Ch.24- Study Guide

Question 1

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Answer 1

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Question 2

2. Which nursing action addresses the gradual decline in life expectancy and the increase in death rates among young and middle-aged adults in the United States?

a. Cares for young adult patients who have been accidently injured or disabled
b. Offers brochures that encourage cancer screening for vulnerable groups
c. Reports signs and symptoms of substance abuse to the health care provider (HCP)
d. Administers prescribed medications to assigned patients in a timely manner

Answer 2

b. Offers brochures that encourage cancer screening for vulnerable groups

Question 3

3. Which behaviors exemplify the qualities of functional families? Select all that apply.

a. Mother tells daughter that being homecoming queen is an expected family tradition.
b. Parents encourage children to try afterschool activities to meet new friends.
c. Family attends a ceremony that honors the youngest son’s contribution to the community.
d. During family dinnertime, children are encouraged to talk about activities and interests.
e. Older sibling shows younger brother several methods to solve math problems.
f. Parents buy their children clothes, computers, cell phones, and other trendy items.

Answer 3

b. Parents encourage children to try afterschool activities to meet new friends.
c. Family attends a ceremony that honors the youngest son’s contribution to the community.
d. During family dinnertime, children are encouraged to talk about activities and interests.
e. Older sibling shows younger brother several methods to solve math problems.

Question 4

4. Which type of family is most likely to seek the services of the health care team for a child with a physical or mental disability?

a. Grand family
b. Adoptive family
c. Extended family
d. Nuclear family

Answer 4

b. Adoptive family

Question 5

5. Which nursing actions contribute to accomplishing the Healthy People 2020 Health Indicators? Select all that apply.

a. Administers medication using the six rights
b. Reinforces the need for preventive dental care
c. Encourages patients to routinely exercise
d. Assists patients to locate smoking cessation literature
e. Shows respect and courtesy to older patients
f. Teaches patients how to limit fats and sugar in the diet

Answer 5

b. Reinforces the need for preventive dental care
c. Encourages patients to routinely exercise
d. Assists patients to locate smoking cessation literature
f. Teaches patients how to limit fats and sugar in the diet

Question 6

6. The nurse is interviewing a woman who is from a different culture than the nurse’s. The nurse directs the questions to the woman, but the woman consistently looks toward her husband and he answers. What would the nurse do first?

a. Ask the husband to leave the room and continue the interview with the wife.
b. Continue the interview and observe for additional nonverbal behaviors.
c. Direct the questions to the husband, because the wife is deferring to him.
d. Discontinue the interview and seek advice about how to interact with this couple.

Answer 6

b. Continue the interview and observe for additional nonverbal behaviors.

Question 7

7. The nurse determines that the family is primarily autocratic. Which observation supports the nurse’s analysis?

a. Mother assumes dominance in decision-making.
b. Parents implement strict rules and expectations.
c. Uncle controls the finances.
d. Children participate in negotiations.

Answer 7

b. Parents implement strict rules and expectations.

Question 8

8. Which patient needs to get both pneumococcal and influenza vaccines?

a. 68-year-old resident in an assisted living facility
b. 3-year-old who goes to daycare every weekday
c. 21-year-old who lives in a college dorm
d. 30-year-old pregnant woman in the first trimester

Answer 8

a. 68-year-old resident in an assisted living facility

Question 9

9. Which patient group is the nurse most likely to assess for possible exposure to teratogens?

a. A group of preschoolers who attend a daycare setting
b. Residents who live at a long-term care center
c. A group of young women who are planning pregnancy
d. A group of adolescents who are at risk for substance abuse

Answer 9

c. A group of young women who are planning pregnancy

Question 10

10. The nurse is assessing a 6-month-old infant, who was 21 inches (53 cm) long at birth. Based on expected growth patterns, what height would the nurse expect on measuring this healthy baby?

a. 22 inches (56 cm)
b. 27 inches (69 cm)
c. 30 inches (76 cm)
d. 31 inches (79 cm)

Answer 10

b. 27 inches (69 cm)

Question 11

11. The nurse is assessing a 1-year-old child who weighed 9 lbs (4 kg) at birth. Based on expected growth patterns, how much should this healthy child weigh?
    _______Ibs (kg)

Answer 11

27

Question 12

12. Most of the weight gain in the first months of life is in the form of fat. What is the best physiologic explanation for this gain of fat?

a. Fat provides insulation and a source of nourishment if teething or other problems decrease food intake for a few days.
b. In cephalocaudal growth, fat must be deposited in areas of the trunk and abdomen before growth in extremities can occur.
c. Breast milk or prepared formulas are high in nutrients that are more readily converted to fat than to muscle or bone tissue.
d. Muscle and bone require more protein and calcium, so development of these tissues is concurrent with intake of solid foods.

