Peds Final Exam (A+ GRADED)
n n n n
An mothern callsn an clinicn nursen ton askn if n hern infantn bornnprematurelyn should n receiven then seasonaln influ
enzan vaccine.n Then nurse'sn next n questionn should n be:
a.n "How n old n isn yourn baby?"
b.n "Did n yourn babyn haven anyn respiratoryn problems?"
c.n "Doesn yourn babyn haven anyn allergies?"
d.n "How n muchn prematuren wasn yourn baby?"n correct n answersn a.n "How n old n isn yourn baby?"
Rationale:n Flun vaccinen and n alln othern vaccinesn aren administered n accordingn ton chronologicaln age.n Flun
vaccinen isn recommended n forn alln infantsn at n6n monthsnof nagenandn givenn yearlyn thereafter.n Ann underlyi
ngn respiratoryn problemn makesn flun vaccinen important.n Awarenessn of n allergiesn isn alson necessary,n but n
then first n questionn isn chronologicaln agen ton determinen if n then infant nisn old n enoughn ton receiven then vaccin
e.
Then nursen cann refern then specialn needsn infant n orn toddlern ton ann earlyn interventionn federal:staten progra
mn offered n at n then localn leveln oftenn through:
a.n Then child'sn homen orn daycaren center.
b.n food n and n nutritionn programs
c.n communityn religiousn organizations
d.n then publicn schooln systemn correct n answersn Then child'sn homen orn an dayn caren center
Rationale:n Observingn then mother:child n interactionn duringn feedingnand nhygienen activitiesn would n dis
closen lackn of n knowledgen of nchild ncare,n poorn feedingntechniques,n orn inappropriaten maternaln bondingn
and n interactionn asn inorganicn causesn orn failuren ton thrive.n Then child'sn lackn ofninterest n inn orninabilityn ton
feed n would nindicatenorganicn causes,n asn wouldn determiningn that n then child nconsumed n adequaten calori
esn forn agen and n findingn an historyn of n prematurityn orn congenitaln anomaly.
Whichn statement n byn then mothern ofnan specialn needsntoddlern requiresn nursingn intervention?n Select n alln
that n apply.
a.n "wen given hern lotsn of n fingern foodsn son shen cann feed n herself"
b.n "shen teethed n late,n and n hern teethn aren stilln comingn inn son wen haven't n looked n forn an dentist."
c.n "wen taken hern ton then parkn whenn then weathern isn good"
d.n "shen scootsn around n onnthen floorn son wenkeepnhern inn anplaypenn forn safety."n correct n answersn b.n "shen t
eethed n late,n and n hern teethn aren stilln comingn inn son wen haven't n looked n forn an dentist."
d.n "shen scootsn around n onn then floorn son wen keepn hern inn an playpenn forn safety."
Rationale:n Safetyn isn important,n but n restrictingn then toddlern tonan playpenn interferesn withnmotorn develo
pment n and n learning.n Toddlersn exploren theirn environment n ton developn motornskillsn and n learnn throughn
trialn and n error.n Beingn enclosed n inn onen environment n (playpen)n doesn notn providen forn this.n Latenteethin
gn mayn occurn inn specialn needsn children.n However,n dentaln caren isn essentialn ton then healthn of n alln childre
n,n and n earlyn evaluationn and n caren isn oftenn evennmoren important n tonthen specialn needsn child.n Specialn ne
edsn childrenn benefit n fromn problemn preventionn orn correctionn inn alln arenasn tonsupport n development nan
d n promoten functioningn at n then highest n possiblen level.n Fingern foodsn support n self-
feedingn and n then autonomyn desired n byntoddlers.n Excursionsn ton thenparkn providenmotorn andnsensorynst
imulationn and n fun.
