nur 222

Exam 4 nur 222 you are a school nurse performing Vision screening for a mild cognitively delayed 7 year old. using the snellen eye chart, the majority of letters from the top of the chart down he got wrong. what is your next best step? -send him to an eye doctor as his vision should be 20/30 or better by this age -mark this a normal assessment and return him to class -perform vision screening with a pictorial screening chart -perform the test again in 1-2 weeks - Correct Answer--perform vision screening with a pictorial screening chart you are a school nurse taking care of a 8 year old with new onset type one diabetes. you notice she's been more withdrawn and is no longer involved in stem club or academic club. what is the next best step? -say "I know this is hard; let's find you something fun to do to cheer you up" -ask "how have you been feeling about your new diagnosis with diabetes" -give her a list of activities of things to get involved with -say "my sister has diabetes and felt sad too. but you will get used to it in no time, she plays soccer and is a ballerina too - Correct Answer--ask "how have you been feeling about your new diagnosis with diabetes" a nurse is comparing physical growth patterns between school-aged and adolescences, which principle should the nurse considers -physical growth usually slows during the adolescent period -secondary sex characteristics usually develop during the adolescents years -boys usually exceed girls in height and weight by the end of the school years -the distribution of muscle and fat remains consitant during the adolescent years - Correct Answer--secondary sex characteristics usually develop during the adolescents years the development of primary sex characteristics is evidence by: -a rapid change in height and weight -growth and development of the Breast -growth and development of ovaries -change in the distribution of fat - Correct Answer--growth and development of ovaries one of the key factors in addressing the health concerns and needs of the adolescent in a clinic of primary care office setting is to -provide confidentiality -include the parents in a discussion about the adolescents sexual health -ask the adolescent if she or he is sexually active -discuss the negative effects of tobacco use - Correct Answer--provide confidentiality a 17 year old has not experienced enlargement of the testes or thickening of the scrotum. a nurse should recognize these signs as indicative of -precocious puberty -normal growth and development -delayed puberty -tanner stage II - Correct Answer--delayed puberty four years ago, a 16 - year old African American girl began breast development, but has not yet had menarche. these findings would indicates to the nurse of which of the following -tanner stage IV -precocious puberty -normal growth and development -stalled puberty - Correct Answer--stalled puberty which are, in general, the earliest changes that occurs during pubertal growth? -breast buds in females, width of penis in males -underarm hair in females; size of penis in males -breast buds in females; growth of testes in male -menarche in females; growth of testes in males - Correct Answer--breast buds in females; growth of testes in male while adolescences is naturally a very healthy period of life, many adolescents experience health problems due to: -genetic defects -hormonal dysfunctions -lifestyle choices -separation from parents - Correct Answer--lifestyle choices while giving nursing care to a post-operative hospitalized adolescent, the nurse should be aware that the major threat felt by the hospitalized adolescents is -altered body image -pain management -restricted physical activity -separation from family - Correct Answer--altered body image a 16 year old is admitted to the hospital for acute appendicitis and an appendectomy is performed. which of the following nursing interventions is most appropriate to facilitate normal growth and development -allow the family to bring the child's favorite computer games -encourage the parents to room-in with the child -encourage the child to rest and read -allow the child to participate in actives with other individuals in the same age group when the conditions permits - Correct Answer--allow the child to participate in actives with other individuals in the same age group when the conditions permits while teaching a 9 year-old child about their impending heart surgery, the nurse should -provide verbal explanation just prior to the surgery -provide the child with a booklet to read about the surgery -introduce the child to another child who had heart surgery three days ago -show the child what happens during surgery using a model of the heart - Correct Answer--show the child what happens during surgery using a model of the heart during which stage of cognitive development dose the individual's thinking move to abstract and theoretical subjects and possibly venture into such topics as achieving world peace finding justice, and seeking meaning in life? -sensorimotor -pre-operational -formal operations -concrete operations - Correct Answer--formal operations a nurse is evaluating