Answer 12

a. Fat provides insulation and a source of nourishment if teething or other problems decrease food intake for a few days.

Question 13

13. The mother of a 5-month-old infant reports the child is irritable; gums are red and edematous, and he demonstrates excessive drooling. What would the nurse recommend?

a. Advise the mother to contact the HCP for treatment of infection.
b. Suggest the mother wipe and massage the gums and offer sips of clear water.
c. Teach the mother to brush the gums with a soft brush and fluoride toothpaste.
d. Advise the mother to give an infant dose of acetaminophen for discomfort.

Answer 13

b. Suggest the mother wipe and massage the gums and offer sips of clear water.

Question 14

14. Under which circumstance would the nurse advise the parents to contact the HCP about their 1-year-old infant?

a. Child seems restless and makes little noises during short napping periods.
b. Baby cries persistently during usual sleep periods and is inconsolable.
c. Infant sleeps 12 hours a night and takes one nap during the day.
d. Child frequently kicks and stretches when in the supine position.

Answer 14

b. Baby cries persistently during usual sleep periods and is inconsolable.

Question 15

15. Which infant behavior is consistent with Piaget’s theory that infants are in the sensorimotor stage of cognitive development?

a. Clings to the parent and protests any separation
b. Reaches for objects and puts them into mouth
c. Demonstrates shoulder control prior to hand control
d. Frequently says, “me” and “no”

Answer 15

b. Reaches for objects and puts them into mouth

Question 16

16. The working mother has an 8-month-old child who has to go to daycare while she works. How can the nurse best help the mother prepare for the first day of daycare?

a. Explain the likelihood of separation anxiety as a normal behavior.
b. Emphasize that the child is likely to sleep most of the day, so he won’t miss her.
c. Describe the benefits of parallel play for cognitive development.
d. Validate the mother’s feelings of guilt and reassure that daycare is beneficial.

Answer 16

a. Explain the likelihood of separation anxiety as a normal behavior.

Question 17

17. The HCP tells the first-time parents how to introduce new foods to the infant. Which information would be reinforced? Select all that apply.

a. Citrus fruits may be given before the infant is 6 months of age.
b. Foods should be mixed together to improve intake of nutrients.
c. Cereals should be started before vegetables and meats.
d. New foods should be introduced one at a time.
e. Several days should pass between introducing new foods.

Answer 17

c. Cereals should be started before vegetables and meats.
d. New foods should be introduced one at a time.
e. Several days should pass between introducing new foods.

Question 18

18. The nurse is watching a group of mothers interact with their young children. Which behavior by a mother most strongly suggests that additional assessment for potential child abuse might be required?

a. Retrieves toddler whenever he tries to run or jump or perform active movements
b. Allows toddler to climb on a table space that is meant for snacks and drinks
c. Berates and shames her toddler for refusing to share toys with other children
d. Talks to other mothers and allows the toddler to fuss without comforting him

Answer 18

c. Berates and shames her toddler for refusing to share toys with other children

Question 19

19. The nurse is interviewing the parents of a toddier who must be admitted for 23-hour observation for a febrile illness. What is the most important question to ask about the child’s bedtime?

a. “Would you prefer that he gets milk or juice in a night bottle?”
b. “What do you usually do when you put him to bed?”
c. “How many hours does he usually sleep?”
d. “What would you like me to tell him about sleeping away from home?”

Answer 19

b. “What do you usually do when you put him to bed?”

Question 20

20. The mother is ordering lunch for her toddler. The nurse would intervene if the mother selected which food for the toddler?

a. Milk
b. Peanut butter sandwich
c. Carrot sticks
d. Small banana

Answer 20

c. Carrot sticks

Question 21

21. The parents report that their 3-year-old child has not started talking, but he seems happy and active and engaged with the world in nonverbal ways. What would the nurse advise the parents to do?

a. Advise the parents to read to the child and ask him to name familiar objects.
b. Suggest expanding opportunities for parallel play, such as at daycare or play groups.
c. Reassure parents that children grow and develop at their own individual pace.
d. Suggest consultation with the HCP for possible hearing or speech problems.

Answer 21

d. Suggest consultation with the HCP for possible hearing or speech problems.

Question 22

22. The HCP asks the nurse to please watch the 4-year-old child because she needs to talk privately to the mother. What is the best way for the nurse to interact with the child?

a. Take the child to the cafeteria and buy him a snack.
b. Give him some crayons and paper and ask him to draw a picture.
c. Ask him to “help” by sorting a bag of rubber bands by size and color.
d. Explain why he has to wait and give him a book to read.

Answer 22

b. Give him some crayons and paper and ask him to draw a picture.

