A school-age child is being evaluated for secondary enuresis.
Which finding should the practical nurse (PN) identify as a sign of this condition?
Impulsive and hyperactive behaviors.
Involuntary passage of feces.
Increased thirst.
Declining invitations for sleepovers.
The Correct Answer is D
Choice A rationale
Impulsive and hyperactive behaviors are typically associated with conditions such as attention-deficit/hyperactivity disorder (ADHD), which involves neurodevelopmental differences affecting executive function and impulse control. While these behaviors can sometimes lead to accidents, they are not a direct sign of secondary enuresis.
Choice B rationale
Involuntary passage of feces, known as encopresis, is a distinct elimination disorder characterized by the repeated passage of stool into inappropriate places, often due to chronic constipation and overflow incontinence. It is a separate condition from enuresis, which specifically refers to involuntary urination.
Choice C rationale
Increased thirst, or polydipsia, is a common symptom of conditions like diabetes mellitus or diabetes insipidus, where the body attempts to compensate for fluid imbalances or high glucose levels. While some medical conditions causing enuresis might also involve increased thirst, it is not a direct sign of enuresis itself.
Choice D rationale
Declining invitations for sleepovers is a behavioral manifestation often observed in children with enuresis. The fear of embarrassment and shame associated with involuntary urination during sleep can lead them to avoid situations where their condition might be exposed, such as overnight stays at friends' houses.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
While suctioning with a bulb syringe may be indicated for secretions, in an active choking episode with a foreign body obstruction, it is not the immediate first action. Back-blows are more effective at dislodging the obstructing object by increasing intrathoracic pressure and creating an artificial cough.
Choice B rationale
Monitoring respirations for 15 seconds is a delay in critical intervention for an infant actively choking. An infant who is choking requires immediate, active intervention to clear the airway and restore effective breathing, as prolonged airway obstruction can quickly lead to hypoxia and cardiac arrest.
Choice C rationale
In a choking infant, the immediate and most effective first action is to perform three back-blows. This maneuver utilizes gravity and rapid increases in intrathoracic pressure to dislodge the foreign object from the airway, aiming to clear the obstruction quickly and restore ventilation.
Choice D rationale
Stopping the feeding and sitting the infant upright might be appropriate if the infant is merely gagging or coughing, but for active choking, this action alone is insufficient to dislodge an aspirated object. Active intervention like back-blows is required to overcome the obstruction.
Correct Answer is D
Explanation
Choice A rationale
While postpartum depression is a serious concern, immediately asking about suicidal thoughts without first establishing a broader understanding of the client's feelings can be premature and potentially alienating. It is essential to first assess the general emotional state and bonding difficulties before jumping to severe mental health concerns.
Choice B rationale
Explaining that this is a common feeling can minimize the client's distress and validate her experience, but it does not provide an avenue for her to express her specific concerns or for the PN to fully assess the depth of her feelings. It can prematurely close off further discussion and assessment.
Choice C rationale
Determining if her husband is bonding with the baby shifts the focus away from the client's own feelings and experiences, which is the primary concern in this situation. While partner involvement is important, the immediate priority is to understand and address the client's reported lack of bonding.
Choice D rationale
Encouraging the client to talk about her feelings provides an open and supportive environment for her to express her specific concerns regarding bonding. This allows the practical nurse to gather more information, assess the severity of the issue, and identify appropriate interventions or referrals if needed, promoting therapeutic communication.
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