A nurse is teaching the parent of a school-age child who has generalized anxiety disorder. Which of the following instructions should the nurse Include in the teaching?

"Discuss events with the child that have led to anxiety in the past."

"Assure the child that he is in control of the situation."

"Provide the child with a detailed action plan when he becomes anxious."

"Leave the child alone when he is exhibiting signs of anxiety."

Answer and Explanation

The Correct Answer is C

A. Discuss events with the child that have led to anxiety in the past.: While understanding past anxiety triggers can be helpful, focusing on specific strategies and action plans is more effective for managing current anxiety.

B. Assure the child that he is in control of the situation.: This might not always be accurate or helpful. Reassuring the child may not address the underlying anxiety or provide practical strategies for managing it.

C. Provide the child with a detailed action plan when he becomes anxious.: This approach is beneficial as it gives the child a structured plan to follow, which can help manage anxiety and provide a sense of control. Specific actions can help the child cope with anxiety in real-time.

D. Leave the child alone when he is exhibiting signs of anxiety.: Avoiding the child during episodes of anxiety can increase feelings of isolation and might not address the child's needs for support and guidance during these times.

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Correct Answer is D

Explanation

A) Painful vesicles along a dermatome:
This finding is typically associated with herpes zoster (shingles), not scabies. Shingles causes painful vesicles that follow the path of a nerve and are confined to one side of the body, which does not align with the presentation of scabies.

B) Acneiform nodules on the face:
Acneiform nodules are related to conditions such as acne vulgaris, not scabies. Scabies does not typically present with acne-like lesions on the face but rather with intense itching and a specific rash.

C) Wheals surrounding raised bite marks:
Wheals and bite marks are more indicative of insect bites or conditions like urticaria (hives). Scabies is caused by mites that burrow under the skin, leading to a different type of rash.

D) Raised, linear burrows:
Raised, linear burrows are characteristic of scabies. These burrows are caused by the female mite as it tunnels just under the skin to lay eggs, resulting in a distinctive rash and intense itching, especially at night.

A. High-pitched bowel sounds B. Abdominal bruit C. Bruising on the flank area D. Coffee-ground emesis

Correct Answer is A

Explanation

A) High-pitched bowel sounds: High-pitched bowel sounds, also known as "tinkling" sounds, are characteristic of mechanical bowel obstructions. These sounds are created by the intestines as they try to move contents past the obstruction, resulting in increased peristaltic activity. In the case of intussusception, where one segment of the intestine telescopes into another, the obstruction can cause these distinctive high-pitched sounds due to the narrowing of the bowel lumen.

B) Abdominal bruit: An abdominal bruit is a swishing sound heard over the abdomen, usually indicating turbulent blood flow through narrowed arteries. It is commonly associated with vascular conditions such as atherosclerosis or renal artery stenosis. It is not related to bowel obstruction, as bowel sounds in obstruction cases are generally due to changes in peristaltic activity rather than blood flow.

C) Bruising on the flank area: Bruising on the flank area, known as Grey Turner's sign, is typically seen in conditions involving retroperitoneal hemorrhage, such as severe pancreatitis or trauma. It is not a symptom of bowel obstruction. Bowel obstruction symptoms generally relate to the gastrointestinal tract and include abdominal pain, distension, and altered bowel sounds.

D) Coffee-ground emesis: Coffee-ground emesis is vomit that appears like coffee grounds, indicating the presence of partially digested blood. This is a sign of upper gastrointestinal bleeding, often due to peptic ulcers or gastritis. In mechanical bowel obstruction, vomiting is more likely to contain bile (bilious vomiting) and may occur if the obstruction is high in the small intestine. The appearance of coffee-ground emesis is not typical for bowel obstructions and indicates a different type of gastrointestinal issue.

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A nurse is teaching the parent of a school-age child who has generalized anxiety disorder. Which of the following instructions should the nurse Include in the teaching?

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