Nokea
A 2-month-old premature infant born at 30 weeks gestation is scheduled for an inguinal hernia repair. Which of the following preoperative findings would BEST predict an increased risk of postoperative apnea?
- A. Hemoglobin 7 gm/dL
- B. Glucose 61 mg/dL
- C. Room air SpO2 92%
- D. N/A
Correct Answer: A
Rationale: Low hemoglobin levels in a premature infant can increase the risk of postoperative apnea due to reduced oxygen-carrying capacity.
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A mother of a term neonate asks what the thick, white, cheesy coating is on his skin. Which correctly describes this finding?
- A. Lanugo
- B. Milia
- C. Nevus flammeus
- D. Vernix 6
Correct Answer: D
Rationale: The thick, white, cheesy coating on the skin of a newborn baby is called vernix caseosa. It is a substance produced by the fetal sebaceous glands and is meant to protect the baby's skin while in the amniotic fluid. Vernix helps to maintain the skin's hydration, provides a barrier against infection, and aids in the transition from the wet intrauterine environment to the dry extrauterine world. It is usually found on the skin of term newborns but can be present in preterm babies as well. As the baby is exposed to air and dries off, the vernix will naturally diminish.
A 2-month-old premature infant born at 30 weeks gestation is scheduled for an inguinal hernia repair. Which of the following preoperative findings would BEST predict an increased risk of postoperative apnea?
- A. Hemoglobin 7 gm/dL
- B. Glucose 61 mg/dL
- C. Room air SpO2 92%
- D. N/A
Correct Answer: A
Rationale: Low hemoglobin levels in a premature infant can increase the risk of postoperative apnea due to reduced oxygen-carrying capacity.
A mother requests that her child receive the varicella vaccine at the 9-month checkup. The nurse's best response is:
- A. Vaccinated children will likely develop a mild case of chickenpox.
- B. The varicella vaccine is not usually administered before 1 year of age.
- C. The vaccine will be given after the doctor examines your child.
- D. A booster will be needed at 18 months.
Correct Answer: B
Rationale: The varicella vaccine is typically not given until the child is 12 months or older.
A nurse is teaching a parent of an infant about treatment of seborrhea dermatitis (cradle cap). Which should the nurse include in the instructions?
- A. Shampoo every three days with a mild soap.
- B. The hair should be shampooed with a medicated shampoo.
- C. Shampoo every day with an antiseborrheic shampoo.
- D. The loosened crusts should not be removed with a fine-toothed comb.
Correct Answer: A
Rationale: The nurse should include in the instructions to shampoo every three days with a mild soap. Seborrheic dermatitis, commonly known as cradle cap in infants, is a common condition characterized by greasy, yellowish, scaly patches on the scalp. Mild cases of cradle cap typically do not require aggressive treatment. Using a mild soap and shampooing every few days can help loosen the scales and prevent buildup without causing irritation to the infant's delicate skin. It is important not to shampoo too frequently or use harsh products as this can exacerbate the condition. Additionally, the loosened crusts can be gently massaged and removed after shampooing with a soft brush or cloth, but it is not necessary to use a fine-toothed comb, as this may cause skin irritation.
Four-year-old Brian appears to be upset by hospitalization. Which is an appropriate intervention?
- A. Let him know it is all right to cry.
- B. Give him time to gain control of himself.
- C. Show him how other children are cooperating.
- D. Tell him what a big boy he is to be so quiet.
Correct Answer: A
Rationale: Option A, "Let him know it is all right to cry," is the most appropriate intervention for a four-year-old like Brian who appears to be upset by hospitalization. Acknowledging and validating his emotions, including the possibility of crying, is important for his emotional well-being. By letting Brian know it is okay to express his feelings, he can feel supported and understood during a potentially difficult time. It is crucial for children to feel that their emotions are valid and accepted, promoting their emotional resilience and coping skills. This approach fosters trust and comfort, helping Brian navigate his emotions in a healthy way.