Introduction to Maternity and Pediatric Nursing Test Bank

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A nurse is collecting subjective and objective information about target populations to diagnose problems based on community needs. This describes which step in the community nursing process?

  • A. Planning
  • B. Diagnosis
  • C. Assessment
  • D. Establishing objectives
Correct Answer: C

Rationale: In the community nursing process, the step of collecting subjective and objective information about target populations to diagnose problems based on community needs is known as "Assessment." This step involves gathering data through observation, interviews, surveys, and other methods to understand the health status, priorities, assets, and resources of the community. This information is essential for identifying the health needs and issues within the community, which then informs the planning and implementation of appropriate interventions. Assessment helps nurses develop a comprehensive understanding of the community's strengths, challenges, and opportunities, enabling them to make informed decisions and tailor interventions to meet the specific needs of the target population.

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While caring for a critically ill child, the nurse observes that respirations are gradually increasing in rate and depth, with periods of apnea. What pattern of respiration will the nurse document?

  • A. Dyspnea
  • B. Tachypnea
  • C. Cheyne-Stokes respirations
  • D. Seesaw (paradoxic) respirations
Correct Answer: C

Rationale: Cheyne-Stokes respirations are characterized by alternating periods of deep, rapid breathing followed by periods of apnea. This cyclic pattern of respiration is often seen in critically ill patients and can be a sign of serious neurological or cardiac dysfunction. The nurse should document Cheyne-Stokes respirations when observing this specific breathing pattern in the child described in the scenario.

The nurse should expect a client with hypothyroidism to report which health concerns?

  • A. Increased appetite and weight loss
  • B. Nervousness and tremors
  • C. Puffiness of the face and hands
  • D. Thyroid gland swelling
Correct Answer: C

Rationale: Hypothyroidism is characterized by an underactive thyroid gland that does not produce enough thyroid hormone. This hormonal imbalance can lead to symptoms such as slow metabolism, weight gain, fatigue, cold intolerance, constipation, and puffiness of the face and hands. The slowed metabolic rate can also cause fluid retention, resulting in the characteristic puffiness associated with hypothyroidism. Increased appetite and weight loss are not typical symptoms of hypothyroidism, as the condition is more commonly associated with weight gain. Nervousness and tremors are more indicative of hyperthyroidism, where the thyroid gland is overactive. Thyroid gland swelling, known as goiter, can occur in various thyroid disorders but is not specific to hypothyroidism.

ahmed 2 months old come to emergency department with epistaxis and prolong PTT, clotting and bleeding time , what you suspect ahmed have :

  • A. thalassemia
  • B. hemophilia
  • C. leukemia
  • D. sickle anemia
Correct Answer: B

Rationale: Ahmed is presenting with epistaxis (nosebleed) and prolonged PTT (partial thromboplastin time), clotting time, and bleeding time, which are indicative of a bleeding disorder. Given the symptoms and lab findings, hemophilia is the most likely cause. Hemophilia is an inherited bleeding disorder characterized by deficiency or dysfunction of clotting factors, particularly Factor VIII (hemophilia A) or Factor IX (hemophilia B). Patients with hemophilia often present with spontaneous bleeding episodes, such as nosebleeds, bruising, and prolonged bleeding after injury or surgery. Thalassemia, leukemia, and sickle cell anemia are not associated with prolonged clotting times and bleeding presentations, making hemophilia the most appropriate choice in this scenario.

Which is the nurse's best interpretation of this?

  • A. Resuscitation is likely to be needed.
  • B. Adjustment to extrauterine life is adequate.
  • C. Additional scoring in 5 more minutes is needed.
  • D. Maternal sedation or analgesia contributed to the low score.
Correct Answer: B

Rationale: The nurse's best interpretation is that the adjustment to extrauterine life is adequate. This can be determined by the Apgar score, which assesses a newborn's well-being shortly after birth. A score of 7-10 indicates that the newborn is adjusting well to life outside the womb, while a score of 4-6 may indicate some difficulties that may require intervention. In this case, the nurse's interpretation suggests that the newborn is doing well in adapting to the new environment.

What is the best age for solid food to be introduced into the infant's diet?

  • A. 2 to 3 months
  • B. 4 to 6 months
  • C. When birth weight has tripled
  • D. When tooth eruption has started
Correct Answer: B

Rationale: The American Academy of Pediatrics recommends introducing solid foods into an infant's diet between 4 to 6 months of age. At this stage, most infants have developed the necessary motor skills to start eating solid foods, such as being able to sit up and hold their head steady. Additionally, their digestive system has matured enough to handle solid foods. Introducing solid foods too early, such as at 2 to 3 months (Option A), can increase the risk of digestive issues and allergies. Waiting for tooth eruption (Option D) is not a reliable indicator as some infants may begin teething earlier or later than others. Waiting for the birth weight to triple (Option C) is not necessary as infants can start on solid foods once they reach the appropriate developmental stage around 4 to 6 months.

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