Nokea
A nurse is assessing a 6-month-old infant. The nurse recognizes the posterior fontanel usually closes at which age?
- A. 6 to 8 weeks
- B. 10 to 12 weeks
- C. 4 to 6 months
- D. 8 to 10 months
Correct Answer: D
Rationale: The posterior fontanel, located at the back of the infant's head, typically closes between 8 to 10 months of age. During infancy, it is normal for fontanels to gradually close as the bones of the skull develop and fuse together. The closure of fontanels is an important part of the infant's growth and development. It is crucial for healthcare providers to monitor fontanel closure as part of a routine physical assessment to ensure proper skull development and growth in infants.
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The child who can transfers object from hand to hand and babbles has achieved the developmental age of
- A. 4 months
- B. 6 months
- C. 8 months
- D. 10 months
Correct Answer: B
Rationale: Transferring objects and babbling typically occur around 6 months.
The least common late neurologic sequelae that may be encountered post craniospinal irradiation in a 9-year-old child with medulloblastoma is
- A. microcephaly
- B. learning disabilities
- C. cognitive impairment
- D. second malignancy
Correct Answer: D
Rationale: Second malignancy is a rare late effect compared to cognitive and learning impairments.
Severe and extensive hemolysis causes which of the ff?
- A. Leg ulcers
- B. Shock
- C. Priapism
- D. Compromised growth
Correct Answer: B
Rationale: Severe and extensive hemolysis can lead to the destruction of a large number of red blood cells, causing a significant release of hemoglobin into the bloodstream. This excessive release of hemoglobin can overwhelm the body's ability to clear it, leading to the accumulation of toxic byproducts such as free hemoglobin and heme. These byproducts can lead to various complications, one of which is the potential for causing shock. Shock is a life-threatening condition characterized by inadequate tissue perfusion and oxygen delivery to vital organs due to a systemic vascular response to the circulating toxins and byproducts of hemolysis. It is a severe consequence of extensive hemolysis and requires immediate medical intervention to stabilize the patient.
In pediatric rhabdomyosarcoma, stages are dependent on primary site whether favorable or unfavorable. Which of the following sites of involvement is considered unfavorable?
- A. vagina
- B. uterus
- C. testis
- D. paranasal sinuses
Correct Answer: D
Rationale: Paranasal sinuses are considered unfavorable sites in rhabdomyosarcoma staging.
A patient has end-stage dilated cardiomyopathy. He comes to the emergency department with dyspnea. He says he went to bed and awoke with a feeling of suffocation. He says it was frightening. Which of the ff. responses by the nurse is most appropriate?
- A. "You must have been dreaming."
- B. "Reclining decreases the heart's ability to pump blood." c."Sleeping increases heart rate, which increases the body's need for oxygen."
- C. "Reclining increases fluid returning to the heart, which builds up fluid in the lungs."
Correct Answer: C
Rationale: The most appropriate response by the nurse is option C, "Reclining increases fluid returning to the heart, which builds up fluid in the lungs." In a patient with end-stage dilated cardiomyopathy, reclining position can lead to increased fluid return to the heart due to the failing pump function. This can result in fluid backing up in the lungs, causing symptoms such as dyspnea or feeling of suffocation. By explaining this mechanism to the patient, the nurse can provide valuable information about the condition and the reason for the distressing symptoms experienced by the patient. It also highlights the importance of proper positioning to alleviate symptoms and improve the patient's comfort.