The nurse is teaching a group of parents about promoting healthy emotional development in school-age children.
Which instructions should the nurse include to help encourage the child's self-esteem? Select all that apply.
Tell her "I love you" and give her a hug before leaving.
Encourage her to do better by pointing out all mistakes.
Complete her homework so she can get good grades.
Give her a chore chart with things she can do each day.
Correct Answer : A,D,E
Choice A rationale
Expressing affection through verbal reassurance and physical touch like hugging provides a secure emotional base for the child. This consistent positive regard from caregivers reinforces the child's intrinsic value and self-worth, which is the foundation of high self-esteem. When children feel loved unconditionally, they are more likely to approach new challenges with confidence, knowing that their value as a person is not solely dependent on their external achievements or their performance in school.
Choice B rationale
Pointing out all mistakes to encourage improvement is a negative reinforcement strategy that can significantly damage a child's self-esteem. Constant criticism leads to a sense of inferiority and a fear of failure, causing the child to become hesitant or anxious when attempting new tasks. To foster self-esteem, caregivers should focus on constructive feedback and highlight the child's strengths and efforts, rather than focusing exclusively on errors or shortcomings during the learning process.
Choice C rationale
Completing a child's homework for them prevents the child from experiencing the satisfaction of overcoming challenges and developing mastery. This intervention sends a subtle message that the child is not capable of succeeding on their own, which undermines self-confidence. The development of self-esteem in the school-age child requires that they perform the work themselves to earn a sense of competence, even if the final result is not perfect or requires multiple attempts.
Choice D rationale
Implementing a chore chart with attainable daily tasks allows the child to contribute to the household and see visible evidence of their productivity. Successfully completing these responsibilities builds a sense of competence and industry. As the child checks off completed tasks, they receive positive reinforcement for their contributions, which directly bolsters their self-image as a capable and helpful family member. This structured approach to responsibility is a key component of healthy emotional development.
Choice E rationale
Allowing a child to solve problems and make responsible choices promotes autonomy and self-efficacy. When children are given the opportunity to navigate age-appropriate dilemmas, they learn to trust their own judgment and develop critical thinking skills. This empowerment is vital for self-esteem, as it demonstrates that the parents have confidence in the child's abilities. Making successful choices reinforces the child's belief in their own agency and their capacity to influence their environment effectively.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Inspection of the placenta is the priority action because retained placental fragments are a primary cause of secondary postpartum hemorrhage. If the placenta is not intact, the remaining tissue prevents the uterus from contracting effectively, leading to uterine atony. By ensuring the placenta and membranes are complete, the nurse can identify the need for immediate manual exploration or surgical intervention to clear the uterus, thereby allowing the myometrium to constrict the bleeding vessels.
Choice B rationale
Manual removal of the placenta is not a routine priority action and is only performed if the placenta fails to separate spontaneously within 30 minutes. This procedure carries risks such as infection and trauma to the uterine lining. It is an intervention for a retained placenta rather than a preventative measure for every birth. Priority is given to non-invasive assessment first, such as inspecting the delivered placenta for missing cotyledons or disrupted vascular structures.
Choice C rationale
The administration of broad-spectrum antibiotics is primarily intended to prevent or treat postpartum infections, such as endometritis. While infection is a serious postpartum complication, it is not the most immediate priority for preventing acute postpartum hemorrhage in the minutes following birth. Hemorrhage prevention focuses on uterine contractility and the removal of products of conception. Antibiotics do not assist in the mechanical process of uterine involution or the constriction of spiral arteries.
Choice D rationale
Pulling on the umbilical cord, or excessive cord traction, is contraindicated and dangerous. This action can lead to uterine inversion, where the uterus turns inside out and protrudes through the cervix, or it can cause the cord to avulse. Uterine inversion is a life-threatening emergency that causes profound shock and massive hemorrhage. Gentle, controlled cord traction should only be applied when there are clear signs of placental separation to avoid these severe complications.
Correct Answer is B
Explanation
Choice A rationale
Contractions that diminish or disappear with ambulation or a change in position are a hallmark of Braxton Hicks contractions, which are false labor. True preterm labor contractions continue and typically intensify regardless of the client's activity level. If walking causes the sensations to stop, it indicates that the uterus is simply irritable rather than undergoing the coordinated, rhythmic contractions required to cause cervical effacement and dilation, which defines the start of actual physiological labor.
Choice B rationale
True labor contractions, including those in preterm labor, often begin in the lower back and radiate toward the front of the abdomen. This pattern reflects the neurological pathways involved in uterine contractions and the engagement of the fetus in the pelvis. Intermittent contractions that follow this specific radiation pattern and increase in frequency are highly suspicious for preterm labor. Braxton Hicks are generally felt only in the front of the abdomen or the groin area.
Choice C rationale
Irregular contractions that vary in intensity and lack a predictable rhythm are characteristic of Braxton Hicks. These are often described as a tightening or squeezing sensation that does not become stronger or closer together over time. True labor involves a progressive increase in the strength, duration, and frequency of the contractions. When the intensity remains variable and does not follow a crescendo pattern, it is less likely to be causing the cervical changes of labor.
Choice D rationale
The timing of contractions in the evening is not a definitive diagnostic feature of preterm labor. Braxton Hicks contractions often occur more frequently at the end of a long day when the client is tired or dehydrated. While preterm labor can occur at any time, the mere presence of evening contractions without other signs like back pain or cervical change is common in late pregnancy. The diagnostic focus is on the quality and regularity rather than the clock. .
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