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A nurse is assessing a client with a suspected diagnosis of hypocalcemia. Which of the following clinical manifestations would the nurse expect to note in the client?
- A. Twitching
- B. Positive Trousseau's sign
- C. Hyperactive bowel sounds
- D. Hyperactive deep tendon reflexes
Correct Answer: A
Rationale: The correct answer is A: Twitching. Hypocalcemia often presents with neuromuscular irritability, leading to manifestations such as twitching. Trousseau's sign is actually a positive indicator of hypocalcemia, not negative, making choice B incorrect. Hypoactive bowel sounds are not typically associated with hypocalcemia, making choice C incorrect. Similarly, hypoactive deep tendon reflexes are not a common finding in hypocalcemia, making choice D incorrect.
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You are caring for a neonate who has a cleft palate. You should inform the mother that surgical correction will be done when the infant is:
- A. 8 to 12 months of age.
- B. 20 to 24 months of age.
- C. 16 to 20 months of age.
- D. 12 to 16 months of age.
Correct Answer: A
Rationale: The correct answer is A: 8 to 12 months of age. Surgical correction for a cleft palate is typically performed around this age to optimize speech development and prevent feeding difficulties. Options B, C, and D suggest later ages for surgery, which may lead to speech and feeding issues due to the delay in correction.
What are the fine, down-like hairs on the newborn's ears, shoulders, lower back, and/or forehead known as?
- A. Vernix.
- B. Lanugo.
- C. Milia.
- D. Vibrissae.
Correct Answer: B
Rationale: Lanugo is the term used to describe the fine, down-like hairs found on a newborn's ears, shoulders, lower back, and/or forehead. These hairs are different from vernix, which is a waxy or cheese-like white substance covering the skin of newborns. Milia are small, white, or yellowish cysts that commonly appear on a newborn's face, while vibrissae are the thick, stiff hairs commonly found around the nose and other parts of the face.
Which individual is most at risk for Osgood-Schlatter disease?
- A. An elderly female who is hospitalized with a hip fracture and on bed rest
- B. A middle-aged male patient who has been exposed to asbestos in the shipping industry
- C. An adolescent who is physically active and the captain of their soccer team
- D. An infant of low birth weight and a gestational age of 28 weeks
Correct Answer: C
Rationale: Osgood-Schlatter disease is a condition that commonly affects adolescents who are physically active, especially during growth spurts. It is caused by overuse of the knee, leading to inflammation of the patellar ligament at the tibial tuberosity. The repetitive stress on the growth plate during activities like running and jumping can trigger this condition. Therefore, an adolescent who is physically active and the captain of their soccer team is most at risk for Osgood-Schlatter disease. Choices A, B, and D are not at high risk for this condition as it is primarily seen in active adolescents.
A patient is admitted to the emergency department with hypovolemia. Which IV solution should the nurse anticipate administering?
- A. 3% sodium chloride
- B. 10% dextrose in water
- C. 0.45% sodium chloride
- D. Lactated Ringer's solution
Correct Answer: D
Rationale: Lactated Ringer's solution is the most suitable IV solution for a patient with hypovolemia. It is a balanced crystalloid solution containing electrolytes such as sodium, chloride, potassium, calcium, and lactate, which closely resemble the body's natural fluids. This solution helps to restore intravascular volume and electrolyte balance in hypovolemic patients. Choice A, 3% sodium chloride, is a hypertonic solution used for specific situations like severe hyponatremia or cerebral edema, not typically for hypovolemia. Choice B, 10% dextrose in water, is a hypertonic solution primarily used for providing calories and free water, not for volume expansion. Choice C, 0.45% sodium chloride, is a hypotonic solution used for conditions like hypernatremia or as maintenance fluid, not for hypovolemia.
Which of the following joints normally allows 360-degree circumflexion?
- A. The knee
- B. The shoulder
- C. The elbow
- D. The fingertips
Correct Answer: B
Rationale: The correct answer is B: The shoulder. The shoulder joint is a ball-and-socket joint that allows for a wide range of motion, including 360-degree circumflexion. This joint provides flexibility and mobility in various directions. Choice A, the knee joint, primarily allows flexion and extension but does not have a 360-degree circumflexion. Choice C, the elbow joint, is a hinge joint that permits flexion and extension but not circumflexion. Choice D, the fingertips, do not form a specific joint that allows circumflexion; rather, they have joints that enable bending and straightening movements.