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A home health nurse is providing care to a child who has cerebral palsy and notes that the child's parent seems withdrawn. The nurse asks the parent how they are doing, and the parent begins crying and states that taking care of their child is “so hard sometimes" and they are not sure how much more stress they can take. Which of the following statements made by the nurse's the most appropriate response?

“I will give you the names and contact information of a few good counselors. Talking to a professional is very helpful."

“Taking care of anyone with complex medical needs can be very overwhelming. What has your healthcare team told you about respite care?”

"You seem to be under a lot of stress. Have you tried reading self-help books on coping with stress?"

"Has something changed with your child's health condition? You can usually handle taking care of them. I will schedule a follow-up appointment with their provider to see what is going on.”

Answer and Explanation

The Correct Answer is B

A. “I will give you the names and contact information of a few good counselors. Talking to a professional is very helpful." While counseling can be beneficial, immediately directing the parent to therapy may feel dismissive of their immediate distress. A more supportive and solution-focused approach, such as discussing respite care, directly addresses the caregiver's burden.

B. “Taking care of anyone with complex medical needs can be very overwhelming. What has your healthcare team told you about respite care?” This response validates the parent's feelings while offering a practical solution. Respite care can provide temporary relief for caregivers, allowing them time to rest and recover, which can reduce burnout.

C. "You seem to be under a lot of stress. Have you tried reading self-help books on coping with stress?" While self-help books may provide general coping strategies, this suggestion does not acknowledge the immediate emotional burden the parent is experiencing or offer direct assistance.

D. "Has something changed with your child's health condition? You can usually handle taking care of them. I will schedule a follow-up appointment with their provider to see what is going on.” Assuming the parent can "usually handle" caregiving may invalidate their struggle. Additionally, suggesting a medical follow-up for the child rather than addressing the caregiver’s needs misses the core issue of caregiver stress.

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Naxlex Comprehensive Predictor Exams

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Correct Answer is ["C","E"]

Explanation

A. Atrial fibrillation on the cardiac monitor. Rheumatic fever can cause carditis, but atrial fibrillation is not a typical finding. Instead, valvular damage, tachycardia, or murmurs are more commonly observed.

B. Elevated BUN and creatinine on morning laboratory results. Rheumatic fever primarily affects the heart, joints, skin, and brain, not the kidneys. Elevated BUN and creatinine are more indicative of post-streptococcal glomerulonephritis, a separate complication of streptococcal infection.

C. Involuntary movements of extremities. Sydenham’s chorea, characterized by involuntary, jerky movements, is a classic neurologic manifestation of rheumatic fever. It results from inflammation affecting the basal ganglia of the brain.

D. Alopecia. Rheumatic fever does not cause alopecia. Hair loss is more commonly associated with autoimmune diseases such as lupus, not post-streptococcal complications.

E. Report of chest pain. Chest pain can indicate carditis, a major criterion for rheumatic fever. Inflammation of the heart's endocardium, myocardium, or pericardium may lead to pain, murmurs, or heart failure symptoms.

F. Oliguria. Decreased urine output is more commonly seen in post-streptococcal glomerulonephritis rather than rheumatic fever, as rheumatic fever primarily affects the heart, joints, and nervous system.

A. “You should focus solely on cognitive development at home, as professional interventions are not effective for children with fragile X syndrome." B. “Since your child has cognitive delays, you should avoid social activities that could overwhelm them and hinder their progress." C. "It's important to work with a multidisciplinary team to address your child's cognitive delays and support their development.” D. “Cognitive delays in children with fragile X syndrome typically resolve on their own, so there is no need for specialized educational plans or therapies."

Correct Answer is C

Explanation

A. "You should focus solely on cognitive development at home, as professional interventions are not effective for children with fragile X syndrome." This is incorrect. Professional interventions, including speech therapy, occupational therapy, and behavioral therapy, are essential for supporting cognitive and social development in children with fragile X syndrome.

B. "Since your child has cognitive delays, you should avoid social activities that could overwhelm them and hinder their progress." Avoiding social activities can actually be harmful, as children with fragile X syndrome benefit from structured social interactions and support. Instead of avoidance, individualized strategies should be used to help the child participate comfortably.

C. "It's important to work with a multidisciplinary team to address your child's cognitive delays and support their development." This is correct. A multidisciplinary team, including special education teachers, therapists, and healthcare providers, helps ensure the child receives individualized support in cognitive, social, and communication skills.

D. "Cognitive delays in children with fragile X syndrome typically resolve on their own, so there is no need for specialized educational plans or therapies." Cognitive delays in fragile X syndrome do not resolve on their own. Early intervention and specialized education plans (e.g., IEPs) are crucial in maximizing the child’s potential.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting data from the chart of a child who has streptococcal pharyngitis after being admitted for suspected rheumatic fever. Which of the following findings should the nurse identify as an indication of possible rheumatic fever? (Select All that Apply)

Correct Answer is ["C","E"]

Explanation

A nurse is reinforcing teaching to the parents of a 6-year-old child who has fragile X-syndrome and is manifesting cognitive delays. Which of the following statements concerning coordination of care should the nurse reinforce?

Correct Answer is C

Explanation

A school nurse is preparing to support children who have a chronic illness in a middle school setting. The nurse should be aware of which of the following challenges chronically a children may face? (Select All that Apply)

A nurse is caring for a 10-year-old client in a pediatric clinic. Exhibits For each potential provider's prescription, click to specify if the assessment findings are consistent with Eczema or Cellulitis. Each finding may support more than 1 disease process.

The nurse caring for a toddler who is diagnosed with congenital hypothyroidism. Which of the following developmental delays should the nurse recognize as the priority concern if the condition is left untreated?

A nurse is assisting in the care of a 6-year-old client who has nephrotic syndrome. Which of the following adverse effects of corticosteroids should the nurse recognize as having the potential to impact the child's psychosocial development? (Select All that Apply.)

A nurse is providing care for an infant who has heart failure and is being discharged from the hospital. When reinforcing discharge education, which of the following clinical manifestations should the nurse ensure caregivers are able to identify as signs of worsening heart failure?

A nurse is assisting in the care of an adolescent client who has been diagnosed with testicular cancer. The nurse understands that testicular cancer most often develops from mutations of which of the following types of cells?