A nurse is caring for a 2-year-old male client. The parent states, "He has started playing with dolls since our baby was born. Does this indicate he will identify as a female as he grows up?" Which of the following responses should the nurse make?
"You will also find he will want to wear girts clothes, including dresses, as well”
"Gender identity is generally not established until the child is around five years old”
"At two years of age, toddlers often engage in play that imitates adult actions."
"When a male toddler chooses to play with dolls, it is an indication he will later identify as a female."
The Correct Answer is C
A. "You will also find he will want to wear girls' clothes, including dresses, as well.": This response incorrectly assumes that playing with dolls predicts future behavior regarding gender expression, which is not accurate. It also may cause unnecessary worry for the parent.
B. "Gender identity is generally not established until the child is around five years old.": While partially true, this response does not directly address the parent's concern about the current behavior. It misses the opportunity to explain that imitating caregiving is a normal developmental stage.
C. "At two years of age, toddlers often engage in play that imitates adult actions.": This response correctly explains that toddlers naturally mimic the behavior they observe in adults, including caregiving activities, without it indicating future gender identity. Play is a normal part of development at this age.
D. "When a male toddler chooses to play with dolls, it is an indication he will later identify as a female.": This statement is inaccurate and misleading. A toddler’s choice of toys reflects curiosity and imitation, not a prediction of future gender identity or roles.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"C"}
Explanation
- Seizures: The client’s symptoms of severe hypertension, persistent headache, hyperreflexia, proteinuria, and low platelet count strongly indicate severe preeclampsia, a condition that can rapidly progress to eclampsia, where seizures occur. This is a critical obstetric emergency requiring immediate intervention to prevent maternal and fetal morbidity.
- Hypoglycemia: The client’s blood glucose level is 85 mg/dL, which is within the normal range. There are no signs such as diaphoresis, confusion, or weakness that would suggest hypoglycemia, and this condition is unrelated to the client's primary diagnosis of severe preeclampsia.
- Cervical insufficiency: Cervical insufficiency typically causes painless cervical dilation and is associated with second-trimester pregnancy losses. The client is at 31 weeks with no reported cervical changes, contractions, or painless dilation, making this complication unlikely in the current clinical scenario.
- Placental abruption: Severe hypertension increases the risk of placental abruption due to damage to the placental blood vessels. Signs of decreased fetal movement and the high-risk profile of preeclampsia support the concern that abruption could occur, leading to serious maternal and fetal compromise.
- Heart failure: Although the client has some edema, there are no other clinical signs such as dyspnea, crackles, or orthopnea that would suggest heart failure. The edema seen here is consistent with preeclampsia rather than decompensated cardiac function.
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"D"}
Explanation
- emotional lability: The client’s sudden and intense shifts in mood, such as calling the nurse "horrible" and then later saying the nurse is "the best," are classic signs of emotional lability. This rapid mood instability is a hallmark feature of borderline personality disorder and reflects difficulties regulating emotions.
- increased heart rate: An increased heart rate is a physiological response often linked to anxiety, panic, or substance use but is not a defining characteristic of borderline personality disorder. It does not directly represent a core emotional or relational disturbance seen in this disorder.
- elevated body temperature: Elevated body temperature is a physical finding associated with infection, inflammation, or drug reactions. It is not a behavioral or psychological symptom related to borderline personality disorder.
- tactile hallucinations: Tactile hallucinations, such as feeling sensations that are not there, are associated with psychotic disorders or substance intoxication rather than borderline personality disorder. They are not characteristic features of this condition.
- fear of abandonment: Individuals with borderline personality disorder have a profound fear of abandonment, whether real or perceived. This fear often leads to intense emotional reactions and unstable interpersonal relationships, as seen in the client’s extreme reactions toward the nurse.
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