,An 3-month-
old n boyn wasn diagnosed n withnfailuren tonthrive.n What nactionnwilln ben most n helpfuln inn assistingn then nurs
en ton determinen if n theren isn ann inorganicn cause?
a.n reviewingn then medicaln recordsn forn an historyn of n prematurityn orn an congenitaln anomaly
b.n assessingn forn adequaten calorien intaken throughn recordingn ouncesn of n formulan consumed
c.n observingn then mother-child n interactionn duringn feedingn and n hygienen activities
d.n observingn then child'sn interest n inn and n abilityn ton feed n correct n answersn c.n observingn then mother-
child n interactionn duringn feedingn and n hygienen activities
Rationale:n Observingn then mother:child n interactionn duringn feedingnand nhygienen activitiesn would n dis
closen lackn of n knowledgen of nchild ncare,n poorn feedingntechniques,n orn inappropriaten maternaln bondingn
and n interactionn asn inorganicn causesn orn failuren ton thrive.n Then child'sn lackn ofninterest n inn orninabilityn ton
feed n would nindicatenorganicn causes,n asn wouldn determiningn that n then child nconsumed n adequaten calori
esn forn agen and n findingn an historyn of n prematurityn orn congenitaln anomaly.
Then nursen isn preparingn an 7-year-
old n girln recoveringn fromn head n trauman and nreceivingn gastrostomyn feedingsn forn dischargen fromn then h
ospital.n Whichn activityn isn most n important n beforen then child n isn discharged n home?
a.n determiningn then parents'n abilityn ton administern then enteraln feedings
b.n preparingn an list n of n homen equipment n and n suppliesn needed
c.n assessingn then parents'n emotionaln status
d.n helpingn then familyn tonaccessn financialn resourcesn correct n answersn a.n determiningn then parents'n abilit
yn ton administern then enteraln feedings
Rationale:n Then parents'n abilityn ton maintainn theirn child'sn nutritionn isn essentialn ton then child'sn well-
being.n Then transitionn cann gon forward n whilen stilln resolvingn financialn resourcen adequacyn and n then emo
tionaln statusn of n thenparents.n Equipment n andn suppliesn willn ben orderednasn part nof n dischargen planningn a
nd n aren not n needed n untiln then parentsn cann safelyn administern feedings.
Then parentsn of n an 10-year-
old n boyn withn cysticn fibrosisn restrict n himn fromn camping,n sleepoversn withn friends,nandn schooln field n tri
ps.n Theyn timen hisn respiratoryn treatmentsn and n logn hisn diet,n choosingn most n foodsn forn him.n Theyn haven
himn seenn medicallyn betweenn scheduled n appointmentsn andn calln theirn physiciann frequentlyn withnconc
erns.n Then nursen considersn thesen behaviorsn indicativen of:
a.n parentaln depression
b.n need n forn respiten care
c.n vulnerablen child n syndrome
d.n parentaln denialn of n then child'sn conditionn correct n answersn c.n vulnerablen child n syndrome
Rationale:n Descriptorsn fit n vulnerablen child n syndrome.n Parentsn "see"n then child n asn moren fragilen and n d
ependent n thann henactuallyn is.n Resultant nprotectiven behaviorsn onn thenpart n of n then parentsn interferen wit
hn then boy'sn abilityn ton grow n and n developn asn normallyn asn possiblen withinn then restraintsn of n hisn illness.
Median isn beginningn ton promoten immunizationsn forn then upcomingn influenzan season.n Then mothern of na
n prematuren infant n 7n monthsn chronologicaln agen and n 5n monthsn corrected n agen asksn about n immunizingn
hern child.n Then nursen responds:
a.n "non child n receivesn seasonaln flun vaccinen untiln agen 4n years"
b.n "yourn child n asn an 7-month-old n should n ben immunized."
c.n "then child'sn corrected n agen makesn himn toon young."
,d.n "prematuren infantsn should n notn benimmunized n against n then seasonaln flun untiln 1n yearn old n chronologi
cally."n correct n answersn b.n "yourn child n asn an 7-month-old n should n ben immunized."
Rationale:n Infantsn receiven influenzan vaccinen at n 6n monthsn of n age.n Chronologicaln agen isn used n forn pre
maturen infants.n Alln then othern responsesn aren incorrect.
Nursesn explainn that n beforen then parentsnof nanprematuren infant nleaven thenhospitaln withn theirn baby,n then
child n must:
a.n ben immunized n against n pertussis
b.n haven non apnean episodes
c.n ben ablen ton nipplen feed
d.n maintainn oxygenationn inn an carn seat n correct n answersn d.n maintainn oxygenationn inn an carn seat
Rationale:n Maintainingn satisfactoryn oxygenationn saturationn whilen sittingn inn an carn seat nisn necessarynp
riorn ton hospitaln dischargen forn prematuren infants.n Specialn paddingnof nthenseat nmayn ben necessary.n Alln i
mmunizationsn willn ben givenn based n onn chronologicaln agen withn pertussisn first n givenn at n 2n months.n Pre
maturen infantsn mayn ben discharged n fromn hospitaln unitsn withn feedingn tubesn and n apnean monitors.