Question 23

23. The school nurse notices that an 8-year-old boy comes to the nursing office during recess for a “tummy ache” which seems to disappear as soon as recess is over. What would the nurse do first?

a. Call the parents and review symptoms that warrant an appointment with the HCP.
b. Ask the teachers if there are any unusual classroom behaviors going on.
c. Alert the principal that there may be some bullying or rough play during recess.
d. Contact the parents and discuss the pattern of stomachache and recess time.

Answer 23

d. Contact the parents and discuss the pattern of stomachache and recess time.

Question 24

24. A mother reports that her child occasionally complains of pain in the legs particularly at night. Which question would the nurse ask to determine if this is an expected symptom?

a. “Has the child been running?”
b. “How old is your child?”
c. “Has your child appeared anxious?”
d. “How much does your child weigh?”

Answer 24

b. “How old is your child?”

Question 25

25. The nurse must give the school-age child an immunization. Based on the nurse's awareness that the child is in the concrete operational stage, what would the nurse do prior to giving the child the injection? a. Ask a helper to hold the child to prevent movement. b. Suggest that the child pretend that she is getting a fairy's kiss. c. Tell the child that it hurts a bit, but prevents sickness. d. Make extra efforts to protect modesty and privacy.

Answer 25

c. Tell the child that it hurts a bit, but prevents sickness.

Question 26

26. Which routine check-ups or screenings are recommended for school-age children? Select all that apply. a. Vision testing b. Dental examination every 6 months c. Hearing testing d. Scoliosis screening e. Cancer screening f. Human immunodeficiency virus testing

Answer 26

a. Vision testing b. Dental examination every 6 months d. Scoliosis screening

Question 27

27. The nurse must perform a dressing change on a 7-year-old child. The nurse explains that the procedure will not be painful, but the child appears apprehensive. What is the best approach for the nurse to use? a. Demonstrate the procedure on a doll and answer questions. b. Ask the child to hold the tape and give praise for cooperation. c. Premedicate with a mild anxiolytic medication and explain. d. Coach the parent through the procedure and stand back.

Answer 27

b. Ask the child to hold the tape and give praise for cooperation.

Question 28

28. The school nurse is talking to a child who sustained an abrasion and bruise during recess. When the nurse asks the child what happened, he begins to cry, shakes his head, and refuses to answer. What would the nurse do first? a. Tell him that all information is confidential, so he doesn't have to feel embarrassed or afraid. b. Call the parents and inform them that the child is emotionally overwhelmed and can't talk. c. Consult the school principal to see if something unusual happened on the playground. d. Talk to him while treating the wounds and give encouragement to establish rapport.

Answer 28

d. Talk to him while treating the wounds and give encouragement to establish rapport.

Question 29

29. A parent expresses concern because her healthy, active 11-year-old son seems very short. She reports that all men on both sides of the family are tall. What is the best information that the nurse can give to the mother about growth and development? Select all that apply. a. During the school-age period, the growth pattern is usually gradual and subtle. b. A second period of rapid growth is expected during adolescence. c. From ages 6-12, height increases by about 2 inches (5 cm). d. He is probably lacking essential nutrients that contribute to height and weight. e. Distant genetic factors are likely to predispose him to a shorter height.

Answer 29

a. During the school-age period, the growth pattern is usually gradual and subtle. b. A second period of rapid growth is expected during adolescence. c. From ages 6-12, height increases by about 2 inches (5 cm).

Question 30

30. Which parent is doing the best job of using good parenting tips in dealing with an adolescent child? a. Parent permits 17-year-old son to set own curfew time on weekends. b. Parent gives up smoking cigarettes and encourages 18-year-old to quit too. c. Parent respects 15-year-old daughter's privacy by not asking questions about friends. d. Parent allows 13-year-old unlimited computer time if grades are maintained.

Answer 30

b. Parent gives up smoking cigarettes and encourages 18-year-old to quit too.

Question 31

31. The parent reports that her 15-year-old daughter seems more moody than usual and she is concerned because there was a teenager in the neighborhood who recently committed suicide. What is the most important question that the nurse would ask to determine if the daughter has a high risk for suicide? a. "Has she had a change in appetite?" b. "Is there a change in her ability to concentrate?" c. "Is she preoccupied with thoughts of death?" d. "Has she talked about ways to commit suicide?"

Answer 31

d. "Has she talked about ways to commit suicide?"

Question 32

32. The nurse is working with a group of parents of high school students. During the discussion, the following statements are made by the parents. Based on an understanding of the needs of adolescents, which statement requires follow-up by the nurse? a. "We try to set reasonable limits on dating and are encouraging group activities." b. "Teenagers who participate in social activities should be home by 9:00 PM on school nights." c. "We are generally not in favor of allowing sex education to be taught at school." d. "There are numerous after-school activities, so we suggest focusing on two or three."

