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 D
Explanation
Choice A rationale
A storybook about a child who has diabetes can be helpful in educating the child about their condition and normalizing their experience. However, it may not be as effective in addressing the immediate distress caused by an insulin injection. Therapeutic play that directly involves the injection experience can be more beneficial in helping the child cope with their fear and anxiety.
Choice B rationale
A period of play in the playroom can provide a distraction and help the child relax. However, it does not specifically address the child’s distress related to the insulin injection. Therapeutic play that involves role-playing the injection process can be more effective in helping the child understand and cope with the procedure.
Choice C rationale
A video game can serve as a distraction and help the child relax. However, it does not directly address the child’s fear and anxiety related to the insulin injection. Therapeutic play that involves role-playing the injection process can be more effective in helping the child understand and cope with the procedure.
Choice D rationale
Using a needleless syringe and a doll allows the child to engage in therapeutic play that simulates the experience of receiving an insulin injection. This type of play helps the child understand the procedure, reduces fear and anxiety, and provides a sense of control over the situation. It is a direct and effective way to help the child cope with the distress caused by the injection.
Correct Answer is B
Explanation
Choice A rationale
Insulin should be administered subcutaneously, not intramuscularly. Rotating sites is important to prevent lipodystrophy, but the correct technique involves subcutaneous injection.
Choice B rationale
Drawing up the short-acting insulin into the syringe first is correct. This prevents contamination of the short-acting insulin vial with long-acting insulin, ensuring accurate dosing.
Choice C rationale
Wiping off the needle with an alcohol swab is not recommended. The needle should remain sterile, and only the top of the insulin vial should be wiped with an alcohol swab.
Choice D rationale
Administering insulin at a 30-degree angle is incorrect. Insulin should be administered at a 90- degree angle if the person can grasp 2 inches of skin, or at a 45-degree angle if only 1 inch of skin can be grasped.