A nurse is speaking to the parent of a 22-month-old child who states the child says "no" to everything. When scolded, the toddler becomes angry and starts crying loudly, then later wants to be held. How should the nurse best interpret this toddler's behavior?

This is normal behavior for a two-year-old child.

The toddler isn't effectively coping with the stress.

This behavior suggests the need for further assessment.

The toddler's need for affection isn't being met.

Answer and Explanation

The Correct Answer is A

A.   It is normal for toddlers to exhibit defiance, say "no" often, and become upset when scolded as part of the development of autonomy and independence. Seeking comfort afterward is also typical.

B.   While the toddler may be struggling with emotional regulation, this behavior is typical and does not necessarily indicate ineffective coping.
C.   There is no indication that further assessment is necessary unless other concerns arise. This behavior is normal for the developmental stage.
D.   The toddler's behavior is not necessarily due to unmet affection; it is more likely part of the developmental process.

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Correct Answer is A

Explanation

A. An IQ of 45 is classified as profound intellectual disability. Clients with this score typically require complete care and support in activities of daily living, including personal care, communication, and supervision.
B. While clients with cognitive impairments may perform some self-care activities with supervision, the IQ score of 45 generally indicates a need for significant assistance.
C. Clients with profound intellectual disability are unlikely to function independently at all times.
D. Complex tasks are beyond the capability of individuals with an IQ score of 45, and they would require significant assistance in daily tasks.

Correct Answer is []

Explanation

Condition:

Acute Laryngotracheobronchitis (Croup)

The harsh, bark-like cough and hoarse cry are classic symptoms of croup (acute laryngotracheobronchitis), a viral infection that typically affects young children. Mild work of breathing and stridor (a high-pitched sound during inspiration) indicate upper airway narrowing, which is characteristic of croup.

Actions to Take

Prepare to administer IV steroids:

Steroids (e.g., dexamethasone) are used to reduce airway inflammation in croup and are considered first-line treatment. They help reduce the swelling in the upper airways, making breathing easier and improving stridor and cough. IV steroids are often used in more severe cases, such as in an emergency department setting.

Administer racemic epinephrine:

Racemic epinephrine is a bronchodilator used to treat moderate to severe cases of croup. It works by reducing inflammation and relaxing the muscles of the upper airway, which helps relieve stridor and airway obstruction. This medication is typically given via nebulizer in the emergency department to provide rapid relief.

Parameters to Monitor

Oxygen saturation:

It is important to monitor oxygen saturation (SpO2) to assess if the child is getting enough oxygen. Croup can lead to hypoxia if the airway becomes severely narrowed. Monitoring oxygen levels ensures that the child is not deteriorating and allows for appropriate interventions if oxygen levels fall below normal (typically below 92% or 90%, depending on clinical guidelines).

Respiratory rate:

Monitoring the respiratory rate provides insight into how well the child is maintaining adequate ventilation. In cases of croup, increased work of breathing and distress can cause a higher respiratory rate. If the rate becomes very high or very low, it may indicate worsening distress or impending respiratory failure. Regular monitoring helps guide treatment and reassessment.

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A nurse is speaking to the parent of a 22-month-old child who states the child says "no" to everything. When scolded, the toddler becomes angry and starts crying loudly, then later wants to be held. How should the nurse best interpret this toddler's behavior?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client with cognitive impairment (CI) and an IQ score of 45. The nurse should plan client care based on which of the following expectations for an IQ score of 45.

Correct Answer is A

Explanation

Correct Answer is []

Explanation

Actions to Take

Parameters to Monitor

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A nurse is speaking to the parent of a 22-month-old child who states the child says "no" to everything. When scolded, the toddler becomes angry and starts crying loudly, then later wants to be held. How should the nurse best interpret this toddler's behavior?