A nurse is assessing a 2-year-old child at a well-child visit. The child’s parent expresses concern about the child’s increasing temper tantrums and difficult behaviors. Which of the following statements should the nurse respond with?
“Discipline is an important aspect of parenting. How do you discipline the child when they act out?”
“Some children have more difficult personalities. There are great parenting books that can help you.”.
“Toddlers are beginning to develop a desire for autonomy. Temper tantrums are normal during this stage.”.
“Diets can play a part in behavioral concerns. What does your child typically eat during the day?”
The Correct Answer is C
Choice A rationale
While discipline is an important aspect of parenting, the nurse’s response should focus on normalizing the child’s behavior and providing reassurance to the parent. Discussing discipline methods may not address the parent’s immediate concern about temper tantrums.
Choice B rationale
Suggesting that some children have more difficult personalities and recommending parenting books may not provide the immediate reassurance and understanding the parent needs. It is important to normalize the child’s behavior and explain that temper tantrums are a normal part of development.
Choice C rationale
Toddlers are beginning to develop a sense of autonomy and independence, which can lead to temper tantrums as they assert their desires and preferences. Explaining that temper tantrums are normal during this stage of development helps reassure the parent and provides a better understanding of their child’s behavior.
Choice D rationale
While diet can play a role in behavior, the nurse’s response should focus on normalizing the child’s behavior and providing reassurance. Discussing diet may not address the parent’s immediate concern about temper tantrums and difficult behaviors.
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Correct Answer is C
Explanation
Choice A rationale
Coughing and shortness of breath in the morning are signs of poor asthma control, not well- controlled asthma. These symptoms indicate that the child’s asthma is not being managed effectively and may require adjustments in their treatment plan.
Choice B rationale
This statement is incorrect. If asthma is not controlled, the child is likely to miss more days of school due to asthma symptoms and exacerbations. Effective asthma management aims to reduce symptoms and prevent asthma attacks, allowing the child to attend school regularly.
Choice C rationale
Eliminating allergens that irritate the lungs is a key strategy in preventing asthma attacks. Allergens such as dust mites, pet dander, mold, and pollen can trigger asthma symptoms. By reducing exposure to these allergens, the child can better manage their asthma and reduce the frequency of attacks.
Choice D rationale
This statement is false. Children with well-controlled asthma can participate in sports and physical activities. Physical activity is beneficial for lung function and overall health. The nurse should teach the child how to prevent exercise-induced asthma symptoms, such as using a bronchodilator before exercise.
Correct Answer is A
Explanation
Choice A rationale
Auscultating the rate and characteristics of the child’s heart sounds is the priority assessment. Acute rheumatic fever can lead to carditis, which affects the heart valves and can cause new or changed heart murmurs.
Choice B rationale
Assessing the client’s erythematous rash is important but not the priority. The rash is a common symptom but does not indicate the severity of the condition.
Choice C rationale
Identifying the degree of parental anxiety is important for providing holistic care but is not the immediate priority in assessing the child’s physical condition.
Choice D rationale
Using a pain-rating tool to determine the severity of joint pain is important for managing symptoms but is not the priority assessment upon admission.