1.
As part of competency-based orientation, the different ___ needs of each patient’s age group must be part of his or her plan of care.
Correct Answer
B. pHysiological and psychological
Explanation
The competency-based orientation requires considering the different physiological and psychological needs of each patient's age group in their plan of care. This means that the healthcare professionals should take into account both the physical aspects, such as the patient's body functions and health conditions, as well as the psychological aspects, such as their emotions, thoughts, and mental well-being. By addressing both physiological and psychological needs, the healthcare team can provide comprehensive and holistic care to meet the patient's overall well-being.
2.
A toddler should be able to walk alone by age ____.
Correct Answer
D. 15 months
Explanation
A toddler should be able to walk alone by age 15 months. This is because by this age, most toddlers have developed the necessary strength and coordination to walk without support. Walking independently is an important milestone in a child's development and typically occurs between the ages of 9 and 15 months. It is important for parents to provide a safe environment for the toddler to practice walking and offer support and encouragement during this stage.
3.
What best describes a neonate’s skin?
Correct Answer
C. Delicate
Explanation
A neonate's skin is described as delicate because it is very thin and sensitive. It is not yet fully developed and lacks the protective barrier that adult skin has. Neonatal skin is prone to dryness, irritation, and damage from environmental factors. It requires special care and gentle handling to prevent any harm or discomfort to the baby.
4.
You can manage pain in an infant by evaluating their _____.
Correct Answer
B. Cry
Explanation
The correct answer is "Cry." When an infant is in pain, crying is their primary form of communication. By evaluating their cry, caregivers can assess the severity and location of the pain. The pitch, intensity, and duration of the cry can provide valuable information about the infant's discomfort, helping caregivers determine the appropriate course of action to manage their pain.
5.
A preschooler-age child refuses to take prescribed medication. Which nursing strategy would be most appropriate?
Correct Answer
D. Showing trust in the child's ability to cooperate even with an unpleasant procedure
Explanation
To gain a preschooler's cooperation, the nurse should show trust and express faith in the child's ability to cooperate even with an unpleasant procedure.
6.
A 5 y.o. child is brought to the ER after being stung multiple times on the face by yellow jackets. Which of the following symptoms of anaphylaxis requires priority medical intervention?
Correct Answer
A. Pulse rate of 60 bpm
Explanation
A. Bradycardia is an ominous sign in children. Older children initially demonstrate tachycardia in response to hypoxemia. When tachycardia can no longer maintain tissue O2, bradycardia follows. The development of cardiopulmonary arrest follows bradycardia.
7.
Parents report that their daughter, age 4, resists going to bed at night. After instruction by the nurse, which statement by the parents indicates effective teaching?
Correct Answer
D. "We'll read her a story and let her play quietly in her bed until she falls asleep."
Explanation
D. Spending time with the parents and playing quietly are positive bedtime routines that provide security and prepare a child for sleep. the child should sleep in her own bed. Locking the door is frightening and may cause insecurity. Active play before bedtime stimulates the child and increases the time needed to settle down for sleep.
8.
A neonate is admitted to a hospital’s central nursery. The neonate’s vital signs are: temperature = 35.8 degrees celcius., heart rate = 120 bpm, and respirations = 40/minute. The infant is pink with slight acrocyanosis. The priority nursing diagnosis for the neonate is
Correct Answer
A. Ineffective thermoregulation related to fluctuating environmental temperatures.
Explanation
The priority nursing diagnosis for the neonate is ineffective thermoregulation related to fluctuating environmental temperatures. This is because the neonate's temperature is lower than the normal range, indicating difficulty in maintaining a stable body temperature. The other options, potential for infection, altered nutrition, and altered elimination pattern, may also be concerns for the neonate, but maintaining a stable body temperature is the most immediate priority to ensure the infant's well-being.
9.
The home health nurse visits the Cox family 2 weeks after hospital discharge. She observes that the umbilical cord has dried and fallen off. The area appears healed with no drainage or erythema present. The mother can be instructed to
Correct Answer
D. Give him a bath in an infant tub urgently
10.
The nurse decides on a teaching plan for a new mother and her infant. The plan should include:
Correct Answer
B. Showing by example and explanation how to care for the infant
Explanation
Teaching the mother by example is a non-threatening approach that allows her to proceed at her own pace.