Nokea
The parents of a child born with ambiguous genitalia tell the nurse that family and friends are asking what caused the baby to be this way. Tests are being done to assist in gender assignment. What should the nurse's intervention include?
- A. Explain the disorder so they can explain it to others.
- B. Help parents understand that this is a minor problem.
- C. Suggest that parents avoid family and friends until the gender is assigned.
- D. Encourage parents not to worry while the tests are being done.
Correct Answer: A
Rationale: It is important for the nurse to provide the parents with accurate information so they can confidently explain the situation to others, helping to reduce stress and misinformation. Avoiding family and friends or minimizing the problem is not helpful.
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The nurse is caring for a child with Beta Thalassemia. Which child is in a group most at risk for Beta Thalassemia?
- A. A three-year-old girl of Mediterranean descent.
- B. A ten-year-old boy of Hispanic descent.
- C. A young girl of African descent.
- D. A baby of European descent.
Correct Answer: A
Rationale: Corrected Rationale: Beta Thalassemia is most common in individuals of Mediterranean descent, such as those from Italy, Greece, and the Middle East. This genetic disorder affects hemoglobin production and can lead to severe anemia. Choice A is the correct answer as individuals of Mediterranean descent are at the highest risk for Beta Thalassemia. Choices B, C, and D are incorrect as they do not belong to the population group most at risk for this genetic disorder.
A toddler's mother calls the nurse because she thinks her son has swallowed a button type of battery. He has no signs of respiratory distress. The nurse's response should be based on which premise?
- A. An emergency laparotomy is very likely.
- B. The location needs to be confirmed by radiographic examination.
- C. Surgery will be necessary if the battery has not passed in the stool in 48 hours.
- D. Careful observation is essential because an ingested battery cannot be accurately detected.
Correct Answer: B
Rationale: Radiographic examination is essential to confirm the location of the battery, as it can cause significant damage, particularly if lodged in the esophagus. Immediate surgery may be required depending on its location and the potential for causing harm.
What condition is the most common cause of acute renal failure in children?
- A. Pyelonephritis
- B. Tubular destruction
- C. Severe dehydration
- D. Upper tract obstruction
Correct Answer: C
Rationale: Severe dehydration is the most common cause of acute renal failure in children, as it leads to prerenal azotemia, which can progress to renal failure if not corrected. Other causes like pyelonephritis and tubular destruction are less common and usually secondary to other conditions.
For minimal change nephrotic syndrome (MCNS), prednisone is effective when what occurs?
- A. Appetite increases and blood pressure is normal
- B. Urinary tract infection is gone and edema subsides
- C. Generalized edema subsides and blood pressure is normal
- D. Diuresis occurs as urinary protein excretion diminishes
Correct Answer: D
Rationale: The effectiveness of prednisone in treating MCNS is indicated by diuresis and a decrease in urinary protein excretion. Subsidence of generalized edema is also a positive sign, but the key indicator is the reduction in proteinuria, which is achieved through diuresis.
What findings on physical assessment of a neonate would indicate the need for further evaluation?
- A. Nystagmus
- B. Epstein pearls
- C. Low-set ears
- D. Positive Babinski reflex
Correct Answer: C
Rationale: Low-set ears in a neonate suggest major abnormalities and should prompt further evaluation. The correct alignment of the top of the pinnae of the ear with the outer canthus of the eye is crucial. Nystagmus, an involuntary eye movement, is common in newborns and often resolves on its own. Epstein pearls, small cysts on the hard palate, are insignificant and disappear over time. A positive Babinski reflex is normal in infants up to 1 year of age. Therefore, the presence of low-set ears is the most concerning finding that requires immediate attention.