N360 - Theory - Evolve questions

The nurse is asked how essential oils may be used as part of aromatherapy. The nurse responds: A) "They may be mixed with carrier oils and used during massage." B) "They may be swallowed in small amounts for stomach distress." C) "They may be applied during pregnancy to prevent stretch marks." D) "They may be placed on herpes lesions on the eye."

A) "They may be mixed with carrier oils and used during massage." Essential oils may be used in the following ways: • They may be added to the bath or used in a douche. • They may be mixed with carrier oils and used during massage. • They may be applied directly to minor injuries to speed healing. • They may be placed on cloth and applied as a compress. • They may be inhaled after vaporization. Precautions should be considered when using essential oils, including: • They are for external use only. • The oils should be diluted in carrier oil before direct application to the skin. • Avoid application to the eyes and mucous membranes. • Many of the oils are contraindicated for use during pregnancy. • Essential oils should be used with caution in epilepsy, hypertension, and estrogen-dependent tumors.

During the 1-month well-baby visit, a pediatric nurse explains to the mother that she should expect to hear babbling in her infant by: A) 2 months. B) 4 months. C) 6 months. D) 9 months.

A) 6 months. During the first 2 months, most of the infant's sounds are vowels and are made primarily in the front part of the mouth. Cooing sounds are heard at approximately 2 to 3 months, usually in response to an adult's voice. By 6 months, babbling sounds are heard, and by 9 to 10 months, the infant forms two-syllable sounds.

Which of the following statements best supports the ethical principle of justice? A) Access to health care should be provided for all people. B) Dialysis should be available for clients who adhere to their prescribed dietary regimes. C) Transplant organs should be allocated based on ability to pay for hospital costs. D) Health-promotion interventions should be provided to those who agree to pay more for health services.

A) Access to health care should be provided for all people. Justice is a major ethical principle of importance in health-promotion settings. Justice is involved with the fair distribution of "goods" such as health, education, food, and shelter. Justice is the equalizing of benefits across society regardless of merit. Evaluating the four options above, it is apparent that the first statement supports justice related to provision of health care to all people, without regard to ability for payment. The other options place conditions on receiving care and interventions based on ability to pay or maintain medical regimes, which does not support the concept of justice.

Which of the following elements might be utilized with energy movement therapy? (select all that apply) A) Acupressure B) Yoga C) Imagery D) Reflexology E) Hydrotherapy

A) Acupressure Correct B) Yoga Correct D) Reflexology Movement therapies use movement and body work to promote physical, mental, emotional, and spiritual well-being. Yoga uses postures, controlled breathing, and meditation. Acupressure stimulates meridian points by stimulation of the acupuncture points with pressing, knuckling, rubbing, squeezing, and stretching. Reflexology is another method of moving energy by using hand pressure. Rather than to acupuncture points, the reflexologist applies pressure to mapped points on the feet or hands or both. Hydrotherapy is the use of water, ice, steam, and hot and cold temperatures to maintain and restore health and is not considered to be movement related.

Cognitive-behavioral therapy (CBT ) is a stress management intervention that can be utilized. Which of the following statements are true about CBT? (select all that apply) A) CBT is effective with many stress-related and mental health disorders. B) CBT is a long-term intervention. C) CBT helps people evaluate their thoughts, challenge them, and replace them with more rational cognitive and behavioral responses. D) CBT can be utilized by any therapist. E) Cognitive-behavioral restructuring teaches people that negative thinking often causes emotional distress.

A) CBT is effective with many stress-related and mental health disorders. C) CBT helps people evaluate their thoughts, challenge them, and replace them with more rational cognitive and behavioral responses. E) Cognitive-behavioral restructuring teaches people that negative thinking often causes emotional distress. Cognitive-behavioral therapy (CBT) is a conceptually based short-term intervention to modify negative or catastrophic thinking and related behaviors, and thereby reduce stress. It is a technique or series of strategies that help people evaluate their thoughts, challenge them, and replace them with more rational cognitive and behavioral responses. Although advanced training is needed, nurses can safely and effectively use basic strategies. Cognitive-behavioral restructuring teaches people that negative thinking often causes emotional distress. This recognition will alter the negative thinking and reduce the negative consequences of stress.

The school nurse teaches which of the following dietary guidelines to the parents of children and adolescents? (select all that apply): A) Children should consume at least 3 cups of fruits and vegetables per day. B) Children require 4 cups of whole milk products per day. C) Children should consume 5 ounces of steak daily. D) Children should consume 5 ounces of lean meat or beans each day. E) Children and adolescents should consume 4 to 6 ounces of grains each day.

A) Children should consume at least 3 cups of fruits and vegetables per day. D) Children should consume 5 ounces of lean meat or beans each day. E) Children and adolescents should consume 4 to 6 ounces of grains each day. Nutrition education incorporated into the general curriculum of school-age children throughout their education experience is important. The American Academy of Pediatrics and the American Heart Association have established dietary guidelines for children and adolescents. Daily nutritional needs of a child who is 9 to 14 years old include the following: • Milk group: 3 cups (24 oz total) of fat-free milk • Meat group: 5 oz of lean meat or beans; or equivalent combinations of these foods • Vegetable group: 2 to 2½ cups vegetables daily • Fruit group: 1½ cups of fruit • Grains group: 4 to 6 oz daily. Half should be whole grain items (AHA, 2011b).

Parents and caregivers who teach and model health-promotion concepts to school-age children can expect which of the following behaviors? (select all that apply): A) Children who develop good personal hygiene and dental care B) Children who become passive health care consumers C) Children who obey authority figures and do as they are told D) Children who make a link between behavior and improved health E) Children who develop health values as part of education

A) Children who develop good personal hygiene and dental care D) Children who make a link between behavior and improved health E) Children who develop health values as part of education Parents, caregivers, and teachers teach health-promotion concepts when they spend time monitoring and reinforcing preventive health practices, such as personal hygiene, dental care, and good nutrition. Role playing, reading an age-appropriate book, and modeling of health-promotion behaviors (e.g., washing hands) also may help children make the link between behavior and improved health. Unfortunately, by imitating some caregivers, children can become passive health care consumers, asking few questions, doing as they are told, and perpetuating poor choices. These responses may also be caused by children's developmental and cultural obligation to obey authority figures. Parents, caregivers, and teachers need to make commitments to demonstrate and teach healthy behaviors at home and in school; this helps children develop health values as part of their educational process toward reaching a healthy adulthood.

Research has documented what symptom one of the strongest predictors of adolescent obesity? A) Depression B) Excessive TV watching C) Lack of physical activity D) Meal skipping

A) Depression Studies have shown a strong correlation between inactivity, such as viewing television, and the tendency to be overweight. Research has identified depression as one of the strongest predictor of adolescent obesity.

The nurse is preparing a class on young adult risk factors for violence. The nurse includes content on which of the following? (select all that apply) A) Homicide is the second leading cause of death in young adults. B) Violence is becoming less prevalent globally. C) Homicide is the leading cause of death for black young men. D) Firearms are involved in less that ½ of homicides. E) More women than men are at risk for death from a firearm.

A) Homicide is the second leading cause of death in young adults. C) Homicide is the leading cause of death for black young men. The presence of firearms in the home is associated with the increased risk of firearm injury to children. Correct Homicide is the second leading cause of death in the 15- to 24-year-old age group and the leading cause of death for black men in the same age category. Firearms are involved in approximately two thirds of these deaths, and men have twice the risk of dying than women. The presence of firearms in the home is associated with the increased risk of unintentional and intentional firearm injury to children. Violence is becoming more prevalent globally related to organized terrorism.

In health-promotion activities, which of the following statements is accurate regarding respect for autonomy? (select all that apply) A) Individuals must be given the information they need to make choices. B) Choices are autonomous when public policy dictates the action. C) Autonomous choices are made when the person can understand the risks and benefits of the choices. D) Autonomous choices are acceptable even when mental capacity is questionable. E) Choices are considered autonomous in the absence of coercive influence.

A) Individuals must be given the information they need to make choices. C) Autonomous choices are made when the person can understand the risks and benefits of the choices. E) Choices are considered autonomous in the absence of coercive influence. In health-promotion activities, respect for autonomy requires that individuals be given the information they need to make choices. Choices can be considered autonomous only if certain criteria are met. The criteria that determine whether or not a person is actually capable of autonomous (voluntary) choice include cognitive maturity, possession of appropriate information to permit decision-making, intact mental capacities (the ability to reason logically), the absence of internal or external coercive influences, and the ability to appreciate the risks and benefits of alternative choices.

A 48-year-old woman complains to her nurse that she is experiencing frequent episodes of insomnia. What are some measures the nurse should educate her about? (select all that apply) A) Insomnia is common for this age group. B) Engage in activity 1 to 2 hours before bed to encourage sleep. C) Avoid or reduce the amount of caffeinated beverages that are consumed. D) Occasional napping should be avoided. E) Have a regular schedule for waking and sleep.

A) Insomnia is common for this age group. C) Avoid or reduce the amount of caffeinated beverages that are consumed. E) Have a regular schedule for waking and sleep. Insomnia is a common finding in this age category. This condition may be the result of overstimulation resulting from drinking too much caffeinated beverages, strenuous exercise within two hours of bedtime, not having a regular schedule for waking and sleep in a 24-hour period (National Sleep Foundation, 2012). Frequently-occurring insomnia can lead to distractibility and irritability and fatigue during the daytime hours. Rest is essential to allow restorative functions of the body to occur. The effects of insomnia can be counteracted by regularly scheduled, high-quality sleep and occasional napping when fatigued.

Which of the following statements accurately describe ethical theories? (Select all that apply) A) Normative theories are concerned with ensuring good actions. B) Descriptive theories tell us what actions to take. C) Consequentialist theories hold that decisions should take into account all knowable potential consequences. D) Religions and duty-based theories assert that certain duties will produce good outcomes. E) Descriptive theories are directive.

A) Normative theories are concerned with ensuring good actions. C) Consequentialist theories hold that decisions should take into account all knowable potential consequences. D) Religions and duty-based theories assert that certain duties will produce good outcomes. Descriptive theories do not tell us what actions we ought to take. They are not directive; they merely tell us how people act toward each other and their environments and what they seem to believe are good or moral actions. Normative theories, on the other hand, are concerned with ensuring good actions. The consequentialist theory holds that the consequences or intended consequences of actions matter. Therefore from the consequentialist perspective, any decision about intended actions or interventions must take into account all knowable potential consequences. Duty-based theories, such as that of Immanuel Kant (1724-1804) and those of various religions (Judaism, Christianity, Islam), depend more on adherence to duties than on good consequences. Individuals are viewed as having certain duties that cannot be circumvented, even if deliberately side-stepping the duty would result in good outcomes. For religions, these rules are imparted in some way by a divine being.

