The nurse is developing a care plan for several clients who were seen in the clinic that day. Which situation will the nurse conclude is most likely to experience challenges in the growth and development of the children?
A family lives with the parents of the mother who is working two jobs.
Both parents work during the day and the child comes home after school to an empty house.
Children attend school while the father works and then sleep in their car at night.
A divorced mother shares an apartment with her best friend and her children.
The Correct Answer is C
Choice A reason: Living with grandparents while the mother works two jobs provides potential supervision, reducing developmental risks compared to homelessness. Sleeping in a car disrupts stability and safety, making this less challenging and incorrect for the situation most likely to impact children’s growth and development.
Choice B reason: An empty house after school poses risks but offers a stable home environment, unlike sleeping in a car, which lacks safety and consistency. Latchkey situations are less severe, making this incorrect compared to the extreme instability of homelessness affecting children’s developmental outcomes.
Choice C reason: Sleeping in a car at night indicates homelessness, severely disrupting children’s physical, emotional, and cognitive development due to lack of stable housing, nutrition, and safety. This situation poses the greatest challenge, aligning with pediatric social determinants of health, making it the correct choice.
Choice D reason: Sharing an apartment with another family provides housing stability, unlike sleeping in a car, which severely impacts development. Crowded living is less detrimental than homelessness, making this incorrect for the situation most likely to challenge children’s growth and development in the care plan.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Holding the buttocks together for 1-2 minutes after suppository insertion prevents expulsion, ensuring the medication is absorbed in a 3-month-old. This aligns with pediatric medication administration protocols, making it the correct intervention to assure effective delivery of the rectal suppository in this infant.
Choice B reason: Pre-warming the suppository is not standard, as it may soften excessively, complicating insertion. Holding the buttocks ensures retention, directly impacting absorption, making this less effective and incorrect compared to the critical step of preventing expulsion in a 3-month-old during suppository administration.
Choice C reason: Using the index finger is inappropriate for an infant, as the pinky finger is safer for their small rectum. Holding the buttocks ensures medication retention, making this unsafe and incorrect compared to the prioritized intervention for effective suppository administration in a 3-month-old child.
Choice D reason: Placing the child on the abdomen may aid positioning but does not ensure suppository retention like holding the buttocks. Retention is critical for absorption, making this less essential and incorrect compared to the direct intervention of securing the suppository in place post-insertion for the infant.
Correct Answer is D
Explanation
Choice A reason: Rheumatic fever follows streptococcal infections but typically presents with joint pain or carditis, not puffy eyes or abnormal urine. Glomerulonephritis matches the post-infectious symptoms, making this incorrect, as it does not align with the child’s clinical presentation after ear infections.
Choice B reason: Lipoid nephrosis causes edema but lacks a clear link to recent infections or hematuria. Acute glomerulonephritis better explains the symptoms post-ear infection, making this less fitting and incorrect for the suspected condition based on the child’s reported signs and history.
Choice C reason: Urinary tract infections cause dysuria or frequency, not typically puffy eyes or hematuria post-infection. Glomerulonephritis aligns with the streptococcal history and symptoms, making this incorrect compared to the condition suspected based on the child’s clinical presentation to the nurse.
Choice D reason: Acute glomerulonephritis, often post-streptococcal from ear infections, causes hematuria (“funny” urine), periorbital edema (puffy eyes), and headache. This aligns with pediatric nephrology evidence, making it the correct condition the nurse suspects, prompting immediate evaluation by a care provider for the child.
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