Question

A nurse is caring for a 12-month-old toddler who is hospitalized and confined to a room with contact precautions in place. Which of the following toys should the nurse recommend in order to meet the developmental needs of the child?

Answer 1

Correct Answers:

Large building blocks

Rationale :

🧱For a 12-month-old toddler, large, lightweight blocks match developmental needs by promoting sensorimotor exploration, early problem-solving, and emerging fine + gross motor skills (grasping, banging, stacking).

🧱On contact precautions, toys should be nonporous and easily disinfected; hard plastic blocks can be wiped/cleaned between uses, supporting infection control.

🧱Safety is optimal: the blocks are too large to be aspirated, reducing choking risk common at this age.

🧱Blocks facilitate solitary play, which is the normative social pattern for toddlers, while still allowing guided interaction with caregivers at the bedside.

🧱Hospital confinement limits movement; block play lets the child practice sitting, reaching, and coordinated movements within a small, safe space, helping prevent developmental regression during hospitalization.

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Answer 2

Correct Answers:

Suction the nares and oropharynx to remove secretions

Rationale :

🔷In infants with RSV, airway clearance is the first priority—excess mucus/secretions increase work of breathing, worsen hypoxemia, and can precipitate apnea, especially in a 3-month-old.

🔷Young infants are obligate nose breathers; nasopharyngeal suctioning promptly improves air entry, oxygen saturation, and feeding tolerance by relieving nasal obstruction.

🔷Following ABCs, restoring a patent airway takes precedence and often corrects low SpO₂ without additional interventions; supplemental oxygen is considered after effective suction if saturations remain low.

🔷Evidence-based supportive care for bronchiolitis prioritizes gentle nasal/oropharyngeal suction, hydration, and minimal handling; this provides the most immediate physiologic benefit.

🔷Practically, suction before feeds and when dyspnea or desaturation increases; reassess RR, retractions, breath sounds, and SpO₂ to evaluate response and need for escalation.

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Answer 3

Correct Answers:

Repeating instructions and evaluate child's understanding.
Encouraging independence and autonomy.
Demonstrate through actual practice with visual aids.
Using simple and concrete language.

Rationale :

Repeating instructions and evaluating the child’s understanding

🧠Adolescents with Down syndrome often benefit from repetition because processing speed and working memory can be limited; repeating key steps consolidates learning.

🧠Using teach-back (ask the adolescent to explain or show the step) verifies true comprehension rather than passive agreement.

🧠Delivering instructions in small chunks with brief pauses prevents cognitive overload and reduces procedure-related anxiety.

🧠Repetition with consistent wording supports predictability, which enhances cooperation and trust.

🧠Documenting what was understood guides individualized reinforcement in subsequent encounters.

Encouraging independence and autonomy

🧠Promoting autonomy (e.g., choosing the order of steps, which arm to use) respects adolescent development and increases engagement.

🧠Offering age-appropriate choices fosters self-efficacy and reduces the risk of learned helplessness.

🧠Involving the adolescent in planning aligns with shared decision-making, improving cooperation and carryover of skills.

🧠Stepwise responsibilities (holding the tourniquet, peeling a dressing) match abilities while maintaining safety.

🧠Collaboration with caregivers ensures support without over-directing, preserving the adolescent’s voice in care.

Demonstrate through actual practice with visual aids

🧠 Learners with Down syndrome tend to be strong visual and hands-on learners; models, pictures, and brief videos make abstract steps concrete.

🧠 Return-demonstration builds motor memory and reveals gaps that verbal instruction alone might miss.

🧠 A brief walk-through (e.g., show swabs, gel, monitor leads) reduces fear of the unknown and improves predictability.

🧠 Using sequence cards or a visual schedule clarifies step order and supports independence.

🧠 Visuals become a reusable cue the adolescent can reference during the procedure, increasing success and calm.

Using simple and concrete language

🧠 Short, literal, one-step directions (e.g., “Hold still,” “Deep breath”) match receptive language needs and reduce misinterpretation.

🧠 Avoiding idioms, metaphors, and medical jargon prevents confusion and minimizes anxiety.

🧠 Pairing plain words with gestures/pictures creates multimodal cues, improving recall and performance.

🧠 Consistent terms (use the same word for the same step every time) strengthen associative learning.

🧠 Checking for understanding after each step ensures real-time correction before moving forward.