What are some of the definitions that support using the term profession to denote the status of nursing? (select all that apply) A) Nursing is considered a profession because it provides a service to society. B) Nursing is considered a profession because of the stable employment opportunities. C) Nursing is self-governing. D) Members of the nursing profession are accountable for their actions. E) Members of a profession abide by a code of ethics.

A) Nursing is considered a profession because it provides a service to society. C) Nursing is self-governing. D) Members of the nursing profession are accountable for their actions. E) Members of a profession abide by a code of ethics. Using the term profession to denote the status of nursing and other disciplines is controversial. Nursing is a profession insofar as it provides a service to society, is self-governing, and its members are accountable for their actions (Grace, 2001). One important characteristic of professions, especially those that provide crucial services to society, is that they have codes of ethics that provide essential elements of their promises of service to society. A significant consequence of professional status is that members can be held accountable for their practice formally by professional licensure boards. More importantly, they are morally accountable for practicing according to their discipline's implicit or explicit code of ethics. Codes of ethics provide a normative framework for professional actions. A professional implicitly accepts these codes on acquiring membership in the discipline.

According to many CAM practitioners, which of the following dimensions comprise the concept of whole health? (select all that apply) A) Physical B) Social C) Emotional D) Spiritual E) Sociophysical

A) Physical B) Social C) Emotional D) Spiritual Whole health is comprised of five dimensions—physical, spiritual, emotional intellectual, and social; other sources add environmental as a six element. To be truly healthy, all the dimensions must be healthy. Western or allopathic medicine traditionally supports the physical dimension, and most often promotes curative interventions rather than preventive modalities.

The nurse caring for the infant in the community setting observes for which of the following passive manifestations of abuse? (select all that apply) A) Poor nutrition B) Neglected visits to primary care providers C) Soft tissue injuries D) Fractures in varying stages of healing E) Emotional neglect

A) Poor nutrition Correct B) Neglected visits to primary care providers E) Emotional neglect The child-abuse syndrome is a clinical condition in infants who have suffered serious active or passive abuse at the hands of their parents or other caregivers. Physical trauma is not the only indicator that nurses should observe for. Passive manifestations of abuse include: poor nutrition, failure to thrive, severe malnutrition, poor physical condition, lack of medical attention, and emotional and moral neglect. Active manifestations of abuse include the presence of brain injuries, fractures, and sexual abuse.

Which of the following stressors are examples of intrinsic factors? (select all that apply) A) Poor time management B) A traffic jam C) Social interactions D) Poor communication E) Catastrophic negative thinking

A) Poor time management D) Poor communication E) Catastrophic negative thinking Intrinsic factors that create stress for an individual are those that are created or exacerbated by poor time management, procrastination, poor communication, catastrophic negative thinking (expecting the worst), or struggling with self-defeating behaviors. A traffic jam is an example of an extrinsic factor, which is something that a person has no control over. Stressors that individuals can modify include changing their environment and social interactions or behaviors.

The nurse is teaching parents about strategies to help reduce preschooler unintentional poisonings in the home. Instructions would include: which of the following?(select all that apply): A) Post the poison control number near every telephone. B) Administer ipecac syrup immediately to the child suspected of swallowing poison. C) Transfer cleaning supplies to old, unattractive canisters. D) Teach the child about poisons at an early age. E) Use safety latches for drawers and cabinet doors. F) Store products in their original container.

A) Post the poison control number near every telephone. D) Teach the child about poisons at an early age. E) Use safety latches for drawers and cabinet doors. F) Store products in their original container. There are many strategies that the nurse should recommend to parents to reduce or eliminate unintentional poisonings. Posting the poison control number supports the ease of having the poison control number readily available in case of an emergency. Administering ipecac is incorrect because ipecac is not always administered for all swallowed poisons. Some poisons will cause more harm to the child if vomiting is induced. Making the environment safe by keeping the products in their original containers and placing safety latches on drawers and cabinets that contain these chemicals enhances the reduction of poisonings because the child will not be able to get at the poison. Teaching the child about poisons is an important role of the parents so that the child will recognize when something is "bad." Never transfer products out of their original containers because then it will be difficult to determine exactly what the chemical is and what the components of the product are.

Music therapy has been used successfully to produce desired outcomes in which of the following client conditions? (select all that apply) A) Postoperative pain B) Postpartum depression C) Acute myocardial infarction D) Pain associated with labor E) Osteoarthritis pain F) Nausea and vomiting induced by chemotherapy

A) Postoperative pain C) Acute myocardial infarction D) Pain associated with labor E) Osteoarthritis pain F) Nausea and vomiting induced by chemotherapy Music therapy works by influencing the area of the brain involved with emotions and feelings, the limbic system. Music therapy has been documented as decreasing anxiety and increasing pain thresholds in postoperative clients. Music therapy has had a significant effect on pain and distress in laboring mothers. Others have found music therapy can be used with clients with osteoarthritis pain. Classical music used with clients with acute myocardial infarction documented a significant decrease in heart rate, respiratory rate, and oxygen demand, after these clients listened to 20 minutes of music. Music therapy has produced a significant decrease in nausea and vomiting associated with administration of chemotherapy.

Common visual conditions which may occur in middle-aged adults include which of the following? (select all that apply) A) Presbyopia B) Glaucoma C) Cataracts D) Macular degeneration E) Presbycusis

A) Presbyopia B) Glaucoma C) Cataracts D) Macular degeneration Presbyopia (farsightedness) is common in middle-age adults, even in individuals who have had no previous problems with their vision. Glaucoma occurs as a result of increased intraocular pressure, which can damage the optic nerve. Cataracts, an opacity of the lens, can develop and cloud the vision in later years of middle age. Macular degeneration is a progressive deterioration of the maculae of the retina and choroid structures of the eye (Mosby, 2008). Presbycusis is an impairment in auditory acuity.

The nurse working with the preschool age group educates parents about which of the following nutritional guidelines? (select all that apply): A) Preschool children should eat at least five servings of fruits and vegetables per day. B) Children aged 3 to 5 should receive 1000 to 1200 calories per day. C) Preschool children should consume approximately half of their diet in carbohydrates. D) Fat requirements in preschool children are higher than those for older children. E) Preschool fat intake should consist of saturated fats.

A) Preschool children should eat at least five servings of fruits and vegetables per day. C) Preschool children should consume approximately half of their diet in carbohydrates. D) Fat requirements in preschool children are higher than those for older children. Preschool children should eat a variety of foods with at least five servings of fruits and vegetables per day. Children aged 3 to 5 years old should receive 1200 to 1600 calories per day depending on their activity level and gender. Preschool children should consume approximately half of their diet in carbohydrates, with the other half consisting of protein (~5% to 20%) and fat (~20% to 35%) With over half of the preschool diet consisting of carbohydrates, whole grains and other complex carbohydrates should be plentiful to attain a total fiber of 20 to 25 grams per day. Fat requirements in preschool children are higher than those for older children, but fat consumption should consist primarily of unsaturated fat, with saturated fat, trans fatty acids, and cholesterol intake as low as possible. (U.S. Department of Agriculture & U.S. Department of Health and Human Services, 2010).

The school nurse is developing an information pamphlet on prevention of obesity in school age children. Interventions stated on the pamphlet would include which of the following? A) Provide foods high in vitamin A and C, fruits, and vegetables for afterschool snacks. B) Eating may occur in front of the television as long as the program is news-related. C) Make different meals for the child based on their likes and dislikes. D) Reward the child with food for school achievement.

A) Provide foods high in vitamin A and C, fruits, and vegetables for afterschool snacks. Nursing interventions to prevent obesity during the school-age years including the following: • Encourage the parents to evaluate their own nutritional values, patterns, and choices. • Explain to parents that there is a relationship between eating in front the television and obesity. • Encourage the parents to assess snacking habits. Help parents choose healthier snacks such as fruits and vegetables. • Help the child assess personal nutrition and make reasonable choices for diet improvement. • Encourage the family to assess "fast food" eating habits and ways to change these habits. • Encourage the child to occasionally prepare meals of his or her choosing that meet requirements of the food pyramid.

Which of the following techniques will help the infant development of trust vs. mistrust? (select all that apply) A) Respond to the infant in a consistent manner. B) Allow the infant to cry to avoid spoiling the child, particularly if the infant has just been fed and diapered. C) Respond to the infant in a prompt manner even if the child has physical needs met. D) Use a pacifier to soothe the infant when crying. E) Provide the infant with predictable and organized routines.

A) Respond to the infant in a consistent manner. C) Respond to the infant in a prompt manner even if the child has physical needs met. E) Provide the infant with predictable and organized routines. Erikson's psychosocial developmental theory is concerned primarily with a series of tasks or crises that each individual must resolve before encountering the next one. The central task during infancy is the development of a sense of trust versus mistrust. Establishing this basic trust or mistrust determines the manner in which the infant approaches all future stages of growth. The infant first develops a sense of trust in the mother (or other caretaker) and then in other significant people. Trust influences the infant's future relationships, allowing for deeper commitment and intimacy. To develop trust the infant requires maximal gratification and minimal frustration to experience a healthy balance between inner needs and outer satisfaction. If the mother or caretaker is consistently responsive to the infant, meeting physical and psychological needs, the infant will likely learn to trust his or her caretaker; view the world as a safe place; and grow up to be secure, self-reliant, trusting, cooperative, and helpful towards others. Prompt, skillful, and consistent response to the infant's needs helps foster security and trust because it enables the infant to predict what will happen within the environment.

Which of the following physical activities are most appropriate for the preschool age group? (select all that apply): A) Ring around the Rosy B) Watching television C) Electronic video games D) Tee ball E) Paintball

A) Ring around the Rosy D) Tee ball The preschooler regulates bodily activity with more purpose and copes with limit setting better than the toddler, but has much energy and requires outlets for this energy during their day. During this period, physical play begins to be more organized and simple games can be learned such as Ring around the Rosy and simple group sports. Although this age group needs physical activity, many preschoolers spend long periods each day watching television, videos, and playing electronic games. Occasionally parents use the electronic diversions inappropriately to entertain the child. Although some excellent television, video, and electronic game programming is available for preschoolers, many electronic entertainment options focus on adult themes and violence. Many experts agree that television, videos, and electronic games disengage the child's mind and support less learning. Games involving paintball are inappropriate for the preschool age child.

