A nurse is collecting data from a toddler during a well-child visit. Which of the following actions should the nurse take to prepare the toddler for a physical examination?
Allow the toddler to handle the equipment.
Completely undress the toddler.
Thoroughly explain each procedure to the toddler.
Start the examination with routine immunizations.
The Correct Answer is A
A. Correct. Allowing the toddler to explore and handle the equipment can help build trust and reduce anxiety during the examination.
B. Completely undressing the toddler might cause anxiety and discomfort.
C. Thorough explanations are more suitable for older children, as toddlers might not fully understand.
D. Starting with immunizations might create anxiety, and it's better to establish rapport before introducing potentially distressing procedures.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Correct. A health care surrogate (also known as a health care proxy or agent. is designated by the individual to make medical decisions on their behalf if they are unable to do so. This individual should be someone the client trusts and is aware of the client's preferences.
B. Incorrect. A living will can be changed or updated by the individual at any time if their preferences change. It is important for the client to review and revise their living will as needed.
C. Incorrect. While legal assistance may be helpful, designating a healthcare surrogate does not necessarily require an attorney.
D. Incorrect. The choice of a healthcare surrogate is a personal decision, and the individual can choose any trusted person to fulfill this role, not just a family member.
Correct Answer is ["B","E"]
Explanation
A. Vertigo is common after inner ear surgery like stapedectomy and can be related to changes in the inner ear. It should be monitored, but it's not an immediate concern unless severe.
B. Correct. A change in facial symmetry (left facial droop) is indicative of potential facial nerve dysfunction, which requires immediate attention.
C. Pupils are reactive to light, and their size is within the expected range, indicating normal pupillary function.
D. A pain rating of 5 on a scale of 0 to 10 indicates moderate pain. While it requires attention, it's not a critical concern.
E. Correct. Diminished hearing following ear surgery is an expected finding, but the nurse should assess the degree and type of hearing loss and communicate this to the healthcare provider.
F. Lung assessment is important but does not require immediate action based on the given information.
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