Then parentsn of n an 9-year-old n girln whon isn dyingn fromn cancern aren distraught n and n guilt-
riddenn whenn theynfind nthatn treatment nisn non longern successful.n What nisn thenbest nwaynforn thennursen ton r
espond?
a.n explainn that n it n isn not n fairn ton then child n ton continuen present n treatment.
b.n telln then parentsn theren isn non moren that n cann ben done.
c.n askn then parentsn if n theyn wishn ton filln out n an do-not-resuscitaten order.
d.n assuren then parentsn thatnexpert n caren ofntheirn child nwilln continue.n correct n answersn d.n assuren then pare
ntsn that n expert n caren of n theirn child n willn continue.
Rationale:n Then nursen needsn ton maken suren then parentsnknownthatn then child nisn notn beingn abandonednby
n then healthcaren team.n Instead,ntreatment nisn changingn but nnotn ending.n Itn isn notn truen theren isn not nanymo
ren that n cann ben donen forn thenchild.n Palliativen caren cann relieven symptomsn and n providen comfort nevenn th
oughn it n willn not n cure.n Waitingn ton inquiren about n an do-not-
resuscitaten decisionn untiln parentsn haven somen adjustment n timen isn considerate.nClaimingn it n isn not nfairnt
on continuen treatment n mayn enhancen then guilt n alreadyn beingn expressed n byn then parents.
Inn workingn withn middlen ton oldern adolescentsn withnspecialn needs,nthennursen teachesn then teensn whenn t
on seekn helpn fromn an healthn professionaln and n about n then medicaln insurancen process.n Thisn nursen is:
a.n beginningn ton preparen then teenn forn transitionn ton adult n care
b.n promotingn improved n usen of n then present n healthcaren resources
c.n workingn ton reducen then financialn burdenn ton then family
d.n attempingn ton relieven stressed n parentsn of n somen responsibility.n correct n answersn a.n beginningn ton pre
paren then teenn forn transitionn ton adult n care
Rationale:n Sincen strangern fearn and n separationn anxietyn isn an developmentaln normn around n8nmonths,n at
tachment n isn criticaln ton providen security.n Alln thenothern interventionsn shouldn benusedn ton promotendevel
opment,n but n attachment n isn essential.
Then nursen isn caringn forn an hospitalized n 8-month-
old n girln withn specialn healthcaren needs.n Whichn interventionn would nbest nhelpn thisn infant n grow n and n de
velop?
a.n support n parentaln attachment n ton then child.
, b.n promoten modified n grossn motorn activitiesn
c.n usen playn ton encouragen finen motorn skilln development
d.n rolen modeln basicn caren and n talk,n read,n andnsingn tonthen child.ncorrect n answersn a.nsupport n parentaln att
achment n ton then child.
Rationale:n Attachment n interferencen mayn alreadyn haven occurred nduen ton frequent n hospitalizationsn an
d n multiplen therapiesn and n treatments.n Anbasicn need nof nthisn girln isn then development n ofn trust ninn andn atta
chment n ton hern parents.n Sincen strangern fearn andnseparationn anxietyn isn an developmentaln normn around n
8n months,n attachment n isn criticaln ton providensecurity.n Alln then othern interventionsn should nbenused ntonpr
omoten development,n but n attachment n isn essential.
Then mothern of n an 10-year-
old n beingn treated n forn kidneynfailuren speaksn veryn brokenn Englishn and nisn clearlyn overstressed.n What nis
n then priorityn nursingn intervention?
a.n assuringn hern and n demonstratingn that n then child n willn ben welln cared n for
b.n gainingn moren informationn about n hern stress
c.n encouragingn hern ton gon homen and n get n somen rest
d.n providingn hern withnan bednandn food n inn then child'sn roomn correct n answersn b.n gainingn moren informati
onn about n hern stress
rationale:n Then priorityn interventionn isn ton determinen then sourcesn of n thenmother'sn stressors.n What n arenh
ern fearsn and n concerns?n What n pressuresn aren present n inn hern life?n Ann interpretern mayn ben necessaryn ton e
nsuren effectiven communication.n Untiln then,n thennursen cannot nben suren that n then othern measuresn aren ap
propriate,n althoughn theyn aren caring.