The parents of a school age child report that their 9-year-old son walks in his sleep almost every night. The school nurse includes which of the following elements of education? (select all that apply): A) Sleep disturbances are more common in the preschool and school-age years. B) Sleep disturbances occur most often in the first 1 to 2 hours after going to sleep. C) Girls are more prone to sleep disturbances than boys. D) Problems may be influenced by fatigue and stress within the child. E) Sleep disturbances are usually related to respiratory problems.

A) Sleep disturbances are more common in the preschool and school-age years. B) Sleep disturbances occur most often in the first 1 to 2 hours after going to sleep. D) Problems may be influenced by fatigue and stress within the child. The most common sleep problems that occur during the preschool and school-age years are night terrors, sleepwalking, sleep talking, and enuresis. Approximately one out of six children (15%) between ages 5 and 12 has sleepwalked at least once, but far fewer children walk in their sleep persistently. Sleepwalking is most likely due to the brain's inability to regulate sleep/wake cycles due to immaturity of the nervous system. As a group, these disturbances have been called disorders of arousal (Boyse, 2010) and share the following characteristics: • They occur immediately before a REM, or rapid eye movement, state of sleep. • Most occur 1 to 2 hours after going to sleep. • There is a family history of sleep problems, and more boys experience sleep problems than girls. • Problems reflect normal central nervous system (CNS) immaturity of the child. • Problems may be influenced by fatigue and stress within the child. • Problems do not involve the respiratory system.

Nurses caring for the young adult population maintain awareness about screening for hypertension. Which of the following statements are true about hypertension in young adults? (select all that apply) A) The Mexican American population has the lowest percentage of individuals with high blood pressure. B) African Americans have the highest rates of high blood pressure. C) Health insurance has a direct correlation with hypertension control. D) Adopting healthy behaviors after being diagnosed with hypertension will not reduce the incidence. E) The prevalence of treatment and control of hypertension is lowest in young adults.

A) The Mexican American population has the lowest percentage of individuals with high blood pressure. B) African Americans have the highest rates of high blood pressure. E) The prevalence of treatment and control of hypertension is lowest in young adults. The Mexican American population has the lowest percentage of high blood pressure individuals (25.5%); the White only, non Hispanic is intermediate at 28.8%; whereas the non-Hispanic, Black/African American population has the highest (42%) (USDHHS, 2010). The prevalence of treatment and control of hypertension was also lowest in young adults (31%) and Mexican Americans (37%). This may be related to lack of a usual source of care, but most surveyed had health insurance, so health insurance alone is not sufficient to correlate with better hypertension control (Gillespie, Kuklina, Briss, Blair, & Hong, 2011). Gillespie et al. (2011) goes on to report that adoption of healthy behaviors, particularly of reducing dietary salt from an average of 3400 mg. to 2300 mg. daily could dramatically reduce the incidence of hypertension.

The nurse assessing conventional level moral development in 12-year-old children would expect to see which behaviors? A) The child looks to others for approval. B) The child views behavior as completely right or wrong. C) The child behaves because there is a fear of punishment. D) The child's moral development is characterized by self-interest.

A) The child looks to others for approval. Kohlberg describes the younger school-age child at the preconventional level of moral development to be characterized by self-interest. This child also behaves because there is a fear of punishment. The young child, ages approximately 6 or 7 years of age, views behavior as completely right or wrong. The school-age child in the conventional level of oral development looks to others for approval.

Which physical growth and development change in toddlers places them at risk for airway obstruction? A) The diameter of the upper respiratory tract is small. B) The respiratory rate decreases to 25 breaths per minute. C) All 20 primary or deciduous teeth erupt be the end of toddlerhood. D) The swallowing pattern using the tongue is fully developed.

A) The diameter of the upper respiratory tract is small. As the toddler grows, the respiratory rate decreases for a mean of 30 breaths per minute at 1 year of age to 25 breaths per minute at 3 years of age. The diameter of the toddler's upper respiratory tract is small when compared with an older child. This small diameter, coupled with the toddler's exploratory nature and lack of judgment in deciding what to place in the mouth, can result in airway obstruction. All 20 primary teeth erupt at the end of toddlerhood, but it is extremely rare that one of these teeth becomes loose. A mature swallowing pattern, using the tongue rather than the cheeks, has not yet developed, and toddlers continue to be at risk for choking.

The nurse, teaching a class on smoking cessation to a group of middle-age adults, presents the adverse effects of smoking, which include that nicotine: A) acts to stimulate the heart. B) calms the central nervous system. C) assists in decreasing blood pressure. D) causes a decrease in carbon monoxide.

A) acts to stimulate the heart. Nicotine acts in the two divisions of the nervous system to affect the central part of the brain and the spinal cord, and the peripheral portion that controls the arms and legs. Nicotine stimulates the heart, leading to an increased pulse and elevated blood pressure. Although smokers frequently believe that cigarettes have a calming effect, this notion is misleading. Nicotine stimulates the body, whereas increasing levels of carbon monoxide causes lethargy. Smokers may feel calm, although they are actually having their sensations dulled by the elevated level of carbon monoxide.

According to Piaget's theory of cognitive development, the young adult is in the stage of formal operational thought and demonstrates abilities to: A) analyze concepts. B) manipulate concrete objects. C) participate in cooperative interactions. D) perceive specific examples.

A) analyze concepts. Piaget's stage of formal operational thought evolves from concrete operational thought in adolescence and extends through the reasoning process of young adults. Achievement of formal operational thinking allows a person to analyze all combinations of possibilities and construct hypotheses that are capable of being tested. Young adult thought becomes more perceptive and insightful; issues can therefore be evaluated realistically and objectively. The person in the concrete operational thought stage is able to manipulate concrete objects, participate in cooperative interactions, and perceive specific examples.

The nurse offers interventions to parents to enhance toddlers' nutritional pattern by telling the parents to (select all that apply): A) avoid foods that may cause choking. B) serve the toddlers' favorite foods when he or she refuses to eat. C) send the toddler to bed if he or she does not want to eat. D) do not use food to bribe, reward, or punish the toddler. E) serve small portions, and let the toddler ask for more. F) serve single foods as mixtures of foods.

A) avoid foods that may cause choking. D) do not use food to bribe, reward, or punish the toddler. E) serve small portions, and let the toddler ask for more. Nursing interventions to assist parents to meet nutritional needs of toddlers include the following: • Offer simple, single foods because mixtures of foods are often rejected. • Serve the toddler's favorite foods along with the new ones. It may take several times before the toddler accepts a new food. • Encourage the use of utensils, but accept that toddlers still often need to use their fingers. • Routines are important to toddlers. Serve scheduled meals and snacks. • Mealtime should be a relaxed and pleasant time, free of distractions. • Do not use food to bribe, reward, or punish the toddler. • Schedule meals and sleep periods such that the child is awake and alert during mealtimes. • Serve small portions and let the toddler ask for more. • Avoid foods that may cause choking. • Drinking more than 2 cups of milk per day can reduce the child's appetite for other healthy foods.

Emphasis on disease prevention for the young adult, after age 25, is on modifying risk factors related to: A) coronary artery disease. B) cirrhosis of the liver. C) cervical cancer. D) colon cancer.

A) coronary artery disease After age 25, the emphasis is on modifying coronary risk factors. Recommendations for screening young adults are undergoing revision, as more information becomes available about the interactive risks of high cholesterol, familial high lipid levels, diabetes mellitus, and smoking.

The nurse emphasizes warning signs of suicidal risks in adolescents during a health education class. These signs include: (select all that apply): A) difficulty concentrating. B) increased accidents. C) hyperactivity. D) lethargy. E) sleep disorders.

A) difficulty concentrating. B) increased accidents. E) sleep disorders. Typical warning signs of suicidal risk in adolescents include: behavioral changes; increased risk taking; increased accidents; substance use/abuse; physical violence to self, others, or animals; decreased appetite; alienation from family and/or peer group; giving away personal items; writing letter or notes, essays, and poems with suicidal content; cognitive/mood changes; expression of hopelessness; increasing rage or anger; dramatic swings in affect; sleep disorders; preoccupation with death; difficulty concentrating; hearing voices/seeing things or people; and new found interest in religion or cults.

The nurse recognizes that the American Nurses Association (ANA) Code of Ethics identifies expectations of ethical behavior through statements regarding: A) the primary goals, values, and obligations of the profession. B) specific standards of care for selected populations. C) disciplinary actions for incompetent nursing practice. D) legal standards of practice.

A) the primary goals, values, and obligations of the profession. The ANA Code of Ethics identifies the primary goals, values, and obligations of the profession of nursing. The specific standards of care and practice are developed by professional organizations and the Nursing Practice Acts of each state based on evidence-based practice. The Board of Nurse Examiners for each state also has been charged with the disciplinary actions for incompetent nurses in the respective state.

The nurse participates in the process of ethical inquiry in health promotion to: (select all that apply) A) facilitate in-depth data gathering. B) resolve all ethical problems related to health promotion. C) understand what is expected of the health-promotion agent viewed as a moral agent. D) gain clarity on actual or potential issues regarding health-promotion endeavors. E) foresee all possible consequences of ethical issues related to health promotion. F) permit the uncovering of hidden agendas and interests. G) focus on salient aspects of problems, thus enhancing professional judgment.

A) facilitate in-depth data gathering. C) understand what is expected of the health-promotion agent viewed as a moral agent. D) gain clarity on actual or potential issues regarding health-promotion endeavors. F) permit the uncovering of hidden agendas and interests. G) focus on salient aspects of problems, thus enhancing professional judgment. The purpose of ethical inquiry in health promotion is to gain clarity on actual or potential moral issues arising in the context of health-promotion endeavors, and to understand what is expected of the health-promotion agent viewed as a moral agent. Ethical inquiry will not permit the resolution of all problems, mainly because the environments in which health-promotion efforts are conceptualized are incredibly complex. It is impossible to foresee all possible consequences of an action. But ethical reasoning can facilitate appropriate and in-depth data gathering, permit the uncovering of hidden agendas and interests, and focus on salient aspects of a particular problem, thus enhancing professional judgment.

The leading causes of death in middle adulthood, in both White and Black populations, are the same and include: A) heart disease. B) kidney disease. C) respiratory disease. D) gastrointestinal disease.

