A healthcare professional plans to discuss childhood nutrition with a group of parents whose children have Down syndrome in an attempt to minimize a common nutritional problem. What problem should be addressed?
- A. Rickets
- B. Obesity
- C. Anemia
- D. Rumination
Correct Answer: B
Rationale: Childhood obesity is a prevalent issue in children with Down syndrome due to factors such as decreased physical activity, slower metabolism, and potential overeating tendencies. Addressing obesity is crucial to promoting healthy lifestyles and preventing associated health complications. Rickets, a condition caused by a deficiency of vitamin D, is not commonly associated with Down syndrome. While anemia can occur in individuals with Down syndrome, obesity is a more common concern. Rumination, the regurgitation of food without nausea, is not a typical nutritional problem in children with Down syndrome.
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The nurse is caring for a 10-year-old with Duchenne muscular dystrophy. As part of the plan of care, the nurse focuses on maintaining his cardiopulmonary function. Which intervention would the nurse implement to best promote maximum chest expansion?
- A. Deep-breathing exercises
- B. Upright positioning
- C. Coughing
- D. Chest percussion
Correct Answer: B
Rationale: Upright positioning is the most appropriate intervention to promote maximum chest expansion in a child with Duchenne muscular dystrophy. By keeping the child in an upright position, lung expansion is maximized, which improves breathing efficiency. Deep-breathing exercises may help with overall lung function but do not directly promote chest expansion. Coughing and chest percussion are more related to airway clearance and do not specifically address maximizing chest expansion.
A nurse in the emergency department observes large welts and scars on the back of a child who has been admitted for an asthma attack. What additional information must be included in the nurse's assessment?
- A. History of an injury
- B. Signs of child abuse
- C. Presence of food allergies
- D. Recent recovery from chickenpox
Correct Answer: B
Rationale: The correct answer is B: Signs of child abuse. Large welts and scars on a child may be indicative of abuse, making it crucial for the nurse to assess and report any suspicions. Assessing the history of an injury (choice A) may not provide insight into the cause of the welts and scars as effectively as looking for signs of potential abuse. Food allergies (choice C) and recent recovery from chickenpox (choice D) are not directly relevant to the observation of welts and scars on the child's back.
When teaching the parents of a child with a diagnosis of type 1 diabetes mellitus about insulin administration, what should the nurse emphasize?
- A. Rotate injection sites
- B. Administer insulin before meals
- C. Store insulin in the refrigerator
- D. Administer insulin at bedtime
Correct Answer: A
Rationale: The correct answer is to rotate injection sites. This practice helps prevent lipodystrophy, a localized loss of fat tissue that can affect insulin absorption. By rotating sites, the child can avoid developing lumps or indentations in the skin where insulin is repeatedly injected. Administering insulin before meals (choice B) may be necessary for certain types of insulin but is not the priority when teaching about insulin administration. Storing insulin in the refrigerator (choice C) is important for maintaining its potency, but it is not the primary emphasis when teaching about insulin administration. Administering insulin at bedtime (choice D) may be necessary based on the child's insulin regimen but is not the primary consideration for teaching injection techniques and site rotation.
Which cardiac defects are associated with tetralogy of Fallot?
- A. Right ventricular hypertrophy, atrial and ventricular defects, and mitral valve stenosis
- B. Origin of the aorta from the right ventricle and of the pulmonary artery from the left ventricle
- C. Right ventricular hypertrophy, ventricular septal defect, pulmonic stenosis, and overriding aorta
- D. Altered connection between the pulmonary artery and the aorta, right ventricular hypertrophy, and an atrial septal defect
Correct Answer: C
Rationale: Tetralogy of Fallot is characterized by a combination of four specific cardiac defects: right ventricular hypertrophy, ventricular septal defect, pulmonic stenosis, and overriding aorta. Choice A is incorrect as it includes mitral valve stenosis, which is not typically part of tetralogy of Fallot. Choice B describes transposition of the great arteries rather than tetralogy of Fallot. Choice D includes an atrial septal defect, which is not part of the classic presentation of tetralogy of Fallot.
An infant who has had diarrhea for 3 days is admitted in a lethargic state and is breathing rapidly. The parent states that the baby has been ingesting formula, although not as much as usual, and cannot understand the sudden change. What explanation should the nurse give the parent?
- A. Cellular metabolism is unstable in young children.
- B. The proportion of water in the body is less than in adults.
- C. Renal function is immature in children until they reach school age.
- D. The extracellular fluid requirement per unit of body weight is greater than in adults.
Correct Answer: D
Rationale: The correct answer is D. Infants have a higher extracellular fluid requirement per unit of body weight, making them more susceptible to dehydration and electrolyte imbalances during illnesses such as diarrhea. Choice A is incorrect as cellular metabolism instability does not directly relate to the infant's condition described. Choice B is inaccurate as the proportion of water in the body is not the primary issue causing the infant's symptoms. Choice C is incorrect as renal function being immature does not explain the sudden change in the infant's health status; it is more related to fluid balance and dehydration.