Nokea
After the introduction of the Back to Sleep campaign in 1992, an increased incidence has been noted of which of the following pediatric disorders? (Select all that apply.)
- A. SIDS
- B. Torticollis
- C. Failure to thrive
- D. Apnea of infancy
Correct Answer: B
Rationale: After the introduction of the Back to Sleep campaign in 1992, which encouraged placing infants on their backs to sleep to reduce the risk of Sudden Infant Death Syndrome (SIDS), an increased incidence has been noted of Torticollis (B) and Plagiocephaly (E).
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The nurse is caring for a newborn with hyperbilirubinemia who is receiving phototherapy. Which is an appropriate nursing intervention for this newborn?
- A. Apply lotion as prescribed to moisturize skin.
- B. Maintain nothing-by-mouth (NPO) status to prevent nausea and vomiting.
- C. Monitor temperature to prevent hypothermia or hyperthermia.
- D. Keep eye patches on for at least 8 to 12 of every 24 hours.
Correct Answer: C
Rationale: Monitoring temperature to prevent hypothermia or hyperthermia is an appropriate nursing intervention for a newborn with hyperbilirubinemia receiving phototherapy. Phototherapy can increase the risk of hypothermia in newborns due to increased heat loss from evaporation, convection, and conduction. On the other hand, hyperthermia can occur if the newborn is over-wrapped or placed too closely to the light source. Therefore, frequent temperature monitoring is essential to maintain a stable body temperature within a normal range and prevent adverse effects related to temperature dysregulation.
A patient admitted with gastrointestinal tract bleeding has a hemoglobin level of 6 g/dL. She asks the nurse why she feels SOB. Which response is best?
- A. "Anemia prevents your lungs from absorbing oxygen effectively."
- B. "You do not have enough hemoglobin to carry oxygen to your tissues."
- C. ""You don't have enough blood to feed your cells."
- D. "You have lost a lot of blood, and that has damaged your lungs."
Correct Answer: B
Rationale: The best response is option B, "You do not have enough hemoglobin to carry oxygen to your tissues." Hemoglobin is the protein in red blood cells that carries oxygen from the lungs to the tissues throughout the body. With a low hemoglobin level of 6 g/dL due to gastrointestinal tract bleeding, there is a reduced capacity to carry oxygen to the body's tissues. This decreased oxygen-carrying capacity leads to symptoms of shortness of breath (SOB) because the body's cells are not receiving an adequate supply of oxygen. It is important to provide a clear and accurate explanation to the patient about the relationship between hemoglobin, oxygen transport, and symptoms of anemia like shortness of breath.
A 52-year old female tells the nurse that she has found a painless lump in her right breast during her monthly self-examination. Which assessment finding would strongly suggest that this client's lump is cancerous?
- A. Eversion of the right nipple and mobile
- B. Mobile mass that is soft and easily mass delineated
- C. Non-mobile mass with irregular edges
- D. Non palpable right axillary lymph nodes
Correct Answer: C
Rationale: A non-mobile mass with irregular edges is a strong indicator of a cancerous lump in the breast. Cancerous lumps often feel fixed or attached to the surrounding tissue and may have irregular shapes rather than smooth, round contours. The lack of mobility and irregular edges increase suspicion for malignancy and warrant further investigation, such as imaging studies and biopsies. It is important for this patient to follow up with a healthcare provider promptly for further evaluation and appropriate management.
For children receiving steroid therapy, which of the following regimens is most appropriate for perioperative management?
- A. Prednisone 1 mg/kg given 24 and 12 hours before surgery
- B. Dexamethasone 0.6 mg/kg IV given 24 and 12 hours before surgery
- C. Hydrocortisone 5 mg/kg IV given 24 and 12 hours before surgery
- D. Methylprednisolone 10 mg/kg IV given 24 and 12 hours before surgery
Correct Answer: C
Rationale: Hydrocortisone is commonly used for perioperative steroid coverage due to its mineralocorticoid and glucocorticoid effects.
Which patient is most at risk for fluid volume overload?
- A. The 40-year-old with meningitis
- B. The 60-year-old with psoriasis
- C. The 35-year-old with kidney failure
- D. The 2-year-old with influenza
Correct Answer: C
Rationale: The patient with kidney failure is most at risk for fluid volume overload because the kidneys are responsible for regulating fluid balance in the body. In kidney failure, the kidneys are unable to effectively filter and excrete excess fluids, leading to an accumulation of fluid in the body. This can result in fluid volume overload, which can be dangerous and lead to complications such as pulmonary edema, congestive heart failure, and hypertension. It is important to monitor this patient closely for signs and symptoms of fluid overload and manage their fluid intake carefully.