NR-222 Health and Wellness - Set 4 - Part 2

Correct Answer: We resume where he left off, and I recommend catching up.

A series is never restarted no matter how delayed; the catch up schedule resumes where it stopped. The nurse also gives a clear personal recommendation, which parents rate as the most influential factor. Option a is incorrect because no interval is long enough to require starting again. Telling this mother otherwise adds needless injections and could convince her the whole effort is not worth resuming. Option b is incorrect because stretching intervals leaves an infant unprotected during the months of highest disease risk. The concern about overload is unfounded, and an alternative spacing plan validates a belief the evidence does not support. Option d is incorrect because postponing the discussion abandons the child's protection and the mother's question. Hesitancy often softens over time, so the nurse acknowledges her concern, corrects the misinformation once, and revisits it at every visit.

Correct Answer: Report the suspicion to child protective services

Immersion burns with sharp demarcation and no splash marks do not come from a child climbing in. The child is stable, so the nurse now acts on reasonable suspicion and reports. Option b is incorrect because repeated questioning of the caregiver is not the nurse's job and can tip off an adult who may then remove the child. Investigating belongs to the agency that receives the report. Option c is incorrect because the threshold is reasonable suspicion, never proof. Waiting to build a case delays protection, and a good faith report carries statutory immunity even if it is later unsubstantiated. Option d is incorrect because the duty to report is personal and cannot be passed along. Facility policy usually adds notification of the provider and social work, but that does not discharge the nurse's own obligation.

Correct Answer: Fidelity, sustained loyalty to chosen values

Identity versus role confusion yields fidelity, which is the ability to stay loyal and committed to freely chosen values, people, and causes even when competing value systems pull in different directions. Option a is incorrect because love is the strength of intimacy versus isolation in young adulthood. It follows fidelity in the sequence, since a person must know who they are before committing to another. Option b is incorrect because wisdom sits at the very end of the list, emerging from integrity versus despair after sixty five. An adolescent has not yet lived the life that gets reviewed. Option d is incorrect because care grows out of generativity in middle adulthood, when a person invests in what they have helped create. Teenagers are still assembling a self, not nurturing the next generation.

Correct Answer: Erikson moved conflicts into conscious social relationships across life

Erikson relocated the drama from unconscious sexual drives into the conscious ego and the social world, and he extended development across the entire lifespan. Those two shifts made his framework usable at any age. Option a is incorrect because that description belongs to Freud, whose stages centered on libido and erogenous zones. Keeping those features would leave nothing distinctive about Erikson's contribution to developmental theory. Option c is incorrect because Erikson lengthened the timeline rather than cutting it short. Freud's genital stage was the last one, while Erikson added intimacy, generativity, and integrity to cover adulthood and old age. Option d is incorrect because eight discrete stages are the backbone of his model. He kept the stage structure he inherited and changed what drives movement through it, not whether stages exist.

Correct Answer: Iron deficiency anemia

Milk is low in iron and blocks iron absorption, and drinking that much fills the toddler so iron rich foods are displaced. Total milk is limited to about twenty four ounces a day. Option a is incorrect because vitamin D toxicity comes from supplement overdosing, not from drinking fortified milk. It would also present with vomiting, poor appetite, and high calcium rather than pallor. Option b is incorrect because a lactose intolerant toddler drinking this volume would have cramping, bloating, gas, and diarrhea. None of that is described, and the child is gaining weight rather than losing it. Option c is incorrect because milk supplies generous protein and calories. The classic picture here is a plump, pale child whose diet lacks iron, which is the opposite of a child short on protein and energy.

Correct Answer: The nineteen year old faces identity, the older faces intimacy

Identity comes first and belongs to adolescence, where the teen is sorting out who he is. Intimacy follows in young adulthood, and avoiding commitment after a breakup is that conflict in play. Option b is incorrect because it flips the order of two adjacent stages. Erikson insisted that a settled sense of self must come before a person can safely fuse that self with someone else. Option c is incorrect because industry closes around age twelve, when the child stops measuring competence against classmates and enters puberty. A nineteen year old weighing career paths is well past that school age task. Option d is incorrect because generativity does not open until roughly forty and involves guiding the generation that follows. Someone in his twenties struggling with commitment has not yet reached that middle adult question.

Correct Answer: Care, concern for what one generates

Middle adults are working on generativity, whose virtue is care, the widening concern for what they have helped create. Tying prevention to grandchildren makes the message land where their investment already sits. Option a is incorrect because love is the young adult's strength, built through committed partnership and deep friendship. The teaching here appeals to a legacy across generations rather than to a bond with one partner. Option c is incorrect because wisdom belongs to the last stage and grows from accepting the life one has lived. A fifty year old is still building, not yet reviewing and reconciling. Option d is incorrect because fidelity comes out of adolescence, when a person first commits to chosen values and groups. Nothing in this teaching strategy is about sorting out identity or holding a commitment steady.