A) heart disease. The three leading causes on both White and Black populations are the same: heart disease, cancer, and cerebrovascular accident. Reducing disabilities and deaths from these chronic conditions are national health-promotion and disease-prevention objectives. Most of the diseases and conditions targeted in the Healthy People 2020 goals and objectives are preventable, or at least, modifiable. Health education, often conducted by professional nurses, is effective with adults who want or must change their life style behaviors.

The nurse provides anticipatory guidance to people during middle age to meet developmental tasks of: (select all that apply) A) helping children become responsible, happy adults. B) rediscovering new satisfaction in the relationship with one's spouse. C) developing an affectionate but independent relationship with aging parents. D) reaching the peak in one's career. E) passing on traditions and skills to grandchildren. F) developing leisure-time activities.

A) helping children become responsible, happy adults. B) rediscovering new satisfaction in the relationship with one's spouse. C) developing an affectionate but independent relationship with aging parents. D) reaching the peak in one's career. F) developing leisure-time activities. The developmental tasks of middle age include: • Helping children become responsible, happy adults • Rediscovering new satisfaction in the relationship with one's spouse • Developing an affectionate but independent relationship with aging parents • Reaching the peak in one's career • Developing leisure-time activities • Achieving mature social and civic responsibility • Accepting and adapting to biological changes • Maintaining or developing friendships

The nurse is reviewing the immunization record of a sexually active adolescent. The nurse determines that the adolescent should receive a: A) hepatitis B vaccine. B) Haemophilus influenzae vaccine. C) measles, mumps, and rubella vaccine. D) pneumococcal meningitis vaccine.

A) hepatitis B vaccine. Because hepatitis B is sexually transmitted, it should be given to the sexually active adolescent, if she has not yet received it, to provide for protection against hepatitis B infection. There is no data to support administration of the measles, mumps, and rubella vaccine. Data should be collected from previous immunization records or from history of exposure to those communicable diseases. The Haemophilus influenzae vaccine is given to adolescents who have chronic illness. The pneumococcal meningitis is administered to college students residing in a dormitory.

The nurse is teaching a group of mothers about toddlers and their play activities by explaining that toddlers: A) participate in parallel play. B) demonstrate skill in sharing and cooperative play. C) enjoy playing together with a group of toddlers. D) learn best with intensive drill during play.

A) participate in parallel play. Most toddlers are interested in other children. However, this interest is limited, because toddlers, though ready to be with other children, are not ready to share. Successful social encounters with toddlers are best described as parallel play, where children play side by side, doing similar things with similar toys, but each working independently. Sharing and cooperative play will not develop until well into the preschool years.

When evaluating the health perception of a preschooler, the nurse understands that this age group views pain or illness as: A) punishment. B) separation anxiety. C) a result of their actions. D) painful regardless of the intervention.

A) punishment. By age 4 or 5, children possess their own beliefs about health from their family. They begin to understand that they play a role in their own health. The preschooler often becomes upset over minor injuries. Pain or illness may be frequently viewed as punishment. The infant and toddler from 6 to 30 months will demonstrate signs of separation anxiety. The school-age child views illness as related to their lack of following parents' instructions for wearing warm clothes, eating nutritious meals, and getting enough rest. The toddler responds to all interventions as if they were going to be painful because they view pain concretely.

Any psychological, social, environmental, physiological, or spiritual stimulus that disrupts homeostasis requiring change or adaptation is a: A) stressor. B) trigger. C) distress. D) cognitive restructuring.

A) stressor. A stressor is any psychological, social, environmental, physiological, or spiritual stimulus that disrupts homeostasis requiring change or adaptation. Stress is a state of threatened homeostasis that triggers various adaptive changes in order to handle the event. Stress can be situational or maturational. One's coping strategies and resources will determine the outcomes of each crisis experience.

The preoperative stage of thinking is displayed by the child as: A) transductive reasoning. B) the trait of irreversibility. C) understanding the perspectives of others. D) an ability to consider more than one factor when solving simple problems.

A) transductive reasoning. Piaget describes the preoperational stage of thinking as transductive reasoning. The child moves only from particular to particular in making associations and solving problems. The preschooler exhibits the concept of concrete thinking. At this stage, children concentrate on only their own perspective. These children focus on one part of an object without shifting. The child does not possess the ability to consider more than one factor at a time when solving simple problems. The preschooler is not able to demonstrate the concept of irreversibility. The child is not able to connect the reverse operation to reach a logical conclusion.

Research has demonstrated the role of stress-hardy characteristics of individuals in promoting better health. These characteristics of stress hardiness include: A) viewing stress as a challenge rather than a threat. B) feeling as though one does not have internal control over stressful situations. C) having to focus commitment on primarily one component (home or work) in life. D) reporting more physical symptoms related to the degree of stress.

A) viewing stress as a challenge rather than a threat. Individuals who possess characteristics of stress-hardiness are shown to be less vulnerable to stress-related symptoms and disease. The characteristics of stress hardiness are control, challenge, and commitment. For stress-hardy individuals, stress is viewed as a challenge rather than a threat; they feel in control of situations in their lives; and they are committed to, rather than alienated from, work, home, and family.

The nurse suggests stimulating experiences for development of their infant to the parents of a 6-month-old infant. These experiences would include: A) singing lullabies to the baby. B) inviting another infant over to play. C) keeping the top of the crib free of hanging mobiles. D)providing a toy that emits animal sounds when the buttons are pushed.

A.) singing lullabies to the baby. The infant's first play is an exercise of the senses, and the toys are visual in nature. The infant needs experiences that involve sight, sound, and touch. Singing to the infant will stimulate the development of sound. The parents should hang a mobile over the crib to stimulate the infant's development of sight. During infancy, the baby's play is solitary and repetitious. The 6-month-old infant does not possess the fine motor skills to push a button on a toy.

According to Piaget, which of the following operations are displayed as the child begins to add flexibility and control to their thinking? A) Formal B) Concrete C) Abstract D) Egocentric

B) Concrete Piaget (2001) refers to the age span of 7 to 11 years as the period of concrete operation, a stage when children learn by manipulating concrete objects and lack the ability to perform thinking operations that require abstraction. During this time, the child moves from egocentric interactions to more cooperative interactions and increased understanding of many concepts gained through environmental connections (Atherson, 2011). Children increasingly change their reasoning from intuitive to logical or rational operations (rule-governed actions) and engage in serial ordering, addition, subtraction, and other basic mathematical skills. The operations of this period are termed concrete because the child's mental operations or actions still depend on the ability to perceive specific examples of what has happened.

The nurse is providing suggestions to individuals with sleep disturbances resulting from stress-related issues. The nurse recommends which of the following? (select all that apply) A) Have a glass of wine right before bedtime. B) Establish a regular sleep-wake schedule, even on weekends. C) Limit naps during the day to 45 minutes. D) Exercise within 1 hour of bedtime. E) Take a hot bath 2 hours before bedtime. F) Sleep in a warm room.

B) Establish a regular sleep-wake schedule, even on weekends. C) Limit naps during the day to 45 minutes. E) Take a hot bath 2 hours before bedtime. The nurse can provide suggestions to clients with stress-related sleep disturbances using the following strategies: • Keep a sleep diary, which helps determine sleep patterns. • Reduce consumption of alcohol and caffeine. • Have a regular sleep-wake schedule, even on weekends. • If unable to fall asleep within 20 to 30 minutes or if waking up and unable to fall back to sleep within that time, get out of bed and do something until groggy and sleepy again. • Use a relaxation tape or practice diaphragmatic breathing to help release tension and calm down. • Limit naps during the day to 45 minutes. • Exercise within 3 to 6 hours of bedtime. • Take a hot bath 2 hours before bedtime. • Sleep in a cool room.

A 50-year-old man is initiating an exercise program to help improve his cardiovascular health. What are some of the recommended guidelines that the nurse should instruct him on? (select all that apply) A) Every adult over the age of 50 should start with a daily running program. B) Overexertion should be avoided. C) Increase fluid intake during periods of strenuous exercise in hot weather. D) Adults over the age of 50 benefit from intense strength training. E) Suggested activities include walking, jogging, swimming and bicycling.

B) Overexertion should be avoided. Correct C) Increase fluid intake during periods of strenuous exercise in hot weather. Correct E) Suggested activities include walking, jogging, swimming and bicycling. Correct Some suggested activities for the middle-aged adult include brisk walking, jogging, swimming, bicycling, and skipping rope as well as walking or biking to work. Activities that focus on skill and coordination should be attempted by the adult over age 40 rather than activities necessitating speed and strength. Moderation is important for all groups of individuals. Caution is recommended for adults nearing age 65 to prevent muscle strains and/or falls, etc. Overexertion, as evidenced by dizziness, chest pressure or chest pain, and unresolved shortness of breath should be avoided. Also, in hot weather, strenuous exercise should be balanced with rest periods and increased intake of fluids to prevent heat stroke.

When a nurse utilizes aggressive action on behalf of a care recipient, he or she is considered to be practicing: A) social justice. B) advocacy. C) moral agency. D) assertiveness.

B) advocacy. Advocacy, as an expectation of nurses, is strongly reinforced both in the Code of Ethics and in innumerable scholarly articles. In legal jurisprudence, advocacy is aggressive action taken on behalf of an individual, or perhaps a group viewed as an individual entity, to protect or secure that individual's rights. Nurses and other health care professionals have a responsibility to speak up on behalf of people whose rights have been compromised or endangered. This is part of the nurse's role because people may not recognize either what is needed to meet their needs or when the care they are receiving is substandard. Social justice is concerned with disparities in socioeconomic conditions leading to poor health and fairness in the distribution of goods such as health, education, food, and shelter. Moral agency on the part of a nurse requires action and motivation directed to some moral end that is enacted through relationships. Utilizing aggressive action on behalf of a care recipient is not defined as assertiveness.

