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 A
Explanation
A. A 4-year-old should typically speak in 4–5-word sentences, sing simple songs, tell imaginative stories, and identify basic colors. The behaviors described align well with normal developmental milestones for this age, indicating appropriate language, cognitive, and social development.
B. There is no indication of delay. In fact, the child is meeting expected developmental milestones. Recommending an evaluation is unnecessary and may cause unwarranted concern.
C. Imaginary friends and storytelling are common and healthy components of imaginative play at this age. They are not signs of a problem, nor are they typically linked to TV use.
D. While the child is developing well, the described skills fall within the normal range for a 4-year-old. Calling the child advanced would be inaccurate and could lead to unrealistic expectations.
Correct Answer is A
Explanation
A. This is the classic presentation of Hodgkin Lymphoma. The lymph nodes are usually firm, rubbery, non-tender, and painless, often in the cervical or supraclavicular region. Painless lymphadenopathy is a key distinguishing feature from infections, which usually cause tender and sometimes erythematous nodes.
B. Generalized soft tissue swelling is not specific to HL. HL typically presents with localized lymph node enlargement rather than diffuse soft tissue swelling. Swelling may occur later if there is organ involvement, but it is not an expected initial finding.
C. While abdominal lymphadenopathy can occur, a protuberant abdomen is not a common or early presentation of Hodgkin Lymphoma. Abdominal involvement is less common in adolescents compared with cervical lymph node involvement.
D. Pelvic masses are uncommon in HL. Nontender masses in the pelvis may suggest other pathologies, such as ovarian tumors, renal masses, or other malignancies, rather than typical HL presentation.
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