Correct Answer: Remove the quilt and bumper from the crib

Nothing belongs in the sleep space except a fitted sheet. A quilt and a bumper, even a mesh one, are suffocation and entrapment hazards, so removing them protects this infant right now. Option a is incorrect because supine positioning is only part of safe sleep. Praising the parents while soft bedding stays in the crib leaves the hazard in place and signals that the setup is acceptable. Option b is incorrect because swapping one loose covering for a bulkier one worsens the risk of suffocation and overheating. Warmth comes from a wearable blanket, not from anything laid over the infant. Option c is incorrect because rolling changes what position an infant may be left in, not what may share the crib. Even an infant who rolls both ways still sleeps on a bare surface.

Correct Answer: Moral theory, exemplified by Kohlberg's work

Moral development covers the thoughts, emotions, and behaviors that shape beliefs about right and wrong and how we treat other people. Kohlberg is the theorist the course pairs with that category. Option b is incorrect because Piaget mapped how thinking itself changes, from sensorimotor exploration through abstract reasoning. His stages set the ceiling on moral reasoning without describing the content of a right or wrong judgment. Option c is incorrect because Gesell studied the biological timetable behind physical milestones and produced the behavior norms behind modern screening tools. Nothing in his work addresses why a teenager reports a friend. Option d is incorrect because Erikson would frame this adolescent's task as building an identity out of chosen values. That overlaps here, yet the stem asks which category studies judgments of right and wrong.

Correct Answer: Assign the same nurses across consecutive shifts

Trust grows from consistency, so the same faces answering the same cries is the intervention. Continuity of caregiver assignment substitutes for the parent's presence when a family cannot stay overnight. Option a is incorrect because variety is the opposite of what an infant in this stage needs. Every new face restarts the question of whether anyone reliable is out there, feeding mistrust instead of hope. Option b is incorrect because handing every comforting task to assistive personnel splits the infant's care among more people, not fewer. It also removes the nurse from the assessments that holding and feeding provide. Option d is incorrect because room location changes visibility, not relationship. A crib near the desk still leaves a rotating cast of strangers responding to this infant, which is the actual developmental problem.

Correct Answer: Water intoxication and poor weight gain

Over diluting formula delivers too little energy and protein and too much free water. The result is failure to thrive and water intoxication, which can drop sodium far enough to cause seizures. Option a is incorrect because constipation follows formula mixed with too little water, the opposite error. This mother is adding water, so her infant's stools would if anything be looser rather than harder. Option b is incorrect because a heavy solute load comes from under diluted formula or from early cow's milk, both of which push protein and minerals past what immature kidneys handle. Extra water lowers that load. Option c is incorrect because commercial formula is iron fortified, and anemia screening is timed for twelve months. Anemia is a slower problem than the sodium shift and calorie deficit this practice creates.

Correct Answer: Staying dry for at least two hours

Staying dry two hours at a stretch shows the bladder is holding urine and sphincter control has developed. Physical readiness plus the child's own interest is what signals the right time. Option b is incorrect because climbing stairs unaided is a gross motor achievement unrelated to bladder control. What matters for toileting is that the child can walk to the bathroom and manage clothing. Option c is incorrect because a birthday says nothing about whether this child is ready. Training tied to a date rather than to signs of interest and control invites power struggles and resistance. Option d is incorrect because nighttime dryness is the last piece to arrive, often not until four or five years. Sleeping through the night reflects sleep consolidation, which is a separate developmental track.

Correct Answer: Stage four, upholding law and social order

Her reason is the law itself and the duty to respect it, not the opinion of any particular friend. Widening the frame from individuals to society marks stage four. Option a is incorrect because stage three turns on pleasing specific people whose regard matters. She would have said her parents or her coach would be disappointed, and neither appears in her explanation. Option c is incorrect because no exchange is on offer. Stage two reasoning always contains a bargain, some version of what a person gets back, and she is gaining nothing by staying home. Option d is incorrect because stage five holds laws up for scrutiny against human welfare. She accepts the drinking age as binding rather than questioning whether it deserves to exist, which keeps her inside the conventional level.

Correct Answer: Stop swaddling now that he has started to roll.

