A 2-year-old child has been crying constantly for his mother since he was hospitalized 3 days ago. The nurse understands that this behavior suggests:
Poor mother-child bond exists.
The child is not separated from his mother often.
The toddler feels abandoned by his mother.
The child is manipulating the staff.
The Correct Answer is B
Toddlers (1–3 years) experience intense separation anxiety during hospitalization due to limited object permanence, strong caregiver attachment, and immature coping mechanisms. Crying after separation is a normal behavioral response reflecting distress from unfamiliar environments and disrupted caregiver proximity.
Rationale:
A. Poor mother-child bonding is not implied by persistent crying. Strong attachment actually intensifies separation distress. A securely attached toddler is more likely to protest separation, so this behavior indicates normal bonding rather than impaired relationship quality.
B. Limited prior separation experience increases distress during hospitalization. Toddlers unfamiliar with prolonged caregiver absence demonstrate persistent crying due to heightened separation anxiety. This reflects normal developmental response rather than pathology or dysfunctional attachment patterns.
C. Feeling abandoned is an adult cognitive interpretation. Toddlers lack abstract reasoning to conceptualize abandonment. Their crying reflects immediate distress from separation rather than a cognitive belief of being permanently left by the caregiver.
D. Manipulative behavior is not developmentally appropriate for toddlers. At this stage, behavior is driven by basic emotional needs and attachment security rather than intentional staff manipulation. Crying is an expression of distress, not deliberate behavioral control.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
School-age children use expressive activities, cognitive processing, emotional articulation, and symbolic play to cope with stress and painful medical experiences. Art-based interventions facilitate psychological processing of procedural trauma and reduce internalized anxiety responses.
Rationale:
A. Distraction from pain is a short-term coping strategy but not the primary therapeutic rationale for drawing in school-age children. Although it may reduce immediate distress, it does not address emotional processing of procedural experience or facilitate psychological expression.
B. Quiet play does not directly stabilize vital signs in a clinically meaningful or targeted way. Physiological stabilization occurs through pain control and autonomic regulation. Drawing is not primarily used for hemodynamic stabilization after procedures in pediatric care.
C. Rapport building may occur indirectly, but the main therapeutic purpose is not relationship establishment. The intervention is primarily focused on emotional expression rather than nurse-child relationship development, making this option incomplete as the best rationale.
D. Drawing allows emotional expression and helps the child process procedural pain experiences cognitively and psychologically. School-age children use symbolic representation to communicate feelings they may not verbalize. It supports coping, reduces anxiety, and facilitates healthy emotional adjustment after painful interventions.
Correct Answer is C
Explanation
Oral drug absorption in young children is determined by developmental differences in gastrointestinal motility, gastric emptying, intestinal enzyme activity, and mucosal surface maturation. In children under 5 years, accelerated and irregular intestinal transit can significantly disrupt the designed pharmacokinetics of extended-release formulations, reducing consistent drug absorption and therapeutic effect.
Rationale:
A. Constipation increases intestinal transit time, which may prolong drug contact with absorptive surfaces and potentially enhance absorption. It does not interfere with the controlled-release mechanism of time-released formulations in children under 5 years.
B. Renal immaturity affects drug excretion and clearance rather than gastrointestinal absorption. Time-release oral medications depend on gastrointestinal transit dynamics, not renal function, making this option unrelated to the absorption issue.
C. Children under 5 have rapid peristalsis and shortened intestinal transit time, reducing controlled drug release and absorption window. This disrupts extended-release formulation kinetics, leading to incomplete or inconsistent systemic drug levels.
D. Reduced gastric acid affects dissolution of acid-dependent drugs but does not significantly impair extended-release medication absorption. Time-release systems are primarily designed for intestinal release, so this factor has minimal impact on overall absorption in this age group.
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