Nokea
The baby with birth brachial plexus palsy (BBPP) will start with occupational or physical therapy at approximately
- A. 1 wk of age
- B. 2 wk of age
- C. 3 wk of age
- D. 4 wk of age
Correct Answer: A
Rationale: Early intervention is critical for optimal recovery in BBPP. Therapy typically begins within the first week of life to prevent contractures and promote nerve regeneration.
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The nurse is caring for a very low birth weight (VLBW) newborn with a peripheral intravenous infusion. Which statement describes nursing considerations regarding infiltration?
- A. Infiltration occurs infrequently because VLBW newborns are inactive.
- B. Continuous infusion pumps stop automatically when infiltration occurs.
- C. Hypertonic solutions can cause severe tissue damage if infiltration occurs.
- D. Infusion site should be checked for infiltration at least once per 8-hour shift.
Correct Answer: C
Rationale: Infiltration of intravenous fluids in VLBW newborns can lead to serious complications, especially if hypertonic solutions are being administered. Hypertonic solutions have a higher osmolarity than the body's fluids, which can cause severe tissue damage if there is infiltration. It is crucial for the nurse to monitor the infusion site closely for signs of infiltration and take prompt action to prevent further harm to the newborn's delicate skin and tissues. The other options are not directly related to the risk and consequences of infiltration in VLBW newborns.
In Langerhans cell histiocytosis (LCH), all the following manifestations are at high risk of mortality in patients EXCEPT
- A. liver
- B. spleen
- C. lung
- D. hematopoietic system
Correct Answer: C
Rationale: Lung involvement, while serious, is less lethal compared to liver, spleen, or hematopoietic system involvement.
For a client newly diagnosed with radiation-induced thrombocytopenia, the nurse should include which intervention in the plan of care?
- A. Administering aspirin if the temperature exceeds 102â—‹1 F (38.8â—‹0 C)
- B. inspecting the skin for petechiae once every shift
- C. providing for frequent rest periods
- D. Placing the client in strict isolation
Correct Answer: C
Rationale: Providing for frequent rest periods is the most appropriate intervention for a client newly diagnosed with radiation-induced thrombocytopenia. Thrombocytopenia is characterized by a decreased number of platelets, which are essential for blood clotting. Clients with thrombocytopenia are at an increased risk for bleeding and bruising. Therefore, it is important to prevent activities that may lead to injury or bleeding. Providing frequent rest periods allows the client to conserve energy and minimize the risk of trauma that could lead to bleeding complications. This intervention helps manage the symptoms associated with thrombocytopenia and promotes the client's safety and well-being.
Which is a function of brown adipose tissue (BAT) in the newborn?
- A. Provides ready source of calories in the newborn period
- B. Insulates the body against lowered environmental temperature
- C. Protects the newborn from injury during the birth process
- D. Generates heat for distribution to other parts of body
Correct Answer: D
Rationale: Brown adipose tissue (BAT) is specialized adipose tissue found in newborns and hibernating mammals, whose primary function is to generate heat through non-shivering thermogenesis. This heat generation is essential for maintaining body temperature in newborns, especially as they have a larger surface area-to-volume ratio, which results in greater heat loss compared to adults. BAT produces heat by metabolizing stored lipids and disrupting the normal process of cellular respiration, leading to the production of heat instead of ATP. The heat generated by BAT is then distributed throughout the body to help maintain a stable core body temperature in newborns, who are not yet able to regulate their body temperature as effectively as adults.
Alveolar type of rhabdomyosarcoma accounts for approximately 1/3 of all cases of pediatric RMS and carries the poorest prognosis. Of the following, the MOST common site of involvement by alveolar type RMS is
- A. orbit
- B. middle ear
- C. extremities
- D. bladder
Correct Answer: C
Rationale: Extremities are the most common site for alveolar rhabdomyosarcoma.