in a magical or unrealistic way. Adolescents are more likely to view illness as a disruption to their sense of independence or control. Infants lack the cognitive development to associate illness with punishment for misdeeds. School-aged children typically have a more concrete understanding of illness and its causes, moving away from magical thinking.
A parent of a school-age child tells the school nurse that the parents are going through a divorce. The child has not been doing well in school and sometimes has trouble sleeping. The nurse should recognize this as what?
- A. Indicative of maladjustment
- B. A common reaction to divorce
- C. Suggestive of a lack of adequate parenting
- D. An unusual response that indicates a need for referral
Correct Answer: B
Rationale: Poor academic performance and sleep disturbances are common reactions in children going through their parents' divorce, reflecting stress and adjustment challenges.
The nurse is planning care for a hospitalized preschool-aged child. Which should the nurse plan to ensure atraumatic care?
- A. Limit explanation of procedures because the child is preschool-aged
- B. Ask that all family members leave the room when performing procedures
- C. Allow the child to choose the type of juice to drink with the administration of oral medications
- D. Explain that EMLA cream cannot be used for the morning lab draw because there is not time for it to be effective
Correct Answer: C
Rationale: Allowing the child to make choices, such as selecting the type of juice, helps to maintain a sense of control and reduce anxiety, ensuring atraumatic care.