[Music] hi guys it's me professor d and welcome back to my channel on this video i'm going to be taking you all the way back to first semester fundamentals i'm going to be covering conception all the way through adolescence if you haven't done so already please be sure like and subscribe below make sure you leave a comment if there's anything you'd like to see me cover and of course press that notification button so that you'll know every time a new video is released so without any further ado guys let's get started first question which of the following data is the most important for the nurse to assess when caring for a woman in her second trimester of pregnancy one fetal excuse me one detection of fetal movement two observation that the uterus is below the pubis three confirmation of the desire to breast or bottle feed or four determination of the presence of a morning sickness and if you're new to my channel guys just go ahead and press that pause button if you need a little bit more time to figure out what you think the answer is and just press play when you're ready so the correct answer is one detection of fetal movement so mom should start feeling um fetal movement between 16 and 20 weeks which is the second trimester of pregnancy now let's look at our other choices because i want you to understand why our other choices are wrong so you have two observation that the uterus is below the pubis well mom's in her second trimester of pregnancy so we expect for that uterus to be above the penis not below how about um choice three confirmation of the desire to breast or bottle feed that that um decision moms really start thinking about that during the third trimester of pregnancy as they get closer right and then choice for determination of the presence of morning sickness that happens during first trimester and for many women that's like the first time that they realize oh i might be pregnant let me go get go ahead and check that hcg from the morning sickness so the correct answer for this is fetal movement which we expect to see between 16 and 20 weeks next question which one of the following newborn reflexes should the nurse be able to elicit at a six month well baby visit one more reflex two starter reflex three babinski reflex or four extrusion reflex now give you a moment to think of your answer so the correct answer guys is uh babinski reflex that's choice three okay and here's the thing with the babinski reflex if we see this after two years old so after the child's 24 months if that reflex is there right what are we going to do we're going to let the doctor know and the doctor is going to go ahead and put that patient over to neurology because if the babinski reflex is still present past two years of age that um it's a sign that there's some kind of neurological deficit that's going on with that patient that has to be investigated further now let's look at our other choices choice one and choice two the moral and startle reflex um you see that in a newborn right and you expect that to disappear by six months of age and then your last choice the excrucia exclusion extrusion the one where automatically their tongue will push out their food you expect to see that go away by four months of age okay so the correct answer for this during a sixth um must visit which one would be normal to still see and that's the babinski reflex sometimes it's called the plantar reflex it's the same thing guys oh uh before i go on to the next question these reflexes have been seen many times on nclex i'm not saying you're going to get a reflex question but if you do get an ob question very often this is one of them and on nclex it's not even um a preference i've seen all of them show up so just make sure you know what your reflexes are make sure how long the infant child should have it and when you expect them to disappear okay in evaluating an infant's physical status and growth the nurse expects to find one birth weight triples by six months of age two the anterior fontanelle closes four to eight weeks after birth three the chest circumference is larger than the head circumference at 12 months or four birth height increases one inch each month for the first six months i'll give you a moment to think of your answer so the correct answer guys is for the birth height increases one inch each month for the first six months and then what happens is after that first six months it grows half an inch okay but there's something else that's very important i want you to know there are two concepts in this question that has been seen on nclex time and time again what are they let's talk about the wrong answer choices i'm gonna tell you why it's wrong and what's correct choice one the weight triples by six months no the weight doubles by six months and it triples by one year by 12 months and that's a famous uh peds question on nclex right and here's another one the second one the anterior fontanelle closes four to eight weeks after birth that is false the anterior fontanelle closes about 12 to 18 months after birth that's another famous peds question that um has been seen on nclex time and time again right so now you know what the correct answer is make sure you write it down because you very well may see that again and your third choice which was wrong the chest circumference is larger than the head circumference at 12 months and that's false it's actually actually equal okay so the correct answer for this one was choice number four but it's very important guys those other choices that were wrong it's very important to know what the correct answer is because those like i said have been seen on nclex upon evaluation of a six-month-old infant's developmental status the nurse expects that the child at this age will be able to one completely roll over to pull self to a standing position three creep on all four extremities or four assume a sitting position independently so the correct answer for this guys is one completely roll over by six months you should expect that the child is able to completely roll over now