A nurse is caring for an 8-month-old child who starts to cry when his parents leave. The nurse should make which of the following statements to the parents?
"At this age you should expect your child to be upset when you leave."
"Your child needs to rest."
will notify the provider of his behavior."
"Your child is responding to an overstimulating environment."
The Correct Answer is A
A. "At this age you should expect your child to be upset when you leave.": This statement provides normalcy to the parents' experience and reassures them that their child's reaction is typical for his age. It acknowledges the child's developmental stage and separation anxiety, helping to alleviate parental concerns.
B. "Your child needs to rest.": While rest is important for infants, this statement does not address the child's emotional needs or the parents' concerns about leaving their child. It may also minimize the significance of the child's distress.
C. "I will notify the provider of his behavior.": Notifying the healthcare provider may be appropriate if the child's distress continues or if there are concerns about the child's well-being, but this statement does not directly address the parents' concerns or provide guidance on how to manage the situation.
D. "Your child is responding to an overstimulating environment.": This statement suggests a possible cause for the child's distress but does not provide guidance or reassurance to the parents on how to address the situation or manage their child's reaction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Obtain a throat culture.
This option is not appropriate as a primary nursing action in the acute management of epiglottitis. While obtaining a throat culture may be necessary for diagnostic purposes, it is not a priority in the immediate care of a child with suspected epiglottitis. The focus should be on ensuring airway patency and providing emergency treatment.
B. Visualize the epiglottis using a tongue depressor.
This option is contraindicated in the acute management of epiglottitis. Direct visualization of the epiglottis using a tongue depressor or other instruments can provoke spasm of the epiglottis and worsen airway obstruction. Attempting to visualize the epiglottis should be avoided until the child's airway has been secured in a controlled environment, such as in the operating room under anesthesia.
C. Provide moist air to reduce the inflammation of the epiglottis.
This option is appropriate. Providing moist air, such as humidified oxygen or a cool mist, can help soothe the inflamed tissues of the epiglottis and upper airway. Moist air may help alleviate discomfort and reduce inflammation, although it will not directly address the risk of airway obstruction. It is often used as supportive therapy in conjunction with other interventions.
D. Initiate airborne precautions.
This option is not necessary for the care of a child with epiglottitis. Epiglottitis is not typically transmitted through airborne droplets. The priority in the management of epiglottitis is ensuring a patent airway and providing appropriate treatment to reduce inflammation and prevent complications.
Correct Answer is A
Explanation
A. Drink eight glasses of fluid daily: This is crucial advice for patients with sickle cell anemia, as adequate hydration helps prevent sickling of red blood cells and reduces the risk of vaso-occlusive crises. Therefore, this precaution is appropriate and should be included in discharge teaching.
B. Maintain an updated Haemophilus influenzae type b (Hib) immunization: While vaccination is essential for overall health, maintaining Hib immunization is not directly related to sickle cell anemia or vaso-occlusive crises. However, it's still important for the child's general well-being and should be addressed but may not be the priority in discharge teaching for sickle cell anemia.
C. Avoid playground activities at school: Children with sickle cell anemia are at risk of vaso-occlusive crises triggered by dehydration, fatigue, or extreme physical exertion. While playground activities can be strenuous, completely avoiding them may not be necessary. Instead, the child should be educated on the importance of staying hydrated, taking breaks when needed, and avoiding excessive physical strain.
D. Assume postural drainage positions every 6 hours: Postural drainage is not typically indicated for sickle cell anemia or vaso-occlusive crises unless there are specific respiratory complications. This precaution is not relevant to the management of sickle cell anemia and should not be included in discharge teaching for this condition.
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