Health Promotion and Maintenance Community Health EAQ

Which parental statement would the nurse recognize as indicating accurate understanding regarding dietary recommendations for an obese preschooler? SATA

I should avoid giving sugar sweetened beverages to my child My child should have 5 servings of fruits and vegetables each day It is important for my child to have at least 1 hour of activity per day.

The nurse is providing discharge teaching for a client who recently had surgery for an abdominal perineal resection of the colon and creation of a colostomy. The nurse would instruct the client to notify the health care provider immediately if which condition develops?

Difficulty inserting the irrigation tube.

Which instruction would the nurse provide to the client in early pregnancy scheduled for her first obstetric ultrasound?

Drink water until bladder is full.

Which parental statement would the nurse recognize as indicating a need for additional education related to expected gross motor development of a 4 year old?

I shouldn't be concerned that my child is unable to ride a tricycle.

A client is trying to become pregnant. The nurse would teach the client that a blood test for progesterone to evaluate fertility would be performed at which time?

One week after ovulation.

The nurse is teaching a client regarding preventive measures for genital tract infections. Which statement made by the client indicates the need for further education? SATA

I should take frequent bubble baths I should choose hosiery with a nylon crotch Is should use colored and scented toilet tissues.

The nurse is documenting the assessment findings of four preschool children. Which child would the nurse suspect had delayed cognitive development?

Preschooler D Unable to imitate others

Which common indication for a cesarean birth would the nurse discuss in a class for expectant parents?

Cephalopelvic disproportion.

The nurse instructs a client who avoids bathing to take a bath or shower each day as a means of maintaining hygiene and preventing infection. Which of theses reactions would the nurse expect if the client is in the action stage? SATA

I try to take a shower every day, but I skip it sometimes because of my tight work schedule I understand that bathing regularly is a good habit, but my bathroom is very cold in the morning I want to take a bath regularly, but I don't have time because I need to look after my kids and my parents.

Six weeks after birth an infant is found to have developmental dysplasia of the hip. The nurse explains to the parents the benefits of early treatment. Which is the rationale for the immediate institution of corrective measures?

Infants' cartilaginous hip joints promote molding of the acetabulum.

Which behaviors would the nurse expect while assessing a 1 year old infant? SATA

Tries to ascend stairs Explores away from the parent.

the nurse is performing a gestational age assessment using the New Ballard Scale. The infant's total neuromuscular score is 16, and the total physical maturity score is 20. According to the graph, at how may weeks' gestation is the newborn?

38

Which client is at the greatest risk for postpartum infection?

A woman who required catheterization after voiding less than 75 mL.

Which foods would the nurse recommend for a client who is at risk for developing osteoporosis? SATA

Chicken Breast Broiled Beef steak

The nurse is teaching first aid to a group of community members. A participant asks which first aid should be administered after calling 911, to a person who suffers extensive burns. Which response by the nurse is appropriate?

Cover the burned areas with a bed sheet beacuse this provides protection.

Which behaviors are expected for an 8 month old infant?

Creeping purposefully Displaying a pincer grasp

Which behaviors would the nurse recognize as developmentally appropriate in a preschooler? SATA

Eagerness for formal education Learning to function independently

What developmental findings does the nurse expect to observe in a 5 year old child? SATA

Enjoys imitative play Makes up rules for a new game

In which way is the genital stage different from the phallic stage?

In the genital stage, sexual urges are directed outside the family circle.

Which factor identified in a client's history places her at increased risks for breast cancer?

Late beginning of childbearing

Which problem predisposes a client to postpartum hemorrhage?

Multifetal pregnancy

In which age group is scoliosis usually identified?

Preadolescence

Which actions would the nurse recommend to alleviate nipple soreness in a breast feeding client? SATA

Take the prescribed analgesic medication Expose the nipples to air several times a day Apply hydrogel pads to the nipples after each feeding.

Which would the nurse expect the size of a newborn to be if the mother had inadequately controlled type 1 diabetes during her pregnancy?

large for gestational age, near term

Which time period would the nurse choose to prepare a preschooler for a surgical procedure before the actual surgery?

several days

The nurse is teaching a client a diet that permits 200 g of carbohydrates, 90 g of fat and 110 g of protein. How many calories per day should the client eat? Record your answer using a whole number.

2050 1 g of fat = 9 calories 1g of carbohydrates or protein = 4 calories

The nurse is planning to teach a 9 year old child with type 1 diabetes to perform blood glucose monitoring. Which information would the nurse use as basis for the teaching?

A child this age can maintain the glucose level in the normal range by changing insulin needs accordingly.

