Nokea
A women in her first trimester contracts rubella. How is the fetus likely to be affected?
- A. Reproductive and urinary defects
- B. Heart defects and cataracts
- C. Spinal cord and skeletal defects
- D. Polydactyly and club feet
Correct Answer: B
Rationale: The correct answer is B: Heart defects and cataracts. Rubella infection during the first trimester can lead to congenital rubella syndrome, causing heart defects and cataracts in the fetus. Rubella affects organ development during this critical period. Choice A is incorrect as rubella does not typically cause reproductive and urinary defects. Choice C is incorrect because rubella does not usually result in spinal cord and skeletal defects. Choice D is incorrect as polydactyly and club feet are not typical manifestations of rubella infection during pregnancy.
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A 38 week gestation newborn weighs 4020 grams, is sluggish, and has limp muscle tone. The baby experienced a broken clavicle during delivery. Based on this information, which can the nurse conclude about the baby?
- A. Neonatal abstinence symptoms
- B. Large for gestational age
- C. Congenital cardiac defect
- D. Respiratory depression
Correct Answer: B
Rationale: The correct answer is B: Large for gestational age. A newborn weighing 4020 grams at 38 weeks is considered large for gestational age. The sluggishness and limp muscle tone can be attributed to the baby's size, which can make movement more challenging. The broken clavicle could have occurred during delivery due to the baby's size and the forces involved. Neonatal abstinence symptoms (choice A) typically present with irritability, tremors, and poor feeding, not sluggishness. Congenital cardiac defects (choice C) usually manifest with cyanosis, tachypnea, and poor feeding. Respiratory depression (choice D) is characterized by poor respiratory effort, not sluggishness and limp muscle tone.
A nurse is caring for an infant with hypospadias. Which of the following is an expected finding?
- A. The meatal opening is on the dorsal surface of the penis.
- B. The urethral opening is on the underside of the penis.
- C. Fluid is present in the scrotal sac containing the testes.
- D. The testes are not palpable within the scrotal sac.
Correct Answer: B
Rationale: Hypospadias involves the urethral opening being located on the underside of the penis.
A nurse is caring for a child with Wilms' tumor. The parents ask why the sign 'Do not palpate the abdomen' has to be placed on their child's bed. Which of the following is the correct response by the nurse?
- A. Any manipulation of the abdomen can result in pain for your child.
- B. Palpation of the abdomen could cause the tumor to grow.
- C. Palpation of the abdomen could result in some of the tumor cells breaking loose, causing it to spread.
- D. Any manipulation of the abdomen will put pressure on the bladder and cause urine to leak.
Correct Answer: C
Rationale: The correct response is C: Palpation of the abdomen could result in some of the tumor cells breaking loose, causing it to spread. Palpating the abdomen in a child with Wilms' tumor can potentially lead to the dissemination of tumor cells into surrounding tissues and blood vessels, increasing the risk of metastasis. This precaution is crucial to prevent the spread of cancer cells and to contain the tumor within the kidney. Choices A, B, and D are incorrect as they do not address the specific risk associated with manipulating the abdomen in a child with Wilms' tumor. Option A focuses solely on pain, which is not the primary concern in this case. Option B is inaccurate as palpation does not cause tumor growth. Option D is irrelevant to the potential consequences of abdominal manipulation in this context.
A nurse is caring for a 4-year-old child diagnosed with leukemia who is admitted with myelosuppression.
- A. "Provide a diet high in carbohydrates."'
- B. "Monitor rectal temperature every 4 hr."'
- C. "Use lemon or glycerin swabs for oral care."'
- D. "Inspect the skin daily for lesions."'
Correct Answer: D
Rationale: The correct answer is D: "Inspect the skin daily for lesions." This is important because myelosuppression can lead to decreased platelets, increasing the risk of skin lesions and bleeding. Monitoring the skin daily can help detect any lesions early and prevent complications.
A: Providing a high-carbohydrate diet is not directly related to managing myelosuppression.
B: Monitoring rectal temperature is important but not directly related to skin lesion detection.
C: Using lemon or glycerin swabs for oral care is important for mucositis, not skin lesions.
A nurse is reinforcing teaching with the parent of an infant who has club feet with bilateral casts.
- A. "Check the toes for any swelling or discoloration."'
- B. "Monthly recasting should be scheduled with the orthopedist."'
- C. "Use a heated fan or dryer to facilitate the drying of the cast."'
- D. "Give the baby Tylenol every 4 hr to help with pain."'
Correct Answer: A
Rationale: The correct answer is A because checking the toes for swelling or discoloration is crucial in monitoring circulation and preventing complications like pressure sores. Choice B is incorrect as casts are typically changed more frequently. Choice C is incorrect as heat can cause burns. Choice D is incorrect as giving Tylenol every 4 hours without a physician's recommendation is not advisable for pain management in infants.