The practical nurse (PN) is caring for a toddler who is hospitalized for pneumonia.
Which stressor is most significant during hospitalization for this age group?
Change in food selections and preparation.
Fear of the unknown and painful procedures.
Unfamiliar people and strange equipment.
Separation from parents and home.
The Correct Answer is D
Choice A rationale
Changes in food selections and preparation can be a minor stressor for hospitalized toddlers, as familiar routines are disrupted. However, while dietary changes might cause some fussiness, they typically do not elicit the profound emotional distress and regression seen with more significant stressors like separation from primary caregivers.
Choice B rationale
Fear of the unknown and painful procedures is certainly a stressor for toddlers. The lack of understanding about medical interventions and the potential for discomfort can cause anxiety. However, for a toddler, the underlying fear of being abandoned by their primary attachment figures often outweighs the fear of the procedures themselves.
Choice C rationale
Unfamiliar people and strange equipment can contribute to a toddler's stress during hospitalization, as they are outside of their usual environment and routine. This can lead to feelings of insecurity and apprehension. However, the emotional impact of these elements is generally less profound than the distress caused by the absence of parents.
Choice D rationale
Separation from parents and home is the most significant stressor for hospitalized toddlers. At this developmental stage, toddlers are deeply reliant on their primary caregivers for security and comfort. Separation can trigger profound feelings of abandonment, anxiety, and lead to regression in developmental milestones.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Washing frequently with mild soap and water is not recommended for umbilical cord care because soap can irritate the delicate skin around the cord stump and potentially delay the natural drying and separation process. Excessive moisture also increases the risk of bacterial colonization and infection, counteracting the goal of keeping the area clean and dry to promote healing and reduce infection risk.
Choice B rationale
Applying baby lotion to the umbilical cord stump is contraindicated. Lotions introduce moisture, which can impede the natural drying and mummification of the cord, prolonging the time until it falls off. Furthermore, lotions contain chemicals that may irritate the sensitive skin or harbor bacteria, increasing the risk of infection and delaying proper healing of the umbilical area.
Choice C rationale
Covering the umbilical cord with a sterile dressing is generally not advised unless specifically indicated by a healthcare provider for a particular condition. A dressing can trap moisture, preventing adequate air circulation needed for drying, and potentially create a warm, moist environment conducive to bacterial growth. This increases the risk of infection and delays natural cord separation.
Choice D rationale
Cleaning the umbilical cord with water and allowing it to air dry is the most evidence-based practice for routine cord care. Water gently removes any discharge without irritating the skin, and air exposure facilitates the drying process, which is crucial for mummification and eventual detachment. This minimizes the risk of infection and promotes natural healing.
Correct Answer is D
Explanation
Choice A rationale
This schedule is incorrect for pertussis (whooping cough) immunization. Pertussis vaccination, usually as part of the DTaP vaccine, is initiated in infancy and requires multiple doses to build adequate immunity, not just a single dose at 1 year or 6 years of age.
Choice B rationale
This schedule is incorrect and deviates from the standard recommendations for pertussis vaccination. The typical primary series of DTaP vaccination begins earlier in infancy and includes specific booster doses at later ages to maintain protection against the disease.
Choice C rationale
This schedule is incorrect for pertussis immunization. While some vaccinations begin at birth, and boosters are given periodically, the specific timing and frequency for pertussis in this option do not align with the established guidelines for the DTaP or Tdap vaccines.
Choice D rationale
This is the recommended immunization schedule for pertussis, typically administered as part of the DTaP vaccine. The primary series at 2, 4, and 6 months establishes foundational immunity, and boosters at 15-18 months and 4-6 years of age are crucial for maintaining long-term protection against the disease.
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