Health and Wellness and Health Promotion EAQ
A parent tells the nurse, "My 9-month-old doesn't have the same strong grasp that she had when she was born, and she's not startled by loud noises anymore." How should the nurse explain these changes in behavior? "Let me check these responses before deciding how to proceed." "When these responses fail, it may indicate a developmental delay." "The baby needs more sensory stimulation to get these responses back." "Those responses are replaced by voluntary activity around 5 months of age."
"Those responses are replaced by voluntary activity around 5 months of age." Touching the palm of a newborn causes flexion of the fingers (grasp reflex ); this response usually diminishes after 3 months of age. An unexpected loud noise causes the newborn to abduct the extremities and then flex the elbows (startle reflex); this response usually disappears by 4 months of age. Persistence of primitive reflexes is usually indicative of a developmental delay. It is not necessary to gather more data, because these changes are consistent with expected growth and development. The data do not support the conclusion that the child is developmentally delayed, and saying so may cause needless concern. Sensory stimulation at this age is directed toward experiences to add new motor, language, and social skills.
The parent of a 3-month-old infant asks the nurse about selecting toys for the infant. Which toy should the nurse tell the parent is most appropriate at this age? Stuffed animal Metallic mirror Push-pull wagon Large plastic ball
Metallic mirror A 3-month-old infant is interested in self-recognition and playing with the baby in the mirror. The stuffed animal, push-pull wagon, and large plastic ball are all appropriate for a toddler.
What is the basic therapeutic tool used by the nurse to foster a client's psychologic coping? Self Milieu Helping process Client's intellect
Self The self is often the most important tool available to the nurse to help a client cope; to be therapeutic, the nurse must be present, actively listening, and attentive. The environment is important, but it is not the most basic tool. The nurse first must use the self before the helping process can begin. The client's intellect is not generally a therapeutic tool used by the nurse.
A nurse is caring for a preschooler who is being prepared for surgery. What does the nurse expect to have the most influence on the child's response to hospitalization? Fear of separation Fear of bodily harm Belief in death's finality Belief in the supernatural
Fear of bodily harm Fear of mutilation is typical of the preschooler because they have vague views of body boundaries. Toddlers are more likely to fear separation from parents. Preschoolers do not view death as final. Although preschoolers do indulge in magical thinking, they have not yet developed the concept of supernatural beliefs.
What is the process of enabling people to increase control over and improve their health? Community care Health promotion High-level wellness Primary prevention
Health promotion
What is the best way for the nurse to promote the social development of a 9-month-old infant? Engaging in peek-a-boo Offering soft clay to manipulate Providing a pegboard for pounding Demonstrating how to speak words
Playing peek-a-boo is age appropriate because it aids the infant's social development by fostering a sense of object constancy and object permanence. Playing with soft clay is age appropriate for the toddler; it promotes gross and fine motor development. Pounding on a pegboard is age appropriate play for toddlers and preschoolers; it helps release tension and develops motor skills. Repeating words is age appropriate for the 1-year-old child.
Developmental Screening Test to their child. They ask, "Why did you make our child draw on paper? We don't let our child draw at home." What is the best response by the nurse? "I should have asked you about drawing first." "These drawings help us determine your child's intelligence." "It lets us test the child's ability to perform tasks requiring the hands." "I don't understand why drawing is forbidden in your home."
"It lets us test the child's ability to perform tasks requiring the hands." The Denver II Developmental Screening Test is one of the tests used to evaluate young children whose development appears to be behind the norm. It involves the use of a variety of methods to determine the level of development. The parents gave their consent to have the test done and were told that a variety of skills would be tested. A developmental screening test is designed not to test intelligence, but rather to test the child's ability to perform specific age-appropriate developmental tasks. It is inappropriate to question the parents' childrearing ability.
A nurse is observing hospitalized toddlers in the playroom. What does the nurse identify as their most important need? Stimulating play Therapeutic play Contact with their parents Gentle discipline from the nurse
Contact with their parents Separation anxiety becomes an issue at this age; toddlers need contact with parents, who provide a sense of security. Stimulating play may offer a distraction, but the greater need is for parental contact. Toddlers are too young for therapeutic play, which is more successful with preschoolers and young school-age children. Gentle discipline from the nurse may be necessary at times, but the greatest need of hospitalized toddlers is to have parental contact.
