The nurse is obtaining a history of a 9-year-old boy who is brought to the clinic for a well-child visit. The parent begins to provide all the information when the child is interviewed. How should the nurse include the child in the conversation?
Respect the child's silence and privacy by speaking to the parents.
Instruct the parents to leave the room so the child can speak freely.
Ask the child if he would like to add anything to his parents' comments.
Encourage the child to answer asks by addressing him directly.
The Correct Answer is D
Choice A rationale
Respecting a child's silence and privacy by speaking only to the parents may be appropriate in some circumstances, but it can also exclude the child from their own healthcare. It is important for the nurse to encourage the child's participation to foster a sense of autonomy and engagement in their health, which is a crucial developmental task for this age group.
Choice B rationale
Instructing parents to leave the room can create a feeling of mistrust or anxiety for both the parent and the child. While private conversations with adolescents are important, a 9-year-old still needs their parents for support. The optimal approach is to include the child while respecting the parental role, building rapport with all parties involved.
Choice C rationale
Asking the child if they would like to add anything to their parents' comments is a passive approach that may not effectively encourage participation. Children may be too shy or intimidated to speak up. A more direct and engaging approach is needed to draw the child into the conversation and demonstrate that their input is valued and important.
Choice D rationale
Encouraging the child to answer questions by addressing them directly is the most effective way to include them in the conversation. This technique validates the child's presence and opinion, promotes their sense of autonomy and self-advocacy, and allows the nurse to gather firsthand information from the child's perspective, which may differ from the parent's account.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Four contractions in 10 minutes is within the normal range for labor augmentation with oxytocin. The goal is to achieve an adequate contraction pattern, which is typically considered to be 2 to 5 contractions in a 10-minute period. This finding indicates that the medication is having the desired effect without causing hyperstimulation of the uterus.
Choice B rationale
A soft uterus between contractions is a normal finding and indicates adequate uterine relaxation. This is a positive sign that the uterus is not experiencing hyperstimulation or tetanic contractions. Uterine hyperstimulation is a risk of oxytocin use and is characterized by a lack of resting tone and an inability of the uterus to relax.
Choice C rationale
Early decelerations are typically benign and are caused by fetal head compression during a contraction. They are characterized by a gradual decrease in fetal heart rate that mirrors the uterine contraction. These are not usually a sign of fetal distress and do not warrant the immediate discontinuation of oxytocin.
Choice D rationale
A contraction duration of 100 seconds is an abnormal finding and indicates uterine hyperstimulation. Normal contraction duration is 60 to 90 seconds. Prolonged contractions reduce placental blood flow and can lead to fetal hypoxia and distress. This finding necessitates the immediate discontinuation of oxytocin to prevent adverse fetal outcomes.
Correct Answer is C
Explanation
Choice A rationale
Zidovudine is a nucleoside reverse transcriptase inhibitor (NRTI). It works by inhibiting the enzyme reverse transcriptase, which is crucial for the replication of retroviruses like HIV. It does not possess any antifungal properties. Fungal infections, such as candidiasis, are often treated with antifungal agents like fluconazole, not antiretroviral drugs.
Choice B rationale
Chorioamnionitis is an intrauterine infection of the chorion and amnion, typically caused by ascending bacteria. It is treated with broad-spectrum antibiotics to address the bacterial etiology. Zidovudine is an antiviral medication specifically targeting the replication of HIV and is ineffective against bacterial infections.
Choice C rationale
Zidovudine works by inhibiting reverse transcriptase, thereby preventing the viral RNA of HIV from being converted into DNA. This mechanism significantly reduces the viral load in the mother and the risk of transplacental transmission to the fetus. This strategy is a cornerstone of preventing perinatal HIV transmission.
Choice D rationale
While zidovudine is a component of highly active antiretroviral therapy (HAART) for managing HIV infection in adults, its primary purpose in the context of labor and delivery is to prevent vertical transmission to the newborn. The treatment regimen for the mother's own HIV complications is a separate, long-term protocol.
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