The nurse is seeing an adolescent boy and his parents in the clinic for the first time. What should the nurse do first?

Correct Answer: A

Rationale: When meeting a new patient and their family for the first time, it is important for the nurse to first introduce themselves. This establishes a professional relationship and helps to build trust. By introducing themselves, the nurse demonstrates respect and initiates communication with the adolescent and their parents. It also sets a positive tone for the interaction and creates a welcoming environment for further discussion. The introduction should include the nurse's name, role, and purpose of the visit.

Correct Answer: C

Rationale: The HOTV chart is the most appropriate vision acuity test for a child who is in preschool. The HOTV chart is specifically designed for young children who may not yet know their letters. It uses simple shapes (H, O, T, V) instead of letters for visual acuity testing, making it more suitable and engaging for preschool-aged children. This chart allows for an accurate assessment of a child's visual acuity even before they are able to recognize letters, ensuring early detection of any vision problems that may affect their learning and development. The other options, such as the Cover test, Ishihara test, and Snellen letter chart, are more commonly used for older children and adults.

Correct Answer: C

Rationale: The statement that best describes the infant's physical development that a nurse should expect to find is that birth weight doubles by age 5 months and triples by age 1 year. This characteristic growth pattern is typical in the first year of life. Infants usually regain their birth weight by around 2 weeks of age, double it by about 5 months, and triple it by 1 year. This steady growth reflects the healthy development of the infant and is an important marker of overall well-being and nutrition. It is a key aspect that healthcare providers, including nurses, monitor closely to ensure the infant is thriving.

Correct Answer: B

Rationale: The earliest age at which an infant typically begins teething with the eruption of their lower central incisors is around 6 months old. Teething typically starts around this age, but it can vary from one infant to another. It is important to note that while 6 months is a common age for teething to begin, some infants may start teething a little earlier or later. It's essential for parents to monitor their baby's development and seek guidance from healthcare professionals if needed.

Correct Answer: B

Rationale: Clinical reasoning is a complex cognitive process used by healthcare providers to make sound clinical decisions about patient care. It involves the gathering and analyzing of information, as well as the formulation and evaluation of potential treatment options. Clinical reasoning is purposeful in that it is driven by the goal of providing the best possible care for the patient. Healthcare providers use their knowledge, skills, and experience to systematically work through patient problems, identify possible solutions, and make informed decisions. The process is goal-directed, aiming to achieve positive health outcomes for the patient based on the best available evidence and clinical expertise.