Nokea
A nurse prepares to administer a vitamin K injection to a newborn infant. The mother asks the nurse why her newborn infant needs the injection. The best response by the nurse would be:
- A. "You infant needs vitamin K to develop immunity."
- B. "The vitamin K will protect your infant from being jaundiced."
- C. "Newborn infants are deficient in vitamin K, and this injection prevents your infant from abnormal bleeding."
- D. "Newborn infants have sterile bowels, and vitamin K promotes the growth of bacteria in the bowel."
Correct Answer: C
Rationale: The correct response by the nurse is C. Newborn infants are born with low levels of vitamin K because they do not have enough of the gut bacteria necessary to produce it. Vitamin K plays a crucial role in blood clotting, and without enough of it, newborns are at risk of a bleeding disorder called vitamin K deficiency bleeding (VKDB). The vitamin K injection given to newborns helps prevent this disorder by providing them with the necessary vitamin K to ensure proper blood clotting. It is important for the mother to understand that this injection is essential for her infant's health and well-being to prevent complications related to vitamin K deficiency.
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A nurse notes that a 12-hour-old newborn has not had the first meconium stool. The nurse documents this finding and continues to monitor the newborn because, in term newborns, the first meconium stool occurs within how many hours of birth?
- A. 6 to 8
- B. 8 to 12
- C. 12 to 24
- D. 24 to 48
Correct Answer: A
Rationale: In term newborns, the first meconium stool typically occurs within the first 6 to 8 hours after birth. Meconium is the baby's first stool, and its presence signifies that the baby's gastrointestinal system is functioning properly. If a newborn has not passed meconium within this timeframe, it may indicate an issue such as bowel obstruction that requires further evaluation and intervention. Therefore, the nurse should document and monitor the situation closely to ensure the newborn's health and well-being.
The nurse understands that which of the ff. best describes the action of enalapril maleate (Vasotec)?
- A. It decreases levels of angiotensin II
- B. It dilates the arterioles and veins
- C. It adjusts the extracellular volume
- D. It decreases cardiac output
Correct Answer: A
Rationale: Enalapril maleate (Vasotec) is an angiotensin-converting enzyme (ACE) inhibitor. The main action of ACE inhibitors like enalapril is to decrease the levels of angiotensin II in the body. Angiotensin II is a potent vasoconstrictor that plays a role in regulating blood pressure, stimulating aldosterone secretion, and promoting sodium and water retention. By inhibiting the conversion of angiotensin I to angiotensin II, enalapril reduces vasoconstriction and aldosterone secretion, leading to vasodilation, decreased blood pressure, and ultimately decreased levels of angiotensin II. This mechanism allows for the dilation of arterioles and veins, reduction in cardiac afterload, and ultimately decreases the workload of the heart.
You are explaining the risk of leukemia in children with Down syndrome to medical students; your discussion will include all the following statements EXCEPT
- A. acute leukemia occurs more frequently in children with Down syndrome than in the general population
- B. AML is more common in children with Down syndrome as compared to ALL
- C. children with Down syndrome have a slightly inferior outcome ratio of ALL/AML in general
- D. children with Down syndrome who develop AML demonstrate remarkable sensitivity to antimetabolites
Correct Answer: D
Rationale: Children with Down syndrome often have better outcomes when treated with specific regimens, contrary to this option.
The nurse is teaching the parents of a child recently diagnosed with ADHD who has been prescribed methylphenidate (Ritalin). Which should the nurse include in teaching about the side effects of methylphenidate?
- A. "Your child may experience a sense of nervousness."
- B. "You may see an increase in your child's appetite."
- C. "Your child may experience daytime sleepiness."
- D. "You may see a decrease in your child's blood pressure."
Correct Answer: A
Rationale: Methylphenidate (Ritalin) is a stimulant medication commonly used in the treatment of ADHD. One of the possible side effects of methylphenidate is an increase in nervousness or jitteriness. This side effect is more common at the beginning of treatment or when the dosage is increased. It is important for parents to be aware of this potential side effect and to inform the healthcare provider if it becomes bothersome for the child. Other common side effects of methylphenidate may include decreased appetite, insomnia, and stomach upset.
What is the care priority for a newborn with bladder exstrophy and a malformed pelvis?
- A. Change the diaper frequently and assess for skin breakdown.
- B. Keep the exposed bladder open in a warm, dry environment.
- C. Offer formula for growth and fluid management.
- D. Cluster care to allow the child uninterrupted sleep and strength for upcoming surgical repair.
Correct Answer: D
Rationale: Minimizing disturbances (clustering care) helps prevent infection and allows the infant to conserve energy before surgical repair.