Nokea
A first-time mother brings in her 5-day-old baby for a well-child visit. The baby weighs 7 lb 5 oz, down from 7 lb 10 oz at discharge. The nurse's best response is:
- A. I will notify the doctor about this weight loss.
- B. Newborns can lose up to 10% of their birth weight and regain it by 2 weeks of age.
- C. I can tell you are a first-time mother; don't worry.
- D. Maybe the baby isn't getting enough milk. How often are you feeding?
Correct Answer: B
Rationale: A small weight loss is normal in the first week of life; infants typically regain their birth weight by 2 weeks.
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Which strategies should the school nurse recommend implementing in the classroom for a child with attention deficit hyperactive disorder (ADHD)? (Select all that apply.)
- A. Schedule heavier subjects to be taught in the afternoon.
- B. Accompany verbal instructions by written format.
- C. Limit number of breaks taken during instructional periods.
- D. Allow more time for testing.
Correct Answer: B
Rationale: Accompany verbal instructions by written format: Children with ADHD may have difficulty retaining verbal instructions due to their distractibility and impulsivity. Providing written instructions alongside verbal ones can help reinforce the information and improve comprehension.
Incomplete development of teeth,bones, and ligaments is the result of:
- A. Congenital hip dysplasia
- B. Duchenne's muscular dystrophy
- C. Osteogenesis imperfecta
- D. Osteomyelitis
Correct Answer: C
Rationale: Osteogenesis imperfecta, also known as brittle bone disease, is a genetic disorder that affects collagen production, leading to brittle and easily fractured bones. In addition to bone fragility, individuals with osteogenesis imperfecta may also experience teeth abnormalities such as dentinogenesis imperfecta (discolored and weakened teeth) and ligament laxity due to the improper development of connective tissues. This incomplete development of teeth, bones, and ligaments is a characteristic feature of osteogenesis imperfecta, making it the correct choice in this scenario. Congenital hip dysplasia, Duchenne's muscular dystrophy, and osteomyelitis do not typically involve the same constellation of symptoms related to teeth, bones, and ligaments seen in osteogenesis imperfecta.
A client has possible malignancy of the colon, and surgery is scheduled. The rationale for administering Neomycin preoperatively is to:
- A. Prevent infection postoperatively
- B. Eliminate the need for preoperative enemas
- C. Decreased and retard the growth of normal bacteria in the intestines
- D. Treat cancer of the colon
Correct Answer: C
Rationale: The rationale for administering Neomycin preoperatively in the case of possible malignancy of the colon is to decrease and retard the growth of normal bacteria in the intestines. This is important because surgical procedures involving the colon carry a risk of infection due to the abundant normal bacterial flora present in the intestines. By administering Neomycin prior to surgery, the goal is to reduce the number of bacteria in the colon and minimize the risk of postoperative infections. It is not used to prevent infection or treat cancer directly, nor is it meant to eliminate the need for preoperative enemas.
Clients will go through operations and who have undergone surgery need the proper observation, treatment, and care. Implementing the nursing process to these patients will help reduce complications. Nurse Maria is preparing Mr. Sy for surgery. Which of the following statements by the client would indicate he is well-informed about his imminent surgery?
- A. " Right after the operation, I will wear the pneumatic compression device while sitting on the chair."
- B. "I will not eat anything after 12 pm the night befire my operation, but I sure can drink."
- C. "The skin preparation site is longer and wider than the actual incision site."
- D. "I will need to sign the consent from after I get to the operating table."
Correct Answer: B
Rationale: Option B, "I will not eat anything after 12 pm the night before my operation, but I sure can drink," indicates that the client understands and is knowledgeable about the pre-operative fasting guidelines. It is crucial for patients to have an empty stomach before surgery to prevent complications related to anesthesia, such as aspiration pneumonia. This statement shows that Mr. Sy is well-informed and compliant with this important pre-operative instruction. Options A, C, and D do not directly demonstrate specific knowledge regarding the surgery preparations.
The beta subunit of human chorionic gonadotropin (HCG) is a useful surface marker in some malignant germ cell tumors (GCTs); it is secreted by syncytiotrophoblasts. In which of the following GCTs this surface marker is characteristically elevated?
- A. teratoma
- B. germinoma
- C. endodermal sinus tumor
- D. embryonal carcinoma
Correct Answer: D
Rationale: Embryonal carcinoma is strongly associated with elevated beta-HCG levels.