NURSING 2362 MODULE 1 EXAM

NURSING 2362 MODULE 1 EXAM Questions 1. ID: A nurse is providing information to a group of pregnant clients and their partners about the psychosocial development of an infant. Using Erikson's theory of psychosocial development, what should the nurse tell the group about the infants? Rely on the fact that their needs will be met Correct Need to tolerate a great deal of frustration and discomfort to develop a healthy personality Must have needs ignored for short periods to develop a healthy personality Need to experience frustration, so it is best to allow an infant to cry for a while before meeting his or her needs Rationale: According to Erikson’s theory of psychosocial development, infants struggle to establish a sense of basic trust rather than a sense of basic mistrust in their world, their caregivers, and themselves. If provided with consistent satisfying experiences that are delivered in a timely manner, infants come to rely on the fact that their needs are met and that, in turn, they will be able to tolerate some degree of frustration and discomfort until those needs are met. This sense of confidence is an early form of trust and provides the foundation for a healthy personality. Therefore the other options are incorrect. Test-Taking Strategy: Eliminate the option that contains the closed-ended word "must." Eliminate the options that are comparable or alike and indicate that experiencing frustration is necessary. Review: Erikson’s theory of psychosocial development as it relates to the infant. Reference: McKinney, E., James, S., Murray, S., Nelson, K. & Ashwill, J. (2013). Maternal- child nursing (4th ed., pp. 74-75). St. Louis: Elsevier. Level of Cognitive Ability: Applying Client Needs: Health Promotion and Maintenance Integrated Process: Teaching and Learning Content Area: Developmental Stages Giddens Concepts: Development, Reproduction HESI Concepts: Developmental, Sexuality/Reproduction Awarded 1.0 points out of 1.0 possible points. 2. ID: A nurse is weighing a breastfed 6-month-old infant who has been brought to the pediatrician's office for a scheduled visit. The infant's weight at birth was 6 lb 8 oz. The nurse notes that the infant now weighs 13 lb. Which action should the nurse take? Tell the mother that the infant's weight is increasing as expected Correct Tell the mother to decrease the daily number of feedings because the weight gain is excessive Tell the mother that semisolid foods should not be introduced until the infant's weight stabilizes Tell the mother that the infant should be switched from breast milk to formula because the weight gain is inadequate Rationale: Infants usually double their birth weight by 6 months and triple it by 1 year of age. If the infant is 6 lb 8 oz, at birth, a weight of 13 lb at 6 months of age is to be expected. Semisolid foods are usually introduced between 4 and 6 months of age. Test-Taking Strategy: Focus on the subject in the question, the current weight of the infant. Recalling that infants double their weight by 6 months of age will direct you to the correct option. Review: the growth rate of an infant. Reference: McKinney, E., James, S., Murray, S., Nelson, K. & Ashwill, J. (2013). Maternal-child nursing (4th ed., pp. 488-489). St. Louis: Elsevier. Potter, P., Perry, A. G., Stockert, P. A., & Hall, A. M. (2013). Fundamentals of nursing. (8th ed., p. 143). St. Louis: Mosby. Level of Cognitive Ability: Applying Client Needs: Physiological Integrity Integrated Process: Nursing Process/Implementation Content Area: Developmental Stages Giddens Concepts: Development, Nutrition HESI Concepts: Developmental, Nutrition Awarded 1.0 points out of 1.0 possible points. 3. ID: A nurse performing a physical assessment of a 12-month-old infant notes that the infant's head circumference is the same as the chest circumference. Based on this finding, what should the nurse do? Suspect the presence of hydrocephalus Suggest to the pediatrician that a skull x-ray be performed Tell the mother that the infant is growing faster than expected Document these measurements in the infant's health-care record Correct Rationale: The head circumference growth rate during the first year is approximately 0.4 inch (1 cm) per month. By 10 to 12 months of age, the infant’s head and chest circumferences are equal. Therefore, suspecting the presence of hydrocephalus, telling the mother that the infant is growing faster than expected, and suggesting that a skull x-ray be performed are incorrect. Test-Taking Strategy: Eliminate the options that are comparable or alike and indicate that the infant has a physiological problem. Review: the expected growth rate of an infant. Reference: McKinney, E., James, S., Murray, S., Nelson, K. & Ashwill, J. (2013). Maternal-child nursing (4th ed., p. 69, 489-490). St. Louis: Elsevier. Level of Cognitive Ability: Applying Client Needs: Health Promotion and Maintenance Integrated Process: Nursing Process/Implementation Content Area: Developmental Stages Giddens Concepts: Clinical Judgment, Development HESI Concepts: Clinical Decision-Making/Clinical Judgment, Developmental Awarded 1.0 points out of 1.0 possible points. 