Nokea
Hemolytic disease is suspected in a mother's second newborn. Which factor is important in understanding how this could develop?
- A. The mother's first child was Rh positive.
- B. The mother is Rh positive.
- C. Both parents have type O blood.
- D. RhIG (RhoGAM) was given to the mother during her first pregnancy.
Correct Answer: A
Rationale: Hemolytic disease of the newborn, also known as erythroblastosis fetalis, is a condition in which a mother's antibodies attack the red blood cells of the unborn baby. This most commonly occurs due to Rh incompatibility. The mother produces Rh antibodies during her first pregnancy with an Rh positive baby. During subsequent pregnancies with an Rh positive baby, these antibodies can cross the placenta and attack the baby's red blood cells, leading to hemolytic disease. Therefore, if the mother's first child was Rh positive, it increases the risk of hemolytic disease in subsequent pregnancies if the babies are also Rh positive.
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Childhood primary brain stem tumors are a heterogeneous group of tumors; the outcome usually depends on the tumor location. Which tumor, depending on the site of tumor, carries the worst prognosis?
- A. focal dorsally exophytic
- B. cervicomedullary diffuse intrinsic
- C. none of the above
- D. diffuse intrinsic
Correct Answer: D
Rationale: Diffuse intrinsic pontine gliomas (DIPG) have the worst prognosis among brainstem tumors.
The clue to need a help for a child who does not respond to his or her name is by age of
- A. 6 months
- B. 8 months
- C. 10 months
- D. 12 months
Correct Answer: D
Rationale: By 12 months, a child should respond to their name; if not, it may indicate a developmental concern.
A woman delivers a 3,250 g neonate at 42 weeks' gestation. Which physical finding is expected during an examination if this neonate?
- A. Abundant lanugo
- B. Absence of sole creases
- C. Breast bud of 1-2 mm in diameter
- D. Leathery, cracked, and wrinkled skin
Correct Answer: D
Rationale: A neonate born at 42 weeks' gestation, also known as post-term, is expected to have skin that appears leathery, cracked, and wrinkled due to prolonged exposure to the amniotic fluid in utero. This is a common physical finding in post-term neonates due to the decreased amount of vernix caseosa and amniotic fluid present on the skin at birth. Abundant lanugo (fine hair), absence of sole creases, and breast bud development are more commonly seen in preterm or term newborns, rather than post-term newborns.
A nurse is planning a class on accident prevention for parents of toddlers. Which safety topic is the priority for this class?
- A. Appropriate use of car seat restraints
- B. Safety crossing the street
- C. Helmet use when riding a bicycle
- D. Poison control numbers
Correct Answer: A
Rationale: The safety topic that is the priority for the nurse's accident prevention class for parents of toddlers is the appropriate use of car seat restraints. Car accidents are one of the leading causes of injuries and deaths among children, and proper car seat usage is crucial in protecting toddlers during car rides. Following the guidelines for car seat installation and usage can significantly reduce the risk of injury or death in the event of a car accident. Therefore, ensuring that parents understand and implement proper car seat restraint practices is essential in promoting the safety of toddlers. While the other safety topics are also important, the risk of injury or death in car accidents is higher compared to other accidents for toddlers, making car seat safety a priority.
The nurse is preparing an intravenous infusion of phenytoin (Dilantin) as prescribed by the physician for the client with seizures. Which of the following solutions will the nurse plan to use to dilute this medication?
- A. Dextrose 5%
- B. Lactated Ringer's solution
- C. Normal saline solution
- D. Dextrose 5% and half-normal saline (0.45%)
Correct Answer: C
Rationale: Phenytoin (Dilantin) is known to be incompatible with dextrose solutions (such as dextrose 5% or dextrose 5% and half-normal saline). Therefore, the nurse would plan to use normal saline solution to dilute phenytoin in order to ensure medication effectiveness and prevent any potential adverse reactions. Lactated Ringer's solution is not commonly used for diluting phenytoin as normal saline solution is the preferred choice due to compatibility considerations.