Pediatric NCLEX PN
The nurse is reinforcing instructions to a 16-year-old male adolescent regarding dietary patterns. The nurse instructs the adolescent about the recommended amount of daily calories. How many calories a day does the nurse recommend as the approximate daily caloric allowance for a male adolescent?
2200 RATIONALE:The recommended amount of daily calories for a male adolescent between the ages of 15 and 18 years is 2200.
The nurse employed in a well-baby clinic is collecting data on the language and communication developmental milestones of a 4-month-old infant. Based on the age of the infant, the nurse expects to note which highest level of developmental milestones?
Babbling sounds RATIONALE:Babbling sounds are common between the ages of 3 and 4 months. Additionally, during this age, crying becomes more differentiated. Between the ages of 1 and 3 months, the infant will produce cooing sounds. An increased interest in sounds occurs between 6 and 8 months, and the use of gestures occurs between 9 and 12 months.
According to Erik Erikson's psychosocial developmental theory, the nurse should anticipate a 5-year-old child to be in which stage?
Initiative vs. guilt
A nursing student is assigned to care for a hospitalized 2-year-old child. The nursing instructor reviews the plan of care with the student and asks the student to identify the expected behavior of the child in regard to separation anxiety. Which statement by the student indicates an understanding of separation anxiety that can occur in a 2-year-old child?
The child may ignore the parents when they visit." RATIONALE:The toddler is particularly vulnerable to separation. A toddler often shows anger at being left by ignoring the parent or by pretending to be more interested in play than in going home. Parents of hospitalized toddlers frequently are distressed by such behavior. The toddler engages in parallel play and plays alongside but not with other children.
The nurse is performing a safety assessment in the home of a mother with two children. The ages of the children are 1 and 3 years. Which observation noted during the assessment would present the greatest hazard to the children?
Toys with small loose parts in the playroom RATIONALE:Toys with small loose parts would be the priority concern. Children at this age are likely to place the small toy parts in their mouths, which could lead to aspiration and choking. The temperature of the water heater is a concern, but it is not the greatest hazard. The mother should be aware of and taught safety measures related to safe water temperatures for bathing the children. A gate placed at the stairs of the second floor is a safety measure. A small dog as a house pet is not necessarily a hazard.
During a well-child visit a mother states she is frustrated with her 2-year-old child. Whenever she asks him if he wants something to eat, he says, "No," but then he starts to cry when she does not give him the food. Which statement by the nurse would indicate an understanding of psychosocial concepts related to growth and development of the toddler?
Your toddler is asserting his independence as he is progressing through the stage of autonomy versus shame and doubt." RATIONALE:According to Erikson, toddlers are acquiring a sense of autonomy while overcoming a sense of shame and doubt. They are attempting to relinquish their dependence and assert independence, which will be present as negativism in their quest for independence. The word no is a very strong part of their vocabulary.
A mother of a 5-year-old child tells the nurse that the child scolds the floor or table if the child hurts herself on the object. According to Piaget's theory of cognitive development, which behavior is this known as?
Animism RATIONALE:Animism means that all inanimate objects are given living meaning. Object permanence, the realization that something out of sight still exists, occurs in the later stages of the sensorimotor stage of development. Egocentric speech occurs when the child talks just for fun and cannot see another's point of view. Global organization means that if any part of an object or situation changes, the whole thing has changed. Options 2 and 4 occur during the preoperational stage.
The nurse has reinforced information to the mother of a toddler regarding toilet training. Which statement by the mother would indicate a need for further teaching?
I should have my child sit on the potty until my child urinates." RATIONALE:The mother should wait until the child is 24 to 30 months old because this makes the task of toilet training considerably easier. Toddlers of this age are less negative and usually are more willing to control their sphincters to please their parents. Bowel control is usually achieved before bladder control. The child should not be forced to sit on the potty for long periods. The ability to sit, squat, and walk well are physical signs of readiness.
The nurse is admitting a 10-month-old infant who is being hospitalized for a respiratory infection. The nurse develops a plan of care for the infant and includes which intervention?
Providing a consistent routine such as touching, rocking, and cuddling throughout the hospitalization RATIONALE:A 10-month-old is in the trust vs. mistrust stage of psychosocial development, according to Erikson. The infant is developing a sense of self, and the nurse should most appropriately provide a consistent routine for the child. Hospitalization may have an adverse effect, and the nurse should touch, rock, and cuddle the infant to promote a sense of trust and to provide sensory stimulation.
The nurse provides information to the mother of a toddler regarding toilet-training. The nurse should tell the mother what information? Select all that apply.
The child should not be forced to sit on the potty for long periods." "The ability of the child to remove clothing is a sign of physical readiness." "Waiting until the child is 24 to 30 months old makes the task considerably easier." "At the age of 24 to 30 months old, the toddler is usually less negative and more willing to control their sphincters to please their parents." RATIONALE:Waiting until the child is 24 to 30 months old makes the task considerably easier because toddlers of this age are less negative and usually more willing to control their sphincters to please their parents. Bowel control typically occurs before bladder control. The child should not be forced to sit for long periods. The ability to remove clothing is one of the physical signs of readiness.
A young adult college student begins to throw objects, shout insults, and stamp his feet after an instructor returned his work, noting it was substandard. Using Erikson's theory of personality development, which developmental stage has this individual unsuccessfully mastered?
Autonomy vs. shame and doubt RATIONALE:A widely accepted theory of personality development is that by Erik Erickson. Each of Erickson's eight stages has two components: the favorable and unfavorable aspects of the core conflict. No core conflict is ever totally mastered, and when individuals face new situations in life, they may revert to a previously mastered core conflict. Negative feelings of doubt and shame arise when individuals are made to feel self-conscious and shame. The positive outcomes of mastering this developmental stage are self-control and willpower. The lasting outcomes of initiative vs. guilt are direction and purpose. Not mastering this stage leads to guilt and lack of purpose. The ego quality developed from a sense of industry is competence. Feelings of inadequacy and inferiority may result from not mastering this task. The outcome of successful mastery of identity vs. role confusion is a sense of personal identity. Inability to solve this conflict results in role confusion.
The nurse is collecting data regarding the motor development of a 24-month-old child. Based on the age of the child, the nurse expects to note which highest level of developmental milestone?
The child uses a doorknob to open a door. RATIONALE:A 24-month-old would be able to use a doorknob to open a door. At age 15 months, the child could build a tower of two blocks. At age 30 months, the child would be able to snap large snaps and put on simple clothes independently.
The nurse is employed in a newborn nursery. The nurse is aware that medication toxicity is more likely to occur in the neonate than in an adult because of which physiologic difference?
The liver is immature. RATIONALE: The increased medication sensitivity of neonates and infants is a result largely of the immature state of five pharmacokinetic processes. These include medication absorption, renal medication excretion, hepatic medication metabolism, protein binding of medication, and exclusion of medication from the central nervous system by the blood-brain barrier.
