Nokea
The healthcare professional is preparing a presentation to a local community group about genetic disorders and the types of congenital anomalies that can occur. What would the professional include as a major congenital anomaly?
- A. Overlapping digits
- B. Polydactyly
- C. Umbilical hernia
- D. Cleft palate
Correct Answer: D
Rationale: Cleft palate is considered a major congenital anomaly due to its significant impact on feeding, speech, and overall health. Overlapping digits (Option A) are a physical anomaly but not typically considered a major congenital anomaly. Polydactyly (Option B) refers to having extra fingers or toes, which is a congenital anomaly but not as major as a cleft palate. Umbilical hernia (Option C) involves a protrusion of abdominal contents through the umbilical ring but is not typically classified as a major congenital anomaly compared to cleft palate.
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Following delivery of a newborn, the 21-year-old mother is experiencing mild vaginal bleeding. You note that her heart rate has increased from 90 to 120 beats/min and she is diaphoretic. Management should include
- A. Oxygen, uterine massage, and transport
- B. Oxygen, placement on the left side, and transport
- C. Oxygen, treatment for shock, and uterine massage during transport
- D. Oxygen, internal vaginal pads, and treatment for shock during transport
Correct Answer: C
Rationale: In this scenario, the 21-year-old mother is showing signs of hemorrhagic shock with increased heart rate, diaphoresis, and vaginal bleeding. The appropriate management includes providing oxygen to support tissue perfusion, treating for shock to restore adequate circulation, and performing uterine massage to help control bleeding during transport. Options A, B, and D do not address the comprehensive management needed for postpartum hemorrhage in this situation.
An infant with a congenital heart defect is being given gavage feedings. The parents ask the nurse why this is necessary. How should the nurse respond?
- A. It limits the chance of vomiting.
- B. It allows the feeding to be administered rapidly.
- C. The energy that would have been expended on sucking is conserved.
- D. The quantity of nutritional liquid can be regulated better than with a bottle.
Correct Answer: C
Rationale: Gavage feedings are necessary for infants with congenital heart defects to conserve the infant's energy by eliminating the need for sucking. This is important because sucking requires energy expenditure, which can be taxing for infants with cardiac defects. Choice A is incorrect as gavage feedings do not primarily limit the chance of vomiting. Choice B is incorrect because the speed of feeding administration is not the primary reason for using gavage feedings in this case. Choice D is incorrect as the regulation of the quantity of nutritional liquid is not the main purpose of gavage feedings in infants with congenital heart defects.
When assessing a 10-month-old infant, what developmental milestone should the nurse expect to observe?
- A. Crawling
- B. Sitting without support
- C. Standing with assistance
- D. Pulling to a stand
Correct Answer: D
Rationale: At 10 months of age, pulling to a stand is a developmental milestone that most infants can achieve. Crawling typically occurs around 6-9 months, sitting without support around 6-8 months, and standing with assistance around 7-11 months. Therefore, choices A, B, and C are not the expected developmental milestones for a 10-month-old infant.
Why should the nurse closely monitor the IV flow rate for a 5-month-old infant with severe diarrhea receiving IV fluids?
- A. Limiting output
- B. Replacing lost fluids
- C. Avoiding IV infiltration
- D. Preventing cardiac overload
Correct Answer: D
Rationale: The correct answer is D: Preventing cardiac overload. Infants are highly vulnerable to fluid overload, making it essential to carefully monitor IV flow rates to prevent complications such as cardiac overload. Rapid administration of IV fluids can lead to an excessive increase in circulating volume, potentially causing cardiac strain or heart failure in infants. Choices A, B, and C are incorrect. Monitoring the IV flow rate is not primarily aimed at limiting output, replacing lost fluids, or avoiding IV infiltration in this scenario. The key concern is to prevent the risk of cardiac overload due to the infant's susceptibility to fluid imbalances.
Which of the following statements regarding 2-rescuer child CPR is correct?
- A. The chest should not be allowed to fully recoil in between compressions as this may impede venous return.
- B. Compress the chest with one or two hands to a depth equal to one-half to one third the diameter of the chest.
- C. The chest should be compressed with one hand and a compression to ventilation ratio of 30:2 should be delivered.
- D. A compression to ventilation ratio of 15:2 should be delivered without pauses in compressions to deliver ventilations.
Correct Answer: B
Rationale: The correct statement regarding 2-rescuer child CPR is to compress the chest with one or two hands to a depth equal to one-half to one third the diameter of the chest. This technique ensures effective chest compressions without causing excessive damage to the chest. Choice A is incorrect because allowing the chest to fully recoil between compressions is essential to facilitate optimal blood flow during CPR. Choice C is incorrect as it describes a compression to ventilation ratio of 30:2, which is not the recommended ratio for child CPR. Choice D is incorrect as a compression to ventilation ratio of 15:2 is not standard practice for child CPR, and pauses in compressions are necessary to provide ventilations effectively.