Which nursing intervention would be based upon utilitarian theory? A) Initiating resuscitation of a 20-week gestation newborn B) Preparing a 52-year-old woman with uterine cancer for a hysterectomy C) Placing a 92-year-old client with terminal congestive heart failure on a ventilator D) Administering chemotherapy to a 17-year-old with leukemia who states that he wants everything terminated

B) Preparing a 52-year-old woman with uterine cancer for a hysterectomy Utilitarian theory proposes that actions are good in so far as they are aimed at yielding the greatest amount of happiness or pleasure, or cause the least amount of harm or pain, to persons and overall within the society. Any decision making must take into account the consequences of the decision. The professional involved in the decision making must also possess the appropriate skills and knowledge to undertake actions that will promote a "good" for persons. The situations stated above require the nurse to determine which situation has the greatest amount of good for society and which causes the least amount of pain. The woman with the uterine cancer diagnosis preparing for surgery has the most promising outcome, and therefore should be selected as the priority intervention based on utilitarian theory. The 20-week gestation newborn has almost no chance of surviving outside of the mother's womb. The adolescent with leukemia who has stated that he does not want the chemotherapy should be respected, even though his parents will make the final decision. Being placed on the ventilator will not cure the 92-year-old client with terminal congestive heart failure. Even with extraordinary interventions, the client with a terminal disease prognosis is one who will not be cured of that disease process.

When an individual elicits the relaxation response through meditation, which stress-management skill is being practiced? A) Healthy pleasures B) Spiritual practice C) Affirmation D) Empathy

B) Spiritual practice Meeting spiritual needs may be facilitated by spiritual practice or activities that help people find meaning, purpose, and connection. Engaging in healthy pleasures occurs when a person participates in activities that are important to them and being them feelings of peace, joy, and happiness. An affirmation is a positive thought, in the form of a short saying or phrase, that has meaning for the individual. Empathy is an effective stress management intervention because it assists with communication. Empathy is the ability to consider another person's perspective and to communicate this understanding back to that person.

The nurse, teaching a class to primiparas about risk factors associated with sudden infant death syndrome (SIDS), explains that prevention strategies include: (select all that apply) A) Prone sleeping position B) Supine sleeping position C) Postnatal smoking D) Sleeping on soft surfaces E) Sleeping on firmer surface F) Overwrapping the baby G) Allowing the baby to sleep with the parents H) Breast-feeding the baby

B) Supine sleeping position E) Sleeping on firmer surface H) Breast-feeding the baby Observational studies have found an association between SIDS and several risk factors, including prone sleeping positions, prenatal or postnatal exposure to tobacco smoke, soft sleeping surfaces, hyperthermia or overwrapping, bed sharing, and lack of breast-feeding. The American Academy of Pediatrics Task force on SIDS recommends that those risk situations be eliminated as preventive strategies.

Which of the following physical changes are expected during the toddler years? (select all that apply): A) Growth in height of 4 to 6 inches per year B) Weight gain of 4 to 6 pounds per year C) Urine specific gravity lower than that of an adult D) Bowel control generally occurs before urinary control

B) Weight gain of 4 to 6 pounds per year D) Bowel control generally occurs before urinary control Increase in heart rate because of increase in size The overall growth rate of the toddler slows significantly, and the increasingly active toddler begins the process of shedding baby fat and straightening their posture. A slow, steady growth in height of 2 to 4 inches per year and in weight of 4 to 6 pounds per year occurs during toddlerhood and remains steady until puberty. The kidneys are well differentiated by the toddler years, and specific gravity and other urine findings are similar to those of adults. The toddler's gastrointestinal tract also reaches functional maturity, although it continues to grow into adulthood. Bowel control usually occurs before urinary control. Lung capacity continues to increase as the toddler grows and changes in the circulatory system include a decrease in heart rate, increase in blood pressure, and changing vascular resistance in response to growth in the size of various blood vessel lumens.

The nurse is discussing strong evidence on effectiveness of alternative and complimentary therapies in reducing harmful effects of stress. Emphasis is placed on the effectiveness of: A) aromatherapy. B) acupuncture. C) chiropractic. D) herbal therapy.

B) acupuncture. A variety of alternatives and complimentary therapies are available as techniques to prevent and reduce harmful effects of stress. Common therapies include acupuncture, hypnosis, aromatherapy, reflexology, chiropractic, and herbal therapies. People are increasingly using alternative therapies as self-help measures, and research to study their effects has exploded in recent years. Nurses can assist clients to base their use on evidence of safety and efficacy. Among the variety of alternative therapies available, acupuncture and hypnosis have strong evidence of effectiveness. Herbal remedies require cautions because they can have harmful as well as beneficial effects, and may interfere with other treatments.

The nurse is assessing a 12-year-old female with an admission diagnosis of anorexia nervosa. The data collected that support this diagnosis should include: (select all that apply): A) binge eating followed by purging. B) compulsive physical activity. C) eating an amount of food that is definitely larger than most people would eat. D) preoccupation with food. E) self-starvation with significant weight loss.

B) compulsive physical activity. D) preoccupation with food. E) self-starvation with significant weight loss. Symptoms of anorexia nervosa include self-starvation with significant weight loss, amenorrhea, compulsive physical activity, preoccupation with food, and a distorted body image. Another eating disorder is bulimia nervosa, which involves a pattern of binge eating followed by purging, induced vomiting, and/or use of laxatives. This client eats an increased amount of food in a discrete period of time.

The nurse initiates an exercise program with middle-aged adults by: A) planning physical activity for a minimum of 45 minutes. B) considering activities that have the least potential for injury. C) counseling the adult that exercise should be rigorous to produce results. D) advising that the heart rate should double during exercise for cardiovascular benefits to be achieved.

B) considering activities that have the least potential for injury. Moderation is the key, along with increased caution as the adult approaches age 65. The exercise program should be realistic, and the activities selected should be activities that the individual enjoyed in the past. Activities should be selected with consideration of the potential for injury. Physical exercise should involve as many muscles as is possible, performed on a regular basis, preferably 3 to 4 times a week, for a minimum of 30 minutes each time. The appropriate level of performance for aerobic exercise is determined by achieving a pulse rate that is established for each individual: taking the number 220, subtracting the person's age, and then computing 75% of that number.

The nurse assesses the preschooler's coping mechanisms as being developmentally appropriate through observation of: A) temper tantrums. B) fantasy play. C) separation anxiety. D) flexible bedtime rituals.

B) fantasy play. Preschoolers use many of the coping mechanisms developed during their toddler years; however, the preschooler generally shows greater ability to verbalize frustration, fewer temper tantrums, and more patience in experimentation to resolve difficulty than the typical toddler. Preschoolers refine their problem-solving skills. Through fantasy play, preschoolers investigate solutions or responses to stressful events and find inner control for challenging situations. Strict adherence to rituals or game rules controls situations for the preschooler. The preschooler has longer and more rigid bedtime rituals than the toddler.

The nurse in the well-baby clinic informs the mother of a 6-month-old infant about introducing solid foods by instructing her to: A) feed the baby solids before the milk. B) make the baby's solid foods smooth and runny. C) introduce solid foods by adding it to the baby's formula bottle. D) mix a little honey in the fruit to stimulate the infant's taste buds.

B) make the baby's solid foods smooth and runny. Tips for introducing solid foods to infants: • The infant's first solid foods should be smooth and runny. • Pureed foods are used until the infant has teeth; chopped foods are used when the infant can chew. • Introduce only one food at a time and in small amounts. • Do not mix solid foods together; the infant should learn to appreciate different tastes and textures. • Do not add solid foods to the infant's bottle. • Do not start to reduce the milk supply until the infant is taking food successfully from the spoon. • Until 1 year of age, feed the baby milk before solid foods. • Do not give honey to infants less than 12 months of age. Honey is a known source of bacterial spores that produce a toxin, which can cause infant botulism.

Nurses caring for the toddler population instruct parents that one of the leading causes of visits to health care providers is: A) amblyopia. B) otitis media. C) burns. D) neglect.

B) otitis media. Otitis media, or inner ear infection, is one of the leading causes of visits to health care providers during the toddler years and the number one reason for which antibiotics are prescribed for these children. Discussing the current literature and evidence-based reports and recommendations often helps parents understand the proper use of antibiotics, which is also imperative in preventing antibiotic resistance. Amblyopia is a major health care concern of the toddler age group and occurs in 2% to 5% of children. Toddlers are at high risk for accidental injuries related to burns and parents should be instructed on measures to avoid injuries. Toddlers suffering from neglect are less likely to be seen by health care practitioners.

When the nurse is assessing a toddler for signs of child abuse, observations of parental behavior may include: A) difficulty leaving the child. B) parental delays in seeking help. C) spontaneous reporting of the details of the injury. D) parental questions about progress and discharge.

B) parental delays in seeking help. Parental behaviors observed by the nurse during an admission assessment of a toddler supporting child abuse may include: • Parental delays in seeking help • Inconsistencies in the history of how the injury occurred • Injury inconsistent with the history or child's developmental capacity • X-rays show old, unexplained fractures • Bruises confined to back surface of the body—neck to knees • Bare and broken hair • Pattern to injury or bruising descriptive of object used to inflict injury • Burns with sharply demarcated edges or circumferential patterns • Perineal injuries of any kind

The nurse explains that the philosophical base for energy medicine involves: A) reading auras. B) rebalancing life energy. C) placing the hands and making symbolic gestures. D) inserting of fine needles into precisely mapped points on the skin surface.

B) rebalancing life energy. The basic premise behind energy work is releasing blockages to energy flow, stimulating deficient life energy, and rebalancing life energy. Acupuncture is the insertion of fine needles into precisely mapped points on the skin surface. Reading auras is the extension of the energy field beyond the physical body. Reiki is placing the hands and making symbolic gestures that create attunement or the opening of the energy channel.

Young adults are screened for cervical cancer through assessment of known risk factors that include: A) obesity. B) smoking. C) hypertension. D) alcohol use.

B) smoking. Known risk factors for cervical cancer include smoking, early age of first intercourse, increasing number of sexual partners, and infection with human papillomavirus (HPV). The typical young adult health examination also looks for signs of chronic disease. Young adults would need to be educated about modifiable risk factors such as obesity and alcohol use.

The nurse is teaching prenatal couples about the critical principles of attachment. These principles include: A) parents of sick infants become attached as quickly as those of healthy infants. B) the mother and father should have close contact with their infant within minutes after birth. C) it is mandatory for the father to witness the birth process so that bonding and attachment will occur. D) parents take on the active role when interacting with their infant, realizing that their infant will be unresponsive.

B) the mother and father should have close contact with their infant within minutes after birth. A sensitive period appears to exist in the first minutes and hours after birth during which it seems necessary for the mother and father to have close contact with their infant for later development to be optimal. • Species-specific responses to the infant appear to exist in the human mother and father when the infant is first given to them. • The attachment process seems to be structured such that the parents become attached to only one infant at a time. • For attachment to occur appropriately, the infant must respond to the mother and father by some signal, such as body or eye movements. • Individuals who witness the birth process become strongly attached to the infant. • Some adults find it difficult to go through the processes of attachment and detachment simultaneously; becoming attached to an infant while mourning the loss or threatened loss of another person is difficult for parents. • Some early events may have long-lasting effects.