4. ID: A new mother asks the nurse, "I was told that my infant received my antibodies during pregnancy. Does that mean that my infant is protected against infections?" Which statement should the nurse make in response to the mother? "Yes, your infant is protected from all infections." "If you breastfeed, your infant is protected from infection." "The transfer of your antibodies protects your infant until the infant is 12 months old." "The immune system of an infant is immature, and the infant is at risk for infection." Correct Rationale: Transplacental transfer of maternal antibodies supplements the infant’s weak response to infection until approximately 3 to 4 months of age. Although the infant begins to produce immunoglobulin (Ig) soon after birth, by 1 year of age the infant has only approximately 60% of the adult IgG level, 75% of the adult IgM level, and 20% of the adult IgA level. Breast milk transmits additional IgA protection. The activity of T-lymphocytes also increases after birth. Even though the immune system matures during infancy, maximal protection against infection is not achieved until early childhood. This immaturity places the infant at risk for infection. Test-Taking Strategy: Eliminate the option containing the closed-ended word "all." Recalling that breastfeeding alone does not protect the infant from infection will assist you in eliminating the option that suggests breastfeeding protects the infant. From the remaining options, use the strategy of selecting the umbrella option to answer correctly. Review: the physiological concepts related to the maturity of body systems in an infant. References: McKinney, E., James, S., Murray, S., Nelson, K. & Ashwill, J. (2013). Maternal-child nursing (4th ed., pp. 477-478). St. Louis: Elsevier. Level of Cognitive Ability: Applying Client Needs: Safe and Effective Care Environment Integrated Process: Nursing Process/Implementation Content Area: Developmental Stages Giddens Concepts: Development, Immunity HESI Concepts: Developmental, Immunity Awarded 1.0 points out of 1.0 possible points. 5. ID: A nurse is assessing the language development of a 9-month- old infant. Which developmental milestone does the nurse expect to note in an infant of this age? The infant babbles. The infant says "Mama." Correct The infant smiles and coos. The infant babbles single consonants. Rationale: An 8- to 9-month-old infant can string vowels and consonants together. The first words, such as "Mama," "Daddy," "bye-bye," and "baby," begin to have meaning. A 1- to 3-month-old infant produces cooing sounds. Babbling is common in a 3- to 4-month-old. Single-consonant babbling occurs between 6 and 8 months of age. Test-Taking Strategy: Focus on the subject, the age of the infant. Recalling the language development that occurs during infancy will direct you to the correct option. Remember that an 8- to 9-month-old infant can string vowels and consonants together. Review: the developmental milestones related to language development in an infant. Reference:McKinney, E., James, S., Murray, S., Nelson, K. & Ashwill, J. (2013). Maternal-child nursing (4th ed., pp. 94, 112). St. Louis: Elsevier. Level of Cognitive Ability: Understanding Client Needs: Health Promotion and Maintenance Integrated Process: Nursing Process/Assessment Content Area: Developmental Stages Giddens Concepts: Commuication, Development HESI Concepts: Communication, Developmental Awarded 1.0 points out of 1.0 possible points. 