Answer 32

c. "We are generally not in favor of allowing sex education to be taught at school."

Question 33

33. Which behaviors indicate that the young adult is achieving the developmental tasks of early adulthood? Select all that apply. a. Lives at home with parents, but is saving for an apartment deposit. b. Accepts that sister's decision to have a big family is okay. c. Establishes a permanent relationship with a same-sex partner. d. Decides to postpone marriage and focus on career. e. Identifies with and seeks out gay and lesbian peer groups.

Answer 33

a. Lives at home with parents, but is saving for an apartment deposit. b. Accepts that sister's decision to have a big family is okay. c. Establishes a permanent relationship with a same-sex partner. d. Decides to postpone marriage and focus on career.

Question 34

34. Which behavior demonstrates that a 60-year-old adult is meeting his developmental task of generativity? a. Ruminates over fears and lifetime failures b. Reorganizes personal belongings and assets c. Gives advice to nephew about succeeding in life d. Reviews will for distribution of worldly goods

Answer 34

c. Gives advice to nephew about succeeding in life

Question 35

35. A 53-year-old woman tells the nurse that she has been experiencing flushing, mood swings, night sweats, and breast tenderness for the past several months. Based on knowledge of lifespan development, which question is the nurse most likely to ask? a. "Do you have a personal or family history of breast cancer?" b. "When was your last normal menstrual period?" c. "Have you experienced a change in libido?" d. "Have you ever been told that you have osteoporosis?"

Answer 35

b. "When was your last normal menstrual period?"

Question 36

36. The nurse is assessing the vision of an older adult patient. Which finding requires follow-up? a. Presbyopia b. Visualization of half of the field c. Decreased depth perception d. Slowed accommodation

Answer 36

b. Visualization of half of the field

Question 37

37. The nurse is working in a long-term care facility. Which activity will help the residents meet the developmental task of ego integrity as described by Erikson? a. Taking the residents out to lunch at a restaurant b. Reminiscing about past important events c. Assisting residents to maintain personal hygiene d. Leading the residents in an arts and crafts project

Answer 37

b. Reminiscing about past important events

Question 38

38. The home health nurse is visiting an older patient who lives alone. She is underweight and the kitchen is unusable because of dirt and clutter. What would the nurse do first? a. Contact a local organization that will deliver meals to the house. b. Notify supervising RN to determine if elder neglect is an issue. c. Assess for additional factors that are contributing to the malnutrition. d. Weigh the patient and calculate the body mass index.

Answer 38

c. Assess for additional factors that are contributing to the malnutrition.

Question 39

39. Based on knowledge of normal changes of the cardiovascular system, which recommendation would the nurse make to an older adult? a. Maintain a low-fat, low-sodium diet. b. Obtain streptococcal pneumonia vaccine. c. Encourage coughing and deep-breathing. d. Change position frequently.

Answer 39

d. Change position frequently.

Question 40

40. Which behavior most strongly indicates that the older adult is successfully aging? a. Spends a lot of time with adult children trying to make up for lost time b. Studies Latin and combines subject matter with previous interest in literature c. Tries various complementary and alternative therapies to improve appearance d. Works through a "bucket list" with an uncharacteristic enthusiasm

Answer 40

b. Studies Latin and combines subject matter with previous interest in literature

Question 41

41. Which health care worker is demonstrating ageism? a. Physical therapist accompanies a resident who lives in a long-term care facility to go outside for a walk b. Phlebotomist examines an older patient's veins and tells the nurse that successful blood draw is unlikely c. HCP tells an older woman that it would be best if her husband was in hospice care d. Nurse continuously smiles and nods as an older patient sharply criticizes the nursing care

Answer 41

d. Nurse continuously smiles and nods as an older patient sharply criticizes the nursing care

Question 42

42. Which activity would the nurse encourage for an older adult who wanted to improve his/ her memory? a. Independently completing activities of daily living (ADLs) b. Watching television programs that are relaxing c. Engaging in activities such as puzzles, reading, and hobbies d. Spending time reflecting on past accomplishments

Answer 42

c. Engaging in activities such as puzzles, reading, and hobbies

Question 43

43. Which health promotion point is most important to prevent onset or reduce problems related to coronary artery disease, hypertension, osteoarthritis, osteoporosis, diabetes, obesity, and chronic obstructive pulmonary disease? a. Low-fat and low-carbohydrate diet b. Regular, paced exercise routine c. Eight hours of sleep or short daytime naps d. Medication compliance as prescribed

Answer 43

b. Regular, paced exercise routine