NCLEX Daily Practical Exercise 34

Welcome to our NCLEX Daily Ten Practice! This practice is designed to help you solidify your knowledge, improve your skills, and prepare thoroughly for the NCLEX exam. With ten questions to tackle each day, you’ll have the opportunity to review a broad range of subjects covered in the NCLEX exam.

 

1. A 65-year-old man, who is a retired professional dancer, has been admitted to the orthopedic unit for spinal stenosis surgery. He lives alone in a two-story house and is concerned about his mobility and self-care post-surgery. Given his unique living situation and profession, which has contributed to his current condition, when should the nurse initiate discharge training and planning to ensure a smooth transition and recovery for this patient?

Correct Answer: B

Answer Explanation:

Discharge planning is a critical aspect of patient care, especially for surgeries that can impact mobility and daily activities. Starting discharge planning upon admission allows for comprehensive preparation, addressing any concerns the patient might have, and ensuring that the patient understands the post-operative care requirements. This proactive approach also provides ample time to arrange for any necessary resources or support the patient might need post-discharge.

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2. A 5-year-old child has been recently admitted to the pediatric unit following a minor accident at school. The child appears hesitant to engage in play activities organized by the hospital’s child life specialist and frequently asks if it’s “okay” to play with certain toys. The parents express concern about their child’s behavior, noting that he was previously very active and curious at home. Based on Erik Erikson’s psychosocial development stages and the child’s age and behavior, the nurse recognizes that the child is primarily navigating which developmental stage?

Correct Answer: B

Answer Explanation:

Erik Erikson’s theory of psychosocial development outlines eight stages that an individual progresses through from infancy to late adulthood. Each stage presents a challenge or conflict that, when resolved, results in the development of a basic virtue. For a 5-year-old child, the predominant stage is “Initiative vs. guilt.” In this stage, children begin to assert their power and control over the world by planning and executing tasks. Success in this stage leads to a sense of purpose, while failure results in feelings of guilt. The child’s hesitancy to engage in play and frequent questioning about the appropriateness of certain activities aligns with this stage.

Option A: Trust vs Mistrust is the first stage of the psychosocial theory. This stage begins at birth and continues to approximately 18 months of age. During this stage, children learn whether or not they can trust the people around them.
Option C: Autonomy vs Shame and doubt is the second stage of Erik Erikson’s stages of psychosocial development. This stage occurs between the ages of 18 months to 3 years. According to Erikson, children at this stage are focused on developing a greater sense of control.
Option D: Intimacy vs Isolation takes place during young adulthood between the ages of approximately 19 and 40. The major conflict at this stage of life centers on forming intimate, loving relationships with other people.

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3. A 26-month-old toddler has been admitted to the pediatric unit following recurrent episodes of temper tantrums and refusal to eat certain foods at home. The parents are concerned and mention that their child has become increasingly assertive, often wanting to do things on their own, like dressing up or using the toilet. They also note moments when the child becomes frustrated and seems ashamed if they can’t complete a task. Based on Erik Erikson’s psychosocial development stages and the described behaviors, the nurse understands that the toddler is primarily navigating which developmental stage?

Correct Answer: C

Answer Explanation:

For toddlers, specifically around the age of 2, the predominant stage is “Autonomy vs. shame and doubt.” In this stage, toddlers begin to assert their independence by making choices and doing things for themselves. Success in this stage leads to feelings of autonomy, while failure or over-controlling parents can lead to feelings of shame and doubt. The described behaviors of the toddler, such as wanting to do things on their own and feeling frustrated or ashamed when they can’t, align with this stage.

Option A: Trust vs Mistrust is the first stage of the psychosocial theory. This stage begins at birth and continues to approximately 18 months of age. During this stage, children learn whether or not they can trust the people around them.
Option B: It is as children enter the preschool years (3-6 years old) that they begin the third stage of psychosocial development centered on initiative versus guilt. It is important for the kids to learn that they can exert power over themselves and the world.
Option D: Intimacy vs Isolation takes place during young adulthood between the ages of approximately 19 and 40. The major conflict at this stage of life centers on forming intimate, loving relationships with other people.

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4. A 20-year-old young adult has been admitted to the hospital following a motor vehicle accident. During the assessment, the patient expresses concerns about their recent breakup and how it might be affecting their overall well-being. They mention feeling isolated from peers and struggling with forming close relationships. The patient’s parents also share that their child has been distancing from family gatherings and often spends time alone. Based on Erik Erikson’s psychosocial development stages and the described behaviors and concerns, the nurse recognizes that the young adult is primarily navigating which developmental stage?

Correct Answer: D

Answer Explanation:

For young adults, typically in their late teens to early twenties, the predominant stage is “Intimacy vs. isolation.” In this stage, young adults seek to form close, intimate relationships with others. Success in this stage leads to strong relationships, while failure results in feelings of isolation and loneliness. The described behaviors and concerns of the patient, such as feeling isolated and struggling with forming close relationships, align with this stage.

Option A: Trust vs Mistrust is the first stage of the psychosocial theory. This stage begins at birth and continues to approximately 18 months of age. During this stage, children learn whether or not they can trust the people around them.
Option B: It is as children enter the preschool years (3-6 years old) that they begin the third stage of psychosocial development centered on initiative versus guilt. It is important for the kids to learn that they can exert power over themselves and the world.
Option C: Autonomy vs Shame and doubt is the second stage of Erik Erikson’s stages of psychosocial development. This stage occurs between the ages of 18 months to 3 years. According to Erikson, children at this stage are focused on developing a greater sense of control.

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5. During a school health fair, a nurse is stationed at the vital signs booth. As students from various age groups approach, the nurse takes their vital signs. Later, while reviewing the recorded data, the nurse identifies one set of vital signs that seems abnormal for the age group. Which of the following vital signs taken during the health fair appears to be outside the typical range for the respective age group?

Correct Answer: B

Answer Explanation:

The normal range of vital signs for 11 to 14-year-olds: Heart rate: 60-105 BPM; Respiratory rate: 12-20 CPM; Blood pressure: Systolic-85-120, diastolic- 55-80 mmHg; Body temperature: 98.0 degrees Fahrenheit (36.6 degrees Celsius) to 98.6 degrees Fahrenheit (37 degrees Celsius). The client’s diastolic pressure is lower than the normal range. Both her respiratory rate and heart rate are slightly increased.

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