Nokea
Place in order the expected sequence of fine motor developmental milestones for an infant beginning with the first milestone achieved and ending with the last milestone achieved. Provide answer using lowercase letters separated by commas (e.g., a, b, c, d, e).
- A. Voluntary palmar grasp
- B. Reflex palmar grasp
- C. Puts objects into a container
- D. Neat pincer grasp
Correct Answer: B
Rationale: 1. Reflex palmar grasp (B) - Infants are born with a reflex called the palmar grasp reflex, which means they automatically close their fingers around an object placed in their palm. This reflex typically disappears around 3-4 months of age.
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The couple with the lowest risk of having a child with sickle cell disease is the one in which the:
- A. Father is HbS and mother is HbS
- B. Father is HbAS and the mother is
- C. Father is HbS and mother is HbAS HbAS
- D. Father is HbA and the mother is HbS
Correct Answer: D
Rationale: Sickle cell disease is an autosomal recessive genetic disorder caused by a mutation in the HBB gene, resulting in the production of abnormal hemoglobin called HbS. In order to have a child with sickle cell disease, both parents must be carriers of the HbS gene.
A client has a serum calcium level of 7.2mg/dl. During the physical examination, the nurse expects to assess:
- A. Trousseau's sign
- B. Hegar's sign
- C. Homan's sign
- D. Goodell's sign
Correct Answer: A
Rationale: A client with a low serum calcium level (hypocalcemia) is at risk for exhibiting Trousseau's sign. Trousseau's sign is a clinical manifestation of hypocalcemia characterized by carpal spasm induced by inflating a blood pressure cuff on the arm above the systolic pressure for a few minutes. This spasm occurs due to the increased neuromuscular irritability caused by low calcium levels. Therefore, a nurse assessing a client with a serum calcium level of 7.2mg/dl should expect to assess Trousseau's sign.
Children with secondary nocturnal enuresis may have
- A. UTI
- B. diabetes mellitus
- C. diabetes insipidus
- D. psychosocial stressor
Correct Answer: D
Rationale: Psychosocial stressors can trigger secondary nocturnal enuresis after a period of dryness.
Which blood gas analyses are most indicative of respiratory acidosis?
- A. pH = 7.22, PCO2 = 55 mmHg, HCO3 = 30 mEq/L.
- B. pH = 7.28, PCO2 = 45 mmHg, HCO3 = 15 mEq/L.
- C. pH = 7.34, PCO2 = 35 mmHg, HCO3 = 25 mEq/L.
- D. pH = 7.40, PCO2 = 25 mmHg, HCO3 = 30 mEq/L.
Correct Answer: A
Rationale: Respiratory acidosis is indicated by a low pH and elevated PCO2, as seen in option A.
The parents of a 3-month-old infant report that their infant sleeps supine (face up) but is often prone (face down) while awake. What knowledge should the nurse's response should be based?
- A. Unacceptable because of the risk of sudden infant death syndrome (SIDS)
- B. Unacceptable because it does not encourage achievement of developmental milestones
- C. Acceptable to encourage fine motor development
- D. Acceptable to encourage head control and turning over
Correct Answer: D
Rationale: The correct knowledge that the nurse's response should be based on is that it is acceptable to encourage head control and turning over. At 3 months of age, encouraging the infant to be prone while awake can help promote the development of head control, neck strength, and eventually facilitate the ability to turn over. This practice is considered safe and beneficial for infants within the appropriate age range, as long as the infant is supervised during the awake period. It is important to promote safe sleep practices for infants to reduce the risk of Sudden Infant Death Syndrome (SIDS), but allowing supervised tummy time for an awake infant is beneficial for their motor development.