6. ID: 8482544667The mother of a 9-month-old infant calls the nurse at the pediatrician's office, tells the nurse that her infant is teething, and asks what can be done to relieve the infant's discomfort. What should the nurse instruct the mother to do? Schedule an appointment with a dentist for a dental evaluation Rub the infant's gums with baby aspirin that has been dissolved in water Obtain an over-the-counter (OTC) topical medication for gum-pain relief Give the infant cool liquids or a Popsicle and hard foods such as dry toast Correct Rationale: Although sometimes asymptomatic, teething is often signaled by behavior such as nighttime awakening, daytime restlessness, an increase in nonnutritive sucking, excess drooling, and temporary loss of appetite. Some degree of discomfort is normal. It is unnecessary to obtain a dental evaluation, but a health-care professional should further investigate any incidence of increased temperature, irritability, ear-tugging, or diarrhea. The nurse may suggest that the mother provide cool liquids and hard foods such as dry toast, Popsicles, or a frozen bagel for chewing to relieve discomfort. Hard, cold teethers and ice wrapped in cloth may also provide comfort for inflamed gums. OTC medications for gum relief should only be used as directed by the healthcare provider. Home remedies such as rubbing the gums with aspirin should be discouraged, but acetaminophen (Tylenol), administered as directed for the child’s age, can relieve discomfort. Test-Taking Strategy: Focus on the subject, teething and relieving the infant’s discomfort. First recall that it is unnecessary to consult with a dentist. Next, eliminate the options that are comparable or alike and involve administering medication to the infant. Review: the measures that will relieve the discomfort of teething. Reference:McKinney, E., James, S., Murray, S., Nelson, K. & Ashwill, J. (2013). Maternal-child nursing (4th ed., p. 105). St. Louis: Elsevier. Level of Cognitive Ability: Applying Client Needs: Physiological Integrity Integrated Process: Nursing Process/Implementation Content Area: Developmental Stages Giddens Concepts: Comfort, Development HESI Concepts: Comfort—Pain, Developmental Awarded 1.0 points out of 1.0 possible points. 7. ID: 8482544675A nurse is teaching the mother of an 11-month-old infant how to clean the infant's teeth. What should the nurse tell the mother to do? Use water and a cotton swab and rub the teeth Correct Use diluted fluoride and rub the teeth with a soft washcloth Use a small amount of toothpaste and a soft-bristle toothbrush Dip the infant's pacifier in maple syrup so that the infant will suck Rationale: Because the primary teeth are used for chewing until the permanent teeth erupt and because decay of the primary teeth often results in decay of the permanent teeth, dental care must be started in infancy. The mother can use cotton swabs or a soft washcloth to clean the teeth. Appropriate amounts of fluoride are necessary for the development of healthy teeth, but infants usually receive fluoride when formula and cereal are mixed with fluoridated water or through fluoride supplementation. Toothpaste is not recommended because infants tend to swallow it, possibly ingesting excessive amounts of fluoride. Dipping the infant’s pacifier in maple syrup is unacceptable because of the risk of tooth decay. Test-Taking Strategy: Focus on the subject, cleaning the teeth. Recalling the risk associated with tooth decay will help eliminate the option that identifies the use of maple syrup. To select from the remaining options, noting that the client in the question is an infant will direct you to the correct option. Review: the procedure for cleaning teeth in an infant. Reference:McKinney, E., James, S., Murray, S., Nelson, K. & Ashwill, J. (2013). Maternal-child nursing (4th ed., p. 105). St. Louis: Elsevier. Level of Cognitive Ability: Applying Client Needs: Health Promotion and Maintenance Integrated Process: Teaching and Learning Content Area: Developmental Stages Giddens Concepts: Client Education, Development HESI Concepts: Developmental, Teaching and Learning/Client Education Awarded 1.0 points out of 1.0 possible points. 8. ID: A nurse provides information about feeding to the mother of a 6-month-old infant. Which statement by the mother indicates an understanding of the information? "I can mix the food in the my infant's bottle if he won't eat it." "Fluoride supplementation is not necessary until permanent teeth come in." "Egg white should not be given to my infant because of the risk for an allergy." Correct "Meats are really important for iron, and I should start feeding meats to my infant right away." Rationale: Egg white, even in small quantities, is not given to the infant until the end of the first year of life because it is a common food allergen. Fluoride supplementation may be needed beginning at of 6 months, depending on the infant’s intake of fluoridated tap water. Foods are never mixed with formula in the bottle. It may be difficult for the infant to consume the formula, and it will also be difficult to determine the infant’s intake of the formula. Solid foods may be introduced into the