A nurse is caring for a preschooler who is in an acute care facility. Which of the following actions should the nurse take?
Establish a new routine for the child to follow while in the facility.
Encourage the child to play with toys such as a pounding board.
Use medical terminology when discussing procedures with the child.
Perform the morning assessments when the parent is not in the room.
The Correct Answer is B
A. Establish a new routine for the child to follow while in the facility. - Preschoolers thrive on routines and familiarity, especially in unfamiliar environments like acute care facilities. Therefore, it's essential for the nurse to maintain the child's existing routine as much as possible to provide a sense of security and stability.
B. Encourage the child to play with toys such as a pounding board. - Encouraging play with age-appropriate toys helps promote normalcy, reduce anxiety, and facilitate coping for preschoolers during their hospital stay. Toys like a pounding board provide opportunities for physical activity and engagement, which can help distract and entertain the child.
C. Use medical terminology when discussing procedures with the child. - Preschoolers have limited understanding of complex medical terminology. Using simple, age-appropriate language helps the child better comprehend what is happening, reducing fear and anxiety. Therefore, it's important for the nurse to avoid medical jargon and use language the child can understand.
D. Perform the morning assessments when the parent is not in the room. - Preschoolers often feel more comfortable and secure when their parents are present, especially in unfamiliar environments like hospitals. Performing assessments in the presence of the parent helps maintain the child's sense of security and allows the parent to participate in the child's care and provide comfort and support.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Hearing loss: While digoxin toxicity can affect various organ systems, including the auditory system, resulting in symptoms such as tinnitus (ringing in the ears), hearing loss is not a typical manifestation of digoxin toxicity.
B. Insomnia: Insomnia is not a common symptom of digoxin toxicity. Clients with digoxin toxicity are more likely to experience neurological symptoms such as confusion, visual disturbances, or changes in mental status.
C. Tachycardia: Digoxin toxicity can cause arrhythmias, but it typically presents with bradycardia rather than tachycardia. Bradycardia is a hallmark sign of digoxin toxicity due to its negative chronotropic effect on the heart.
D. Blurred vision: Blurred or yellow-tinted vision is a classic symptom of digoxin toxicity, often described as "yellow halos" around lights. Visual disturbances occur due to the drug's effects on the optic nerve and can progress to more severe manifestations, such as changes in color vision or photophobia. Therefore, blurred vision is a key indicator of digoxin toxicity and requires prompt assessment and intervention.
Correct Answer is B
Explanation
A. "Think about a positive outcome to a stressful situation." - This instruction describes a cognitive restructuring technique, which involves reframing negative thoughts with positive ones. While cognitive restructuring can be helpful for managing stress and anxiety, it is not specifically related to progressive relaxation.
B. "Tighten a muscle group, then release the tension and move to the next one." - This is the correct instruction for progressive relaxation. Progressive relaxation involves systematically tensing and relaxing muscle groups throughout the body to reduce physical tension and promote relaxation. By sequentially tensing and releasing muscle groups, the client learns to recognize and control muscle tension, which can help alleviate stress and anxiety.
C. "Focus on a pleasant memory and express your emotions in writing." - This instruction describes a journaling or expressive writing technique, which can be beneficial for processing emotions and reducing stress. However, it is not specific to progressive relaxation.
D. "Picture taking the stress you feel and pushing it down and out of your feet." - This instruction describes a visualization or imagery technique, where the client visualizes releasing stress from the body. While visualization can be a component of relaxation exercises, it is not specifically associated with progressive relaxation, which focuses on muscle tension and relaxation.
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