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Answer 4

Correct Answers:

Bananas

Rationale :

🍌For a 2-year-old, soft, easily mashable foods like bananas minimize choking risk and support safe self-feeding.

🍌Bananas provide readily digestible carbohydrates and potassium, aligning with toddler nutrition needs.

🍌They can be cut into small slices or lightly mashed, promoting independence and fine motor skill development.

🍌Hard, raw, or round foods are avoided at this age due to airway occlusion risk, making bananas an age-appropriate choice.

🍌Offering familiar, mild-flavored foods can improve intake during periods of picky eating common in toddlers.

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Answer 5

Correct Answers:

Give pancreatic enzymes whole or sprinkled on a small amount of food with food intake

Rationale :

🍽️Pancrelipase must be given with all meals and snacks so enzymes mix with chyme in the duodenum, optimizing fat, protein, and carbohydrate digestion.

🍽️Capsules may be swallowed whole or the enteric-coated microbeads can be sprinkled on a small amount of acidic soft food (e.g., applesauce); this protects the enzymes from gastric acid and ensures intestinal release.

🍽️Beads should not be chewed, crushed, or mixed with hot/alkaline foods, which would inactivate the enzymes and reduce efficacy.

🍽️Doses are typically titrated to stool quality and weight gain; persistent bulky, greasy stools usually indicate insufficient dosing, reinforcing the importance of dosing with food.

🍽️Follow doses with a cool liquid and perform oral care to reduce mucosal irritation from residual beads.

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Answer 6

Correct Answers:

83

Rationale :

✍️Use Rate (mL/hr) = Total volume (mL) ÷ Time (hr).

✍️1,000 mL ÷ 12 hr

✍️ 83.33 mL/hr

✍️Which rounds to 83 mL/hr per whole-number pump settings.

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Answer 7

Correct Answers:

Providing the child with opportunities to keep up with their schoolwork

Rationale :

🎒An 8-year-old is in Erikson’s Industry vs. Inferiority stage, where success comes from mastery of tasks and productivity.

🎒Maintaining schoolwork in the hospital preserves routine, supports skill competence, and fosters a sense of accomplishment.

🎒Academic engagement reduces anxiety about falling behind and sustains peer-relevant goals, protecting self-esteem.

🎒Involving the child in structured, achievable tasks reinforces industry and promotes adaptive coping during hospitalization.

🎒This approach aligns with family-centered care, integrating developmental needs with medical treatment.

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Answer 8

Correct Answers:

Call poison control immediately for guidance how to proceed.

Rationale :

☎️Poison Control provides agent-specific, time-sensitive instructions (e.g., dilution, observation, decontamination, or ED referral) that optimize outcomes.

☎️Empiric actions (e.g., inducing vomiting or giving milk) can be harmful; guidance ensures evidence-based next steps for the specific toxin.

☎️Early consultation helps determine home management vs. transport, reducing treatment delays and complications.

☎️Caregivers should be prepared to report substance, amount, time since exposure, and symptoms for accurate triage.

☎️Keep the container/label for reference and follow instructions precisely until care is transitioned if needed.

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Answer 9

Correct Answers:

"The condition affects the movement of sodium and water, leading to hyponatremia, as seen in the client's laboratory values."

Rationale :

🧂Cystic fibrosis involves CFTR dysfunction, impairing chloride transport and altering sodium and water movement across epithelial surfaces.

🧂Excessive salt loss in sweat predisposes to hyponatremia, reflected here by serum sodium ~128 mEq/L (low).

🧂During exacerbations, patients can develop salt-wasting dehydration, making electrolyte monitoring and replacement essential.

🧂The pathophysiology centers on airway, GI, and sweat gland epithelia, explaining the systemic fluid-electrolyte impact.

🧂Education should emphasize adequate salt/fluid intake, especially during fever, heat, or exercise, to prevent symptomatic hyponatremia.

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Answer 10

Correct Answers:

Airway obstruction

Rationale :

🫁 Epiglottitis causes rapid supraglottic swelling, making sudden airway obstruction the primary and most dangerous risk.

🫁Classic findings—high fever, severe sore throat, drooling, dysphagia, muffled voice, tripod position, inspiratory stridor—signal impending obstruction.

🫁Priority care is airway management with minimal agitation, humidified oxygen, and readiness for controlled intubation.

🫁Avoid oropharyngeal inspection with depressors in unstable patients to prevent precipitating complete obstruction.

🫁Prompt antibiotics and airway protection reduce morbidity and mortality, especially in non- or under-immunized children.

