The nurse is conducting discharge teaching about signs and symptoms of heart failure to parents of an infant with a repaired tetralogy of Fallot. Which signs and symptoms should the nurse include? (Select all that apply.)

The correct answer is choice D. It is a belief common at this age.

Choice A rationale:

The statement does not suggest a failed attempt to develop a conscience. The scenario described is more related to the cognitive development of an 8-year-old child. Children at this age often have magical thinking and may interpret events, such as illness, as punishments for perceived wrongdoing. This is a normal aspect of their cognitive development rather than a reflection of a failed attempt to develop a conscience.

Choice B rationale:

While beliefs about punishment and consequences are present in many religions, the scenario is not about a general religious belief but rather a specific belief held by the individual child. This belief is reflective of the child's cognitive understanding and not necessarily a religious teaching common to most religions.

Choice C rationale:

The belief is not necessarily suggestive of excessive family pressure. While family dynamics can influence a child's beliefs and behaviors, the scenario describes a typical cognitive developmental stage where children are still learning to differentiate between reality and their own thoughts, leading to magical thinking and unique interpretations.

Choice D rationale:

The belief is indeed common at this age. During middle childhood, children often exhibit concrete operational thinking, which includes a tendency to interpret events in a self-centered and concrete manner. Beliefs like the one described in the scenario, where the child connects her illness to perceived bad behavior and potential consequences, are characteristic of this developmental stage.

The correct answer is choice A, E.

Choice A rationale:

Using an air conditioner is an effective way to reduce exposure to pollens and dust. Air conditioners filter the air and help prevent outdoor allergens from entering the indoor environment. This choice is correct because it addresses one of the primary sources of exposure to allergens.

Choice B rationale:

Keeping humidity in the house above 60% is not a recommended approach. High humidity can promote the growth of mold and dust mites, which can exacerbate allergies. Maintaining humidity levels between 30-50% is generally recommended for reducing allergen exposure.

Choice C rationale:

Keeping pets outside might seem like a logical option to reduce allergen exposure; however, pet allergens can still be carried indoors on clothing and shoes. Moreover, if individuals are not allergic to pet dander, keeping the pets inside may not pose an issue.

Choice D rationale:

Replacing wall-to-wall carpeting with wood and tile floors is a good strategy for reducing allergen exposure. Carpets can trap dust, pollen, and other allergens, while hard surfaces are easier to clean and do not accumulate allergens as readily. This choice is correct because it addresses a common source of indoor allergens.

Choice E rationale:

Putting dust-proof covers on pillows and mattresses is another effective strategy for reducing allergen exposure. These covers create a barrier that prevents dust mites and their allergens from permeating the sleeping environment. This choice is correct because it directly addresses the issue of dust mite allergens.