the development levels of a 2 year old. which of the following does the nurse expect to observe in this child -uses a fork to eat -uses a cup to drink -uses a knife for cutting food -pours own milk into a cup - Correct Answer--uses a cup to drink which of the following best describes parallel play between two toddlers -sharing crayons to color separate pictures -playing a board game with a nurse -sitting near each other while playing with separate dolls -sharing their dolls while playing - Correct Answer--sitting near each other while playing with separate dolls a mother of a 3 year old tells a clinic nurse that the child is rebelling consistently and having temper tantrums, the nurse most appropriately tells the mother to: -punish the child every time the child says "no" to change the behavior -allow the behavior because this is normal at this age period -set limits on the child's behavior -ignore the child when this behavior occurs - Correct Answer--set limits on the child's behavior which of the following is an appropriate toy for an 18 month old -multiple piece puzzle -miniature Carrs -non-toxic finger paints -comic books - Correct Answer--non-toxic finger paints a mother brings her child in for his 12 month check up. she is concerned that he is speech delayed compared to other children in his class at day care. what is appropriate language development at 12 months old -the child can say 3-5 words besides "momma" and "dada" -the child does not typically begin to say words until 15 months of age - the child can say 10 words including two words phrases such as momma go -the child can only say momma and dada - Correct Answer--the child can say 3-5 words besides "momma" and "dada" a kindergarten child who has developed a fever at school ask the school nurse " when will my mommy be here to get me?" the nurse knows that the child's mother will be arriving in approximately 30- minutes. which of the following would be the best nursing response? -your mommy should gather in about an half hour -your mommy should get here when the big hand on the clock reaches 12 -your mommy should get here when lunch times begins for everyone -your mommy should get here soon - Correct Answer--your mommy should get here when lunch times begins for everyone you are the nurse are caring fora 3 year old who did well during a finger stick, but is now breathing rapidly and screaming while holding her hand. what is the best initial action by the nurse? -call the doctor for a medication to reduce anxiety as she is having a panic attack -apply a band aid -ask the child "can we read a story about a brave girl who was in the hospital" -guide her to create in through her nose and out through her mouth until she calms down - Correct Answer--apply a band aid a father is concerned because his 15 months old is not doing well with potty training. what should the nurse's response be? -continue putting him on his potty seat it's happen eventually -stop trying, he won't have control of his bladder and bowels until he is 3 years old -they usually have interest and awareness of bowels and bladder elimination around 18 months osage, so try again in a few months -try to reward him into using the potty - Correct Answer--they usually have interest and awareness of bowels and bladder elimination around 18 months osage, so try again in a few months what is an appropriate snack for a toddler -grapes -popcorn -banana -peanuts - Correct Answer--banana a nurse must administer a 2 year old liquid antibiotics. how should the nurse do this? -put the syringe in the child's inner cheek and administer -wait until they're asleep and administer -tell the child it is candy and it will taste good -mix it with the child's food - Correct Answer--put the syringe in the child's inner cheek and administer if parents keep a toddler dependent in areas where he is capable of using skills the toddler will develop a sense of which of the following? -mistrust -shame -guilt -autonomy - Correct Answer--shame the parent of a 2 year old child are concerned that the child wants to do everything by himself and seems to be rejecting their authority. the nurse's response should be based on which if the following -the parent need to tighten their control on the child -the need for autonomy is not usually seem until puberty -limiting choices and punishing the child will restore trust -the independence displayed by the child is a normal result of maturation - Correct Answer--the independence displayed by the child is a normal result of maturation which sign/symptoms occur first in female puberty -adrenarche (pubic hair) -thelarche (breast buds) -menarche (menstrual cycles) -lowering of voice - Correct Answer--thelarche (breast buds) the mother of a 10 year old female presents to the office with concerns because her daughter has not stated her period. what statement to the mother is most appropriate? -this is normal pubertal development as the average age of menarche or onset of periods is 12 years old -no answer text provided -this is early for her to start her periods. the physician may refer you to an endocrinologist -this is normal development - Correct Answer--this is normal pubertal development as the average age of menarche or onset of periods is 12 years old a mother tells the nurse in private that she is concerned about her 14 year old son's sexuality and asks the nurse to talk to him alone and then "fill her in" with the information her shares, she states " I just want what's best for him" what is the nurse's best response -its probably best we don't ask him, because I can't share the information with you because of patient confidentiality -that mist be tough. perhaps he can share this information with another trusted caregiver in the home -I understands it is hard when kids don't open up to their parents. I will talk with him and let you know -I will give your son time to share things like this during a one-to-one consultation, but this information is confidential unless he poses harm to himself or someone else - Correct Answer--I will give your son time to share things like this during a one-to-one consultation, but this information is confidential unless he poses harm to himself or someone else which of the following is NOT a secondary sexual characteristic -hair growth -menstruation -voice change -breast enlargement - Correct Answer--menstruation which of the following is when the adolescent believes that everyone is watching them to see when they make mistakes or excel? -abstract thought -concrete operations -personal fable -imaginary audience - Correct Answer--imaginary audience according to Erickson, what level of psychological development is the school ager in -initiative versus guilt -industry versus inferiority -identity versus role confusion -trust versus mistrust - Correct Answer--industry versus inferiority you are the nurse providing discharge teaching for a 12 year old child who was hospitalized for a burn sustained from playing with fire works after school. what would you include in the discharge teaching? -creating a safety plan for after school time when the guardians are not present -inform the guardian it is not safe to leave their child unattended after school -tell the guardian they will be reported to social services if he is injured again -tell the guardian they need to hire a babysitter for after school - Correct Answer--creating a safety plan for after school time when the guardians are not present which statement, if made by the mother of an 11 year old, Amy negatively impact the Childs body image -you look beautiful today -all of my clothes are too tight. I'm starting a new diet tomorrow -ballerinas come in all shape and sizes -look at your strong muscles - Correct Answer--all of my clothes are too tight. I'm starting a new diet tomorrow which would be an example of the normally developing school agers' play? -two 12 year old play smart phone games while sitting next to each other on the couch -2 children build with their own lego sets sets while sitting next to each other -a child plays with his imaginary friend in his room -a group of girls form a no boys allowed club - Correct Answer--a group of girls form a no boys allowed club Ego Integrity VS Despair - Age 65+ - Age 30-65 - Age 21-31 - Correct Answer-- Age 65+ Peak physical development -young adult -older adult -middle adult - Correct Answer--young adult Self-identity -younger adult -middle adult -older adult - Correct Answer--younger adult Physical changes begin -younger adult -middle adult -older adult - Correct Answer--middle adult Concerned about finances -younger adult -middle adult -older adult - Correct Answer--older adult Strength of wisdom -younger adult -middle adult -older adult - Correct Answer--older adult Strength of care for others -younger adult -middle adult -older adult - Correct Answer--middle adult Intimate partner -younger adult -middle adult -older adult - Correct Answer--younger adult Not see HCP regularly -younger adult -middle adult -older adult - Correct Answer--younger adult Volunteers -younger adult -middle adult -older adult - Correct Answer--middle adult Risk taker -younger adult -middle adult -older adult - Correct Answer--younger adult Peak analytical thinking -younger adult -middle adult -older adult - Correct Answer--younger adult Nutrition concerns -younger adult -middle adult -older adult - Correct Answer--older adult Exercise -younger adult -middle adult -older adult - Correct Answer--middle adult according to Erickson, toddlers are in which level of psychosocial development -autonomy vs. shame and doubt -identity vs. role confusion -industry vs. inferiority -trust vs. mistrust - Correct Answer--autonomy vs. shame and doubt a mom ask you "what is the best way to deal with my 2 year old son's tantrums" which would not be an appropriate response? -consistency among all caregivers is important in preventing and dealing with tantrums -it is ok to give in to what he wants during a tantrum -reward him with stickers when he shows positive behavior instead of tantrums -be sure you give him reasonable consequences for his action - Correct Answer--it is ok to give in to what he wants during a tantrum which is NOT an appropriate discipline method for an 18-month old -rewarding for good behavior