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Almost all of the diseases detected in neonatal screening programs have a very low prevalence; the strategy is to use the initial screening test to separate a highly suspect group from normal and then follow this suspect group aggressively. Of the following, the disease that has low prevalence rendering it not useful for neonatal screening testing is
- A. phenylketonuria
- B. hypothyroidism
- C. cystic fibrosis
- D. neuroblastoma
Correct Answer: D
Rationale: Neuroblastoma has a very low prevalence and is not typically screened for in neonatal programs due to its rarity and the inefficiency of mass screening for such a condition.
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A highly careful mother of a 10-month-old baby boy complains of inadequate weight gain due to refusal of spoon feeding. The LEAST helpful advice is to
- A. respect infant independence
- B. offer softer diet
- C. use 2 spoons (1 for the child and 1 for the parent)
- D. use finger foods
Correct Answer: B
Rationale: Offering softer food may not address the underlying issue of refusal.
A nurse is preparing to complete an admission assessment on a 2-year-old child. The child is sitting on the parent's lap. Which technique should the nurse implement to complete the physical exam?
- A. Ask the parent to place the child in the hospital crib.
- B. Take the child and parent to the exam room.
- C. Perform the exam while the child is on the parent's lap.
- D. Ask the child to stand by the parent while completing the exam.
Correct Answer: C
Rationale: The most appropriate technique in this scenario would be to perform the exam while the child is on the parent's lap. This approach helps build trust and comfort for the child, as they are in a familiar and secure environment. It can also help the nurse assess the child's behavior and interactions with the parent during the exam, providing valuable information about the child's developmental stage and emotional well-being. Additionally, conducting the exam in this way can help reduce anxiety and fear that the child may experience in an unfamiliar setting like the hospital crib or exam room.
Poor prognostic factors in Hodgkin lymphoma include all the following EXCEPT
- A. age of more than 15 year at the time of diagnosis
- B. stage IV disease
- C. manifested by positron emission tomography (PET) scan positivity
- D. presence of bulky mediastinal mass
Correct Answer: A
Rationale: Older age is generally considered a poor prognostic factor, but not necessarily worse than other listed options.
Minda, a 65-year old female has been admitted with a left hemisphere stroke. Which behavioral change would the nurse expect to find upon assessment?
- A. impulsive, unsafe activity
- B. motor deficits on the right eye
- C. motor deficits on the left side of the body
- D. error in word choices
Correct Answer: D
Rationale: A left hemisphere stroke typically affects the right side of the body due to the way the brain controls motor functions. Since the left hemisphere is also responsible for language and speech processing, patients with a left hemisphere stroke commonly exhibit errors in word choices, difficulty speaking or understanding language, aphasia, and other language-related impairments. This is known as Broca's aphasia or expressive aphasia. Therefore, the nurse would expect to find errors in word choices as a behavioral change in a patient like Minda with a left hemisphere stroke.
Through which of the following does lymph return to the blood?
- A. Carotid arteries
- B. Inferior vena cava
- C. Aorta
- D. Subclavian veins
Correct Answer: D
Rationale: Lymph returns to the blood circulation through the subclavian veins. The lymphatic system collects excess fluid, proteins, and waste products from the tissues and returns them to the bloodstream. The lymphatic vessels eventually converge into larger lymphatic ducts, and these ducts empty the lymph into the subclavian veins near the heart. From there, the lymph mixes with the blood, allowing it to circulate throughout the body and maintain fluid balance.