The parents of a 5-year-old boy are concerned about how a recent motorcycle accident to his father will affect the child. Although the father has fully recovered, the child is very concerned if the father is away longer than expected; the child is not as talkative but appears withdrawn and quiet. The nurse should point out the child’s behavior is likely related to which factor?

The child is imitating the adults’ behavior and just trying to be nice to everyone.

The child is afraid of losing his father and trying to show how much he loves him.

The boy is afraid of being hurt himself and thinks being especially good will protect him from accidents.

The boy believes he caused the accident by telling his father he “hoped he crashed” when the boy couldn’t go along.

Answer and Explanation

The Correct Answer is B

Choice A reason: Imitating adult behavior to be nice does not explain the child’s withdrawal and concern when the father is away. Fear of loss better accounts for these anxiety-driven behaviors post-accident, making this less fitting and incorrect for the child’s emotional response to the traumatic event.

Choice B reason: The child’s withdrawal and concern when the father is away suggest fear of losing him after the accident, a common reaction in young children. This aligns with pediatric psychology evidence on trauma response, making it the correct factor explaining the child’s behavior in this context.

Choice C reason: Fear of personal injury is less likely than fear of losing the father, given the child’s focus on the father’s absence. Withdrawal reflects attachment anxiety, not self-protection, making this less accurate and incorrect compared to the loss-related emotional response observed in the child.

Choice D reason: Believing he caused the accident is possible but less supported without evidence of guilt statements. Fear of loss better explains the child’s withdrawal and concern for the father’s absence, making this speculative and incorrect for the primary behavioral factor affecting the 5-year-old.

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Correct Answer is D

Explanation

Choice A reason: Asking about family size is irrelevant, as growth norms are based on population standards, not family stature. The toddler’s 6-pound gain and 2.5-inch growth are normal for a 2-year-old, making this unhelpful and incorrect compared to reassuring based on standard growth parameters for toddlers.

Choice B reason: The child’s growth (6 pounds, 2.5 inches) is within normal limits for a 2-year-old, so stating it is less than expected is inaccurate. Gathering nutritional history is unnecessary without growth concerns, making this incorrect compared to reassuring the mother about normal development in her child.

Choice C reason: Requiring a follow-up in 3 months is unnecessary, as the toddler’s growth is normal (6 pounds, 2.5 inches in a year). Reassuring the mother addresses her concerns directly, avoiding unwarranted visits, making this incorrect for responding to a toddler with standard growth patterns.

Choice D reason: A 6-pound (2.7 kg) weight gain and 2.5-inch (6.4 cm) height increase are within normal limits for a 2-year-old, per pediatric growth charts. Reassuring the mother alleviates anxiety and aligns with evidence-based growth standards, making this the correct response to her concerns about growth.

A. Have the caregiver sign a permission form acknowledging that the girl has been given the drug without pregnancy testing. B. Speak with the teen alone to ask her if she is sexually active. If she says she is not sexually active, let the provider know that it is okay to write the prescription. C. Acknowledge the caregiver’s discomfort about the pregnancy testing but encourage her to allow the daughter to have the testing so that she can use the medication. D. Arrange for the daughter to have the pregnancy testing without the caregiver’s knowledge.

Correct Answer is C

Explanation

Choice A reason: Signing a form to bypass pregnancy testing violates isotretinoin safety protocols, risking fetal harm due to teratogenicity. Encouraging testing ensures compliance, making this unsafe and incorrect compared to addressing the caregiver’s concerns while prioritizing the teen’s safety for acne treatment.

Choice B reason: Speaking to the teen alone respects privacy but doesn’t address the caregiver’s refusal or ensure testing compliance, required for isotretinoin. Encouraging testing with the caregiver’s consent is safer, making this inadequate and incorrect compared to securing agreement for mandatory pregnancy testing.

Choice C reason: Acknowledging the caregiver’s discomfort builds trust while emphasizing the necessity of pregnancy testing for isotretinoin’s safe use, preventing fetal harm. This aligns with pediatric medication safety protocols, making it the best action to ensure the 16-year-old can safely receive acne treatment.

Choice D reason: Testing without caregiver knowledge violates consent and trust, risking legal and ethical issues. Encouraging open discussion ensures compliance, making this unethical and incorrect compared to the nurse’s role in facilitating agreement for required pregnancy testing for the teen’s isotretinoin therapy.

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Naxlex Comprehensive Predictor Exams

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Explanation

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Explanation

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