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| Section | Weight | Objectives |
|---|---|---|
| Psychosocial Integrity | 6-12% | - Psychosocial Integrity
|
| Health Promotion and Maintenance | 6-12% | - Health Promotion and Maintenance
|
| Physiological Adaptation | 11-17% | - Physiological Adaptation
|
| Reduction of Risk Potential | 9-15% | - Reduction of Risk Potential
|
| Pharmacological and Parenteral Therapies | 13-19% | - Pharmacological and Parenteral Therapies
|
| Basic Care and Comfort | 6-12% | - Basic Care and Comfort
|
| Management of Care | 15-21% | - Management of Care
|
| Safety and Infection Control | 10-16% | - Safety and Infection Control
|
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NEW QUESTION # 98
A 4 year old has an imaginary playmate, which concerns the mother. The nurse's best response would be:
Answer: C
Explanation:
Explanation
(A) This is normal for a preschooler, and a referral is not appropriate. (B) Telling a parent not to worry is unhelpful. This response does not address the mother's concern. (C) This response is incorrect. The behavior is normal and will usually disappear by the time the child enters school. (D) This behavior is normal development for a preschooler.
NEW QUESTION # 99
A 4-year-old child has Down syndrome. The community health nurse has coordinated a special preschool program. The nurse's primary goal is to:
Answer: C
Explanation:
Explanation
(A) Respite care for the family may be needed, but it is not the primary goal of a preschool program. (B) Facilitation of optimal growth and development is essential for every child. (C) A demanding and challenging educational program may predispose the child to failure. Children with retardation should begin with simple and challenging educational programs. (D) Mental retardation associated with Down syndrome may not permit mainstream education. A preschoolprogram's primary goal is not preparation for mainstream education but continuation of optimal development.
NEW QUESTION # 100
A 3-year-old child is hospitalized with burns covering her trunk and lower extremities. Which of the following would the nurse use to assess adequacy of fluid resuscitation in the burned child?
Answer: C
Explanation:
(A) Blood pressure can remain normotensive even in a state of hypovolemia. (B) Serum potassium is not reliable for determining adequacy of fluid resuscitation. (C) Urine output, alteration in sensorium, and capillary refill are the most reliable indicators for assessing adequacy of fluid resuscitation. (D) Pulse rate may vary for many reasons and is not a reliable indicator for assessing adequacy of fluid resuscitation.
NEW QUESTION # 101
The parents of a 2-year-old child are ready to begin toilet training activities with him. His parents feel he is ready to train because he is now 2 years old. What would the nurse identify as readiness in this child?
Answer: C
Explanation:
Explanation
(A) Children experience impatience with soiled diapers when readiness for training is apparent. They often desire to be changed immediately. (B) A child must be able to use verbal or nonverbal skills to communicate needs. (C) A readiness indicator would be awaking dry from naps. (D) The age at which a sibling was toilet trained has no implications for training this child.
NEW QUESTION # 102
When a client arrives on the labor and delivery unit, she informs the nurse that she has been having contractions for the last 5 hours. Now the pain is constant and not cyclical as it was earlier. The nurse considers the possibility of uterine rupture. Which of the following symptoms would be consistent with a uterine rupture?
Answer: B
Explanation:
Explanation/Reference:
Explanation:
(A) This symptom would indicate a rupture of the membranes, which would be expected during labor.
There would be no cause for alarm if the fluid were clear. (B) With uterine rupture and the risk of maternal shock secondary to blood loss, the most likely sign would be hypotension indicating hypovolemic shock.
(C) In the event of a uterine rupture, an abdominal examination would likely reveal rigidity or tenderness.
(D) The most likely finding would be a decrease in fetal movement related to fetal distress due to impaired uteroplacental blood flow. Maintaining the client on her left side would help to maximize uterine blood flow.
NEW QUESTION # 103
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