Nokea
An infant is brought to the clinic by his mother, who has noticed that he holds his head in an unusual position and always faces to one side. Which of the following is the most likely explanation?
- A. Torticollis, with shortening of the sternocleidomastoid muscle
- B. Craniosynostosis, with premature closure of the cranial sutures
- C. Plagiocephaly, with flattening of one side of the head
- D. Hydrocephalus, with increased head size
Correct Answer: A
Rationale: The correct answer is torticollis, characterized by the shortening of the sternocleidomastoid muscle, limiting the range of motion of the neck and causing the chin to point to the opposing side. Craniosynostosis is the premature closure of cranial sutures, leading to an abnormal head shape but not necessarily affecting head position. Plagiocephaly is flattening of one side of the head due to external forces or positioning, not muscle shortening. Hydrocephalus presents with an increased head size due to the accumulation of cerebrospinal fluid, not with a fixed head position.
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Which of the following is an example of intragroup conflict?
- A. A nurse writes a grant for a non-profit organization to raise money for advertising
- B. Members of a multidisciplinary team cannot agree on the best course of action for a client
- C. A client does not receive his medication on time because the nurse was on break
- D. A nurse feels frustrated that her employer does not provide on-site child care
Correct Answer: B
Rationale: Intragroup conflict refers to disagreements within a group. The correct answer, 'Members of a multidisciplinary team cannot agree on the best course of action for a client,' exemplifies this type of conflict well. In this scenario, professionals within the same team are unable to reach a consensus on how to proceed with client care. Choices A, C, and D do not reflect intragroup conflict. Writing a grant for a non-profit organization, a client not receiving medication due to a nurse's break, and a nurse feeling frustrated about the lack of on-site child care do not involve conflicts within a group of professionals.
While assessing a one-month-old infant, which of the findings does not warrant further investigation by the nurse?
- A. Abdominal respirations
- B. Inspiratory grunt
- C. Nasal flaring
- D. Cyanosis
Correct Answer: A
Rationale: Abdominal respirations in infants are considered normal due to the underdeveloped intercostal muscles. Infants rely more on their abdominal muscles to facilitate breathing since their intercostal muscles are not fully matured. Therefore, abdominal respirations do not typically require further investigation. Inspiratory grunt, nasal flaring, and cyanosis are findings that warrant additional assessment as they can indicate potential respiratory distress or other underlying health issues in infants. Inspiratory grunt may suggest respiratory distress, nasal flaring can be a sign of increased work of breathing, and cyanosis indicates poor oxygenation, all of which require prompt evaluation and intervention to ensure the infant's well-being.
Which of these statements best describes the characteristics of an effective reward feedback system?
- A. Specific feedback is given as close to the event as possible
- B. Staff is given feedback in equal amounts over time
- C. Positive statements precede negative statements
- D. Performance goals should be higher than what is attainable
Correct Answer: A
Rationale: The correct answer is that specific feedback should be given as close to the event as possible in an effective reward feedback system. This is important because feedback is most useful when provided immediately. Giving feedback promptly reinforces positive behavior and helps in modifying problem behaviors. Providing feedback close to the event helps in ensuring that standards are clearly understood and can be met. Choices B, C, and D are incorrect because staff should not be given feedback in equal amounts over time, positive statements do not necessarily have to precede negative statements, and setting performance goals higher than what is attainable can lead to demotivation and decreased performance.
A nurse is assigned to care for a deaf client. During her lunch hour, she visits the hospital library and reads more about deaf culture in order to better provide appropriate care for her client. This action is an example of:
- A. Cultural knowledge
- B. Cultural noise
- C. Cultural diversity
- D. Cultural divide
Correct Answer: A
Rationale: Cultural knowledge involves seeking information and educating oneself about different cultural groups. In this scenario, the nurse is demonstrating cultural knowledge by learning more about deaf culture to improve the care provided to the deaf client. This proactive approach helps in understanding the client's background, beliefs, and communication preferences, leading to better outcomes. 'Cultural noise' and 'Cultural divide' are incorrect as they do not reflect the nurse's positive action of seeking knowledge to enhance care. 'Cultural diversity' is also incorrect as it does not accurately describe the nurse's specific action of acquiring knowledge about a particular culture.
A child has recently been diagnosed with Duchenne muscular dystrophy (DMD). The parents are receiving genetic counseling prior to planning another pregnancy. Which of the following statements includes the most accurate information?
- A. Duchenne is an X-linked recessive disorder, so daughters have a 50% chance of being carriers and sons a 50% chance of developing the disease.
- B. Duchenne is an X-linked recessive disorder, so both daughters and sons have a 50% chance of developing the disease.
- C. Each child has a 1 in 4 (25%) chance of developing the disorder.
- D. Sons only have a 1 in 4 (25%) chance of developing the disorder.
Correct Answer: A
Rationale: The correct answer is that Duchenne is an X-linked recessive disorder, meaning the affected gene is located on one of the two X chromosomes of a female carrier. If a son receives the X chromosome bearing the gene, he will develop the disease, giving him a 50% chance of being affected. Daughters, on the other hand, are not affected by Duchenne but have a 50% chance of being carriers since they inherit one copy of the defective gene from the mother. The other X chromosome is inherited from the father, who cannot be a carrier. Therefore, choice A is accurate. Choice B is incorrect because daughters do not develop the disease, and sons have a 50% chance of developing, not both having a 50% chance. Choice C is incorrect as it does not consider the X-linked inheritance pattern of Duchenne. Choice D is inaccurate as it incorrectly states that only sons have a 25% chance of developing the disorder, omitting the carrier status of daughters.