An child'sn medicaln record n containsn then diagnosisn failuren ton thriven (FTT).n Then nursen realizes:n Select n a
lln that n apply.
a.n then causen mayn ben organicn orn inorganicn
b.n it n mayn haven developmentaln delayn asn an contributingn factor
c.n it n could n ben related n ton poverty
d.n then growthn chart n showsn ann extended n period n of n poorn weight n gain.n
e.n that n specialn needsn childrenn oftenn carryn thisn diagnosisn correct n answersn a,n b,n c,n d n and n e
rationale:n Alln aren truen of n failuren ton thrive.n Physicaln orn physiologicn problemsn causen organicn failuren to
n thrive.n Inorganicn failuren ton thriven derivesn fromn psychosocialn sources.n Then linen betweenn then twonma
yn not n alwaysn ben clear,n however,n sincen causesn of n then problemn cann ben mixed.
Knowingn that n caregiversn of n an specialn needsn child n usuallyn given of n themselvesn inn almost n unendingn w
ays,n then nursen willn assist n then parentsn by:
a.n helpingn themn developn workablen health-promotingn activitiesn forn themselves.n
b.n arrangingn ton haven then child n spend n moren timen inn school
c.n modifyingn then caren plann ton focusn onn onlyn then basicn essentials
d.n steppingn inn and nprovidingn additionaln direct n caren correct n answersn a.nhelpingn themn developn workab
len health-promotingn activitiesn forn themselves.
rationale:n Onlyn an smalln percentagen of n parentsn routinelyn taken timen tonpromoten theirn ownnhealth.n Care
n forn then caregivern isn essentialn orn then healthn of n then entiren familyn willn suffer.n In-home-
caren nursesn need n ton workn withn thenfamilyn and nnot nintruden onn familyn functionn (steppingn inn ton given m
oren direct n care).n Reducingn caren tonbasicn essentialsn isn likelyn not n ton meet n then child'sn particularn needs.n
Havingn then child n inn schooln longern hoursn isn appropriaten onlyn if n thisn servesn then child.
n n n n
An mothern callsn an clinicn nursen ton askn if n hern infantn bornnprematurelyn should n receiven then seasonaln influ
enzan vaccine.n Then nurse'sn next n questionn should n be:
a.n "How n old n isn yourn baby?"
b.n "Did n yourn babyn haven anyn respiratoryn problems?"
c.n "Doesn yourn babyn haven anyn allergies?"
d.n "How n muchn prematuren wasn yourn baby?"n correct n answersn a.n "How n old n isn yourn baby?"
Rationale:n Flun vaccinen and n alln othern vaccinesn aren administered n accordingn ton chronologicaln age.n Flun
vaccinen isn recommended n forn alln infantsn at n6n monthsnof nagenandn givenn yearlyn thereafter.n Ann underlyi
ngn respiratoryn problemn makesn flun vaccinen important.n Awarenessn of n allergiesn isn alson necessary,n but n
then first n questionn isn chronologicaln agen ton determinen if n then infant nisn old n enoughn ton receiven then vaccin
e.
Then nursen cann refern then specialn needsn infant n orn toddlern ton ann earlyn interventionn federal:staten progra
mn offered n at n then localn leveln oftenn through:
a.n Then child'sn homen orn daycaren center.
b.n food n and n nutritionn programs
c.n communityn religiousn organizations
d.n then publicn schooln systemn correct n answersn Then child'sn homen orn an dayn caren center
Rationale:n Observingn then mother:child n interactionn duringn feedingnand nhygienen activitiesn would n dis
closen lackn of n knowledgen of nchild ncare,n poorn feedingntechniques,n orn inappropriaten maternaln bondingn
and n interactionn asn inorganicn causesn orn failuren ton thrive.n Then child'sn lackn ofninterest n inn orninabilityn ton
feed n would nindicatenorganicn causes,n asn wouldn determiningn that n then child nconsumed n adequaten calori
esn forn agen and n findingn an historyn of n prematurityn orn congenitaln anomaly.