The nurse discusses discipline for school-age children with a group of parents at a parent-teacher association meeting. Principles include (select all that apply): A) focusing on the misbehavior in an attempt to eliminate it. B) using distraction or substitution to avoid a problem situation. C) ignoring the child's whining after a decision has been made. D) using humor to decreases the intensity of the situation. E) modeling appropriate behavior. F) setting age-relevant limits.

B) using distraction or substitution to avoid a problem situation. D) using humor to decreases the intensity of the situation. E) modeling appropriate behavior. F) setting age-relevant limits. Effective discipline is essential to family harmony and individual child growth and reflects cultural beliefs. The goal of discipline is to encourage and reinforce positive child behaviors, eliminate inappropriate child behaviors, improve parent-child communication, and meet parental needs. Effective discipline requires these essential components: a positive, supportive, loving relationship between parent/child, use of positive reinforcement strategies to increase desired behavior, and removal of reinforcements or application of punishment to reduce/eliminate undesired behaviors.

The nurse advocates that acupuncture is a useful treatment intervention of: A) hypertension. B) osteoporosis. C) substance abuse. D) gastrointestinal bleeding.

C) substance abuse. Acupuncture is a useful treatment for substance abuse. It has also been found to be effective for postoperative pain, the nausea and vomiting of chemotherapy, other pain syndromes, stroke rehabilitation, and asthma.

Which statement, if made by a parent after attending a teaching session on initiating a toilet training program for toddlers, indicates a need for further teaching? A) "I take my child to the potty after a meal." B) "I offer praise when my child uses the potty." C) "I require my child to sit on the potty until she goes." D) "I have given my child underpants as a reward for using the potty."

C) "I require my child to sit on the potty until she goes." Before beginning toilet training, parents should begin to check their toddlers for the prerequisite skills for toileting, which include being able to walk well, stoop and recover, stay dry for at least 2 hours during the day, and communicate sensations before elimination as well as the discomfort of wet or messy pants, and the need for assistance. First, introduce the child to the potty seat or chair. The potty should provide secure seating with the child's feet touching the floor. Because of the gastrocolic reflex, bowel elimination is more likely after a meal; this is a good time to place the toddler on the potty. Encourage the toddler to stay on the chair for 2 to 3 minutes and always explain what to do ("Go potty") rather than what not to do ("Don't wet your pants"). Do not refer to elimination as dirty or yucky. Remember that this is your child's first creation. Praise the child for the desired behavior. Introduce underwear as a badge of success. Ignore undesired behavior and never punish the child by scolding, spanking, or other punitive measures.

According to the American Nurses Association, which of the following statements are true regarding a holistic nurse? (Select all that apply.) A) Holistic care is provided in private practice. B) Holistic nursing care is provided by nursing assistants. C) A mind-body-spirit-emotion approach is taken in holistic nursing care. D) Holistic nursing serves as a bridge between conventional and complementary alternative healing practices. E) A holistic nurse may specialize in one or more modalities.

C) A mind-body-spirit-emotion approach is taken in holistic nursing care. D) Holistic nursing serves as a bridge between conventional and complementary alternative healing practices. E) A holistic nurse may specialize in one or more modalities. The American Nurses Association recognizes holistic nursing as an official nursing specialty with its own defined scope and standards of practice. According to the American Holistic Nurses Association, a holistic nurse is a legally licensed nurse who takes a mind-body-spirit-emotion approach to the practice of nursing. The holistic nursing practice serves as a bridge between conventional healing and complementary and alternative healing practices, and is trained in both healthcare models. A holistic nurse works in a variety of settings and may specialize in one or more modalities, such as acupuncture, chiropractic, or energetic healing.

According to Erikson, what is the developmental task of toddlers? A) Doubt B) Shame C) Autonomy D) Preoperational

C) Autonomy According to Erikson (1995, 1998), the developmental task of toddlers is to acquire a sense of autonomy while overcoming a sense of doubt and shame. To exert autonomy, toddlers must relinquish the dependence on others that was enjoyed during infancy. Continued dependency has the potential to create a sense of doubt in toddlers about their ability to take control of, and ultimately take responsibility for, their own actions. Toddlers begin to move into a preoperational stage, according to Piaget.

Pregnant women are counseled about rubella screening and vaccination. Which of the following conditions are associated with congenital rubella syndrome? A) Blindness B) Sudden infant death syndrome (SIDS) C) Developmental delay D) Autism

C) Developmental delay Rubella in young adults is generally a minor disease; however, when the disease is contracted during the first trimester of pregnancy, miscarriage, stillbirth, or congenital rubella syndrome (CRS) can result. CRS is associated with loss of hearing, ocular defects, developmental delay and growth retardation, and cardiac malformations. All women of childbearing age should be screened (titer monitored) for rubella antibodies and those who are not immune should be immunized. Nurses inform women of childbearing age that antibody testing is recommended before pregnancy and that vaccination is available.

Which of the following statements are accurate regarding the safety and effectiveness of complementary and alternative medicines (CAM)? (Select all that apply.) A) CAM therapies carry a strong scientific evidence base. B) CAM therapies are regulated by the FDA. Incorrect C) Many CAM therapies have not been studied with clinical trials. D) FDA regulations are less strict for over-the-counter medications. E) Most CAM providers are not credentialed.

C) Many CAM therapies have not been studied with clinical trials. D) FDA regulations are less strict for over-the-counter medications. E) Most CAM providers are not credentialed. Most CAM therapies lack a strong scientific evidence base, as many have not been studied with rigorous, well-designed clinical trials. The U.S. Food and Drug Administration (FDA) regulate dietary supplements, but the regulations are less strict than for prescription or over-the-counter medications. For example, safety and efficacy do not have to be proved before marketed, although, once on the market, it does monitor label claims and inserts. Most CAM providers are not credentialed in a standardized national system, so credentialing regulations and standards vary nationally. Some require training, testing, and continuing education, but most do not. CAM safety precautions include careful selection of providers, taking time to research and understand the treatment and maintaining awareness of possible scams.

Which of the following concepts are accurate regarding the biological changes in the young adult period? (select all that apply) A) Young adulthood sees the highest illness rate of any other age group. B) Physical growth continues into the 30s. C) Most concerns are related to ensuring optimal body functioning. D) Physical abilities of the young adult are at their peak. E) Illness compensatory mechanisms generally operate optimally.

C) Most concerns are related to ensuring optimal body functioning. D) Physical abilities of the young adult are at their peak. E) Illness compensatory mechanisms generally operate optimally. Young adulthood is generally the healthiest time of life. Physical growth is mostly complete by the age of 20; most concerns related to physiological development are focused on ensuring the optimal functioning of body systems. The young adult's physical abilities are in peak condition, and compensatory mechanisms operate optimally during illness to provide minimal disruption in health patterns. Nursing goals for individuals of this age group are oriented toward prolonging this period of optimal physical energy; developing the mental, emotional, spiritual, and social potential; encouraging proper health habits; anticipating and screening for and, therefore, being able to treat the onset of chronic disease at an early stage; and treating disease when appropriate.

he nurse is teaching parents about typical sleep disturbances of the preschooler. Which recommendation would the nurse make to the parents? A) Bedtime rituals of 1 hour or more should decrease sleep disturbances Incorrect B) Frightening television shows and stories should be banned before bedtime C) Parents should help the child differentiate between "pretend" and "real" occurrences D) When the child has night wakening events, reassurance occurs when the child is taken to the parent's bed

C) Parents should help the child differentiate between "pretend" and "real" occurrences Parents of preschoolers can benefit from the following recommendations: • Bedtime rituals of 30 to 45 minutes are common. • Night wakening events are common in the preschool years. The child who wakes up at night should be reassured and encouraged to return to his or her own bed. • Parents should have clear rules about children sleeping with them if children will not stay in their own beds. • Restricting frightening television shows and stories and discussing "real" versus "pretend" ideas and stories can help lessen the incidence of nightmares.

The community health nurse performs an assessment on a local family to determine their stress-coping abilities. Which of the following is an example of the primary appraisal of the coping ability of a family experiencing financial hardship? A) The family becomes aware of information of which they were previously unaware. B) The family identifies information related to their perceived problems. C) The family describes perceived actual and potential positive and negative outcomes. D) Individuals within the family verbalize methods to cope with the actual or potential harm, threat, or challenge.

C) The family describes perceived actual and potential positive and negative outcomes. Assessment of the stress-coping abilities of an individual, family, or community is part of a comprehensive health assessment that includes past and present subjective and objective data. Primary appraisal of coping includes descriptions of perceived actual and potential positive and negative outcomes. Negative outcomes refer to harm, whereas positive outcomes refer to the challenges resulting from stressors that an individual perceives can be overcome. Secondary appraisal consists of the individual's identification of choices to cope with the actual or potential harm, threat or challenge.

Which statement supports the principle of beneficence that overrides a person's autonomy? A) The nurse presses the button to administer pain medication through a patient-controlled analgesia (PCA) infusion. B) The nurse maintains confidentiality to an HIV-positive husband who does not want his wife informed of his HIV status. C) The nurse instructs parents that their newborn must be placed in a car seat that faces the back of the seat in the back seat of the car. D) The nurse counsels a 21-year-old woman delivering her third child that she should request a tubal ligation.

C) The nurse instructs parents that their newborn must be placed in a car seat that faces the back of the seat in the back seat of the car. Beneficence means to do good. As a moral principle, beneficence presents us with the duty to maximize the benefits of actions while minimizing harm. When society formulates rules that are designed to protect persons against the negative effects of their own actions, these rules are considered "beneficent," yet they override a person's autonomy. One example of this is the use of safety restraints—car seats for children and seat belts for adults—when driving or riding in an automobile. It is inappropriate to consider beneficence as a moral principle when withholding confidential information that may harm another, as in the case of the HIV-positive husband. The client must control the PCA infusion and choice of when to administer additional pain medication. If the nurse presses the button to administer additional medication, the client may suffer adverse effects related to receiving too much medication, because the client is not determining pain medication needs. Counseling a client regarding when to request a tubal ligation is inappropriate based on the nurses' cultural values. The client should be given information on the advantages and disadvantages of the surgical procedure and its consequences, and the client has the autonomy to make her decision.