While changing a newborn girl's diaper the nurse observes a brick red stain on the diaper. How would the nurse interpret this clinical finding?

An uncommon benign occurrence.

The nurse is teaching a group of adults about the signs and symptoms of colorectal cancer. Which common clinical manifestations would the nurse include in the teaching program? SATA

Anemia Rectal Bleeding Chang in Bowel Habits

Which concepts would the nurse include in the education about age appropriate behavior provided to the parents of a 4 year old child? SATA

Animism Imagination

Once identification bands have been applied and vital signs have been taken, which is the initial intervention the nurse would make to a newborn?

Assisting the new mother with breast-feeding

Which activity would the nurse expect a 1 year old child to have accomplished?

Attempting to climb stairs

The nurse is estimating a newborn's gestational age. Which parameters would the nurse use when completing the assessment? SATA

Breast size Genital development

A client with type 2 diabetes travels frequently and asks how to plan meals during trips. Which is the best response by the nurse?

Choose the foods you normally do and follow your food plan wherever you are.

A preschooler had a blood lead level (BLL) measurement of 17 mcg/dL, followed by another BLL of 17 mcg/dL measured 4 months later. Which action would the nurse take to care for this client? SATA

Conduct a full developmental assessment Refer the client for home environmental assessment.

Which is the initial nursing action when a multipara requests something for pain?

Examining the client's cervix for dilation and effacement

Which health history would the nurse consider a contraindication to administering the second diphtheria/tetanus/pertussis (DTaP) immunization to a 4 month old infant?

High fever after the first dose.

The nurse is teaching a mother about the developmental behaviors of a 7 month old infant. Which statement by the mother indicates the need for further teaching?

I can leave my child with my new friend for some time.

Which statement made by the parents of a toddler indicates then need for parenting skills education?

I give my child a cookie when everthing on the plate is finished.

The nurse is teaching an adolescent's parents about guidance to give to an adolescent. Which statements made by a parent indicate a need for further education?

I should avoid giving independence. I should avoid providing unconditional love.

The nurse is educating the mother of a 1 year old baby about an adequate child's diet plan. Which statement made indicates the need for further education?

I should give low-fat or skimmed milk to the child until he or she is 2 years old.

The nurse teaches a student about how to interview an adolescent. Which statements made by the student indicate the need for further education? SATA

I should make assumptions regarding his or her feelings I should interview an adolescent along with his or her parents.

The nurse is assessing a newborn whose mother had a precipitate birth at home. For which complication would the nurse assess the newborn

Intracranial hemorrhage.

A client with chronic hypertension and superimposed preeclampsia give birth at 39 weeks gestation to a 4 Ib 12 oz (2155g) infant. Which condition would the nurse anticipate when assessing the infant?

Intrauterine growth restriction.

Which statement by the nurse is accurate and appropriate to the parents of a toddler-age client who has never been to the dentist?

It is a good idea to let you child go with you for a dental visit before scheduling one for your child.

A child presents with iron poisoning from having ingested several chewable mineral supplement pills containing iron. Which symptoms would the nurse recognize as indicating that the poisoning has progressed to stage IV? SATA

Jaundice Hypoglycemia

Which gross motor skills would the nurse expect children 3 to 5 years of age to develop? SATA

Jumping rope Waling stairs

At 42 weeks gestation a client gives birth to a newborn weighing 8Ib 5 oz. On examination the infant, which would the nurse expect to observe? SATA

Long Nails Wrinkled Skin

The parent of a 7 month old boy states, "you know, my son doesn't sit up by himself yet. Shouldn't he be able to do this by now?" How would the nurse respond?

Many babies don't sit up until they're 8 months old.

A client is at 38 weeks' gestation and is in labor, with ruptured membranes and the fetus is in a breach position. Which would the nurse conclude from observing the amniotic fluid as green?

Meconium is being expelled with contractions.

For which reason may insulin requirements of a client with type 1 diabetes decrease during the first trimester?

Morning sickness my result in decreased food intake.

Which activities would be taught by the nurse as methods of relieving back pain in pregnancy? SATA

Pelvic rocking Forward tilting Sacral pressure

Which is the most important factor for the nurse to consider when selecting nursing measures to help parent-child relationships during the immediate postpartum period?

Physical status of the infant.

Which behavior would the nurse expect when observing a 5 month old infant?

Picking up a toy and putting it in the mouth.

A client in labor is having an indwelling urinary catheter inserted. Which action by the nurse would help prevent late decelerations of the fetal heart rate during this procedure?

