A nurse is providing care to 13-year-old who has an atrial septal defect (ASD). Their caregivers raise concerns regarding mood changes, reporting the child seems more anxious and worried than usual over the past year. Considering the diagnosis of ASD, which of the following responses is appropriate for the nurse to make?
"Worrying is normal for this age group."
"All children with ASD have mood disorders."
"Children with ASD are at greater risk for experiencing anxiety."
"Children may become anxious when they have to be in a health care setting."
The Correct Answer is C
A. "Worrying is normal for this age group.": Some worry is developmentally common, but new or worsening anxiety, especially over a year, merits assessment rather than being dismissed as simply normal.
B. "All children with ASD have mood disorders.": There is an increased risk of mood and anxiety disorders in children with congenital heart disease, but not every child will develop a mood disorder.
C. "Children with ASD are at greater risk for experiencing anxiety.": Children with atrial septal defect and other congenital heart conditions have a higher risk for anxiety and mood problems; caregivers should monitor and seek evaluation if concerns arise.
D. "Children may become anxious when they have to be in a health care setting.": Health-care–setting anxiety can occur in many children, but this statement does not address the condition-specific increased risk for anxiety associated with congenital heart disease.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. A 28-year-old client who has a history of pelvic inflammatory disease: A past history of PID is not an absolute contraindication to combined oral contraceptives; OCPs may in some cases reduce the risk of PID.
B. A 32-year-old client who has benign breast disease: Benign breast disease alone is generally not an absolute contraindication to combined oral contraceptives; careful evaluation may be advised depending on findings.
C. A 38-year-old client who reports smoking one pack of cigarettes every day: Smoking ≥15 cigarettes/day in women aged 35 or older is a contraindication to combined estrogen-containing contraceptives because of substantially increased cardiovascular risk.
D. A 26-year-old client who has migraine headaches at the start of each menstrual cycle: Migraine without aura is not an absolute contraindication for combined OCPs in young women; migraines with aura would be a contraindication because of stroke risk.
Correct Answer is ["A","B","C","E"]
Explanation
A. Abdominal pain: Severe abdominal pain can signal hepatic dysfunction, gallbladder disease, or vascular problems (e.g., hepatic vein thrombosis) associated with oral contraceptives and needs prompt evaluation.
B. Speech disturbances: New speech changes can be a sign of stroke or transient ischemic attack -OCPs increase thrombotic risk in some patients, so neurological symptoms must be reported immediately.
C. Headache: Sudden or severe headaches (or new, persistent headaches) may indicate hypertension, migraine with aura, or cerebrovascular events and should be reported.
D. Weight gain: Not typically urgent to report. Weight change is a common side effect of hormonal contraceptives; it should be discussed during follow-up if bothersome, but it is not an immediate warning sign like the others.
E. Eye or visual problems: Visual disturbances (blurry vision, visual loss) may indicate hypertensive crisis, retinal thrombosis, or cerebrovascular events and require immediate evaluation.
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