The mother of a 7-year-old child is concerned that the child "touches and plays" with the genitals despite being punished for doing so. Which response should the nurse make to the mother? (SELECT ALL THAT APPLY)

"How often do you punish him by giving him a time-out or by using physical discipline?"

"Physical punishment is not the best way to modify a child's behavior."

"It isn't unusual for him to fondle his genitals, as this is part of his exploration of his body."

"Constantly touching the genitals indicates a urinary tract infection in a toddler."

"Give him a little time, and he'll grow out of it. He's just too young to understand right now."

Answer and Explanation

Correct Answer : B,C,E

A. "How often do you punish him by giving him a time-out or by using physical discipline?": This response focuses on the mother's disciplinary methods rather than addressing the child's behavior directly. It may come across as judgmental or critical of the mother's parenting approach and does not provide helpful guidance or support.

B. "Physical punishment is not the best way to modify a child's behavior.": This response is appropriate because it addresses the mother's concern about punishment for the child's behavior. It educates the mother about the ineffectiveness and potential harm of physical punishment in modifying behavior. Instead, positive reinforcement, redirection, and open communication are recommended strategies for guiding children's behavior.

C. "It isn't unusual for him to fondle his genitals, as this is part of his exploration of his body.": This response normalizes the child's behavior of touching and playing with his genitals as part of natural childhood development. It reassures the mother that such behavior is common and not necessarily indicative of abnormality or misconduct. Education about normal childhood sexual development can alleviate parental concerns and promote understanding and acceptance.

D. "Constantly touching the genitals indicates a urinary tract infection in a toddler.": This response is incorrect and may unnecessarily alarm the mother. While frequent touching of the genitals could indicate discomfort or irritation associated with a urinary tract infection in a toddler, it is not the case for a 7-year-old child. Additionally, it is essential to avoid making medical diagnoses without proper assessment by a healthcare professional.

E. "Give him a little time, and he'll grow out of it. He's just too young to understand right now." This response acknowledges the child's developmental stage and suggests that the behavior is likely temporary and will naturally resolve as the child matures. It reassures the mother that the behavior is typical for a child of this age and may not require immediate intervention.

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Correct Answer is B

Explanation

A. Functional incontinence: Functional incontinence occurs when a person has difficulty reaching the toilet due to physical or cognitive impairments. Cloudy, amber urine with an unpleasant odor is not indicative of functional incontinence.

B. Urinary tract infection (UTI): Cloudy, amber urine with an unpleasant odor is a common symptom of a UTI. UTIs often cause changes in urine color, odor, and clarity due to the presence of bacteria and inflammatory cells in the urine.

C. Ketone bodies in the urine: Ketones in the urine can occur in conditions such as uncontrolled diabetes or during periods of fasting. However, cloudy, amber urine with an unpleasant odor is more indicative of a UTI rather than the presence of ketones.

D. Nocturia: Nocturia refers to waking up during the night to urinate. While it may be associated with certain urinary conditions, it does not directly correlate with the appearance and odor of the urine.

A. 17-year-old who has just had an ankle cast applied. B. 60-year-old recovering from a heart attack. C. 80-year-old admitted for an infected tooth. D. 28-year-old new mother of twins.

Correct Answer is B

Explanation

A. 17-year-old who has just had an ankle cast applied: While constipation may occur due to reduced mobility after having an ankle cast applied, teaching about the hazards of straining during bowel movements is not the priority for this client. The immediate concern may be related to cast care and mobility.

B. 60-year-old recovering from a heart attack: This client is recovering from a heart attack, and straining during bowel movements can increase intra-abdominal pressure and potentially lead to complications such as vagal stimulation, which may trigger arrhythmias or further stress the heart. Therefore, teaching about the hazards of straining during bowel movements is essential for this client to prevent complications and promote cardiac safety.

C. 80-year-old admitted for an infected tooth: While constipation may occur as a side effect of certain medications or due to decreased oral intake, teaching about straining during bowel movements is not the immediate priority for this client, given the primary reason for admission is an infected tooth. However, if constipation becomes a concern during the admission, it can be addressed accordingly.

D. 28-year-old new mother of twins: While postpartum mothers may experience constipation due to various factors such as changes in hormone levels, reduced mobility after delivery, and opioid use for pain management, teaching about the hazards of straining during bowel movements may not be the priority compared to other immediate postpartum care needs, such as breastfeeding support, perineal care, and newborn care.

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The mother of a 7-year-old child is concerned that the child "touches and plays" with the genitals despite being punished for doing so. Which response should the nurse make to the mother? (SELECT ALL THAT APPLY)

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