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During a funduscopic examination of a school-age child, the nurse notes a brilliant, uniform red reflex in both eyes. How should the nurse interpret this finding?
- A. Normal finding
- B. Abnormal finding, so child needs referral to ophthalmologist
- C. Sign of possible visual defect, so child needs vision screening
- D. Sign of small hemorrhages, which will usually resolve spontaneously
Correct Answer: A
Rationale: A brilliant, uniform red reflex during a funduscopic examination is considered a normal finding. The red reflex is caused by the reflection of light off the retina, specifically the blood vessels in the retina. A uniform red reflex indicates that the light is reflecting evenly from both eyes, suggesting symmetrical and clear lenses and corneas. This finding is typically seen in healthy individuals and is a reassuring sign of normal eye health.
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A new mother wants to be discharged with her newborn as soon as possible. What should be done prior to discharge?
- A. Newborn has voided at least once
- B. Newborn does not spit up after feeding
- C. Jaundice, if present, appeared before 24 hours
- D. Appointment is made for home care or a primary care practitioner office visit within next 2 or 3 days
Correct Answer: D
Rationale: Prior to discharge from the hospital, it is important that a new mother makes an appointment for home care or a primary care practitioner office visit within the next 2 or 3 days for the newborn. This ensures that the newborn will receive necessary follow-up care, monitoring, and evaluation after leaving the hospital. It is crucial for the newborn's health and well-being to have timely postnatal check-ups to address any concerns or issues that may arise in the early days after birth. This follow-up care also allows healthcare providers to assess the newborn's growth, feeding, and overall health progression.
Which menu choices for a child diagnosed with renal failure and experiencing hyperkalemia indicate the need for further instruction by the nurse?
- A. Carrots and green, leafy vegetables
- B. Spaghetti and meat sauce with breadsticks
- C. Hamburger on a bun and cherry gelatin
- D. Chips, cold cuts, and canned foods
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Which manifestations are expected in the early stages of acute hepatitis?
- A. Nausea, vomiting, and generalized malaise.
- B. Nausea, vomiting, and left-upper quadrant pain.
- C. Malaise and jaundice only.
- D. Jaundice only.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Which statement best represents the first stage of the first period of reactivity in the newborn?
- A. It begins when the newborn awakes from a deep sleep.
- B. It ends when the amount of respiratory mucus has decreased.
- C. It is an excellent time to acquaint the parents with the newborn.
- D. It is an excellent time for mother to sleep and recover.
Correct Answer: A
Rationale: The first stage of the first period of reactivity in the newborn begins when the newborn awakes from a deep sleep. This stage is characterized by increased muscle tone, alertness, and interest in the environment. It typically starts about 30 minutes after birth and can last up to 2 hours. During this stage, the newborn may be restless, have an increased heart rate, and show increased vocalization. It is an important time for bonding and initial interactions with the parents, as the newborn is most alert and responsive during this period.
The healthcare provider should question an order for glucocorticoids in the treatment of a patient with what condition?
- A. Systemic fungal infection
- B. Diabetes Mellitus
- C. Myasthenia Gravis
- D. Glaucoma
Correct Answer: A
Rationale: Glucocorticoids are contraindicated in the treatment of a patient with systemic fungal infection or in patients receiving live vaccines due to their immunosuppressive effects. Glucocorticoids can exacerbate fungal infections by suppressing the immune response. While caution is advised in patients with diabetes mellitus, myasthenia gravis, and glaucoma, the presence of a systemic fungal infection warrants questioning the use of glucocorticoids to prevent worsening of the fungal infection.