Free CPN Practice Questions PDF

When using a vibrating cold device, it is crucial to avoid placing the frozen ice pack or vibrating unit directly over broken, irritated, or excoriated skin to prevent further tissue damage and infection. However, the nurse can still utilize the Gate Control Theory by placing the device proximally on healthy, intact skin to intercept the pain signals. Option A is incorrect because applying the device over excoriated skin can exacerbate the dermatitis and cause severe discomfort. Option B is incorrect because vapocoolant sprays contain propellants that will burn and irritate compromised skin. Option D is incorrect because the nurse should always attempt to provide appropriate pain management, and alternative placements allow for effective mitigation without compromising the child's skin integrity.

While transient clinging and occasional rule resistance can be normative stress responses to family transitions, intense hyperarousal and an exaggerated startle response are specific indicators of trauma exposure. Children exposed to domestic violence often exhibit profound autonomic nervous system dysregulation alongside behavioral regression. Assessing for hyperarousal helps distinguish trauma-induced regression from typical developmental setbacks. Option A is a common, mild stress response. Option C reflects typical self-soothing behavior. Option D is developmentally appropriate limit-testing for a preschooler, lacking the severity of trauma-related dysregulation.

Newborn screening reliably identifies sickle cell trait, which frequently causes profound parental anxiety due to confusion with the actual disease. The primary nursing action is to provide clear education that the trait is a benign carrier state and the child will not develop sickle cell disease. Options A and D involve interventions and referrals that are standard for managing sickle cell disease, not the trait, and would unnecessarily elevate parental fear. Option C is redundant and unnecessary because the newborn screening has already confirmed the diagnosis using highly sensitive methods like electrophoresis or high-performance liquid chromatography.

Guiding the adolescent to identify their own warning signs and preferred contacts respects their input and ensures the safety plan is personalized and realistic. This collaborative approach increases the likelihood that the teen will actually use the plan. Option A is incorrect because focusing exclusively on the parents removes the teen from the process, failing to build their self-regulation skills. Option B is incorrect because a standardized contract does not reflect the adolescent's unique triggers or coping strategies, making it less effective than a personalized plan. Option D is incorrect because simply reminding the teen to call a hotline is a directive approach that lacks the comprehensive, collaborative planning needed for effective mental health support. Engaging teens directly is vital.

Infants with CF often struggle with poor weight gain due to malabsorption and increased metabolic demand. The best approach is to increase the caloric density of their intake by fortifying breast milk with high-calorie formula powder, which preserves the immunological benefits of breast milk while providing necessary calories. Switching entirely to standard formula (Option A) removes breast milk benefits and may still lack sufficient calories for a CF patient. Introducing solids at four months (Option C) is developmentally inappropriate and lacks dense calories. Restricting feeds (Option D) will only worsen the poor weight gain.

When using standardized tools like the ASQ-3 or Denver II, you must calculate the corrected age for any child born before 37 weeks gestation until they reach 24 months of age. Since this child was born at 28 weeks, they are 12 weeks or about 3 months premature. Subtracting 3 months from their 18-month chronologic age gives a corrected age of 15 months, making option A the best choice. Option B is incorrect because using chronologic age would falsely lower the child's scores. Option C is unnecessary as the ASQ-3 is perfectly valid for premature infants when adjusted correctly. Option D is unsafe because early identification of delays is critical, especially for high-risk premature infants.