Place a rolled towel under the clients right hip

Which behaviors would the nurse determine are developmentally appropriate in a healthy 7 month old infant? SATA

Playing peek-a-boo Turning completely over Reaching to be picked up Sitting for a short time without support.

Which toys would the nurse select as developmentally appropriate for a 1 year old infant? SATA

Push-Pull Toy Nested Boxes Squeaking plastic toy

Which instruction would the nurse include when teaching about the correct use of a female condom?

Remove the condom before standing up.

A 1 year old child is brought to the pediatric clinic for the first time. Which developmental milestone would be achieved by this age?

Responding to peek-a-boo.

Which finding for a 6 month old infant would necessitate further developmental assessment by the nurse?

Showing little response when an activity stopped.

Which characteristics of a male newborn would alert the nurse to conclude that it is a preterm infant? SATA

Small breast buds Wrinkled thin skin Pinnae that remains flat when folded.

Arrange the procedure for posterior palpation of the thyroid gland in sequence.

Stand behind the client Place thumbs on the nape of the client's neck Us the index and middle fingers of both hands to feel the thyroid isthmus Ask the client to flex the neck slightly forward and to the right. Palpate the sternocleidomastoid muscle with the index and middle fingers Ask the client to swallow water so that the thyroid will move up.

The nurse is using the Cochrane library to study systematic review articles and meta-analyses of clinical trials. Which difference will the nurse find in both?

Systematic review articles draw conclusions without statistics; Meta-analyses use statistics for conclusions.

A mother comes to the clinic with her 7 month old child for a routine checkup. Which assessment findings noted by the nurse suggest that the child is exhibiting appropriate fine motor development? SATA

The child bangs objects together The child pulls a string to obtain an object.

Which situation indicates that the child has reached concrete operations stage of Piaget's theory of cognitive development?

The child is able to understand that the volume, length, or shape of an object remains the same despite a change in their physical appearance.

The parents of a school age child tell the nurse, my child seems very hot or red in the face, has abdominal pain, and appears jittery." Which suggestion would the nurse offer as a possible cause for the child's signs and symptoms?

The child is experiencing stress in some are of life.

The nurse is caring for a client 1 week after the client experienced a spinal cord injury at the T3 level. Which short-term goal is appropriate in planning care for this client?

The client will carry out personal hygiene activities.

When assessing frequency of contractions, the time is measured between which two events?

The complete relaxation of the uterus at the end of a contraction to the start of the next contraction.

A pregnant client in the third trimester tells the nurse in the prenatal clinic that she is experiencing heartburn after every meal. Which explanation would the nurse provide regarding the cause of the heartburn?

The esophageal sphincter relaxes and allows acid to be regurgitated.

Which clinical finding would the nurse anticipate regarding the alveoli in the lungs of a neonate born at 28 weeks gestation?

They have a tendency to collapse with each breath.

How will the nurse document the abnormal heart sound heard during the cardiac assessment?

Third heart sound (S3)

Which statement by the parents of an infant with Erb palsy would the nurse determine indicates accurate understanding of their infant's prognosis?

This is a progressive paralysis with no cure.

A client states a desire to follow a total vegetarian (vegan) diet. The client requests assistance in planning a menu to ensure adequate protein quality. Which suggestion should the nurse make?

Us a mixture of plant proteins to provide essential amino acids.

When the clinic nurse is teaching a group of clients with heart failure about dietary interventions to prevent fluid overload, which topic will be included?

Use of fresh or frozen vegetables instead of canned ones

Which play activities are appropriate for a 6 year old child who is in the acute phase of nephrotic syndrome? SATA

Video Games Children's books

Which gross motor skills would the nurse assess for during a health maintenance visit for a toddler-age client? SATA

Walking up and down steps Standing on one foot for several seconds

Which response would the nurse give to a client who has undergone a total hysterectomy because of fibroids when the client asks if she will still need Pap smears?

You will no longer need pap smears but still need regular examinations for other preventive care.

Which developmentally appropriate toys would the nurse provide for a 3 year old child? SATA

Dress up Play telephone Box filled with plastic figures

The parents of a preterm infant are preparing to take their baby home. How would the nurse best evaluate the parents' competency in infant care?

Observe the parents while they are giving care to their infant.

a client asks the nurse about the most common side effect associated with the use of a copper intrauterine device (IUD). Which answer would the nurse provide?

Heavier menstrual periods.

On the third postpartum day the nurse is preparing a breast-feeding mother of twins for discharge. Which statement by the client indicates a potential problem?

