A newborn is being discharged at age 48 hours. The parents ask how the newborn should be bathed this first week home. How should the nurse recommend to bathe the newborn?
- A. Daily with mild soap
- B. Daily with an alkaline soap
- C. Two or three times this week with plain water
- D. Two or three times this week with mild soap
Correct Answer: C
Rationale: It is recommended to bathe a newborn only a few times during the first week with plain water to avoid drying out the baby's delicate skin. Newborns do not need to be bathed daily, as excessive bathing can strip their skin of natural oils and lead to dryness or irritation. Plain water is gentle and sufficient for cleaning a newborn's skin without causing any harm. After the first week, parents can gradually introduce mild soap if needed for cleaning, but it is still not necessary to bathe the baby daily.
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A preterm newborn, after spending 8 weeks in the NICU, is being discharged. The parents of the newborn express apprehension and worry that the newborn may still be in danger. How should the nurse interpret these statements?
- A. Normal
- B. A reason to postpone discharge
- C. Suggestive of maladaptation
- D. Suggestive of inadequate bonding
Correct Answer: A
Rationale: It is normal for parents of preterm newborns who have spent time in the NICU to express apprehension and worry upon discharge. The NICU experience can be stressful and overwhelming for families, and it is common for parents to feel anxious about taking their newborn home. The nurse should provide support and education to help alleviate the parents' concerns and ensure a smooth transition from the hospital to home. It is important to acknowledge the parents' feelings, offer reassurance, and reinforce the importance of follow-up care and monitoring.
A client with diabetes mellitus must learn how to self-administer insulin. The physician has prescribed 10 U of U- 100 regular insulin and 35 U of 100-U isophane insulin suspension (NPH) to be taken before breakfast. When teaching the client how to select and rotate insulin injection sites, the nurse should provide which instruction?
- A. "Inject insulin into healthy tissue with large blood vessels and nerves."
- B. "Rotate injection sites within the same anatomic region, not among different regions."
- C. "Administer insulin into areas of scar tissue or hypotrophy whenever possible."
- D. "Administer insulin into sites above muscles that you plan to exercise heavily later that day."
Correct Answer: B
Rationale: The nurse should instruct the client to rotate injection sites within the same anatomic region, not among different regions. Proper rotation of injection sites helps prevent lipodystrophy (changes in fat tissue) and ensures consistent absorption of insulin. By rotating sites within the same region, the client can minimize the risk of developing localized skin complications. Additionally, rotating sites helps to ensure that the insulin is absorbed consistently, leading to more predictable blood glucose control. It is important to avoid injecting into areas of scar tissue, hypotrophy, large blood vessels, or nerves, as these can affect the absorption of insulin and may lead to inconsistent blood glucose levels.
Which is an objective of care for a 10-year-old child with minimal change nephrotic syndrome?
- A. Reduce blood pressure.
- B. Reduce excretion of urinary protein.
- C. Increase excretion of urinary protein.
- D. Increase ability of tissues to retain fluid.
Correct Answer: B
Rationale: The management goal for a child with minimal change nephrotic syndrome is to reduce the excretion of urinary protein. In this condition, there is an abnormal loss of protein in the urine due to damage in the glomeruli of the kidneys. Reducing the excretion of urinary protein helps prevent complications associated with protein loss, such as edema and hypoalbuminemia. While reducing blood pressure may be important in some cases, the primary focus for this specific condition is to address the protein leak in the urine. Increasing the excretion of urinary protein would worsen the condition, and increasing the ability of tissues to retain fluid is not the desired outcome in this context.
Minda, a 65-year old female has been admitted with a left hemisphere stroke. Which behavioral change would the nurse expect to find upon assessment?
- A. impulsive, unsafe activity
- B. motor deficits on the right eye
- C. motor deficits on the left side of the body
- D. error in word choices
Correct Answer: D
Rationale: A left hemisphere stroke typically affects the right side of the body due to the way the brain controls motor functions. Since the left hemisphere is also responsible for language and speech processing, patients with a left hemisphere stroke commonly exhibit errors in word choices, difficulty speaking or understanding language, aphasia, and other language-related impairments. This is known as Broca's aphasia or expressive aphasia. Therefore, the nurse would expect to find errors in word choices as a behavioral change in a patient like Minda with a left hemisphere stroke.
The long-term complications seen in thalassemia major are associated to which of the following?
- A. Anemia
- B. Growth retardation
- C. Hemochromatosis
- D. Splenomegaly
Correct Answer: C
Rationale: Thalassemia major is a genetic disorder characterized by abnormal hemoglobin production. Individuals with thalassemia major require frequent blood transfusions to manage their anemia, leading to iron overload in the body. Over time, this excess iron can accumulate in various organs such as the liver, heart, and endocrine glands, causing damage and dysfunction. This condition is known as hemochromatosis. Long-term complications of hemochromatosis include liver cirrhosis, heart failure, diabetes, and endocrine disorders. Therefore, the long-term complications seen in thalassemia major are primarily associated with hemochromatosis rather than anemia, growth retardation, or splenomegaly.