A nurse is planning care for an adolescent who is withdrawn and avoids social group activities. Which of the following interventions should the nurse plan to include?
Encourage the adolescent to spend more time alone to build self-confidence.
Assign the adolescent as the leader of a group project in a school activity.
Arrange one-on-one counseling sessions to explore the causes of social withdrawal.
Advise the adolescent to focus solely on academic achievements to boost self-esteem.
The Correct Answer is C
A. Encouraging the adolescent to spend more time alone may reinforce their withdrawal and does not promote social interaction or engagement.
B. Assigning the adolescent as a leader may increase anxiety and exacerbate their withdrawal rather than encourage socialization.
C. One-on-one counseling can provide a safe space for the adolescent to express feelings and explore the reasons for their withdrawal, which is a supportive and therapeutic intervention.
D. Focusing solely on academic achievements may lead to further isolation and does not address the need for social skills development and peer interaction.
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Correct Answer is C
Explanation
A. Clients on digoxin should actually have an adequate intake of potassium, as low potassium levels can increase the risk of digoxin toxicity.
B. If a pediatric client spits out digoxin, the dose should not be repeated automatically; instead, the nurse should assess the situation and follow the facility's protocol regarding missed doses.
C. Measuring the apical pulse for one full minute before administering digoxin is critical; if the pulse is below the established threshold (usually <60 bpm for children), the medication should be held and the provider notified.
D. While evaluating for nausea, vomiting, and anorexia is important, it is not an appropriate immediate action before administering the medication. The priority action is to assess the apical pulse.
Correct Answer is D
Explanation
A. Weak pulses are more indicative of reduced cardiac output or other cardiac issues, rather than specifically a large patent ductus arteriosus (PDA).
B. Cyanosis with crying can occur in various conditions, but it is not a hallmark of a large PDA; it typically presents with other symptoms.
C. Chronic hypoxemia is more associated with severe heart defects or lung conditions, whereas a large PDA may present with other signs first.
D. A systolic murmur is a classic finding in large PDAs due to the left-to-right shunting of blood, making it the most expected manifestation in this scenario.