The nurse assessing a 24-month-old toddler expects expressive language to include: A) repeats 2 digits from memory. B) jargon and echolalia are predominately used. C) talks in word phrases, and 2 to 3 word sentences. D) average sentence length is approximately 2½ words.

C) talks in word phrases, and 2 to 3 word sentences. The 18-month-old toddler uses jargon and echolalia. The 24-month-old toddler talks in word phrases and 2 to 3 words sentence. The 30-month-old toddler repeats 2 digits from memory, and the average sentence length is approximately 2½ words for these children.

Bloom (1984) has developed a hierarchy of cognitive levels in the adult learner. The analysis cognitive level for the adult learner would be: A) recalling specific facts. B) grasping the meaning of the communicated message. C) breaking down material into its constituent parts while noting their relationship. D) applying knowledge in the form of abstractions and ideas to concrete situations.

C) breaking down material into its constituent parts while noting their relationship. Bloom (1984) developed a hierarchy of cognitive levels in the adult learner. The first level is knowledge, which is the recall of specifics. The second level is comprehension. The learner grasps the meaning of communicated messages and relates it to other material. The third level is application. The learner applies knowledge in the form of abstractions and ideas to concrete situations. Analysis is the fourth level, wherein the adult breaks down the material into its constituent parts while noting their relationship. The final and fifth level is synthesis, wherein the person is able to combine various elements to form a plan and then judge the extent to which the ideas and materials satisfy the established criteria.

The nurse assesses the cognitive abilities of the adolescent according to Piaget's stage of formal operations as: A) accepting family beliefs and values. B) developing extrovert behaviors. C) having an intolerance of things as they are. D) recognizing the importance of putting others' needs ahead of one's own.

C) having an intolerance of things as they are. Adolescence is characterized by a shift in cognitive abilities to Piaget's stage of formal operations. A behavioral manifestation of an adolescent's formal operations is an intolerance of things as they are. They constantly challenge the way things are and challenge themselves to consider the way things can or should be. Adolescents begin to "think about their thinking." This causes the adolescent to become highly introspective. Introspection also combines with a reemergence of egocentrism leading to adolescents' sense of being the primary focus—special, unique, and exceptional. Teens can be vehement in trying to convince others of their viewpoints. Their idealism can lead to a rejection of family values, religion, or social causes.

Physiological effects of stress include: A) decreasing the antiinflammatory response. B) decreasing musculoskeletal tension and tone. C) increasing the heart rate, blood pressure, and respiratory rate. D) shifting of blood for the large muscle groups to the visceral organs.

C) increasing the heart rate, blood pressure, and respiratory rate. Stress causes physiological arousal along three pathways: the musculoskeletal system, the autonomic nervous system, and the psychoneuroendocrine system. The musculoskeletal system responds to stress by increasing tension and tone. The autonomic nervous system causes an increase in heart rate, blood pressure, and respiratory rate. The heightened awareness of the environment is triggered, and the blood shifts from the visceral organs to the large muscles. The psychoneuroendocrine system stimulates the secretion of glucocorticoids and other neuroendocrine substances into the systemic circulation, which increases glucose levels and the antiinflammatory response.

The scientific, evidence-based use of combined complementary and alternative medicine (CAM) and traditional medicine with an emphasis on safety and effectiveness is known as: A) complementary therapy. B) alternative therapy. C) integrative therapy. D) allopathic medicine.

C) integrative therapy. According to the National Institute of Health's National Center for Complementary and Alternative Medicine (NCCAM), integrative therapy is the scientific, evidence-based use of combined CAM and traditional medicine with an emphasis on safety and effectiveness. It defines complementary therapy as the use of CAM alongside and as a complement to allopathic traditional medicine. Alternative therapy uses CAM in place of traditional medicine. Allopathic medicine focuses on identifying diseases and conditions by a physician or mid-level practitioner.

A condition of the bone that is the result of bone lysis exceeding the rate of bone matrix synthesis is called: A) osteoarthritis. B) kyphosis. C) osteopenia. D) osteoporosis.

C) osteopenia. Osteopenia is a condition of subnormally mineralized bone, usually as a result of a rate of bone lysis that exceeds the rate of bone matrix synthesis. Thoracic kyphosis is an angulation of the posterior spine that is sometimes referred to as "hunchback." Osteoarthritis is a degenerative joint disease that influences activity and endurance and is most frequently seen in the knees and hands. Osteoporosis is a disorder characterized by abnormal loss of bone density and deterioration of bone tissue, with an increased fracture risk. It occurs most frequently in postmenopausal women who have fair complexions and are small, sedentary individuals, and people on long-term steroid use.

The nurse is implementing cognitive restructuring as a stress-management intervention with a group of pregnant teens. The nurse explains that cognitive restructuring reduces stress by: A) glossing over misfortune, suffering, or negative feelings. B) helping people identify who is responsible for their stress. C) recognizing that negative thinking often causes emotional distress. D) assisting people to focus on a narrow range of feelings causing their stress.

C) recognizing that negative thinking often causes emotional distress. Cognitive therapy is a conceptual model for short-term intervention to modify thinking and reduce stress. In the context of cognitive therapy, cognitive restructuring is a technique or series of strategies that help people evaluate their thoughts, challenge them, and replace them with responses that are more rational. Cognitive restructuring teaches people to recognize that negative thinking often causes emotional distress. Cognitive restructuring does not gloss over or deny misfortune, suffering, or negative feelings. Cognitive restructuring assists people to become unstuck from negative moods, so they can experience a broader range of feelings.

The time during which infants develop the coordination to master activities which allow them to interact with the environment is known as the: A) reflexive period. B) psychosocial period. C) sensorimotor period. D) immunological period.

C) sensorimotor period. Piaget's sensorimotor period (up to age 18 months) describes the time during which infants develop the coordination to master activities that allow them to interact with the environment. During this period the infant solves problems using sensory systems and motor activity rather than symbolic processes, which develop later. Piaget's cognitive developmental theory focuses on intellectual changes that occur in a sequential manner as a result of continual interaction between the infant and the environment. Reflexes are responses that are normally exhibited by new stimulation. Psychosocial development of the infant is established through a sense of trust and immunization efforts are not related to the infant's ability to master activities.

In health promotion settings, individual autonomy may be limited by: A) freedom of action. B) freedom of speech. C) the duty of protecting the health and safety of society. D) public policy.

C) the duty of protecting the health and safety of society. In health-promotion settings and endeavors the concept of autonomy can be understood from two different perspectives. From the vantage point of public health, the extent of individual autonomy, or freedom of action, may be limited by the duty of protecting the health and safety of the society. From this perspective there is an age-old struggle between civil rights and public safety. Moral questions ask to what degree society is justified in regulating the health and safety of society at large. There is an inevitable tension associated with curtailing civil liberties in the name of safety or health. Freedom of speech is not associated with individual autonomy as it relates to health promotion.

During middle adulthood, physiological changes affect most bodily systems. These changes include: A) increased cardiac output. B) increased glomerular filtration rates. C) thinning of the intervertebral disks. D) decreased bone density and mass.

C) thinning of the intervertebral disks. Physiological changes that occur during middle adulthood include: • Hair of the adult begins to thin and turn gray. • The skin's moisture and turgor decreases and with the loss of subcutaneous tissue, wrinkles appear. • Fat deposits increase during these years with increases in weight gain. • Cardiac output decreases. • Bone density and mass progressively decrease. • Thinning of the intervertebral disks accounts for approximately a loss of 1 inch in height. • Acid indigestion and belching increases due to decreased gastrointestinal motility. • Stools become harder and dry due to decreased gastrointestinal motility. • As blood supply to the kidneys decrease, the glomerular filtration rate is decreased. • Blood vessels lose elasticity and become thicker.

The school nurse is performing scoliosis screening on 14-year-old girls. Signs indicative of scoliosis include: A) alignment of the spinous processes. B) lower scapula height on the side of thoracic convexity. C) thoracic convexity with lateral spine curvature. D) waist and leg symmetry.

C) thoracic convexity with lateral spine curvature. Scoliosis screening begins in early adolescence. So that the entire back can be seen, the adolescent should remove all clothing from the upper body. While the adolescent stands up straight, check for any asymmetry; observe and palpate for differences in shoulder or scapular height, a prominence of either scapula or hip, waist asymmetry, and misalignment of the spinous processes. Lateral curvature and thoracic convexity of the spine indicate scoliosis. With the feet together, legs straight, and arms hanging freely, the adolescent bends forward until the back is parallel with the floor. The adolescent is assessed for prominence of the ribs, or rib hump, on one side only, and leg asymmetry. With scoliosis, the chest wall on the side of convexity is prominent, and the scapula on the side of convexity is elevated.

The nurse is teaching 8- and 9-year-old children about safe bicycling. The nurse emphasizes the principles of transportation safety, including: A) riding on the side of the road traveling opposite to the traffic. B) riding the bike through the cross walks after checking for traffic. C) wearing an approved, properly fitting helmet when bicycling. D) using a backpack to carry objects instead of the back basket.

C) wearing an approved, properly fitting helmet when bicycling. Because of increased independence, school-age children face significant exposure to situations threatening their health. Consequently, parents of these children must be involved in community and legislative activities that provide safe play environments. Each child should have a well-maintained bicycle, ride only in safe areas approved by parents, observe rules for vehicle traffic, ride on the side of road with traffic, "bike defensively," and use a federally approved riding helmet.

A target goal of Healthy People 2020 is to reduce the incidence of hepatitis C. The nurse focuses on individuals most at risk, which includes persons with: A) hepatitis A. B) Epstein-Barr virus. C) human papilloma virus. D) chronic renal disease on hemodialysis.

D) chronic renal disease on hemodialysis. Individuals most at risk for hepatitis C are those who have injected illicit drugs, received clotting factors before 1987, are on hemodialysis, are human immunodeficiency virus (HIV) positive, or have elevated liver function values. The other diseases listed do not have a positive correlation to hepatitis C.

The nurse incorporates epidemiological findings in assessing for risks associated with intimate partner violence, which include: A) adequate economic resources. B) equal job position of the partners. C) both partners achieved college graduation. D) differences in prestige associated with the partners' careers.

D) differences in prestige associated with the partners' careers. Epidemiological studies have attempted to determine the risks for intimate partner violence. Poverty and associated stress stemming from lack of economic resources appear to induce abuse against women. The unequal position of women in a relationship and the manner in which conflict is managed, as well as differences in education and prestige associated with the partner's occupations, are related to risk of violence.