Whichn statement n byn then mothern ofnan specialn needsntoddlern requiresn nursingn intervention?n Select n alln
that n apply.
a.n "wen given hern lotsn of n fingern foodsn son shen cann feed n herself"
b.n "shen teethed n late,n and n hern teethn aren stilln comingn inn son wen haven't n looked n forn an dentist."
c.n "wen taken hern ton then parkn whenn then weathern isn good"
d.n "shen scootsn around n onnthen floorn son wenkeepnhern inn anplaypenn forn safety."n correct n answersn b.n "shen t
eethed n late,n and n hern teethn aren stilln comingn inn son wen haven't n looked n forn an dentist."
d.n "shen scootsn around n onn then floorn son wen keepn hern inn an playpenn forn safety."
Rationale:n Safetyn isn important,n but n restrictingn then toddlern tonan playpenn interferesn withnmotorn develo
pment n and n learning.n Toddlersn exploren theirn environment n ton developn motornskillsn and n learnn throughn
trialn and n error.n Beingn enclosed n inn onen environment n (playpen)n doesn notn providen forn this.n Latenteethin
gn mayn occurn inn specialn needsn children.n However,n dentaln caren isn essentialn ton then healthn of n alln childre
n,n and n earlyn evaluationn and n caren isn oftenn evennmoren important n tonthen specialn needsn child.n Specialn ne
edsn childrenn benefit n fromn problemn preventionn orn correctionn inn alln arenasn tonsupport n development nan
d n promoten functioningn at n then highest n possiblen level.n Fingern foodsn support n self-
feedingn and n then autonomyn desired n byntoddlers.n Excursionsn ton thenparkn providenmotorn andnsensorynst
imulationn and n fun.
,An 3-month-
old n boyn wasn diagnosed n withnfailuren tonthrive.n What nactionnwilln ben most n helpfuln inn assistingn then nurs
en ton determinen if n theren isn ann inorganicn cause?
a.n reviewingn then medicaln recordsn forn an historyn of n prematurityn orn an congenitaln anomaly
b.n assessingn forn adequaten calorien intaken throughn recordingn ouncesn of n formulan consumed
c.n observingn then mother-child n interactionn duringn feedingn and n hygienen activities
d.n observingn then child'sn interest n inn and n abilityn ton feed n correct n answersn c.n observingn then mother-
child n interactionn duringn feedingn and n hygienen activities
Rationale:n Observingn then mother:child n interactionn duringn feedingnand nhygienen activitiesn would n dis
closen lackn of n knowledgen of nchild ncare,n poorn feedingntechniques,n orn inappropriaten maternaln bondingn
and n interactionn asn inorganicn causesn orn failuren ton thrive.n Then child'sn lackn ofninterest n inn orninabilityn ton
feed n would nindicatenorganicn causes,n asn wouldn determiningn that n then child nconsumed n adequaten calori
esn forn agen and n findingn an historyn of n prematurityn orn congenitaln anomaly.
Then nursen isn preparingn an 7-year-
old n girln recoveringn fromn head n trauman and nreceivingn gastrostomyn feedingsn forn dischargen fromn then h
ospital.n Whichn activityn isn most n important n beforen then child n isn discharged n home?
a.n determiningn then parents'n abilityn ton administern then enteraln feedings
b.n preparingn an list n of n homen equipment n and n suppliesn needed
c.n assessingn then parents'n emotionaln status
d.n helpingn then familyn tonaccessn financialn resourcesn correct n answersn a.n determiningn then parents'n abilit
yn ton administern then enteraln feedings
Rationale:n Then parents'n abilityn ton maintainn theirn child'sn nutritionn isn essentialn ton then child'sn well-
being.n Then transitionn cann gon forward n whilen stilln resolvingn financialn resourcen adequacyn and n then emo
tionaln statusn of n thenparents.n Equipment n andn suppliesn willn ben orderednasn part nof n dischargen planningn a
nd n aren not n needed n untiln then parentsn cann safelyn administern feedings.
