The mother of a 5-year-old child is concerned that her daughter has an imaginary friend named Bill that comes and plays with her. What explanation could the nurse offer this mother?
This is a form of regression
Magical thinking may include playing with imaginary friends
Inclusion of imaginary friends may indicate lack of parental attention
She needs to seek psychiatric help for her daughter
The Correct Answer is B
A. This is a form of regression is incorrect because regression involves reverting to behaviors from an earlier developmental stage (e.g., bedwetting or thumb-sucking) often triggered by stress or illness. Having an imaginary friend is a normal developmental behavior in preschoolers and is not considered regression.
B. Preschool-aged children (ages 3–6) are in Piaget’s preoperational stage and Erikson’s initiative vs. guilt stage, during which imaginative and symbolic play is typical. Imaginary friends are a common expression of magical thinking and creativity, allowing children to explore social roles, practice problem-solving, and express emotions in a safe, controlled way. This behavior is developmentally appropriate and usually does not indicate a psychological problem.
C. Inclusion of imaginary friends may indicate lack of parental attention is incorrect because the presence of imaginary friends is not a sign of neglect or lack of attention. It is a normal aspect of imaginative play, even in children who receive adequate parental interaction and support.
D. She needs to seek psychiatric help for her daughter is incorrect because the presence of an imaginary friend in a preschooler is not pathological. Unless accompanied by other concerning behaviors (e.g., social withdrawal, aggression, developmental regression), it is considered a normal developmental phenomenon.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Insulin is rarely given intravenously except in acute hospital settings (e.g., DKA management) under strict monitoring. IV administration by a child at home is unsafe and inappropriate due to the risk of hypoglycemia, infection, and vascular complications. The chest is also not a recommended site for injections.
B. Subcutaneous injections are the preferred route for regular insulin administration at home. Insulin is absorbed more slowly from subcutaneous tissue, providing a steady onset of action and reducing the risk of rapid hypoglycemia. The outer thigh, abdomen, upper arms, and buttocks are common subcutaneous injection sites, with the outer thigh often recommended for self-injection in children due to accessibility and ease of rotation to prevent lipodystrophy.
C. Intramuscular injections are not recommended for routine insulin administration because absorption is faster and less predictable, increasing the risk of hypoglycemia. The abdomen is not a typical intramuscular injection site; IM insulin injections are generally avoided except in specific clinical settings under supervision.
D. Intradermal injections deliver medication into the dermis, not subcutaneous tissue. This route is used for allergy testing or tuberculosis screening, not for insulin administration, as it does not allow for proper absorption and therapeutic effect.
Correct Answer is A
Explanation
A. Myelomeningocele is a type of spina bifida in which a portion of the spinal cord and meninges protrude through a defect in the vertebral column. The exposed sac is fragile and at high risk for infection and trauma. Covering it with a sterile, saline-moistened dressing maintains moisture, prevents desiccation, and reduces the risk of infection. This is the highest priority nursing intervention prior to surgical repair.
B. While thermoregulation is important in newborns, preventing cold stress is secondary to protecting the integrity of the myelomeningocele sac. The sac’s protection and prevention of infection take priority over temperature control.
C. Leaving the sac exposed and dry increases the risk of rupture and infection, which can lead to severe complications including meningitis or neurological damage. This approach is unsafe and contrary to standard preoperative care guidelines.
D. Positioning an infant with myelomeningocele requires caution to avoid pressure on the sac. Typically, the infant is placed prone or on the side with careful padding to prevent sac trauma. Frequent repositioning without proper support could injure the sac. Therefore, routine side-to-side turning is not recommended until after surgical repair and stabilization.
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