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NSG 234 Exam 1

No.

1 :
A nurse is caring for a 12-month-old toddler who is hospitalized and confined to a room with contact precautions in place. Which of the following toys should the nurse recommend in order to meet the developmental needs of the child?

2 :
The nurse identifies the following during the assessment of a 3-month-old with RSV. Based on the vital signs and assessment findings what is the priority nursing action at this time?

3 :
A nurse is preparing an adolescent with Down Syndrome for a procedure. Which of the following approaches would be appropriate?(Select all that apply)

4 :
A nurse is teaching a parent of a 2-year-old child about food choices. Which of the following foods should the nurse recommend?

5 :
Which of the following should the nurse include when teaching parents how to administer pancreatic enzymes to a child with cystic fibrosis?

6 :
A client is receiving 1000 mL of normal saline over 12 hours on an infusion pump. The nurse will set the infusion pump rate to how many milliliters per hour (mL/hr) (Round to a whole number)

7 :
In caring for an 8-year-old hospitalized child, the nurse can best reflect Erickson's theory of school-age developmental tasks by:

8 :
The nurse educates a group of parents that the most important step they can take if they suspect their child has ingested a poison is:

9 :
A nurse at an emergency department is caring for a child who was admitted with cystic fibrosis exacerbation. The child's parent is given the lab results and asks how the values relate to cystic fibrosis. Which of the following statements by the nurse is accurate?

10 :
A nurse recognizes that a child diagnosed with epiglottitis is a risk for which of the following complications?

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NSG 234 Exam 1

No.

1 : A nurse is caring for a 12-month-old toddler who is hospitalized and confined to a room with contact precautions in place. Which of the following toys should the nurse recommend in order to meet the developmental needs of the child?

2 : The nurse identifies the following during the assessment of a 3-month-old with RSV. Based on the vital signs and assessment findings what is the priority nursing action at this time?

3 : A nurse is preparing an adolescent with Down Syndrome for a procedure. Which of the following approaches would be appropriate?(Select all that apply)

4 : A nurse is teaching a parent of a 2-year-old child about food choices. Which of the following foods should the nurse recommend?

5 : Which of the following should the nurse include when teaching parents how to administer pancreatic enzymes to a child with cystic fibrosis?

6 : A client is receiving 1000 mL of normal saline over 12 hours on an infusion pump. The nurse will set the infusion pump rate to how many milliliters per hour (mL/hr) (Round to a whole number)

7 : In caring for an 8-year-old hospitalized child, the nurse can best reflect Erickson's theory of school-age developmental tasks by:

8 : The nurse educates a group of parents that the most important step they can take if they suspect their child has ingested a poison is:

9 : A nurse at an emergency department is caring for a child who was admitted with cystic fibrosis exacerbation. The child's parent is given the lab results and asks how the values relate to cystic fibrosis. Which of the following statements by the nurse is accurate?

10 : A nurse recognizes that a child diagnosed with epiglottitis is a risk for which of the following complications?

1 :
A nurse is caring for a 12-month-old toddler who is hospitalized and confined to a room with contact precautions in place. Which of the following toys should the nurse recommend in order to meet the developmental needs of the child?

2 :
The nurse identifies the following during the assessment of a 3-month-old with RSV. Based on the vital signs and assessment findings what is the priority nursing action at this time?

3 :
A nurse is preparing an adolescent with Down Syndrome for a procedure. Which of the following approaches would be appropriate?(Select all that apply)

4 :
A nurse is teaching a parent of a 2-year-old child about food choices. Which of the following foods should the nurse recommend?

5 :
Which of the following should the nurse include when teaching parents how to administer pancreatic enzymes to a child with cystic fibrosis?

6 :
A client is receiving 1000 mL of normal saline over 12 hours on an infusion pump. The nurse will set the infusion pump rate to how many milliliters per hour (mL/hr) (Round to a whole number)

7 :
In caring for an 8-year-old hospitalized child, the nurse can best reflect Erickson's theory of school-age developmental tasks by:

8 :
The nurse educates a group of parents that the most important step they can take if they suspect their child has ingested a poison is:

9 :
A nurse at an emergency department is caring for a child who was admitted with cystic fibrosis exacerbation. The child's parent is given the lab results and asks how the values relate to cystic fibrosis. Which of the following statements by the nurse is accurate?

10 :
A nurse recognizes that a child diagnosed with epiglottitis is a risk for which of the following complications?