you see choices two three and four pulling to a standing position creeping on off for extremities assuming a sitting position independently without mom or dad propping them up right those three things nine months we expect to see that developmental milestone at nine months not at six at six months we expect them to fully be able to roll over guys i have to tell you this so one of my students asked me how come i'm so nice to you on my videos because i yell at them all the time and i told i i told her i said well if i yell at my students on youtube they'll unsubscribe and i i need them to stay subscribed to me right but no um when you guys see like i get a little bit more animated than usual i'll tell you to look at me in my eyeball or i pop off about something make a mental note why that means it's super important and you're most likely to see it on nclex or maybe on one of your finals okay but i'm not being me when i yelled at you guys i'm just very passionate about this all right next question in planning nursing care for an 18 month old child the nurse should know that the predominant developmental characteristic of children of this age is one parallel play two peer pressure three mutilation anxiety or four imaginary playmates okay guys so at 18 months the answer is one parallel play remember 18 months from one to three they're still what toddlers and so at this stage they have not learned associatively yet right so they're playing by themselves but next to each other so one girl will be playing with her doll next to another girl playing with her doll or next to a boy playing with their truck because at the toddler age they don't discriminate oh you're a boy you have cooties i don't like you no they don't do that yet they're still toddlers so at the toddler stage one two three they have parallel play where where they'll play with their toy next to another child playing with their toy regardless if it's a male or female but they're not playing together it's not associative play yet so the correct answer is one let's look at our other choices you have choice two peop peer pressure you see that in school age children six seven eight nine right in school age where you know they might not want to do something but then one of their classmates say oh don't be such a scaredy cat nanny and any boo-boo and then they go ahead and do it right right because they're putting into peer pressure so we see that in the school age child three mutilation anxiety what is that that is the fear of bodily harm and we see that in the preschool children the two three four five right at this age the preschool age remember band-aids are very important why they are deathly afraid that if they get a cut all of their insides are going to pour outward right so that's why band-aids are so important they get a little boo-boo you want to put a band-aid on there why because psychologically right it calms them down because they realize they think that the the band-aid is going to help keep all of their insides inside of their body and not spill outside of their body all right so mutilation anxiety we see that in the preschool children and then of course imaginary playmates also we see this in the preschool age the nurses the nurse in working with children of this age plans to allow a five-year-old boy who was admitted to the surgical center to have his tonsils removed to one perform his own pre-op hygienic care two have alone time to relax before the procedure three handle the equipment when taking his blood pressure four have access to age appropriate magazines and puzzles for diversion and the correct answer is three handled equipment when taking his blood pressure why this is a five-year-old boy so at five-year-old at five years old what do they like to do pretend and imagine so while you're doing what you need to do for that patient which is take the vitals right you'll like you allow that child to just handle the equipment or you can even do it before so they're comfortable with that equipment now let's look at the wrong choice choices you have one perform his own pre-op hygienic hair so let me get this right you have a patient that's about to get their tonsils removed and you're gonna trust that five-year-old patient to brush their own teeth to clean out their own mouth to clean their body right come on they're five years old so no they're not old enough we can't give them that type of responsibility yet two have alone time to relax before the procedure this child is five you leave them alone what are you gonna do you're going to increase their anxiety you don't want to leave them alone matter of fact you want them to have familiar faces with them such as mommy and daddy big sister little brother um choice four have access to age-appropriate magazines and puzzles for diversion let me tell you how to try to trick you with this one because they wrote age appropriate guess what at five years old they're not reading magazines they can hardly read what do they like coloring books if anything right so they're not going to be reading magazines or playing puzzles they want to play so the correct answer is three-hand equipment when taking blood pressure for a four year a four and a half year old child is crying from pain related to her fractured leg which of the following is the most appropriate nursing response to her alteration and comfort one please try not to move your leg and that will make it feel better two i'll give you a shot of medicine that will help take the pain away three it's okay to it's okay if you need to cry would you like to hold your favorite doll four would you like to tell me now where you want to where you want me to give you your shot okay guys the two choices that even mention the shot those should be the ones that you automatically got rid of right because the minute that child hears that words that were chopped i can't speak i'm sorry guys i cannot speak tonight the minute that child hears that word shot what what does that do that increases that child's anxiety right so one please try not to