The nurse is speaking with the parents of a 4 year old child following a family discussion with the health care provider about the child's terminal condition and the possibility to transition to end-of-life care. The parents state, "We don't think we can make this decision right now. What would you do? Choose the nurse's BEST response.

You seem overwhelmed, I'll contact the chaplain to come and talk with you about the options

I find it helpful to investigate the options. I will get you a pamphlet about end-of-life care

Its hard to say what the best decision is, but I know the end-of-life team provides wonderful care

These decisions are challenging. Tell me about your beliefs and understanding about end-of life

Answer and Explanation

The Correct Answer is D

A. You seem overwhelmed, I'll contact the chaplain to come and talk with you about the options: While offering chaplain support is valuable, it's essential to engage in a conversation with the parents first to understand their needs and concerns.

B. I find it helpful to investigate the options. I will get you a pamphlet about end-of-life care: Providing information is valuable, but in this case, the parents are expressing their emotional distress, and they may need a more empathetic and personalized approach.

C. It's hard to say what the best decision is, but I know the end-of-life team provides wonderful care: While reassuring, this response doesn't actively engage with the parents or explore their feelings and beliefs, which are crucial for making this challenging decision.

D. These decisions are challenging. Tell me about your beliefs and understanding about end-of-life.

This response acknowledges the parents' difficulty with the decision and opens the door for a deeper conversation. It allows the nurse to understand the parents' perspectives, values, and concerns, which is crucial in providing holistic and patient-centered care. This information will help the nurse support the family and guide them through the decision-making process, addressing their specific needs and preferences.

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Correct Answer is C

Explanation

Option A is incorrect because Tanner staging is not solely based on developmental achievement according to age. It assesses physical development irrespective of age.

Option B is incorrect because it is not based on the color of pigmentation on the scrotum but rather on multiple physical characteristics.

Option C. Based on the development of pubic hair in girls.

The Tanner staging system, also known as sexual maturity rating or sexual maturity scale, is a system used to assess the sexual development of children and adolescents based on physical characteristics, primarily focusing on secondary sexual characteristics. It is used to assess the stage of puberty in both boys and girls. In the case of girls, it includes the development of pubic hair, breast development, and other changes like the growth of the areola.

Option D is incorrect because it doesn't solely focus on staged voice changes in males. The Tanner staging system includes a range of characteristics, including voice changes, genital development, and pubic hair growth, to assess sexual maturity in both males and females.

A. Appropriate dose of aspirin and rest B. Immobilization of the leg and a dose of ibuprofen C. Heating pad and administration of factor Vill concentrate D. Pressure on the site and administration of the required clotting factor

Correct Answer is D

Explanation

A. Appropriate dose of aspirin and rest: Aspirin is an antiplatelet medication that can worsen bleeding in individuals with hemophilia. It should be avoided. Rest alone is not sufficient in this situation.

B. Immobilization of the leg and a dose of ibuprofen: Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) that can increase the risk of bleeding. Immobilizing the leg may help prevent further injury, but it does not address the underlying bleeding issue or provide the necessary clotting factor.

C. Heating pad and administration of factor VIII concentrate: While the administration of factor VIII concentrate is appropriate, the use of a heating pad is not advisable, as it can potentially worsen bleeding by dilating blood vessels in the area.

D. Pressure on the site and administration of the required clotting factor.

Hemophilia is a bleeding disorder in which the blood doesn't clot properly. When a hemophilic child has a significant bruise or bleeding, it is crucial to administer the specific clotting factor that they are deficient in (Factor VIII or IX) to stop the bleeding. Applying pressure to the site can also help control bleeding.

In summary, option D is the priority because it directly addresses the bleeding issue in the child with hemophilia by applying pressure to the site and administering the necessary clotting factor. This is crucial in preventing further bleeding and complications.

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Naxlex Comprehensive Predictor Exams

The nurse is aware that the Tanner staging system for sexual maturity is:

Correct Answer is C

Explanation

Which intervention is a priority for a hemophilic child who has fallen and badly bruised his leg?

Correct Answer is D

Explanation

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