A nurse is preparing a toddler for a procedure. Which of the following actions should the nurse plan to take?

Use a direct approach.

Explain the procedure using simple diagrams.

Prepare the toddler 1 day in advance.

Demonstrate use of the equipment.

Answer and Explanation

The Correct Answer is B

Choice A reason: A direct approach may overwhelm a toddler, who needs simple, visual explanations like diagrams to reduce fear. Assuming a direct approach is best risks anxiety, critical to avoid in ensuring a toddler’s emotional comfort and cooperation during preparation for medical procedures.

Choice B reason: Explaining the procedure with simple diagrams is age-appropriate for toddlers, reducing fear and enhancing understanding through visuals. This is critical for cooperation, supporting emotional well-being, ensuring effective preparation, and promoting a positive experience during medical procedures in young children.

Choice C reason: Preparing a toddler 1 day in advance may increase anxiety due to limited time comprehension; same-day preparation is better. Assuming advance preparation is ideal risks distress, critical to prevent in ensuring emotional readiness and cooperation for toddlers undergoing medical procedures.

Choice D reason: Demonstrating equipment may scare toddlers without context; simple diagrams are more effective for preparation. Assuming demonstration is best risks increasing fear, critical to avoid in ensuring a toddler’s comfort and understanding during preparation for medical procedures in healthcare settings.

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Correct Answer is B

Explanation

Choice A reason: Ignoring the nurse reflects avoidance, not rationalization, where clients justify behaviors, like blaming a partner. Assuming ignoring is rationalization risks misidentifying coping, potentially missing stress management needs, critical to avoid in supporting clients with chronic stress diagnoses.

Choice B reason: Stating behavior is due to a partner’s actions is rationalization, justifying stress responses to avoid responsibility. Recognizing this is critical for addressing maladaptive coping, guiding therapeutic interventions, and supporting healthier stress management strategies in clients with chronic stress diagnoses.

Choice C reason: Refusing treatment reflects denial, not rationalization, where clients provide excuses like blaming others. Assuming refusal is rationalization risks misinterpreting coping, potentially delaying intervention, critical to prevent in addressing chronic stress and promoting treatment acceptance in clients.

Choice D reason: Frequent calls reflect anxiety or dependency, not rationalization, where clients justify behaviors, like blaming others. Assuming calls are rationalization risks missing emotional needs, critical to avoid in ensuring proper stress management and support for clients with chronic stress diagnoses.

A. Urine output 20 mL/hr. B. Fetal heart rate 116/min. C. Blood pressure 150/92 mm Hg. D. Absence of eclampsia.

Correct Answer is D

Explanation

Choice A reason: Urine output of 20 mL/hr is below the desired 30 mL/hr during magnesium sulfate therapy, indicating potential toxicity or renal issues, not a therapeutic effect. Absence of eclampsia is the goal. Monitoring for low output risks missing seizure prevention, critical for maternal safety in preeclampsia management.

Choice B reason: Fetal heart rate of 116/min is within normal (110-160/min) but not a direct therapeutic effect of magnesium sulfate, which prevents seizures. Absence of eclampsia is key. Assuming heart rate is the focus risks overlooking maternal neurological status, critical for ensuring seizure prevention in preeclampsia treatment.

Choice C reason: Blood pressure of 150/92 mm Hg, while elevated, is not the primary therapeutic effect of magnesium sulfate, which targets seizure prevention, not hypertension. Absence of eclampsia is priority. Focusing on blood pressure risks neglecting seizure monitoring, critical for maternal safety in preeclampsia management with magnesium.

Choice D reason: Absence of eclampsia (seizures) is the primary therapeutic effect of magnesium sulfate in preeclampsia, stabilizing neuronal excitability, preventing life-threatening convulsions. Monitoring this ensures maternal safety, critical for preventing neurological damage, supporting fetal well-being, and guiding therapy adjustments in high-risk obstetric care.

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A nurse is preparing a toddler for a procedure. Which of the following actions should the nurse plan to take?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a new diagnosis of chronic stress. Which of the following findings should the nurse recognize as a manifestation of rationalization?

Correct Answer is B

Explanation

A nurse is assessing a client who has preeclampsia and is receiving magnesium sulfate via continuous IV infusion. For which of the following therapeutic effects should the nurse monitor the client?

Correct Answer is D

Explanation

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