Which stressors are commonly observed in hospitalized toddlers? Select all that apply.
Social isolation.
Interrupted routines.
Fear of being hurt.
Sleep disturbances.
Self-concept disturbances.
Correct Answer : A,B,C,D
Choice A rationale
Social isolation is a significant stressor for toddlers, whose developing sense of security is highly dependent on familiar caregivers. Separation from parents and limited interaction with other children can disrupt this attachment, leading to anxiety and a sense of abandonment. This emotional distress is a direct result of their cognitive stage, where they lack the capacity for abstract thought to understand temporary separation. This can cause significant emotional and developmental regression, including withdrawal and behavioral changes.
Choice B rationale
Toddlers thrive on predictable routines for their sense of safety and control. Hospitalization disrupts these established patterns, including meal times, sleep schedules, and play activities. The unpredictable nature of hospital care, such as frequent assessments and procedures, creates a feeling of chaos and loss of control. This interruption can lead to increased stress, anxiety, and behavioral issues as the child struggles to adapt to the new, unstructured environment.
Choice C rationale
Toddlers have a limited understanding of bodily integrity and medical procedures. They may perceive painful or invasive procedures as a threat or punishment. The fear of being hurt is a primary stressor, as they lack the cognitive ability to rationalize the necessity of medical interventions. This fear is exacerbated by the presence of unfamiliar people in scrubs and the use of medical equipment, which can seem frightening and overwhelming.
Choice D rationale
Sleep is critical for a toddler’s growth and development. Hospitalization often leads to significant sleep disturbances due to the noisy and brightly lit environment, frequent interruptions for assessments, and the underlying stress and anxiety of being in an unfamiliar place. This disruption to their normal sleep-wake cycle can result in irritability, fatigue, and difficulty coping with other stressors, hindering their physical and psychological recovery.
Choice E rationale
Self-concept disturbances are not typically a primary stressor for toddlers. Self-concept, which involves an individual's perception of their own identity and worth, is a more abstract concept that develops later in childhood. Toddlers are in a stage of developing autonomy and a sense of self separate from their parents, but their stressors are more immediate and concrete, such as separation anxiety, fear, and disruption of routines, rather than complex self-perceptions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Racemic epinephrine nebulizer therapy is a highly effective measure for bronchodilation in a child with croup. This alpha-adrenergic agonist works by stimulating receptors in the smooth muscle of the airway. This stimulation leads to vasoconstriction, reducing the mucosal edema and swelling of the vocal cords and trachea that are characteristic of croup. The rapid reduction in upper airway inflammation and swelling directly alleviates stridor and respiratory distress, improving airflow and oxygenation.
Choice B rationale
Teaching a child to take long, slow breaths is generally a technique used for anxiety or to prevent hyperventilation. However, in a child with croup, the upper airway obstruction makes deep breathing difficult and may increase their distress. The effort to take long, slow breaths against a narrowed airway can further exacerbate the child's respiratory effort and may not provide any significant relief from the underlying swelling.
Choice C rationale
Administering an oral analgesic would be ineffective for aiding bronchodilation in a child with croup. The primary issue in croup is upper airway inflammation and edema, not pain. Analgesics, such as acetaminophen or ibuprofen, primarily work to reduce fever and discomfort. They have no direct pharmacological effect on the smooth muscles of the bronchi or on the mucosal swelling that is causing the respiratory distress.
Choice D rationale
Urging a child to continue to take oral fluids is important for hydration, but it does not directly aid in bronchodilation. In a child with significant respiratory distress from croup, encouraging oral fluids may actually pose a risk for aspiration due to their difficulty breathing and potential fatigue. While hydration is a supportive measure, it does not address the underlying pathology of airway swelling and is not a primary intervention for bronchodilation.
Correct Answer is D
Explanation
Choice A rationale
Insomnia is a common symptom of postpartum depression, often characterized by difficulty falling or staying asleep, or waking up early. This sleep disturbance, when coupled with other symptoms such as persistent sadness, loss of interest in activities, and fatigue, is a key diagnostic criterion for the condition.
Choice B rationale
Intermittent crying in the first week postpartum, now resolved, is a common symptom of the "baby blues.”. The baby blues are a transient condition, typically resolving within the first two weeks. Postpartum depression, in contrast, involves more severe and persistent symptoms lasting longer than two weeks.
Choice C rationale
Delusions are a symptom of postpartum psychosis, a rare and severe mental health condition that is distinct from postpartum depression. Postpartum psychosis involves a break from reality and is a psychiatric emergency. Delusions are not characteristic of postpartum depression.
Choice D rationale
Induced vomiting is a symptom associated with eating disorders, such as bulimia nervosa. While eating disorders can coexist with postpartum depression, induced vomiting is not a defining symptom of postpartum depression itself. It is a separate clinical finding.
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