My flow is bright fed with small brown clots the size of my thumb

Which movement would the nurse assess to determine a client's rang of motion in the ankle? SATA

Eversion Inversion Dorsiflexion Plantar flexion

Which intervention would be included in the preparation of a 9 year old child undergoing an infratentorial craniotomy?

Having the child draw a picture of a brain and briefly clarifying misconceptions.

The nurse is teaching a client about different prevention and detection practices to ensure breast health. Which statement made by the client indicates the need for further teaching?

I will increase my meat consumption.

A nurse is caring for a client who has been sleeping for 12 to 14 hours on weekend nights. The nurse instructs the client to sleep for no longer than 9 hours because excessive sleeping can lead to health issues. Which reaction might the nurse expect if the client is in the maintenance stage?

I've been following a proper sleep pattern for more than a year.

Which intervention would the nurse provide to meet the developmental needs of hospitalized preschool-aged children?

Providing materials for simulating activities.

Which approach would the nurse take when preparing a 4 year old child for an otoscopic examination?

You can help by holding my light while I get ready.

The nurse instructs the unlicensed assistive personnel (UAP) to obtain vital signs from four clients. For which client would the nurse instruct the UAP to obtain a radial pulse?

a 30 month old child

A client who has just begun breast feeding reports that her nipples feel very sore. Which instruction would the nurse provide to this new mother? SATA

Deeply latch the infant to the breast with each feeding. Take the analgesic medication prescribed to limit the discomfort Assume a different position when breast feeding to adjust the infant's sucking.

The nurse is planning to teach an adolescent about diabetes and self-administration of insulin. Which would the nurse complete first?

Determine what the adolescent know about diabetes.

Which statements would the nurse include in a teaching session for pregnant couples regarding fetal growth and development? SATA

Development occurs in head to toe and central to peripheral pattern Pregnancy includes the preembryonic, embryonic and fetal stages of development During pregnancy the embryo grows form a single cell to a complex physiologic being.

The nurse assesses the growth and development of a 12 month old infant and compares the results with the previous assessment findings. Which finding indicates an abnormality in the neonate? Chest: 42 cm at 6 mths and 43 cm at 12 months

Chest Circumference

Which would the nurse expect a 24 month old toddler to be able to do?

Climb stairs with two feet on each step

Which statement explains the importance of play in toddlers? SATA

Toddlers prefer to play beside other children Toddlers prefer to stay clos to parents while playing

A woman presents in labor with her baby in frank breech, left sacral anterior position. Where would the nurse listen for the fetal heart tone?

Mother's left side, above the umbilicus

Which statement would the nurse use to teach the therapeutic modalities for depression?

Operant conditioning will reward positive behavior. Says this is SATA, but there is only one answer.

Which is the most reliable birth control method for the nurse to recommend to a client with type 1 diabetes?

Oral contraceptive.

The nurse is assisting a client plan a therapeutic diet high in vitamin C to help with healing. Which excellent sources of vitamin C would the nurse include in the plan? SATA

Oranges Cantaloupe Strawberries

The nurse is conducting physical examinations for girls who will participate in school sports. Which finding would cause the nurse to suspect female athlete triad? SATA

Osteopenia Amenorrhea Eating disorder Rapid Weight Loss Low Caloric intake All are correct

Which foods would the nurse recommend to a client who is concerned with ensuring that her diet is not deficient in folic acid (folate)? SATA

Black and pinto beans Enriched bread and pasta

A client has the habit of staying up and watchin movies until 4 AM on weekends. The nurse educates the client about the risks of not following a proper sleep routine. The client responds by saying, "I understand you point, but I haven't had any major problems yet." Which stage of health behavior change does the nurse recognize?

Contemplation

Which nursing intervention would be indicated in the care of a client in the first stage of labor with the fetal heart rate baseline that was in the 150s and is now in the 130s with variability present?

Continuing to monitor the client

Which questions regarding gross motor skills would the nurse include when conducting the interview portion of the developmental assessment with the parent of an infant between 10 and 12 months of age? SATA

Does your baby stand independently? Is your baby able to walk with assistance? Dose your baby sit from a standing position?

The nurse is evaluating a 15 month old toddler's ability to perform physical tasks. Which behavior indicates to the nurse that the child's development is age appropriate? SATA

Drinking form a cup Waling with a wide-based gait Throwing toys around the room.

The nurse is teaching a student about assessments to be performed in adolescents with dysfunctional uterine bleeding. Which statement made by a nursing student indicates a need for further education? SATA

I should choose appropriate therapeutic measures for her menstrual problems. I should ask the adolescent to explain the cause of her disorder before an assessment is made.