move your leg and it will make it better you telling the child that will do nothing that child's in pain that will do nothing by you telling them if they don't move their leg that it's going to make it better that's wrong two i'll give you a shot of medicine to make the pain go away that's gonna make them cry even more then you have choice four would you like to tell me where you want me to give you your shot that is going to make the child cry even more what you want to do is three tell them it's okay to cry if they want to and then ask them if they want their favorite doll what are you doing when you say that to them you're distracting them and then you give them their favorite doll and of course the child can may still feel pain but it won't be as bad because they're distracted and plus you gave them a choice so it make the child feel like they have some kind of choice in a situation that they're not too happy about to begin with when teaching basic infant safety to the parents of a three-month-old the nurse should emphasize one placing gates at stairways two keeping bathroom doors closed three giving large hard teething biscuits or four removing feeding bibs at bedtime and the correct answer is four guys excuse me removing feeding bibs at bedtime why we don't want that child to suffocate they're only how old three months old so that bib flips over on that child's face do they have the physical dexterity to move that bib out of their face no they don't okay that bib can suffocate them right or if that bend is tight around the back but the baby's moving a little bit and gets tighter and tighter and tighter does that child the three-month-old infant do they have the dexterity to unloosen that bib no they don't okay so that bib can suffocate them let's look at our other choices one placing gates at the stairways two keeping bathroom doors closed three giving a large hard teeth but um large hard teething biscuits you see the first two the gates and stairways and keeping bathroom doors closed you're going to teach this more around 8 to 12 months because what is happening around eight to 12 months they're crawling they're creeping they can get around so yes you got to put gates on the stairs to prevent a fall right yes you got to keep the bathroom door closed so they can't get in there because there's learning to crawl and they're getting around it's not like when they were three months old you put in one place and that's where they stay no they're moving about so one and two is more for eight to twelve months right three give large hard teething biscuits here's a problem with the teething biscuits that the reason why we tell the parents to stay away from and not to do it the child saliva can soften the biscuit and a piece of the biscuit falls off and guess what it can lodge into the baby's throat and choke the baby to death so that's why we don't like that and we stay away from that and so the correct answer guys is number four removing feeding bibs at bedtime the parents of a three-month-old ask the nurse what behavior they should expect the nurse informs the parents that the child is able to one say dada two smile responsively three differentiate strangers or four play social peek-a-boo games and the correct answer is two smile responsively so around two to three months the child goes from responding reflexively to respondingly and they're smiling because something genuinely is making their smile and they're happy right let's look at our other choices one saying da da we usually see this around 1 years old 12 months three differentiating strangers we start to see that around eight months old and this is around the time we also start to see what the strange anxiety starts creeping in right and then we have four four is famous for nclex i don't know why but nclex loves asking about peekaboo so just make sure you know this choice four playing peek-a-boo games and we see this where around nine months okay so nine months we see that they start appreciating peekaboo and they can't get enough of it the nurse assists the family of nine-year-old with nutritional information a recommended after school snack for a child this age is one milkshakes two potato chips three plain popcorn or four bite-sized candy okay so they're nine years old the correct answer is plain popcorn and i want to point something out to you they put that word plain in front of popcorn for a minute for a minute for a reason why because they wanted you to know that that popcorn is not salty it's plain popcorn that popcorn is not caramel popcorn it's plain popcorn let's look at our other choices one milkshake milkshake has too much what fat what is milkshake ice cream and milk and sugar right so milkshake is not a good one that one has too much fat choice two potato chips potato chips has too much what salt too much grease that's not a good one choice for bite-sized candy that has too much sugar so the best choice for this is plain popcorn for your nine-year-old that's a great snack what else fresh fruit vegetables cheese right non-fat um you could give them um a second kids like to oh my gosh pudding pudding with the non-fat milk okay the elementary school nurse is responsible for evaluating each child's overall physical development during the school age years the nurse anticipates that one the child's body weight will almost triple two there will be few physical differences among children three the child will grow an average of one to two inches per year or four body fat will gradually increase contributing to a heavier appearance okay the correct answer is three the child will grow an average of one to two inches per year that is correct let's look at our other choices one the child's body weight will almost triple no it's gonna almost double not triple we expect to see them gain around four to seven pounds a year okay choice two there'll be few physical differences among children it's actually the opposite there will be many physical differences among children and then you have choice four the body fat will gradually increase