Swaddling stops at the first sign of rolling, usually around three or four months. A swaddled infant who ends up prone cannot free the arms to lift the head clear. Option a is incorrect because the cutoff is a skill, not a birthday. Tying the decision to six months would leave this infant wrapped for months after rolling has already made the practice dangerous. Option b is incorrect because weighted swaddles, blankets, and sleep sacks are all excluded from infant sleep. Added weight restricts chest movement and the ability to reposition, which is the opposite of what safety requires. Option d is incorrect because an infant is always placed supine, swaddled or not. Side placement is unstable, tips readily into prone, and pairing it with a wrap removes the arms the infant would use to recover.

Correct Answer: Milk pooling on his teeth at night causes decay.

Milk or juice pooling around the teeth during sleep produces early childhood caries. No bottle goes into the crib, and propping a bottle also raises the risk of otitis media and aspiration. Option a is incorrect because juice is worse than milk in a bedtime bottle, not better. Its sugars sit on the enamel all night, and juice for this age is limited to a small amount in a cup. Option b is incorrect because a pea sized amount belongs to children age three and older. A toddler with erupting teeth uses a smear about the size of a grain of rice twice daily. Option c is incorrect because a dental home should be established by the first birthday, or within six months of the first tooth. Waiting until three would let caries advance unseen for two full years.

Correct Answer: We clip his pacifier to his shirt so it stays close.

A pacifier must never be attached to a string, cord, or clothing, because the cord is a strangulation hazard in the sleep space. This statement shows the parents need correction. Option a is incorrect because a pacifier offered at nap and bedtime independently lowers the risk of sleep related death. At four weeks breastfeeding is established enough for it to be introduced. Option c is incorrect because supervised, awake tummy time is exactly what is recommended. It builds neck, shoulder, and trunk strength and prevents the flattened head that comes from constant supine positioning. Option d is incorrect because putting an infant down drowsy but awake is the standard teaching for building self soothing. Nothing in that habit needs correcting, so it cannot be the answer here.

Correct Answer: Individualism and exchange, serving mutual interests

The reasoning is a straight trade, which is the signature of stage two. Reciprocity separates it from stage one, where a child obeys only to keep from being punished. Option a is incorrect because nothing here mentions a consequence he is dodging. He is negotiating an advantage for himself, which is a different motive from unquestioning obedience to avoid a penalty. Option b is incorrect because approval seeking would sound like sharing so his sister thinks well of him. He wants dessert, and the sister's opinion of his character plays no part in the deal. Option d is incorrect because self chosen universal principles such as justice and human dignity sit at the very top of the ladder. Kohlberg found that level so rare he eventually treated it as theoretical.

Correct Answer: Assess the child's respiratory status immediately

Developmental interventions never outrank physiological stability. Rising respiratory rate with nasal flaring signals worsening work of breathing, so airway and breathing are assessed before any play or teaching happens. Option b is incorrect because medical play is genuinely valuable for this age group, yet it addresses fear rather than oxygenation. A child in respiratory distress needs the nurse's eyes and stethoscope, not a doll. Option c is incorrect because explaining in simple concrete words matters right before a procedure. No procedure is pending here, and talking through steps would delay recognition of a child whose breathing is deteriorating. Option d is incorrect because offering choices restores a sense of control, which suits a stable preschooler. Control is not this child's problem at the moment; her rising respiratory effort is, and it comes first.

Correct Answer: Parallel play typical of toddlers

Toddlers play alongside one another with similar toys but not with one another. Parallel play is the hallmark of this stage, and sharing is a skill that arrives in the preschool years. Option a is incorrect because solitary play describes an infant exploring objects alone, with no other child in the picture. Here two children have chosen to sit near one another, which is the distinguishing detail. Option b is incorrect because associative play involves borrowing and lending materials within a loose shared activity. These toddlers are exchanging nothing at all, so the pattern has not reached that level. Option d is incorrect because cooperative play is organized around rules, roles, and a shared goal, the way a board game or team sport works. Nothing that structured is happening between these two.

Correct Answer: Point out stained teeth and reduced sprint speed

The personal fable convinces adolescents that distant harm happens to other people. Immediate, visible, peer relevant consequences bypass that belief because they touch appearance and performance right now. Option a is incorrect because volume does not defeat a belief about invulnerability. He has already dismissed those numbers as facts about strangers, and repeating them louder reinforces the sense of being lectured. Option c is incorrect because a thirty year horizon lands well outside what feels real to a teenager. Pathology unfolding across decades sits in the same mental drawer as the statistics he already ignores. Option d is incorrect because surveillance by parents turns a health issue into a control struggle. Adolescents are consolidating an identity, and handing the problem to adults invites refusal on principle rather than change.