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A nurse in the pediatric clinic is collecting data from a 15-year-old child who has a history of epilepsy. The child's pediatric collaborative healthcare team includes the pediatrician, neurologist, life specialist, case manager, and nurse. Which of the following scenario(s) are examples of collaborative goal setting? (Select All that Apply.)

The child's parents express concerns about seizure management during sleep and the neurologist works to adjust the child's medication to decrease the incidence of nightime seizures.

The child remains seizure-free after six months of taking a lower dosage of medication after a dose change by the provider.

The child expresses a desire to participate in a team sport at school and the team determines which sports are safe and any necessary safety precautions with the child and parents.

The nurse checks the child at each visit for mental health concerns and relays their assessment findings to the parents, child life specialist, and pediatrician.

The child's parents receive suggestions about complementary therapies from a family member and begin using them for their own child.

Answer and Explanation

Correct Answer : A,C,D

A. The child's parents express concerns about seizure management during sleep, and the neurologist works to adjust the child's medication to decrease the incidence of nighttime seizures. This is an example of collaborative goal setting because the healthcare team listens to parental concerns and works together to modify treatment to improve the child’s seizure management. The neurologist, parents, and possibly the pediatrician are involved in decision-making, ensuring a team-based approach to care.

B. The child remains seizure-free after six months of taking a lower dosage of medication after a dose change by the provider. This is not collaborative goal setting because it describes an outcome rather than a team-based decision-making process. The provider adjusted the medication, but there is no mention of discussion or input from multiple members of the healthcare team or the child and parents.

C. The child expresses a desire to participate in a team sport at school, and the team determines which sports are safe and any necessary safety precautions with the child and parents. This is collaborative goal setting because it involves the child, parents, and healthcare team working together to find safe and appropriate activities. The discussion ensures that the child’s personal goals are supported while prioritizing their safety.

D. The nurse checks the child at each visit for mental health concerns and relays their assessment findings to the parents, child life specialist, and pediatrician. This is an example of collaborative care because the nurse shares important assessment findings with the interdisciplinary team. By involving the pediatrician and child life specialist, the team can address the child’s mental health in addition to their physical condition.

E. The child's parents receive suggestions about complementary therapies from a family member and begin using them for their own child. This is not an example of collaborative goal setting because the healthcare team was not involved in the decision-making process. Effective collaboration requires input from qualified professionals, ensuring that treatments are safe and evidence-based.

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

Explanation

A. Delayed motor development. Children with muscular dystrophy often experience delayed milestones, such as difficulty walking, running, or climbing stairs. This is due to progressive muscle weakness, which affects motor skill acquisition.

B. Lung defects. While respiratory muscle weakness can occur in later stages of muscular dystrophy, congenital lung defects are not a primary characteristic of the condition. Respiratory complications typically arise due to muscle deterioration rather than structural lung defects.

C. Scoliosis. Progressive muscle weakness leads to postural instability, increasing the risk of scoliosis (abnormal spinal curvature). This is particularly common in Duchenne muscular dystrophy (DMD) as the muscles supporting the spine weaken.

D. Insomnia. Sleep disturbances are not a primary symptom of muscular dystrophy. However, respiratory complications or discomfort in later stages may contribute to sleep issues, but insomnia is not a defining feature.

E. Muscle weakness. Progressive muscle weakness is the hallmark of muscular dystrophy. It typically starts in the proximal muscles (hips, thighs, shoulders) and worsens over time, leading to mobility challenges and loss of independence.

A. “You must breastfeed to give the baby the best nutrients.” B. "Breastfeeding is not recommended because of the high risk of transmission.” C. “Pumped breastmilk may be given to your child." D. "You should sterilize your pumped breastmilk prior to feeding.”

Correct Answer is B

Explanation

A. "You must breastfeed to give the baby the best nutrients." While breastfeeding provides essential nutrients, it is not recommended for mothers with HIV due to the risk of viral transmission through breast milk, even if the mother is on antiretroviral therapy.

B. "Breastfeeding is not recommended because of the high risk of transmission." HIV can be transmitted through breast milk, and health organizations, including the WHO and CDC, advise against breastfeeding if safe alternatives, such as formula feeding, are available. Formula feeding is the preferred method in high-resource settings.

C. "Pumped breastmilk may be given to your child." Pumping does not eliminate HIV from breast milk. The virus remains present, posing the same transmission risk as direct breastfeeding.

D. "You should sterilize your pumped breastmilk prior to feeding." There is no reliable method for sterilizing breast milk at home that effectively eliminates HIV without destroying its nutritional value. Instead, formula feeding or donor milk from screened sources is recommended.

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Naxlex Comprehensive Predictor Exams

A nurse is collecting data from a child who has been diagnosed with muscular dystrophy. Which of the following findings should the nurse expect? (Select All that Apply.)

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

Explanation

A nurse is reinforcing education about nutrition for a patient who has HIV and has a newborn. Which of the following statements should the nurse provide in the teaching?

Correct Answer is B

Explanation

A nurse is reinforcing teaching to the parent of a terminally ill child about end-of-life care. Which of the following statements by the parents indicates an understanding of the teaching?

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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?

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A nurse is reinforcing education with a caregiver of a pediatric client about diaper dermatitis. Which of the following statements should the nurse make?

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