diet when the infant is 5 to 6 months old. Rice cereal may be introduced first because of its low allergenic potential; or, depending on the pediatrician’s preference, fruits and vegetables may be introduced first. Test-Taking Strategy: Note the words “indicates an understanding of the information.” Read each option carefully and think about the principles associated with feeding and nutrition. Recalling that allergy is a concern will direct you to the correct option. Review: the principles related to nutrition an infant. Reference: McKinney, E., James, S., Murray, S., Nelson, K. & Ashwill, J. (2013). Maternal-child nursing (4th ed., p. 102). St. Louis: Elsevier. Hockenberry, M., & Wilson, D. (2013). Wong’s Essentials of pediatric nursing (9th ed., p. 329). St. Louis: Mosby. Level of Cognitive Ability: Evaluating Client Needs: Physiological Integrity Integrated Process: Nursing Process/Evaluation Content Area: Nutrition Giddens Concepts: Development, Nutrition HESI Concepts: Developmental, Nutrition Awarded 1.0 points out of 1.0 possible points. 9. ID: A nurse provides instructions to a mother of a newborn infant who weighs 7 lb 2 oz about car safety. What should the nurse tell the mother? To secure the infant in the middle of the back seat in a rear-facing infant safety seat Correct To place the infant in a booster seat in the front seat of the car with the shoulder and lap belts secured around the infant That it is acceptable to place the infant in the front seat in a rear-facing infant safety seat as long as the car has passenger-side air bags That because of the infant's weight it is acceptable to hold the infant as long as the mother and infant are sitting in the middle of the back seat of the car Rationale: Infants should not be restrained in the front seats of cars. If a passenger-side air bag is deployed, the air bag may severely jolt an infant safety seat, harming the infant. Infants weighing less than 20 lb and those younger than 1 year should always be in the middle of the back seat in a rear-facing car safety seat. An infant must be placed in an infant safety seat and is never to be held by another person when riding in a car. Test-Taking Strategy: Eliminate the options that are comparable or alike and recommend placing the infant in the front seat. To select from the remaining options, keep safety in mind and remember that the infant should never be held and should be placed in an infant safety seat. Review: car safety principles for an infant. References: McKinney, E., James, S., Murray, S., Nelson, K. & Ashwill, J. (2013). Maternal-child nursing (4th ed., pp. 107-108). St. Louis: Elsevier. American Academy of Pediatrics for information on car safety Level of Cognitive Ability: Applying Client Needs: Safe and Effective Care Environment Integrated Process: Teaching and Learning Content Area: Safety Giddens Concepts: Development, Safety HESI Concepts: Developmental, Safety Awarded 1.0 points out of 1.0 possible points. 10. ID: A nurse provides instructions to a mother about crib safety for her infant. Which statement by the mother indicates a need for further instructions? "I need to keep large toys out of the crib." "The drop side needs to be impossible for my infant to release." "Wood surfaces on the crib need to be free of splinters and cracks." "The distance between the slats needs to be no more than 4 inches wide to prevent entrapment of my infant's head or body." Correct Rationale: The distance between slats must be no more than 2 ⅜ inches to prevent entrapment of the infant’s head and body. The mesh in a mesh-sided crib should have openings smaller than ¼ inch. The drop side must be impossible for the infant to release, and wood surfaces should be free of splinters, cracks, and lead-based paint. The mother should avoid placing large toys in the crib, because an older infant may use them as steps to climb over the side, possibly resulting in serious injury. Test-Taking Strategy: Note the strategic words "need for further instructions" in the query of the question. These words indicate a negative event query and the need to select the incorrect statement by the mother. Visualizing each of these options and keeping safety in mind will direct you to the correct option. Review: crib safety instructions. Reference: McKinney, E., James, S., Murray, S., Nelson, K. & Ashwill, J. (2013). Maternal-child nursing (4th ed., p. 109). St. Louis: Elsevier. Level of Cognitive Ability: Evaluating Client Needs: Safe and Effective Care Environment Integrated Process: Teaching and Learning Content Area: Safety Giddens Concepts: Development, Safety