A 9-year-old boy is diagnosed with type 1 diabetes mellitus (DM). Which stage of Erikson’s theory of psychosocial development is the nurse addressing when teaching this client about insulin injections?
Autonomy.
Identity.
Industry.
Initiative.
The Correct Answer is C
Choice A reason: Autonomy is not the stage of Erikson's theory of psychosocial development that the nurse is addressing when teaching this client about insulin injections. Autonomy is the stage that occurs from 18 months to 3 years of age, when the child develops a sense of independence and self-control. The conflict in this stage is between autonomy and shame and doubt. The nurse may address this stage when teaching the client's parents about how to support their child's autonomy and avoid overprotection or criticism.
Choice B reason: Identity is not the stage of Erikson's theory of psychosocial development that the nurse is addressing when teaching this client about insulin injections. Identity is the stage that occurs from 12 to 18 years of age, when the adolescent develops a sense of self and personal identity. The conflict in this stage is between identity and role confusion. The nurse may address this stage when teaching the client about how to cope with the psychosocial challenges of having a chronic condition and how to maintain a positive self-image and self-esteem.
Choice C reason: Industry is the stage of Erikson's theory of psychosocial development that the nurse is addressing when teaching this client about insulin injections. Industry is the stage that occurs from 6 to 11 years of age, when the child develops a sense of competence and achievement. The conflict in this stage is between industry and inferiority. The nurse may address this stage when teaching the client about how to manage their diabetes and how to acquire the skills and knowledge needed for self-care and health promotion.
Choice D reason: Initiative is not the stage of Erikson's theory of psychosocial development that the nurse is addressing when teaching this client about insulin injections. Initiative is the stage that occurs from 3 to 6 years of age, when the child develops a sense of initiative and creativity. The conflict in this stage is between initiative and guilt. The nurse may address this stage when teaching the client about how to express their feelings and opinions about their diabetes and how to participate in decision-making and problem-solving.
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Correct Answer is C
Explanation
Choice A reason: Scheduling the child for a STAT magnetic resonance imaging (MRI) of the neck is not a priority action for the nurse. MRI is a diagnostic test that uses magnetic fields and radio waves to produce images of the internal structures of the body. MRI of the neck may be useful to rule out other causes of respiratory distress, such as tumors, abscesses, or foreign bodies, but it is not an urgent procedure. Moreover, MRI requires the child to lie still for a long time, which may be difficult or impossible for a child who is anxious and in respiratory distress.
Choice B reason: Providing a nebulizer treatment with bronchodilators is not a suitable action for the nurse. Nebulizer is a device that delivers medication in the form of a mist that can be inhaled into the lungs. Bronchodilators are medications that relax the smooth muscles of the airways and improve airflow. Nebulizer treatment with bronchodilators may be helpful for children with respiratory distress caused by asthma, bronchiolitis, or chronic obstructive pulmonary disease, but not for children with respiratory distress caused by upper airway obstruction, which is the most likely scenario for this child.
Choice C reason: Obtaining bedside trays for intubation or tracheotomy by the healthcare provider is the most appropriate action for the nurse. Intubation is a procedure that involves inserting a tube through the mouth or nose into the trachea to secure the airway and provide ventilation. Tracheotomy is a surgical procedure that involves creating an opening in the neck and inserting a tube into the trachea to bypass the upper airway obstruction. Both procedures are life-saving interventions for children with respiratory distress caused by upper airway obstruction, which is the most likely scenario for this child. The nurse should prepare the necessary equipment and assist the healthcare provider in performing these procedures.
Choice D reason: Beginning prescribed intravenous antibiotic administration is not a relevant action for the nurse. Antibiotics are medications that kill or inhibit the growth of bacteria that cause infections. Antibiotics may be indicated for children with respiratory distress caused by bacterial infections, such as pneumonia, tonsillitis, or epiglottitis, but not for children with respiratory distress caused by non-infectious causes, such as foreign bodies, anaphylaxis, or congenital anomalies. Moreover, antibiotics are not an immediate intervention for respiratory distress, as they take time to exert their effects.
Correct Answer is A
Explanation
Choice A reason: Instilling benzocaine otic drops regularly is not a recommended practice for preventing or treating otitis media. Benzocaine is a topical anesthetic that can temporarily relieve ear pain, but it does not address the underlying cause of the infection. Moreover, benzocaine can cause allergic reactions, skin irritation, or methemoglobinemia, a condition that reduces the oxygen-carrying capacity of the blood. The nurse should instruct the caregiver to avoid using benzocaine otic drops unless prescribed by a health care provider.
Choice B reason: Avoiding any smoking inside the house is a good practice for preventing otitis media. Smoking can irritate the respiratory tract and impair the function of the cilia, the hair-like structures that help clear mucus and bacteria from the middle ear. Smoking can also increase the risk of respiratory infections, allergies, and asthma, which are associated with otitis media. The nurse should praise the caregiver for avoiding smoking and encourage them to maintain a smoke-free environment for the infant.
Choice C reason: Giving the infant the full course of antibiotics is a necessary practice for treating otitis media. Antibiotics can help eliminate the bacteria that cause the infection and reduce the inflammation and pain in the middle ear. However, antibiotics should be used only when prescribed by a health care provider, and the caregiver should follow the instructions carefully. The nurse should remind the caregiver to give the infant the exact dose of antibiotics at the right time and for the entire duration of the treatment, even if the symptoms improve.
Choice D reason: Scheduling a visit for pneumococcal vaccine is a preventive measure for otitis media. Pneumococcal vaccine can protect the infant from the most common strains of Streptococcus pneumoniae, a bacterium that causes otitis media and other serious infections. The vaccine is recommended for all children under 2 years of age, and it is given in four doses at 2, 4, 6, and 12 to 15 months of age. The nurse should verify the infant's immunization status and advise the caregiver to follow the recommended schedule for the pneumococcal vaccine.
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