The mother of a 4-year-old boy tells the nurse that her son occasionally wets his pants during the day. How should the nurse respond?
"Tell me about the circumstances when this occurs."
"Is there a family history of diabetes?"
"Suddenly having accidents can be a sign of diabetes."
"That's normal: don't worry about it."
The Correct Answer is A
A. "Tell me about the circumstances when this occurs.": This response allows the nurse to gather more information about the child's toileting habits and potential triggers for the accidents.
Understanding the context can help identify possible underlying causes and guide appropriate interventions.
B. "Is there a family history of diabetes?": While diabetes can be a cause of increased urination, asking about a family history of diabetes is premature and may unnecessarily alarm the parent before further assessment.
C. "Suddenly having accidents can be a sign of diabetes.": Jumping to conclusions about a serious medical condition like diabetes without further assessment or evidence can cause unnecessary anxiety for the parent. It's important to gather more information and consider other potential causes before suggesting a diagnosis.
D. "That's normal: don't worry about it.": While occasional daytime wetting accidents can be common in young children, dismissing the concern without further assessment may overlook potential underlying issues that could benefit from intervention or support.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Speak to the child using mature language and appeal to his or her desire for self-care. - School-age children are typically more independent and responsive to mature communication. Acknowledging their desire for self-care fosters cooperation during the examination process.
B. Include the child in all parts of the examination: speak to the caregiver before and after the examination. - While involving the child in the examination process is important, school-age children may prefer direct communication rather than primarily interacting with caregivers.
C. Keep up a running dialogue with the caregiver, explaining each step as you do it. - While
involving caregivers in the examination process is important, maintaining a dialogue primarily with them may not fully engage the child during the assessment.
D. Address the child by name; speak to the caregiver and do the most invasive parts last. - While considering the child's comfort and addressing them directly is essential, school-age children
may respond better to direct communication rather than deferring to caregivers for discussion
Correct Answer is B
Explanation
A. Inspection, percussion, palpation, auscultation: This sequence starts with visual inspection, followed by percussion (tapping the body to assess underlying structures), palpation (using the hands to feel for abnormalities), and finally auscultation (listening with a stethoscope to assess sounds such as heart, lung, or bowel sounds). However, palpation is usually performed before percussion.
B. Inspection, palpation, percussion, auscultation: This is the correct sequence for performing a physical examination. It begins with visual inspection, followed by palpation to assess for
tenderness, masses, or other abnormalities, then percussion to evaluate the density of underlying structures, and finally auscultation to listen to internal sounds.
C. Palpation, percussion, inspection, auscultation: This sequence starts with palpation, followed by percussion, then inspection, and finally auscultation. However, inspection is typically performed before palpation in a physical examination.
D. Inspection, auscultation, palpation, percussion: This sequence starts with visual inspection, followed by auscultation, palpation, and percussion. While auscultation often follows inspection, palpation is usually performed before auscultation.
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