Which tertiary prevention measure is included in the plan of care for a patient newly diagnosed with asthma? Cholesterol screening Eliminating allergens Glaucoma screening Safe sex practices
Eliminating allergens Eliminating allergens is considered a tertiary prevention measure, or one that minimizes the problems with asthma and potential responses to environmental triggers, effects of asthma disease and disability. Cholesterol screening is considered a form of secondary screening, which involves measures designed to identify individuals in an early stage of a disease process so that prompt treatment can be started. Glaucoma screening is also considered a form of secondary screening. Safe sex practices are considered a form of primary prevention, or strategies aimed at optimizing health and disease prevention in general and not linked to a single disease entity.
An infant with bronchiolitis caused by respiratory syncytial virus (RSV) is admitted to the pediatric unit. What does the nurse expect the prescribed treatment to include? Humidified cool air and adequate hydration Postural drainage and oxygen by hood Bronchodilators and cough suppressants Corticosteroids and broad-spectrum antibiotics
Humidified cool air and adequate hydration Humidified cool air and hydration are essential to facilitating improvement in the child's physical status. Postural drainage is not effective with this disorder; oxygen is used only if the infant has severe dyspnea and hypoxia. Bronchodilators are not used, because the bronchial tree is not in spasm; cough suppressants are ineffective. Corticosteroids are ineffective; antibiotics are also ineffective, because the causative agent is viral.
The nurse understands that which of the following health promotion activities are associated with increased adherence? Increasing physiological well-being. increasing security, by providing psychological comfort Increasing self-esteem, by promoting independence and learning Providing comfort and support
Increasing self-esteem, by promoting independence and learning Empowering the patient through education promotes self-esteem and increasing adherence. Teaching patient activities that are to be used after discharge enhances independence and promotes self-esteem. Physiological well-being is important for healing. Psychological comfort is important for healing as well; however, this is not the best option. Providing comfort and support are important for good nursing care; however, this is not the best option for promoting adherence.
The parents of an infant ask a nurse why their baby is not receiving the measles, mumps, and rubella (MMR) vaccine at the same time that other immunizations are being given. What explanation should the nurse give about why the MMR vaccine is administered at 12 to 15 months of age? There is an increased risk of side effects in infants. Maternal antibodies provide immunity for about 1 year. It interferes with the effectiveness of vaccines given during infancy. There are rare instances of these infections occurring during the first year of life.
Maternal antibodies provide immunity for about 1 year. Maternal antibodies to measles, mumps, and rubella infection persist in the infant until approximately 15 months of age. Side effects are no more common among infants than in toddlers. The measles vaccination does not interfere with the effectiveness of other vaccines. Although the measles, mumps, and rubella do occasionally occur after the administration of the MMR vaccine during the first year of life, the vaccine is not given during this time because of the presence of maternal antibodies.
A child returns to his room after left-side cardiac catheterization. What is involved in the postprocedure nursing care? Encouraging early ambulation Monitoring the insertion site for bleeding Comparing blood pressures in the two extremities Restricting fluids until the blood pressure has stabilized
Monitoring the insertion site for bleeding Postprocedure hemorrhage, a life-threatening complication after cardiac catheterization, is possible because arterial blood is under pressure and the catheter has entered an artery. Rest will be encouraged; flexion of the insertion site should be avoided to prevent disturbance of the clot. Comparing blood pressures in the two extremities is unnecessary; the pulse distal to the catheterization insertion site is monitored. The blood pressure will not be unstable unless a problem develops; fluid intake should be encouraged.
A nurse in the daycare center is teaching several aides about the play behavior of 2-year-old toddlers. What is this type of play called? Group Parallel Dramatic Cooperative
Parallel Toddlers play independently but beside other children; they are aware of the other children, often grabbing toys from them, but do not socially interact with them. Group play is characteristic of older children. Dramatic play or acting is characteristic of older children; starting at the preschool age, they assume and act out roles. Cooperative play is also characteristic of older children; starting at the preschool age; they learn to share, wait their turn, and become sensitive to their peers' needs.
A nurse is counseling the family of a child with AIDS. What is the most important concern that the nurse should discuss with the parents? Risk for injury Susceptibility to infection Inadequate nutritional intake Altered growth and development
Susceptibility to infection Children with AIDS have a dysfunction of the immune system (depressed or ineffective T lymphocytes, B lymphocytes, and immunoglobulins) and are susceptible to opportunistic infections. All children are subject to injury because of their curiosity, inexperience, and lack of judgment. Although inadequate nutrition can be a problem for children with AIDS, the prevention of infection is the priority. Although children with AIDS are usually small for age, altered growth and development is not as life threatening as an infection.
