A 2-year-old child will undergo a cardiac catheterization tomorrow to evaluate his ventricular septal defect. Based on his developmental stage, the nurse:

• A.Uses pictures to explain the procedure to the child and his parents that evening
• B.Explains the procedure using simple words and sentences just before the preoperative sedation
• C.Asks the parents to explain the procedure to the child after she explains it to them
• D.Asks the parents to leave the room while the preoperative medication and instructions are given

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A 9-month-old infant visits her pediatrician for a routine visit. A developmental assessment was initiated by the nurse. Which skill would cause the nurse to be concerned about the infant's developmental progression?

• A.She sits briefly alone with assistance.
• B.She creeps and crawls.
• C.She pulls herself to her feet with help.
• D.She stands while holding onto furniture.

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A client has been in labor 10 hours and is becoming very tired. She has dilated to 7 cm and is at 0 station with the fetus in a right occipitoposterior position. She is complaining of severe backache with each contraction. One comfort measure the nurse can employ is to:

• A.Place her in knee-chest position during the contraction
• B.Use effleurage during the contraction
• C.Apply strong sacral pressure during the contraction
• D.Have her push with each contraction

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A client has just received an epidural block. She is laboring on her right side. The nurse notes that her blood pressure has dropped from 132/68 to 78/42 mm Hg. The nurse's first action would be to:

• A.Call the physician immediately and give dopamine IM
• B.Turn her on her left side and recheck her blood pressure in 5 minutes
• C.Administer oxytocin (Pitocin) immediately and increase the rate of IV fluids
• D.Increase the rate of IV fluids and start O2 by mask

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A 60-year-old woman exhibits forgetfulness, emotional lability, confusion, and decreased concentration. She has been unable to perform activities of daily living without assistance. After a thorough medical evaluation, a diagnosis of Alzheimer's disease was made. An appropriate nursing intervention to decrease the anxiety of this client would include:

• A.Allowing the client to perform activities of daily living as much as possible unassisted
• B.Confronting confabulations
• C.Reality testing
• D.Providing a highly stimulating environment

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