The nurse is assessing the vital signs of a 3-week-old infant with a respiratory infection and notes that the respiratory rate is 35 breaths/minute. On the basis of this finding, what is the most appropriate action?

Administer Oxygen

Document the findings

Reassess the respiratory rate in 15 minutes

Notify the health care provider

Answer and Explanation

The Correct Answer is B

A. Administering oxygen is unnecessary, as the respiratory rate is within the normal range for a 3-week-old (30-60 breaths/min).

B. A respiratory rate of 35 breaths/minute is normal for an infant, so the nurse should document this finding.

C. Reassessing the respiratory rate is unnecessary unless other symptoms are present.

D. There is no need to notify the healthcare provider, as the respiratory rate is within normal limits.

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Correct Answer is C

Explanation

A. While toddlers may show curiosity about bodies, this is not a defining characteristic of this developmental stage.

B. Imaginary playmates are more typical of preschoolers rather than toddlers, who engage more in parallel play.

C. The toddler stage is characterized by negative behaviors as children assert their autonomy, often expressing frustration through tantrums or defiance.

D. Erikson's stage of initiative versus guilt occurs during the preschool years, not in toddlers, who are in the stage of autonomy versus shame and doubt.

A. Dental care B. How to establish trust C. Need for increased caloric intake D. How to encourage cooperative play E. Management of tantrums

Correct Answer is ["A","C","E"]

Explanation

A. Dental care is important at this stage as toddlers begin to have more teeth and can develop cavities.

B. Establishing trust is a developmental task more relevant in infancy rather than toddlerhood.

C. Toddlers need adequate nutrition, but their caloric intake does not need to be significantly increased compared to infants.

D. Cooperative play is more common in preschoolers, as toddlers typically engage in parallel play.

E. Tantrums are common in toddlers as they develop independence and may struggle with emotional regulation, so teaching management strategies is key.

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The nurse is assessing the vital signs of a 3-week-old infant with a respiratory infection and notes that the respiratory rate is 35 breaths/minute. On the basis of this finding, what is the most appropriate action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing the psychosocial development of a toddler, The nurse should recognize that this stage is characterized by which of the following?

Correct Answer is C

Explanation

A nurse is providing health promotion teaching to the parents of a toddler. Which of the following information should the nurse include in the teaching? (Select all that apply.)

Correct Answer is ["A","C","E"]

Explanation

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