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A parent brings a toddler, age 19 months, to the clinic for a regular check-up. When palpating the toddler’s fontanels, what should the nurse expects to find?
- A. Closed anterior fontanel and open posterior fontanel
- B. Open anterior and fontanel and closed posterior fontanel
- C. Closed anterior and posterior fontanels
- D. Open anterior and posterior fontanels
Correct Answer: C
Rationale: By 19 months, both the anterior and posterior fontanels should be closed as the skull bones have fused.
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Extracorpuscular causes of haemolysis include:
- A. a-Thalassaemia
- B. Hereditary ovalocytosis
- C. Warm antibody autoimmune haemolytic anaemia
- D. Pyruvate kinase deficiency
Correct Answer: C
Rationale: Warm antibody autoimmune haemolytic anaemia is an extracorpuscular cause of haemolysis. a-Thalassaemia and pyruvate kinase deficiency are intracorpuscular causes.
The nurse is caring for a child who has undergone a cardiac catheterization. During recovery, the nurse notices the dressing is saturated with bright red blood. The nurse's first action is to:
- A. Call the interventional cardiologist
- B. Notify the cardiac catheterization laboratory that the child will be returning
- C. Apply a bulky pressure dressing over the present dressing
- D. Apply direct pressure 1 inch above the puncture site
Correct Answer: D
Rationale: Direct pressure above the puncture site helps control bleeding by localizing pressure over the vessel.
A child born with Down syndrome should be evaluated for which associated cardiac manifestation?
- A. Congenital heart defect (CHD)
- B. Systemic hypertension
- C. Hyperlipidemia
- D. Cardiomyopathy
Correct Answer: A
Rationale: CHD is found frequently in children with Down syndrome.
Which finding might delay a cardiac catheterization procedure on a 1-year-old?
- A. 30th percentile for weight
- B. Severe diaper rash
- C. Allergy to soy
- D. Oxygen saturation of 91% on room air
Correct Answer: B
Rationale: A severe diaper rash may indicate potential infection, which is a contraindication for the standard groin approach during catheterization.
The nurse is teaching a client with glomerulonephritis about self-care. Which dietary recommendations should the nurse encourage the client to follow?
- A. Increase intake of high-fiber foods, such as bran cereal
- B. Restrict protein intake by limiting meats and other high-protein foods
- C. Limit oral fluid intake to 500 ml per day
- D. Increase intake of potassium-rich foods such as bananas or cantaloupe
Correct Answer: B
Rationale: Reducing protein intake helps decrease the workload on the kidneys, which is beneficial in glomerulonephritis.