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
Distended neck veins are not a typical manifestation of pyloric stenosis. This condition primarily affects the gastrointestinal system, leading to symptoms related to feeding and digestion rather than cardiovascular symptoms like distended neck veins.
Choice B rationale
Red currant jelly stools are associated with intussusception, not pyloric stenosis. Intussusception involves the telescoping of one part of the intestine into another, leading to obstruction and the characteristic stool appearance.
Choice C rationale
Projectile vomiting is a hallmark symptom of pyloric stenosis. This occurs due to the obstruction at the pylorus, which prevents food from passing into the small intestine, leading to forceful expulsion of stomach contents.
Choice D rationale
A ridged abdomen is not a typical symptom of pyloric stenosis. While the abdomen may be distended due to the obstruction, the primary symptom is projectile vomiting.
Correct Answer is A
Explanation
Choice A rationale
A blood pressure of 90/40 mm Hg, heart rate of 135/min, respirations of 32/min, and an oral temperature of 38°C (100.4°F) indicate potential signs of sepsis or another serious condition. The elevated heart rate and respiratory rate, along with the fever, suggest an infection that requires immediate medical attention.
Choice B rationale
While the vital signs in this option are slightly elevated, they are not as concerning as those in Choice A. The heart rate and respiratory rate are within acceptable ranges for a 2-year-old, and the temperature is only slightly elevated.
Choice C rationale
The vital signs in this option are within normal ranges for a 2-year-old child. There is no immediate cause for concern based on these vital signs.
Choice D rationale
The vital signs in this option are also within acceptable ranges for a 2-year-old child. While the heart rate is slightly elevated, it is not as concerning as the vital signs in Choice A.