contributing to heavy appearance it's actually the opposite the body fat will decrease you're going to see more of a fat distribution so that child will actually actually look thinner not heavier a six-year-old's hospitalized for asthma which of the following activities would be appropriate to help this child resolve the crisis of hospitalization one crayons and coloring book two a thousand piece puzzle to complete three a cd player with soothing cds four a nerf football to throw around the room and you guys should all get this right because i just talked to you about the six year old and what they like to do so the correct answer is one crayons the coloring book okay that's what they like to do anything with coloring or drawing or painting anything that helps them use their imagination and be creative that's what they're going to want to do let's look at our other choices you have choice 2 1 000 piece puzzle stop it i can't do a thousand piece puzzle can you why are you going to try to give that to a six year old that makes no sense stop three cd player with soothing music they don't care about soothing music they're six not sixty then choice four a nerf football to throw around the room that's not age appropriate at six years old they don't care about a nerf football that's for older child they're gonna wanna color so coloring book is very appropriate for childless age which one of the following statements is correct regarding the pre-adolescent developmental stage one it appears two years earlier in boys and girls two intimate feelings are confided in the parents three interest in the opposite sex is not a factor for this group or four it signals the development of secondary sex characteristics and the correct answer guys is for it signals the development of secondary sex characteristics so for the girls you start seeing the buds the breasts right for boys you start seeing the facial hair they start getting little peach fuzz above their lips right their voice starts getting a little bit deeper now let's look at our other choices two it appears two years earlier for boys and girls that is false it actually appears earlier in girls than boys choice two intimate feelings are confined in their parents nope that's false at this age pre-adolescence the kids all have what best friends and so they talk to their best friend about how their body's changing or what's going on not their parents and then choice three interest in the opposite sex is not a factor for this group and that is false they start liking boys and they'll have a different crush every week and the boys start liking girls so yes there is interest in the opposite sex so the only correct answer for this question is choice number four in order to obtain information which of the following is the most appropriate question ask of a 14 year old female who is visiting the county health center for birth control help one have you told your parents that you're sexually active two are any of your friends participating in sexual behaviors three what can you tell me about any of your past sexual activities four have you been physically protecting yourself with safe sex measures and the correct answer three what can you tell me about any of your past sexual activities have you guys noticed something in all these questions number three is the only one that's asking an open-ended question all right look at the other choices one have you told your parents yes or no two are there any friends participating yes or no four have you been physically protecting yes or no but choice three is the only one that's not a yes or no question it's open-ended okay whenever we want to elicit information we ask an open-ended question i tell you guys this all the time there are very few situations where you're going to ask closing the question suicide are you having thoughts of harming yourself or someone else abuse are you being abused is such and such hurting you right because many people are being abused they want to tell somebody but no one's ever asked them directly people always beat around the bush okay and what's my third one close-ended question oh assessment okay if you need an answer right now you got a gunshot wound patient you're about to go to the operating room and as you're rushing that patient to the room do you have any allergies are you on any medications did you take alcohol when was the one that when was the last time that's actually an open-ended question but you know um have you had alcohol in the last eight or twelve hours okay so when you're doing an assessment when you're doing an assessment you're asking about abuse you're asking about suicide you're gonna ask close-knit questions but 98 of the time other than that it's going to be open-ended questions you want that patient to talk because the more that they talk the more that you learn okay if you said to them look at one have you told your parents that you're sexually active what if daddy's the one that she needs that protection from two are any of your friends participating sexual behaviors what does that have to do with what that patient came in for and then four have you been physically protecting yourself with safe self safe sex measures if they just say yes or no what is your next step you want them jabbing you want them talking so you can learn and see what you have to teach them see what you have to correct see if you need to get the authorities involved you're not going to know unless you ask the open-ended questions and allow that patient to talk oh my goodness i didn't even realize guys i'm sorry that was my last question i'm all out of questions okay guys so that is it for fundamentals conception through adolescent i'm gonna make sure that i cover the rest of the stages for you those videos are coming soon guys thank you so much for watching if you have any friends or you know anybody that is studying for boards or in the program please share my video don't forget to go ahead and like comment and subscribe below press that notification button and i'll see you next time