Then parentsn of n an 10-year-
old n boyn withn cysticn fibrosisn restrict n himn fromn camping,n sleepoversn withn friends,nandn schooln field n tri
ps.n Theyn timen hisn respiratoryn treatmentsn and n logn hisn diet,n choosingn most n foodsn forn him.n Theyn haven
himn seenn medicallyn betweenn scheduled n appointmentsn andn calln theirn physiciann frequentlyn withnconc
erns.n Then nursen considersn thesen behaviorsn indicativen of:
a.n parentaln depression
b.n need n forn respiten care
c.n vulnerablen child n syndrome
d.n parentaln denialn of n then child'sn conditionn correct n answersn c.n vulnerablen child n syndrome
Rationale:n Descriptorsn fit n vulnerablen child n syndrome.n Parentsn "see"n then child n asn moren fragilen and n d
ependent n thann henactuallyn is.n Resultant nprotectiven behaviorsn onn thenpart n of n then parentsn interferen wit
hn then boy'sn abilityn ton grow n and n developn asn normallyn asn possiblen withinn then restraintsn of n hisn illness.
Median isn beginningn ton promoten immunizationsn forn then upcomingn influenzan season.n Then mothern of na
n prematuren infant n 7n monthsn chronologicaln agen and n 5n monthsn corrected n agen asksn about n immunizingn
hern child.n Then nursen responds:
a.n "non child n receivesn seasonaln flun vaccinen untiln agen 4n years"
b.n "yourn child n asn an 7-month-old n should n ben immunized."
c.n "then child'sn corrected n agen makesn himn toon young."
,d.n "prematuren infantsn should n notn benimmunized n against n then seasonaln flun untiln 1n yearn old n chronologi
cally."n correct n answersn b.n "yourn child n asn an 7-month-old n should n ben immunized."
Rationale:n Infantsn receiven influenzan vaccinen at n 6n monthsn of n age.n Chronologicaln agen isn used n forn pre
maturen infants.n Alln then othern responsesn aren incorrect.
Nursesn explainn that n beforen then parentsnof nanprematuren infant nleaven thenhospitaln withn theirn baby,n then
child n must:
a.n ben immunized n against n pertussis
b.n haven non apnean episodes
c.n ben ablen ton nipplen feed
d.n maintainn oxygenationn inn an carn seat n correct n answersn d.n maintainn oxygenationn inn an carn seat
Rationale:n Maintainingn satisfactoryn oxygenationn saturationn whilen sittingn inn an carn seat nisn necessarynp
riorn ton hospitaln dischargen forn prematuren infants.n Specialn paddingnof nthenseat nmayn ben necessary.n Alln i
mmunizationsn willn ben givenn based n onn chronologicaln agen withn pertussisn first n givenn at n 2n months.n Pre
maturen infantsn mayn ben discharged n fromn hospitaln unitsn withn feedingn tubesn and n apnean monitors.
Then parentsn of n an 9-year-old n girln whon isn dyingn fromn cancern aren distraught n and n guilt-
riddenn whenn theynfind nthatn treatment nisn non longern successful.n What nisn thenbest nwaynforn thennursen ton r
espond?
a.n explainn that n it n isn not n fairn ton then child n ton continuen present n treatment.
b.n telln then parentsn theren isn non moren that n cann ben done.
c.n askn then parentsn if n theyn wishn ton filln out n an do-not-resuscitaten order.
d.n assuren then parentsn thatnexpert n caren ofntheirn child nwilln continue.n correct n answersn d.n assuren then pare
ntsn that n expert n caren of n theirn child n willn continue.
Rationale:n Then nursen needsn ton maken suren then parentsnknownthatn then child nisn notn beingn abandonednby
n then healthcaren team.n Instead,ntreatment nisn changingn but nnotn ending.n Itn isn notn truen theren isn not nanymo
ren that n cann ben donen forn thenchild.n Palliativen caren cann relieven symptomsn and n providen comfort nevenn th
oughn it n willn not n cure.n Waitingn ton inquiren about n an do-not-
resuscitaten decisionn untiln parentsn haven somen adjustment n timen isn considerate.nClaimingn it n isn not nfairnt
on continuen treatment n mayn enhancen then guilt n alreadyn beingn expressed n byn then parents.
Inn workingn withn middlen ton oldern adolescentsn withnspecialn needs,nthennursen teachesn then teensn whenn t
on seekn helpn fromn an healthn professionaln and n about n then medicaln insurancen process.n Thisn nursen is:
a.n beginningn ton preparen then teenn forn transitionn ton adult n care
b.n promotingn improved n usen of n then present n healthcaren resources
c.n workingn ton reducen then financialn burdenn ton then family
d.n attempingn ton relieven stressed n parentsn of n somen responsibility.n correct n answersn a.n beginningn ton pre
paren then teenn forn transitionn ton adult n care
Rationale:n Sincen strangern fearn and n separationn anxietyn isn an developmentaln normn around n8nmonths,n at
tachment n isn criticaln ton providen security.n Alln thenothern interventionsn shouldn benusedn ton promotendevel
opment,n but n attachment n isn essential.
