A 14-year-old boy has acne and according to his parents, dominates the bathroom by using the mirror all the time.
Which of the following remarks by the nurse would be least helpful in talking to the boy and his parents?
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Solution
“This is probably the only concern he has about his body. So don’t worry about it or the time he spends on it.”
Stating that this is probably the only concern the adolescent has and telling the parents not to worry about it or the time he spends on it shuts off further investigation and is likely to make the adolescent and his parents feel defensive.
Option B: The statement about peer acceptance and time spent in front of the mirror for the development of self-image provides information about the adolescent’s needs to the parents and may help to gain trust with the adolescent.
Option C: Asking the adolescent how he feels about the acne will encourage the adolescent to share his feelings.
Option D: Discussing the cleansing method shows interest and concern for the adolescent and also can help to identify any patient-teaching needs for the adolescent regarding cleansing.
Which of the following would be most appropriate for a nurse to use when describing menarche to a 13-year-old?
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Solution
A female’s first menstruation or menstrual “periods”
Menarche refers to the onset of the first menstruation or menstrual period and refers only to the first cycle. Uterine growth and broadening of the pelvic girdle occur before menarche.
The adolescent’s inability to develop a sense of who he is and what he can become results in the sense of which of the following?
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Solution
Role diffusion
According to Erikson, role diffusion develops when the adolescent does not develop a sense of identity and a sense or where he fits in.
Option A: Toddlers develop a sense of shame when they do not achieve autonomy.
Option B: Preschoolers develop a sense of guilt when they do not develop a sense of initiative.
Option C: School-age children develop a sense of inferiority when they do not develop a sense of industry.
A child age 7 was unable to receive the measles, mumps, and rubella (MMR) vaccine at the recommended scheduled time. When would the nurse expect to administer MMR vaccine?
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Solution
At age 10
Based on the recommendations of the American Academy of Family Physicians and the American Academy of Pediatrics, the MMR vaccine should be given at the age of 10 if the child did not receive it between the ages of 4 to 6 years as recommended. Immunization for diphtheria and tetanus is required at age 13.
Which of the following skills is the most significant one learned during the school age period?
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Solution
Reading
The most significant skill learned during the school-age period is reading. During this time the child develops formal adult articulation patterns and learns that words can be arranged in structure.
Options A, B, and D: Collective, ordering, and sorting, although important, are not most significant skills learned.
After teaching a group of parents about accident prevention for school agers, which of the following statements by the group would indicate the need for more teaching?
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Solution
“Schoolagers are unable to understand potential dangers around them.”
The school ager’s cognitive level is sufficiently developed to enable good understanding of and adherence to rules. Thus, school agers should be able to understand the potential dangers around them.
Option A: With growth comes greater freedom and children become more adventurous and daring.
Option B: The school-aged child is also still prone to accidents and home hazards, especially because of increased motor abilities and independence. Plus the home hazards differ from other age groups. These hazards, which are potentially lethal but tempting, may include firearms, alcohol, and medications.
Option D: School-age children begin to internalize their own controls and need less outside direction. Plus the child is away from home more often. Some parental or caregiver assistance is still needed to answer questions and provide guidance for decisions and responsibilities.
A hospitalized school ager states: “I’m not afraid of this place, I’m not afraid of anything.” This statement is most likely an example of which of the following?
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Solution
Reaction formation
Reaction formation is the school ager’s typical defensive response when hospitalized. In reaction formation, expression of unacceptable thoughts or behaviors is prevented (or overridden) by the exaggerated expression of opposite thoughts or types of behaviors.
Option A: Regression is seen in toddlers and preschoolers when they retreat or return to an earlier level of development.
Option B: Repression refers to the involuntary blocking of unpleasant feelings and experiences from one’s awareness.
Option D: Rationalization is the attempt to make excuses to justify unacceptable feelings or behaviors.
Which of the following activities, when voiced by the parents following a teaching session about the characteristics of school-age cognitive development would indicate the need for additional teaching?
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Solution
Developing plans for the future
The school-aged child is in the stage of concrete operations, marked by inductive reasoning, logical operations, and reversible concrete thought. The ability to consider the future requires formal thought operations, which are not developed until adolescence.
Options A, B, and C: Collecting baseball cards and marbles, ordering dolls by size, and simple problem-solving options are examples of the concrete operational thinking of the schoolager.
When providing therapeutic play, which of the following toys would best promote imaginative play in a 4-year-old?
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Solution
Dress-up clothes
Dress-up clothes enhance imaginative play and imagination, allowing preschoolers to engage in rich fantasy play.
Options A and C: Building blocks and wooden puzzles are appropriate for encouraging fine motor development.
Option D: Big wheels and tricycles encourage gross motor development.
Which of the following suggestions should the nurse offer the parents of a 4-year-old boy who resists going to bed at night?
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Solution
“Read him a story and allow him to play quietly in his bed until he falls asleep.”
Preschoolers commonly have fears of the dark, being left alone especially at bedtime, and ghosts, which may affect the child’s going to bed at night. Quiet play and time with parents is a positive bedtime routine that provides security and also readies the child for sleep.
Option A: The child should sleep in his own bed.
Option B: Telling the child about locking him in his room will viewed by the child as a threat. Additionally, a locked door is frightening and potentially hazardous.
Option C: Vigorous activity at bedtime stirs up the child and makes more difficult to fall asleep.