Imaginary friends are common among pre-school as a way for them to manipulate their environment. The parents of Jillian a 4 year old child told the nurse that the child has an invisible friend named Jonjon. Jillian blames Jonjon for any misbehaviour and is often heard scolding him calling him a bad boy. The nurse understands that the best interpretation of this behaviour is which of the following?

Correct Answer: C

Rationale: The correct answer is C) A way of the child to assume control. This behavior of Jillian having an imaginary friend named Jonjon and blaming him for misbehavior is likely a way for Jillian to assert control over her environment. Imaginary friends are common in preschoolers and can serve as a coping mechanism for children to navigate their emotions and situations they may not fully understand. By placing blame on Jonjon, Jillian may be trying to distance herself from negative behavior and attribute it to an external source, giving her a sense of control over her actions. Option A) A delay in moral development is incorrect because having an imaginary friend and assigning blame to them is a normal part of child development and does not necessarily indicate a delay in moral development. Option B) Impaired parent-child relationship is incorrect as there is no evidence in the scenario to suggest a strained relationship between Jillian and her parents. Option D) Inconsistent parental discipline strategies is incorrect as there is no information provided that links Jillian's behavior to inconsistent discipline from her parents. In an educational context, understanding the significance of imaginary friends and the role they play in children's development can help nurses and caregivers support children's emotional and cognitive growth. By recognizing these behaviors as normal and age-appropriate, adults can provide appropriate guidance and support to help children navigate their emotions and experiences effectively.

Correct Answer: A

Rationale: In this question, the correct answer is A) Tricuspid atresia. Tricuspid atresia is a congenital heart defect where the tricuspid valve is missing or abnormally developed, leading to a lack of communication between the right atrium and right ventricle. This results in right ventricular hypertrophy as the right ventricle has to work harder to pump blood into the pulmonary artery, causing decreased pulmonary blood flow. Option B) Patent ductus arteriosus is incorrect because it is characterized by a persistent opening between the pulmonary artery and the aorta, leading to increased pulmonary blood flow, not decreased. Option C) Pulmonic valve stenosis is incorrect as it would typically present with increased pressure in the right ventricle and increased pulmonary blood flow, rather than decreased. Option D) Aortic valve stenosis is incorrect as it affects the left side of the heart, leading to left ventricular hypertrophy and symptoms such as chest pain and dizziness, not right-sided findings. Educationally, understanding the pathophysiology of congenital heart defects is crucial in pediatric nursing. Recognizing the specific characteristics of each defect, such as in this case, helps nurses provide appropriate care and anticipate potential complications for pediatric patients with cardiac conditions. This knowledge is essential for NCLEX preparation as it tests the ability to apply theoretical knowledge to clinical scenarios.

Correct Answer: D

Rationale: In the case of a child being admitted to the hospital with giardiasis, the correct medication that the nurse would expect to be prescribed is Metronidazole (Flagyl). Metronidazole is the drug of choice for treating giardiasis due to its effectiveness against the parasite causing the infection. Prednisone (Orapred) is a corticosteroid used for reducing inflammation, and it is not indicated for the treatment of giardiasis. Amoxicillin clavulanate (Augmentin) and Clarithromycin (Biaxin) are antibiotics commonly used for bacterial infections, not parasitic infections like giardiasis. Educationally, it is important for nursing students preparing for the NCLEX exam to understand the specific medications used to treat various pediatric conditions. Understanding the rationale behind medication choices is crucial for providing safe and effective care to pediatric patients. By knowing the correct medication for giardiasis, nurses can ensure appropriate treatment and improve patient outcomes.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Chickenpox. Airborne isolation is required for a child hospitalized with chickenpox due to its highly contagious nature. Chickenpox is caused by the varicella-zoster virus, which spreads through respiratory droplets when an infected person coughs or sneezes. Isolating the child helps prevent the spread of the virus to other patients, visitors, and healthcare workers. Regarding the other options: A) Exanthema subitum (roseola): Roseola is transmitted through respiratory secretions but does not require airborne isolation. Contact precautions are usually sufficient. B) Erythema infectiosum (fifth disease): Fifth disease is spread through respiratory secretions and blood but does not require airborne precautions unless there are complications. C) Mumps: Mumps is also transmitted through respiratory droplets but typically requires droplet precautions, not airborne isolation. Educational context: Understanding the specific isolation requirements for different infectious diseases is crucial for pediatric nurses to prevent the spread of infections within healthcare settings. Proper isolation precautions help protect vulnerable patients, staff, and visitors from contracting potentially serious illnesses. Nurses must be knowledgeable about when to implement airborne, droplet, contact, or standard precautions to provide safe and effective care to pediatric patients.

Correct Answer: B

Rationale: The correct answer is B) Individuals with cognitive impairment need a well-defined, concrete code of sexual conduct. This answer is appropriate because individuals with cognitive impairment may have difficulty understanding social cues, boundaries, and appropriate sexual behavior. Providing clear guidelines and boundaries can help protect them from exploitation and ensure their safety. Option A) Sexual drive and interest are limited in individuals with cognitive impairment is incorrect because individuals with cognitive impairment may still have sexual desires and interests, but they may struggle to express these in socially appropriate ways. Option C) Contraceptive protection should not be considered an option is incorrect because individuals with cognitive impairment are at risk of sexual abuse and exploitation. It is essential to discuss contraceptive options to prevent unwanted pregnancies and sexually transmitted infections. Option D) Sterilization is recommended for any adolescent with cognitive impairment is incorrect and unethical. Sterilization should not be performed without the individual's informed consent, and there are other ways to support individuals with cognitive impairments in making informed decisions about their sexual health. Educationally, it is crucial for nurses to understand the unique needs and challenges faced by individuals with cognitive impairment when discussing sexuality. By providing appropriate education and support, nurses can help promote healthy sexual development and prevent harm in this vulnerable population.