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A newborn with hypospadias: The parents ask if circumcision is an option. Which is the best response?
- A. Circumcision is a fading practice and is now contraindicated.
- B. Circumcision is recommended to prevent infection.
- C. Circumcision is an option but should be delayed, as the foreskin may be needed for surgical repair.
- D. Circumcision can never be performed in a child with hypospadias.
Correct Answer: C
Rationale: In hypospadias, preserving the foreskin may be beneficial for repair, so circumcision is usually delayed.
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Herpes zoster is caused by the varicella virus and has an affinity for:
- A. sympathetic nerve fibers.
- B. parasympathetic nerve fibers.
- C. posterior root ganglia and posterior horn of the spinal cord.
- D. lateral and dorsal columns of the spinal cord.
Correct Answer: C
Rationale: Herpes zoster, commonly known as shingles, is caused by the reactivation of the varicella-zoster virus, the same virus that causes chickenpox. This virus has an affinity for sensory nerve fibers, particularly those located in the posterior root ganglia and the posterior horn of the spinal cord. When the virus becomes reactivated, it travels along these nerves to the skin, leading to the characteristic painful rash and blisters that are seen in herpes zoster. The involvement of these specific nerve fibers explains the typical dermatomal distribution of the rash in shingles.
Which part of the brain controls breathing?
- A. Medulla
- B. Cerebrum
- C. Cerebellum
- D. Thalamus
Correct Answer: A
Rationale: The medulla oblongata, located in the brainstem, is responsible for controlling essential autonomic functions such as breathing, heart rate, and blood pressure. Specifically, the medulla regulates the rhythm and depth of breathing by sending signals to the respiratory muscles, including the diaphragm and intercostal muscles. In response to changing levels of oxygen and carbon dioxide in the blood, the medulla adjusts the breathing rate to maintain proper oxygenation of the body tissues. Damage to the medulla can result in respiratory failure, highlighting its critical role in controlling breathing.
Nurse Lina gives discharge instructions to Aling Maria, who is experiencing an exacerbation of COPD because of an upper respiratory tract infection, regarding her diet at home. Which of the following food choices would be appropriate?
- A. low fat low cholesterol
- B. low sodium diet
- C. bland soft diet
- D. high calorie high protein
Correct Answer: D
Rationale: A patient experiencing an exacerbation of COPD, especially due to an infection, requires a diet that is high in calories and protein. This is because during exacerbations, the body's energy requirements increase due to increased work of breathing and inflammation. High-calorie intake helps provide the necessary energy for breathing and healing. Additionally, a high-protein diet is important for maintaining respiratory and skeletal muscle strength, which can be affected during exacerbations of COPD. Therefore, a high-calorie high-protein diet would be most appropriate for Aling Maria to support her recovery and overall health during this period.
A client receiving external radiation to the left thorax to treat lung cancer has a nursing diagnosis of Risk for impaired skin integrity. Which intervention should be part of this client's plan of care?
- A. Avoiding using a soap on the irradiated areas
- B. Applying talcum powder to the irradiated areas daily after bathing
- C. Wearing a lead apron during direct contact with the client
- D. Removing thoracic skin markings after each radiation treatment
Correct Answer: A
Rationale: The correct intervention that should be part of the plan of care for a client at risk for impaired skin integrity due to external radiation is avoiding using a soap on the irradiated areas. Soap can be drying to the skin and may exacerbate skin reactions caused by radiation therapy. It is important to keep the skin in the radiation field clean, but avoiding soap will help prevent further irritation and damage to the skin. Instead, a gentle cleanser recommended by the healthcare provider should be used to clean the irradiated areas. Additionally, maintaining good hydration and moisturizing the skin as recommended by the healthcare team can also help minimize skin reactions.
Early this morning, a baby boy was circumcised by using the Plastibell method. When should the nurse tell the mother that the baby can be discharged?
- A. The newborn voids
- B. Receiving vitamin K
- C. Yellow exudate forms over glans
- D. The Plastibell rim falls off
Correct Answer: D
Rationale: The nurse should inform the mother that the baby can be discharged once the Plastibell rim falls off. The Plastibell method involves placing a small plastic ring over the foreskin, which cuts off circulation and causes the foreskin to fall off on its own within a week to 10 days after the procedure. Once the Plastibell rim has fallen off, it indicates that the circumcision site has healed, and the baby is ready to be discharged. The other options, such as the newborn voiding, receiving vitamin K, or yellow exudate forming over the glans, are important aspects of post-circumcision care but are not indicative of the baby being ready for discharge.