The nurse teaches new mothers about research on pacifiers and breast-feeding. Which statement by a mother indicates an understanding of the instruction? A) "I have no problem giving a pacifier to a breast-feeding baby." B) "I offer a pacifier after each feeding to satisfy my baby's sucking needs." C) "There is significant research that indicates harm is associated with occasional pacifier use." D) "I do not give my baby a pacifier because I know it is associated with shorter breast-feeding duration."

D) "I do not give my baby a pacifier because I know it is associated with shorter breast-feeding duration." Research on breast-feeding and pacifiers includes findings that suggest a shorter duration of breast-feeding associated with pacifier use but little harm associated with occasional pacifier use. Researchers suggest that offering a pacifier after feeding is not recommended and that mother's should encourage the baby to satisfy sucking needs on the mother's breasts.

The nurse provides educational information to the female adolescent on decreasing the incidence of acne, which includes: A) "Decrease chocolate intake in your diet." B) "Expose your face to sunlight at least 2 hours per day." C) "Remove all pustules and papules with special instruments." D) "Wash your face with soap and water two to three times per day."

D) "Wash your face with soap and water two to three times per day." Washing with soap and water two or three times a day is the best way to remove dirt and oil. The adolescent should not attempt to remove the pustules and papules that form. Squeezing the lesions can result in further irritation of the gland and permanent injury to the tissue. Sunlight can have a beneficial effect on acne; however, prolonged exposure should be avoided. The effect of diet on acne is a highly controversial issue. Current evidence indicates that dietary restrictions specific to acne are unnecessary.

A new mother asks the nurse when the baby's anterior fontanel will close. The nurse explains that it will close at: A) 2 months. B) 6 months. C) 12 months. D) 18 months.

D) 18 months. The new mother is educated about the expected growth and development of the infant. She should be informed that the posterior fontanel closes at 2 months. The infant should grow about 1 inch per month for the first 6 months and by 12 months, the infant's birth weight has tripled. By 18 months of age, the anterior fontanel has closed.

Which play activity would the nurse plan for a 4-year-old girl 2 days after undergoing an appendectomy? A) Playing a game of Monopoly B) Dressing up in a Cinderella gown C) Participating in a game of hopscotch D) Drawing pictures of her mother and father

D) Drawing pictures of her mother and father Most 4-year-old children play simple interactive games, dress themselves, copy a number of basic geometric figures well, and draw recognizable people. Preschoolers enjoy using language skills in telling stories and asking questions, and they can balance on one foot, jump, and run well. Because the child is 2 days postappendectomy, the activity selected would have to be one that is appropriate for her condition and recovery. Dressing up in fairy tale clothing would be an activity of a healthy 4-year-old child but not one recovering from surgery. The game of hopscotch is too vigorous. Playing a game of Monopoly is at a higher level than her intellectual development. Drawing pictures of her family would be the best choice for a play activity.

The school nurse assesses preschoolers for genetic conditions such as: A) Down syndrome. B) congenital hypothyroidism. C) sickle cell disease. D) Duchenne muscular dystrophy.

D) Duchenne muscular dystrophy. During the preschool years, the genetic conditions that are most likely to appear are cystic fibrosis, Duchenne muscular dystrophy, fragile X syndrome, and Williams syndrome. Down syndrome is usually diagnosed soon after birth because the infant exhibits physical characteristics that warrant evaluation for the chromosome karyotype. Congenital hypothyroidism and sickle cell disease are determined during the neonatal period through the newborn screening test.

According to Healthy People 2020, the leading causes of death among children and young adults are due to injuries from which of the following? A) Homicide B) Suicide C) Burns D) Motor vehicle crashes

D) Motor vehicle crashes Healthy People 2020 reports that 72% of all deaths among children and young adults are due to injuries from four causes: motor vehicle crashes (30%), all other unintentional injuries (15%), homicide (15%), and suicide (12%) (U.S. Department of Health and Human Services [USDHHS], 2010). Preventive health concerns for young adults can be separated into two categories: developing behaviors that promote a healthy lifestyle and decreasing the incidence of accidents, injuries, and acts of violence. Health behaviors, safety practices, diet, exercise, weight control, sexuality, and addictions are widely discussed topics for the young adult age group.

The hallmark of the first substage of Piaget's preoperational stage is the ability of the preschooler to function using: A) abstract thinking. B) concrete thinking. C) auditory cues. D) language.

D) language. The older toddler enters the first substage of the preoperational stage described by Jean Piaget. The hallmark of this preconceptual substage includes the ability to function symbolically using language. The preschool child demonstrates increased symbolic functioning during the intuitive substage, from age 4 to 7 years. The predominant feature of this and the following period is the concrete thought process, as compared with adult abstract thinking. As they experience symbolic mental representations, preschoolers process mental symbols as though they were actually participating in the event.

The most common childhood school-age cancer is: A) retinoblastoma. B) neuroblastoma. C) Wilms tumor. D) leukemia.

D) leukemia. Leukemia is the most common form of cancer in childhood during the school years. Of those affected under 5 years of age, 90% will be cured with current medical treatment (Leukemia & Lymphoma Society, 2010). Among the 12 major types of childhood cancers, leukemia and cancers of the brain and central nervous system (second most common forms of childhood cancers) account for more than 50% of all new cases (National Cancer Institute, 2010). Lymphomas (Hodgkin disease and non-Hodgkin lymphoma) also affect school-age children and adolescents as the third most common group of malignancies. Non-Hodgkin lymphoma is more common during the school-age years, and boys experience this malignancy 3 times more often than do girls.

To facilitate the adolescent's need for controlling behaviors, the nurse implements an intervention that: A) asks the adolescent how he or she would like to handle the situation. B) consults with the parents regarding the adolescent's health care needs. C) gives specific, detailed instructions in writing. D) partners with the adolescent to develop a plan.

D) partners with the adolescent to develop a plan. Adolescents must be in charge of some aspects of life and can no longer accept family and school rules without question as they did in the past. This need to control extends to health care. The nurse cannot simply give directions or instructions, but rather, present the options and allow the adolescent to partner together to work out an acceptable plan. The primary discussion needs to be performed with the adolescent, instead of with the parents.

The nurse facilitates the adolescent's self-perception-self-concept development by: A) complementing the adolescent for what is accomplished. B) developing a plan for the adolescent's future growth. C) encouraging the adolescent to join in group activities. D) praising the adolescent for who he or she is.

D) praising the adolescent for who he or she is. Assessment, anticipatory guidance, education, and counseling are strategies that the nurse can use to guide the adolescent in developing a healthy self-perception that incorporates a healthy body image. It is important for nurses to remember to praise adolescents for who they are rather that for what they do, value each of them as unique, demonstrate belief in their abilities to grow and develop, and delight in their discoveries of themselves and their unique means of expressing it.

Parents of a 7-year-old boy request a discussion with the school nurse on how they can resolve the child's nighttime enuresis. The nurse advises that nighttime enuresis: A) is an intentional act with a psychological basis. B) should have consequences to eliminate the behavior. C) has no serious physical problems and should be ignored. D) requires a family plan to deal with the wet bed to decrease family arguments.

D) requires a family plan to deal with the wet bed to decrease family arguments. Nocturnal enuresis causes disruption for both child and family. The child may frequently experience teasing from classmates and siblings. It can have profound effects on life socially, emotionally, and behaviorally. Although many forms of enuresis do not pose any significant health risk, there are social stressors. A night away from home appears impossible because of fear of wetting. Parents may be angry about the frequent bed changes and washes and may try punishments, thinking that the child should be able to control the problem. Parental stress places additional pressure on the child, who may already have low self-esteem and lack self-confidence because of perceived inability to control the problem (Pillinger, 2011).

The nurse is preparing an educational activity for adolescents. The primary reason that emphasis is placed on teaching testicular self-examination is because: A) adolescents are naturally interested in their developing bodies. B) baseline assessment data is necessary for comparison in the future. C) rapid anatomical changes are occurring in the testes. D) testicular cancer is the number one cancer in the adolescent male.

D) testicular cancer is the number one cancer in the adolescent male. Testicular cancer is the number one cancer in adolescent and young adult males. Adolescent males should learn to do a testicular self-examination and continue this practice monthly. Nurses should introduce and teach methods of self-examination to adolescents who are naturally interested in their developing bodies. Even though the adolescent's body is undergoing anatomical changes, the primary reason for testicular self-examination is preventative for early identification of cancer. Baseline data collected during adolescence is not a priority for future comparison.

The nurse, presenting a class on strategies to prevent drowning in toddlers, instructs parents to: A) teach their toddler how to swim. B) place the toddler in the tub with 1 or 2 inches of water. C) make sure pails of water are less than ½ full. D) use personal flotation devices on the toddler when boating.

D) use personal flotation devices on the toddler when boating. Children between the ages of 1 and 3 years old are the highest risk for drowning because most do not know how to swim, and most do not have the skills to keep their heads above water or to get out of the water. Toddlers can drown in water just deep enough to cover their noses and mouths. Although swimming pools and other natural bodies of water are a big part of the problem, even pails of water, toilets, bathtubs, and wading pools are dangerous to a toddler. When toddlers fall into a pail of water or a toilet, it is hard for them to straighten up because their entire weight is forward. Toddlers should never be left unattended—even for a few seconds—near the bathtub, hot tub, wading or swimming pool, toilet, or pail of water. All swimming pools should be fenced and have self-closing gates and latches. Toddlers must be supervised constantly and competently whenever they are near water and fitted properly with personal flotation devices whenever they are on a boat.

The nurse understands that holistic health care practice: A) has no scientific basis. B) is not covered by health care insurance C) treats the symptoms that the client demonstrates D) considers that people have emotions, spirits, and E) relationships that combine with the physical body.

E) relationships that combine with the physical body. Holistic health practices are used to promote wellness. They are used to treat illness and reduce pain. Holism is the understanding that people are not just physical bodies; people have emotions, spirits, and relationships that combine with the physical body to make a whole person. The holistic movement in the healing arts reflects the theory of holism, and recognizes that all these aspects of the person must be considered when planning and delivering care. The entire person is treated, not only symptoms. It is important to identify the cause of the symptoms and treat the cause. Many of the interventions used in holistic health practices are backed by centuries of tradition, and today research is occurring to document their scientific merit. These holistic practices are often considered alternative practices, some of which are covered by health insurances.