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After undergoing surgery using steel bar placement to correct pectus excavatum, what position should the nurse instruct the parents to avoid for the child?
- A. Semi-Fowler position.
- B. Supine position.
- C. High Fowler position.
- D. Side-lying position.
Correct Answer: D
Rationale: After undergoing surgery for pectus excavatum correction with steel bar placement, the nurse should instruct the parents to avoid placing the child in a side-lying position. This position should be avoided to prevent displacement of the steel bar, which could compromise the surgical outcome. Semi-Fowler, supine, and high Fowler positions do not pose the same risk of displacing the steel bar and are generally safe and comfortable for the child in this postoperative period.
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A nurse is caring for an infant with phenylketonuria (PKU). What diet should the nurse anticipate will be ordered by the healthcare provider?
- A. Fat-free
- B. Protein-enriched
- C. Phenylalanine-free
- D. Low-phenylalanine
Correct Answer: D
Rationale: A low-phenylalanine diet is necessary for infants with PKU because it helps prevent the accumulation of phenylalanine, which can result in brain damage. Fat-free (Choice A) and protein-enriched (Choice B) diets are not specifically indicated for PKU. While phenylalanine-free (Choice C) may seem logical, complete elimination of phenylalanine is not practical or safe as it is an essential amino acid. Therefore, the correct choice is a low-phenylalanine diet, which restricts phenylalanine intake to a safe level.
An order is written for an isotonic enema for a 2-year-old child. What is the maximum amount of fluid the nurse should administer without a specific order from the health care provider?
- A. 100 to 150 mL
- B. 155 to 250 mL
- C. 255 to 360 mL
- D. 365 to 500 mL
Correct Answer: B
Rationale: For a 2-year-old child, the maximum recommended amount of fluid for an isotonic enema is between 155 to 250 mL to prevent overdistension and potential harm. Choice A (100 to 150 mL) is too low and may not be effective in achieving the desired outcome. Choices C (255 to 360 mL) and D (365 to 500 mL) exceed the safe range for a 2-year-old child and can lead to overdistension, electrolyte imbalance, or other complications. Therefore, the correct answer is B.
While teaching a parent how to prevent accidents while caring for a 6-month-old infant, what motor development ability should be emphasized?
- A. Sits up
- B. Rolls over
- C. Crawls short distances
- D. Stands while holding on to furniture
Correct Answer: B
Rationale: The correct answer is B: Rolls over. At 6 months, most infants can roll over, increasing the risk of falls. It is important to emphasize to the parent the need for careful supervision to prevent accidents. While choices A, C, and D are also milestones in infant motor development, rolling over at this age poses a higher risk of accidents due to the increased mobility and potential for falls.
When developing the plan of care for a child with burns requiring fluid replacement therapy, what information would the nurse expect to include?
- A. Administration of colloid initially followed by a crystalloid
- B. Determination of fluid replacement based on the type of burn
- C. Administration of most of the volume during the first 8 hours
- D. Monitoring of hourly urine output to achieve less than 1 mL/kg/hr
Correct Answer: C
Rationale: The correct answer is C. In fluid replacement therapy for burns, it is crucial to administer most of the volume during the first 8 hours to prevent shock and maintain perfusion. This rapid administration is essential to stabilize the child's condition. Choices A and B are incorrect because the initial fluid replacement in burns typically involves administering crystalloids, not colloids, and the fluid replacement is generally calculated based on the extent of the burn injury, not the type of burn. Choice D is incorrect as monitoring hourly urine output to achieve less than 1 mL/kg/hr is not recommended in burn patients; instead, urine output should be monitored to achieve 1-2 mL/kg/hr in children to ensure adequate renal perfusion.
When teaching a class about trisomy 21, the instructor would identify the cause of this disorder as:
- A. nondisjunction.
- B. X-linked recessive inheritance.
- C. genomic imprinting.
- D. autosomal dominant inheritance.
Correct Answer: A
Rationale: Trisomy 21, also known as Down syndrome, is caused by nondisjunction, which is an error in cell division that leads to the presence of an extra chromosome 21. This additional chromosome alters the normal genetic makeup, resulting in the characteristics associated with Down syndrome. Therefore, the correct answer is nondisjunction (Choice A). Choices B, C, and D are incorrect because Trisomy 21 is not caused by X-linked recessive inheritance, genomic imprinting, or autosomal dominant inheritance. Understanding the specific genetic mechanism involved in Trisomy 21 is crucial for grasping the basis of this chromosomal disorder.