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A nurse is preparing to test a school-age child's vision. Which eye chart should the nurse use?
- A. Denver Eye Screening Test
- B. Allen picture card test
- C. Ishihara vision test
- D. Snellen letter chart
Correct Answer: D
Rationale: The nurse should use the Snellen letter chart to test a school-age child's vision. The Snellen chart is specifically designed to assess distance vision by having the child read rows of letters of various sizes from a specific distance. This chart is commonly used for vision screenings and has standardized letter sizes that help determine visual acuity. The other options listed - Denver Eye Screening Test, Allen picture card test, and Ishihara vision test - are not typically used for testing visual acuity in the same way the Snellen chart is.
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Neonates of mothers with diabetes are at risk for which complication following birth?
- A. Atelectasis
- B. Microcephaly
- C. Pneumothorax
- D. Macrosomia
Correct Answer: D
Rationale: Neonates of mothers with diabetes are at risk for macrosomia following birth. Macrosomia refers to a condition where the newborn baby is significantly larger than average, typically weighing more than 4,000 grams (8 pounds, 13 ounces) at birth. This risk is primarily due to maternal hyperglycemia, which can lead to excessive fetal growth. The elevated glucose levels in the maternal circulation can cross the placenta and stimulate fetal insulin production, resulting in increased growth and potentially leading to macrosomia. Neonates born with macrosomia are at increased risk for complications during delivery, such as shoulder dystocia, birth injuries, and the need for cesarean delivery.
A 36 y.o. woman who has had no prenatal care comes into the hospital in active labor for her fourth child. She has vesicles evident on her perineum. The following nursing actions are appropriate to protect the unborn baby and the staff, EXCEPT:
- A. Maintain standard precautions
- B. Prepare for the possibility that the baby may be delivered by CS.
- C. Notify the obstetrician and nurse midwife about the vesicles as soon as possible.
- D. Apply antibiotic ointment to the vesicles and place the mother in reverse isolation
Correct Answer: D
Rationale: When a woman with vesicles on her perineum comes into the hospital in active labor, it is important to take precautions to protect the unborn baby and the staff. However, applying antibiotic ointment to the vesicles and placing the mother in reverse isolation is not appropriate in this situation. This is because her condition is most likely due to herpes simplex virus (HSV) infection, which can be transmitted to the baby during birth leading to severe complications. Placing the mother in reverse isolation can increase the risk of transmission to the healthcare staff as well. Instead, notifying the obstetrician and nurse midwife about the vesicles as soon as possible is crucial for proper management and preparing for the possibility that the baby may be delivered by cesarean section is important to reduce the risk of transmission during vaginal birth. Maintaining standard precautions is essential to prevent the spread of infection.
The nurse is providing dietary instructions to a client with hypoglycemia. To control hypoglycemic episodes, the nurse should recommend:
- A. increasing saturated fat intake and fasting in the afternoon.
- B. increasing intake of vitamins B and D and taking iron supplements.
- C. eating a candy bar if light-headedness occurs.
- D. consuming a low-carbohydrate, high-protein diet and avoiding fasting.
Correct Answer: D
Rationale: Consuming a low-carbohydrate, high-protein diet and avoiding fasting is the best recommendation to control hypoglycemic episodes in clients. When someone has hypoglycemia, their blood sugar levels drop too low. A diet that is low in carbohydrates and high in protein can help regulate blood sugar levels and prevent sudden drops that lead to hypoglycemic episodes. Additionally, avoiding fasting helps maintain a consistent intake of nutrients throughout the day, which is important for managing blood sugar levels. It is essential to eat regular, balanced meals and snacks to keep blood sugar levels stable and prevent hypoglycemia.
Which of the following statements is true regarding Joel's disorder? a.Hemophilia is an autosomal dominant disorder in which the woman carries the trait
- A. Hemophilia follows regular laws of Mendelian inherited disorders such as sickle ceil anemia
- B. This disorder can be carried by either male or female but occurs in the sex opposite that of the carrier
- C. Hemophilia is an X-linked disorder in which the mother is usually the carrier of the illness but is not affected by it
Correct Answer: C
Rationale: Hemophilia is an X-linked disorder, meaning the gene responsible for hemophilia is carried on the X chromosome. Typically, hemophilia is passed down from a carrier mother to her male offspring who then express the disorder. This is because males have only one X chromosome (inherited from their mother), making them more vulnerable to X-linked disorders. Females have two X chromosomes, which means that even if one carries the hemophilia gene, the other X chromosome may carry a normal gene that can compensate, making females less likely to exhibit symptoms of hemophilia. In this case, Joel's disorder aligns with the typical pattern of inheritance for hemophilia as described in statement C.
When doing a nutritional assessment on a Hispanic family, the nurse learns that their diet consists mainly of vegetables, legumes, and starches. How should the nurse assess this diet?
- A. Indicates they live in poverty
- B. Is lacking in protein
- C. May provide sufficient amino acids
- D. Should be enriched with meat and milk
Correct Answer: C
Rationale: The nurse should assess that the diet of the Hispanic family, which consists mainly of vegetables, legumes, and starches, may provide sufficient amino acids. While this diet may lack animal sources of protein commonly found in meat and milk, plant-based foods like legumes and grains can complement each other to provide all essential amino acids necessary for protein synthesis in the body. This combination of foods essentially forms a complete protein source, supporting overall nutritional needs. It's important for the nurse to recognize the potential nutritional value in the diet and offer education on balanced meal planning to ensure adequate protein intake for the family. The assessment should focus on the overall nutrient adequacy and not solely on the presence of specific food items.