Then nursen isn caringn forn an hospitalized n 8-month-
old n girln withn specialn healthcaren needs.n Whichn interventionn would nbest nhelpn thisn infant n grow n and n de
velop?
a.n support n parentaln attachment n ton then child.
, b.n promoten modified n grossn motorn activitiesn
c.n usen playn ton encouragen finen motorn skilln development
d.n rolen modeln basicn caren and n talk,n read,n andnsingn tonthen child.ncorrect n answersn a.nsupport n parentaln att
achment n ton then child.
Rationale:n Attachment n interferencen mayn alreadyn haven occurred nduen ton frequent n hospitalizationsn an
d n multiplen therapiesn and n treatments.n Anbasicn need nof nthisn girln isn then development n ofn trust ninn andn atta
chment n ton hern parents.n Sincen strangern fearn andnseparationn anxietyn isn an developmentaln normn around n
8n months,n attachment n isn criticaln ton providensecurity.n Alln then othern interventionsn should nbenused ntonpr
omoten development,n but n attachment n isn essential.
Then mothern of n an 10-year-
old n beingn treated n forn kidneynfailuren speaksn veryn brokenn Englishn and nisn clearlyn overstressed.n What nis
n then priorityn nursingn intervention?
a.n assuringn hern and n demonstratingn that n then child n willn ben welln cared n for
b.n gainingn moren informationn about n hern stress
c.n encouragingn hern ton gon homen and n get n somen rest
d.n providingn hern withnan bednandn food n inn then child'sn roomn correct n answersn b.n gainingn moren informati
onn about n hern stress
rationale:n Then priorityn interventionn isn ton determinen then sourcesn of n thenmother'sn stressors.n What n arenh
ern fearsn and n concerns?n What n pressuresn aren present n inn hern life?n Ann interpretern mayn ben necessaryn ton e
nsuren effectiven communication.n Untiln then,n thennursen cannot nben suren that n then othern measuresn aren ap
propriate,n althoughn theyn aren caring.
An child'sn medicaln record n containsn then diagnosisn failuren ton thriven (FTT).n Then nursen realizes:n Select n a
lln that n apply.
a.n then causen mayn ben organicn orn inorganicn
b.n it n mayn haven developmentaln delayn asn an contributingn factor
c.n it n could n ben related n ton poverty
d.n then growthn chart n showsn ann extended n period n of n poorn weight n gain.n
e.n that n specialn needsn childrenn oftenn carryn thisn diagnosisn correct n answersn a,n b,n c,n d n and n e
rationale:n Alln aren truen of n failuren ton thrive.n Physicaln orn physiologicn problemsn causen organicn failuren to
n thrive.n Inorganicn failuren ton thriven derivesn fromn psychosocialn sources.n Then linen betweenn then twonma
yn not n alwaysn ben clear,n however,n sincen causesn of n then problemn cann ben mixed.
Knowingn that n caregiversn of n an specialn needsn child n usuallyn given of n themselvesn inn almost n unendingn w
ays,n then nursen willn assist n then parentsn by:
a.n helpingn themn developn workablen health-promotingn activitiesn forn themselves.n
b.n arrangingn ton haven then child n spend n moren timen inn school
c.n modifyingn then caren plann ton focusn onn onlyn then basicn essentials
d.n steppingn inn and nprovidingn additionaln direct n caren correct n answersn a.nhelpingn themn developn workab
len health-promotingn activitiesn forn themselves.
rationale:n Onlyn an smalln percentagen of n parentsn routinelyn taken timen tonpromoten theirn ownnhealth.n Care
n forn then caregivern isn essentialn orn then healthn of n then entiren familyn willn suffer.n In-home-
caren nursesn need n ton workn withn thenfamilyn and nnot nintruden onn familyn functionn (steppingn inn ton given m
oren direct n care).n Reducingn caren tonbasicn essentialsn isn likelyn not n ton meet n then child'sn particularn needs.n
Havingn then child n inn schooln longern hoursn isn appropriaten onlyn if n thisn servesn then child.
