Nokea
Nurse Karen is providing postoperative care for Dustin who has cleft palate (CP); she should position the child in which of the following?
- A. In an infant seat
- B. In the supine position
- C. In the prone position
- D. On his side
Correct Answer: B
Rationale: When providing postoperative care for a child with cleft palate (CP), nurse Karen should position the child in the supine position. This position allows for proper airway management and helps prevent aspiration. Placing the child in the supine position also aids in monitoring respiratory status and reducing the risk of complications post-surgery. It is important to maintain proper positioning to ensure the child's safety and comfort during the recovery period.
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The nurse is caring for a newborn whose mother is diabetic. Which clinical manifestations should the nurse expect to see?
- A. Hypoglycemic, large for gestational age
- B. Hyperglycemic, large for gestational age
- C. Hypoglycemic, small for gestational age
- D. Hyperglycemic, small for gestational age
Correct Answer: C
Rationale: Infants born to mothers with diabetes, especially uncontrolled diabetes, are at risk for hypoglycemia due to exposure to high glucose levels in utero. The infant's pancreas may have been producing high levels of insulin in response to the mother's high blood glucose levels, leading to hypoglycemia after birth. Additionally, these infants are typically smaller for gestational age (SGA) due to the effects of high blood sugar levels on fetal growth. Therefore, the nurse should expect the newborn of a mother with diabetes to exhibit signs of hypoglycemia and be small for gestational age.
which of the following must be present in order for an infant with complete transposition of the great vessels to survive at birth?
- A. coarctation of aorta
- B. pulmonary stenosis
- C. patent ductus arteriosus
- D. mitral stenosis
Correct Answer: C
Rationale: In an infant with complete transposition of the great vessels, the survival at birth depends on the presence of a patent ductus arteriosus (PDA) to allow mixing of oxygenated and deoxygenated blood. In this condition, the aorta arises from the right ventricle and the pulmonary artery arises from the left ventricle, leading to separate circulatory pathways for oxygenated and deoxygenated blood. The survival of the infant is dependent on the remaining fetal shunts, such as a PDA, to maintain an adequate mixing of blood until corrective surgery can be performed. Therefore, the presence of a PDA is essential for the survival of an infant with complete transposition of the great vessels at birth.
In pediatric rhabdomyosarcoma, stages are dependent on primary site whether favorable or unfavorable. Which of the following sites of involvement is considered unfavorable?
- A. vagina
- B. uterus
- C. testis
- D. paranasal sinuses
Correct Answer: D
Rationale: Paranasal sinuses are considered unfavorable sites in rhabdomyosarcoma staging.
Nurse Katriz is planning a client education program for sickle cell disease (SCD); what topics should be included in the plan of care?
- A. Aerobic exercise to improve oxygenation
- B. Fluid restraint to 1 qt (1 L)/day
- C. A high-iron, high-protein diet
- D. Proper hand washing and infectionavoidance
Correct Answer: D
Rationale: People with sickle cell disease (SCD) are at a higher risk of infections due to their impaired immune system. Infections can trigger a sickle cell crisis, which can be life-threatening. Therefore, proper hand washing and infection avoidance are crucial components of the care plan for clients with SCD. This topic should be included in Nurse Katriz's client education program to help reduce the risk of infections and promote better health outcomes for individuals with SCD.
A nurse is educating a family whose child is newly diagnosed with scoliosis. The nurse explains that the goal of therapy is to:
- A. limit or stop progression of the curvature.
- B. prepare the child for surgery.
- C. minimize the psychosocial complications of prolonged immobilization.
- D. develop a pain management protocol that will minimize complications of medications. 115
Correct Answer: A
Rationale: The goal of therapy for scoliosis is to limit or stop the progression of the curvature. This can involve a combination of treatments such as bracing, physical therapy, and sometimes surgery. By addressing the curvature early and implementing appropriate interventions, healthcare providers aim to prevent further worsening of the spinal deformity and improve the long-term outcomes for the child. Minimizing the progression of scoliosis is crucial to prevent complications such as back pain, breathing difficulties, and cosmetic concerns. Therefore, educating the family on the importance of therapy in limiting or stopping the curvature progression is a key aspect of managing scoliosis in children.