The nurse finds that a 2 year old child has impaired fine motor skills. The nurse recommends toys that will be beneficial for the child. Which statement by the child's parents needs correction?

I should provide battery-operated cars

Which parental statement would the nurse recognize as indicating a need for further education about protecting a preschooler from lead exposure?

I will use only hot water for cooking food. I will regularly vacuum hard-surfaced floors or windowsills or wells.

A client tells the nurse that her mother died of endometrial cancer 1 year ago and that she is afraid she will also develop this same cancer. Which risk factor stated by the client after an education session on risk factors indicates that further teaching is needed?

Late-onset menarche

After a difficult birth, a neonate has an Apgar score of 8 after 5 minutes. Which assessments are assigned 2 points for their categories? SATA

Reflex irritability: cry Heart Rate: 110 b/m Respiratory Rate: good cry

The nurse hears these sounds while auscultating a client's heart. Which abnormal sound would the nurse document for this client? 2_1_Cardiovascular_Hematologic_and.mp3. 1. systolic murmur 2. S3 3. S4 4. Pericardial friction rub

S4 low pitched sound; heard in late diastole, just before the first heart sound S1.

Which is appropriate play for an 8 month old infant? SATA

Textured book Stuffed animal Hanging mobile

The nurse is assessing a school-age child who suffers from encopresis. Which advice provides effective treatment for this condition? SATA

You should drink lots of fluid You should include cereals in you diet You should eat fresh fruit for breakfast.

Which behavior would indicate that one of a toddler's developmental milestones has been achieved

accepting external limits

Which developmental language milestone would the nurse expect in a 4 year old child? SATA

uses six to eight word sentences Has a vocabulary of 1000 words.

Which common side effect associated with the use of a copper intrauterine device (IUD) would the nurse discuss with the client during a teaching session?

Excessive menstrual flow

Which education would the nurse provide the parents of a 4 year old child about typical sleeping patterns in preschoolers? SATA

Total sleep averages 12 hours at night In the awake period, the child may sleepwalk It is common for the child to awaken during the night.

Which activity would the nurse encourage as age appropriate for a 10 week old infant

Tummy Time

Which statement describes the difference in typical fine motor development between 4 year old and 5 year old children?

Five year olds can print a few letters, numbers, or words; 4 year olds cannot.

Which clinical finding in a newly delivered client requires immediate investigation?

A slow trickle of blood from the vagina.

Which intervention would the nurse recommend to the mother of a 6 month old infant who experiences injection site redness, swelling and discomfort?

Administer a dose of acetaminophen (Tylenol).

Which parent education would the nurse provide about typical behaviors of an 8 month old infant?

Being shy with strangers Showing interest in small objects.

The nurse is providing education about excellent food sources of vitamin A for a client who is deficient in this vitamin. Which foods would the nurse include in the teaching? SATA

Carrots Leafy Greens Cantaloupe

Which intervention would the nurse add to the plan of care for a client with bipolar disorder who is using pressured speech and has stopped eating and sleeping? SATA

All answers are correct Limiting caffeine intake Giving olanzapine as prescribed Providing soft music at bedtime Maintaining a record of I&O Monitoring blood pressure every 30 minutes Offering a high-calorie, high-protein drink every hour.

Which points require correction regarding wellness promotion in the older adult? SATA

Curing diseases or other illnesses completely is essential to promote wellness in the older adult. It is necessary to prevent older adults from taking part in physical activities to keep them from sustaining injuries an older adult should live in social isolation to prevent stress

During which time frame would the nurse instruct the couple planning to use the calendar (rhythm) method of contraception to refrain from intercourse if the woman's cycles are every 28 days?

Days 10 to 17 of the menstrual cycle

A parent whose infant is born with talipes equinovarus (clubfoot) tells the nurse, "I am afraid to have more children because they might have the same problem." What is the best response by the nurse?

Exploring the parent's understanding of the probable causes of this disorder.

Which instructions would the nurse give a 60 year old client who is at an increased risk for corneal damage?

Use saline drops Wear prescribed lenses for best vision Have corrective lenses solely for reading

Which time in the menstrual cycle would the nurse recommend the client come in for intrauterine device IUD insertion?

Anytime in the cycle.

Which are the sedentary client's responses regarding instruction to become physically active in the order reflecting the stages of health behavior changes?

"I'm fit and completely healthy, ......." "I know that exercise is good for my health, ...." "I don't even know how to begin exercising. Could you refer me to a personal trainer?" " I go to the gym every day, but feel like giving up" "I need help fitting my exercise routine into my daily schedule"