Nokea
An additional defect is associated with exstrophy of the bladder. For what anomaly should the nurse assess the infant?
- A. Imperforate anus
- B. Absence of one kidney
- C. Congenital heart disease
- D. Pubic bone malformation
Correct Answer: D
Rationale: The correct answer is D, pubic bone malformation. Exstrophy of the bladder is commonly associated with pubic bone malformation because the condition involves a defect in the pelvic region. Choices A, B, and C are incorrect. Imperforate anus, absence of one kidney, and congenital heart disease are not typically associated with exstrophy of the bladder.
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After surgery to correct hypertrophic pyloric stenosis (HPS) in a 3-week-old infant who had been formula-fed, which postoperative feeding order is appropriate?
- A. Thickened formula 24 hours after surgery
- B. Withholding feedings for the first 24 hours
- C. Regular formula feeding within 24 hours after surgery
- D. Additional glucose feedings as desired after the first 24 hours
Correct Answer: C
Rationale: After surgery for hypertrophic pyloric stenosis (HPS), it is appropriate to resume regular formula feeding within 24 hours postoperatively to promote recovery. Choice A, thickened formula after surgery, may be too heavy for the infant's digestive system at this early stage. Withholding feedings for the first 24 hours (Choice B) is not recommended as early feeding helps with recovery. Additional glucose feedings (Choice D) are not necessary and may not provide the balanced nutrition required after surgery.
You are managing a 10-month-old infant who has had severe diarrhea and vomiting for 3 days and is now showing signs of shock. You have initiated supplemental oxygen therapy and elevated the lower extremities. En route to the hospital, you note that the child's work of breathing has increased. What must you do first?
- A. Lower the extremities and reassess the child
- B. Begin positive pressure ventilations and reassess the child
- C. Place a nasopharyngeal airway and increase the oxygen flow
- D. Listen to the lungs with a stethoscope for abnormal breath sounds
Correct Answer: A
Rationale: In this scenario, the infant is presenting with signs of respiratory distress, as evidenced by the increased work of breathing. Lowering the extremities can help reduce the workload on the diaphragm and improve respiratory mechanics. This action can be beneficial in optimizing the infant's breathing before considering more invasive interventions. Option B, initiating positive pressure ventilations, should be considered if the infant's condition deteriorates further and not as the first step. Option C, placing a nasopharyngeal airway and increasing oxygen flow, is not indicated as the primary intervention for increased work of breathing. Option D, listening to the lungs with a stethoscope, may provide additional information but is not the most urgent action needed in this situation.
What is an early sign of congestive heart failure that the nurse should recognize?
- A. Tachypnea
- B. Bradycardia
- C. Inability to sweat
- D. Increased urinary output
Correct Answer: A
Rationale: Tachypnea, which refers to rapid breathing, is an early sign of congestive heart failure. In heart failure, the heart's inability to pump efficiently can lead to fluid accumulation in the lungs, causing the child to breathe faster to try to compensate for the decreased oxygen exchange. Bradycardia (slow heart rate) is not typically associated with congestive heart failure; instead, it may indicate a different issue. Inability to sweat is not a common early sign of congestive heart failure. Increased urinary output is not a typical early sign of congestive heart failure; instead, it may be a sign of other conditions like diabetes or kidney issues.
A 34-year-old woman, who is 36 weeks pregnant, is having a seizure. After you protect her airway and ensure adequate ventilation, you should transport her
- A. on her left side
- B. in the prone position
- C. in the supine position
- D. in a semi-sitting position
Correct Answer: A
Rationale: When a pregnant woman experiences a seizure, it is crucial to transport her on her left side. This position helps to improve blood flow to the fetus by preventing compression of the inferior vena cava, reducing the risk of further complications. Placing her in the prone position (lying face down) or supine position (lying on her back) may compromise blood flow to the fetus and lead to adverse outcomes. Similarly, transporting her in a semi-sitting position may not provide the optimal circulation needed for both the woman and the fetus during this critical situation.
The parents of a child who has just been diagnosed with type 1 diabetes ask about exercise. What should the nurse explain about exercise in type 1 diabetes?
- A. Exercise will increase blood glucose levels
- B. Exercise should be restricted
- C. Extra snacks are needed before exercise
- D. Extra insulin is required during exercise
Correct Answer: C
Rationale: In type 1 diabetes, extra snacks are needed before exercise to prevent hypoglycemia. It is important to provide additional carbohydrates to maintain blood glucose levels during physical activity. Choices A, B, and D are incorrect. Exercise typically lowers blood glucose levels in individuals with diabetes; however, proper management and adjustments in insulin and food intake are necessary to prevent hypoglycemia. Exercise should not be restricted in individuals with type 1 diabetes but should be planned in coordination with healthcare providers to ensure safety and optimal glucose control. While some individuals may need adjustments in insulin dosages during exercise, the general statement that extra insulin is required during exercise in type 1 diabetes is not accurate.