A nurse is contributing to a plan of care for a 24-month-old toddler. Which of the following actions should the nurse take?

Allowing the toddler to button up their own shirt

Asking the toddler questions that have "yes" or "no" answers

Providing the toddler with opportunities to share toys with others

Making sure the toddler has at least one nap during the day

Answer and Explanation

The Correct Answer is D

A. Allowing a toddler to button up their own shirt can be frustrating for them as they may not have developed the fine motor skills required for this task, leading to potential distress.
B. Asking toddlers questions that require a "yes" or "no" answer can limit their language development as it does not encourage them to use language expressively.
C. While providing opportunities to share toys with others is important for social development, it is not the most critical aspect of care in this context.
D. Ensuring the toddler has at least one nap during the day is crucial as toddlers need ample sleep for proper development and to prevent overtiredness, which can affect their mood and behavior.

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Correct Answer is C

Explanation

Rationale:

A) The diastolic value is recorded as the disappearance of Korotkoff sounds (K5), not the first sound (K1).

B) The cuff pressure should be released at a rate of 2-3 mm Hg/second, not 5 mm Hg/second.

C) Positioning the child's arm at the level of the heart ensures an accurate blood pressure measurement.

D) The cuff bladder size should be approximately 40% of the child's upper arm circumference, not 20%.

A. "I will take my child's rectal temperature daily to ensure the most accurate reading." B. "I will make sure my child receives the MMR vaccine by the end of the week." C. "I will take my child to the park to ride her new bike." D. "I will inspect the inside of my child's mouth for sores every day."

Correct Answer is D

Explanation

Rationale:

A) Taking rectal temperatures may increase the risk of infection and is not typically recommended during chemotherapy.

B) Live vaccines such as MMR are generally contraindicated during chemotherapy due to the risk of vaccine-related complications in immunocompromised individuals.

C) Going to the park may expose the child to environmental pathogens and is not recommended during chemotherapy.

D) Inspecting the inside of the child's mouth for sores is important for early detection of oral mucositis, a common side effect of chemotherapy that can increase the risk of infection.

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A nurse is contributing to a plan of care for a 24-month-old toddler. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to obtain a blood pressure reading from a school-age child. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

A nurse is reinforcing discharge teaching about preventing infections with the parent of a child who is receiving chemotherapy and has a platelet count of 100,000/mm3. Which of the following statements by the parent indicates an understanding of the teaching?

Correct Answer is D

Explanation

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