What finding would lead healthcare providers to suspect Turner syndrome in a child?
- A. Webbed neck
- B. Microcephaly
- C. Gynecomastia
- D. Cognitive delay
Correct Answer: A
Rationale: A webbed neck is a classic physical characteristic seen in individuals with Turner syndrome, a genetic condition that results from a missing or partially missing X chromosome in females. This distinctive feature occurs due to excess skin on the neck and is a key clinical clue for healthcare providers. Microcephaly (choice B) refers to a small head size and is not typically associated with Turner syndrome. Gynecomastia (choice C) is the enlargement of breast tissue in males and is not a common finding in Turner syndrome. Cognitive delay (choice D) involves intellectual or developmental delays and is not a specific feature of Turner syndrome.
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A nurse is caring for an infant with a tentative diagnosis of hypertrophic pyloric stenosis (HPS). What is most important for the nurse to assess?
- A. Quality of the cry
- B. Signs of dehydration
- C. Coughing up feedings
- D. Characteristics of the stool
Correct Answer: B
Rationale: The correct answer is B: Signs of dehydration. Assessing for signs of dehydration is crucial in infants with hypertrophic pyloric stenosis (HPS) because they are at high risk due to frequent vomiting. Dehydration can lead to serious complications if not promptly addressed. Choices A, C, and D are not the priority assessments for HPS. While the quality of the cry can provide some information on the infant's distress level, dehydration assessment takes precedence. Coughing up feedings may not be specific to HPS, and characteristics of the stool, although important in general assessments, are not the priority in this situation.
When the working mother of a toddler is preparing to take her child home after a prolonged hospitalization, she asks the nurse what type of behavior she should expect to be displayed. What is the nurse's most appropriate description of her child's probable behavior?
- A. Excessively demanding behavior
- B. Hostile attitude toward the mother
- C. Cheerful, with shallow attachment behaviors
- D. Withdrawn, without emotional ties to the mother
Correct Answer: A
Rationale: After a prolonged hospitalization, a toddler may exhibit excessively demanding behavior as they readjust to being home. This behavior can stem from the child feeling insecure or anxious about the changes in their environment. The child may seek extra attention and reassurance during this transition period. Choices B, C, and D are incorrect because hostility, shallowness in attachment, and withdrawal without emotional ties are less likely behaviors to be displayed by a toddler readjusting to home after a hospital stay.
A child has been diagnosed with classic hemophilia. A nurse teaches the child's parents how to administer the plasma component factor VIII through a venous port. It is to be given 3 times a week. What should the nurse tell them about when to administer this therapy?
- A. Whenever a bleed is suspected
- B. In the morning on scheduled days
- C. At bedtime while the child is lying quietly in bed
- D. On a regular schedule at the parents' convenience
Correct Answer: B
Rationale: Administering factor VIII in the morning on scheduled days is the correct choice. This timing ensures that the factor VIII levels remain stable throughout the day when the child is active and at risk of bleeding. Choice A is incorrect because factor VIII should be given on a regular schedule rather than only when a bleed is suspected. Choice C is not ideal as the child may be more active during the day, increasing the risk of bleeding. Choice D is also incorrect as the administration should follow a specific schedule to maintain therapeutic levels of factor VIII in the child's system.
When explaining a viral disease that begins with malaise and a highly pruritic rash starting on the abdomen, spreading to the face and proximal extremities, and potentially leading to severe complications, which childhood disease is a nurse discussing with members of a grammar school's Parent-Teachers Association?
- A. Rubella
- B. Rubeola
- C. Chickenpox
- D. Scarlet fever
Correct Answer: C
Rationale: The correct answer is Chickenpox (varicella). This viral disease typically starts with malaise and a highly pruritic rash that begins on the abdomen and then spreads to the face and proximal extremities. Chickenpox can result in serious complications such as pneumonia and encephalitis. Rubella (German measles) presents with a milder rash and is less pruritic than chickenpox. Rubeola (measles) is characterized by a rash that spreads from the head to the trunk. Scarlet fever is caused by group A Streptococcus bacteria and is not a viral illness.
A child with a diagnosis of nephrotic syndrome is being treated with corticosteroids. What is an important nursing consideration?
- A. Monitor for signs of infection
- B. Monitor blood pressure
- C. Monitor for hyperglycemia
- D. Monitor for hypertension
Correct Answer: A
Rationale: When a child with nephrotic syndrome is undergoing treatment with corticosteroids, it is crucial to monitor for signs of infection. Corticosteroids can suppress the immune system, increasing the child's susceptibility to infections. Monitoring for signs of infection allows for early detection and prompt intervention. While monitoring blood pressure, hyperglycemia, and hypertension are important considerations in certain conditions and treatments, they are not the primary concern when a child with nephrotic syndrome is on corticosteroid therapy.