A 16 year old child is hospitalized, according to Erik Erikson, what is an appropriate intervention?
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Solution
Tell the friends to visit the child
The child is 16 years old, In the stage of IDENTITY VS. ROLE CONFUSION. The most significant persons in this group are the PEERS.
Option B refers to children in the school age
Option C refers to the young adulthood stage of INTIMACY VS. ISOLATION.
Option D: The child is not dying and the situation did not even talk about the child’s belief therefore, calling the priest is unnecessary.
The nurse who volunteers at a senior citizens center is planning activities for the members who attend the center. Which activity would best promote health and maintenance for these senior citizens?
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Solution
Walking three (3) to five (5) times a week for 30 minutes
Exercise and activity are essential for health promotion and maintenance in the older adult and to achieve an optimal level of functioning. About half of the physical deterioration of the older client is caused by disuse rather that by the aging process or disease. One of the best exercises for an older adult is walking, progressing to 30 minutes session three (3) to five (5) times each week. Swimming and dancing are also beneficial.
The nurse is caring for an agitated older client with Alzheimer’s disease. Which nursing intervention most likely would calm the client?
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Solution
Putting an arm around the client’s waist
Nursing interventions for the client with Alzheimer’s disease who is angry, frustrated, or hostile include decreasing environmental stimuli, approaching the client calmly and with assurance, not demanding anything from the client, and distracting the client. For the nurse to reach out, touch, hold a hand, put an arm around the waist, or in some way maintain physical contact is important.
Options A and B: Playing a radio may increase stimuli, and turning the lights out may produce more agitation.
Option D: The client with Alzheimer’s disease would not be a candidate for group work if the client is agitated.
The mother of a nine (9)-year-old who is four (4) feet tall asks a nurse which of the following car safety devices is the most appropriate to use. The best nursing response is which of the following?
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Solution
Booster belt
Belt-positioning booster seat is typically used for children ages 8-12-year-old and at least 4 feet, 9 inches tall.
Option A: When children outgrow their rear-facing seat they are buckled in a forward facing car seat until the age of five or when they reach the upper weight or height limit of the seat.
Option B: Rear-facing–only seats are used for infants up to 22 to 45 pounds.
Option C: Children no longer need to use a booster seat once seat belt fit them properly.
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?
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Solution
Allow the child to participate in activities with other individuals in the same age group when the condition permits
Adolescents often are not sure whether they want their parents with them when they are hospitalized. Because of the importance of the peer group, separation from friends is a source of anxiety. Ideally, the members of the peer group will support their ill friend.
Options A, B, and C isolate the child from the peer group.
A nurse is preparing to care for a five (5)-year-old who has been placed in traction following a fracture of the femur. The nurse plans care, knowing that which of the following is the most appropriate activity for this child?
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Solution
Crayons and coloring book
In the preschooler, play is simple and imaginative and includes activities such as crayons and coloring books, puppets, felt and magnetic boards, and Play-Doh.
Option A: Large picture books are most appropriate for the infant.
Options B and D: A radio and a sports video are most appropriate for the adolescent.
A clinic nurse assesses the communication patterns of a five (5)-month-old infant. The nurse determines that the infant is demonstrating the highest level of developmental achievement expected if the infant:
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Solution
Uses monosyllabic babbling
Using monosyllabic babbling occurs between 3 and 6 months of age.
Option A: Using simple words such as “mama” occurs between 9 and 12 months.
Option C: Linking syllables together when communicating occurs between 6 and 9 months.
Option D: Cooing begins at birth and continues until 2 months.
The home care nurse is visiting an older female client whose husband died six (6) months ago. Which behavior, by the client, indicates ineffective coping?
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Solution
Neglecting her personal grooming
Coping mechanisms are behaviors used to decrease stress and anxiety. In response to a death, ineffective coping is manifested by an extreme behavior that in some instances may be harmful to the individual physically or psychologically. Option D is indicative of a behavior that identifies an ineffective coping behavior in the grieving process.
The nurse is providing an educational session to new employees, and the topic is abuse to the older client. The nurse tells the employees that which client is most characteristic of a victim of abuse
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Solution
A 90-year-old woman with advanced Parkinson’s disease
The typical abuse victim is a woman of advanced age with few social contacts and at least one physical or mental impairment that limits the ability to perform activities of daily living. In addition, the client usually lives alone or with the abuser and depends on the abuser for care.
A nurse is evaluating the developmental level of a two (2)-year-old. Which of the following does the nurse expect to observe in this child?
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Solution
Uses a cup to drink
By age 2 years, the child can use a cup and can use a spoon correctly but with some spilling.
Option A: By ages 3 to 4, the child begins to use a fork.
Options C and D: By the end of the preschool period, the child should be able to pour milk into a cup and begin to use a knife for cutting.