Nokea
The MOST common behavioral sleep disorder in a 4-month-old baby who needs to be rocked to sleep is
- A. early signs of ADHD
- B. primary restless legs syndrome
- C. sleep terrors
- D. sleep-onset association disorder
Correct Answer: D
Rationale: Sleep-onset association disorder involves reliance on specific conditions to fall asleep.
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A nurse is assessing a preterm newborn for the possibility of necrotizing enterocolitis (NEC). Which assessment findings should the nurse expect to find if NEC is confirmed? (Select all that apply.)
- A. Minimal gastric residual
- B. Abdominal distention
- C. Apnea
- D. Urinary output at 2 ml/kg/hr
Correct Answer: B
Rationale: Abdominal distention: NEC is characterized by abdominal distention due to gas and fluid accumulation in the intestines, leading to a bloated appearance of the abdomen.
At what age should the nurse expect the anterior fontanel to close?
- A. 2 months
- B. 2 to 4 months
- C. 6 to 8 months
- D. 12 to 18 months
Correct Answer: D
Rationale: The nurse should expect the anterior fontanel to close between the ages of 12 to 18 months. The fontanel is the soft spot on a baby's head that allows for the growth of the skull during infancy. It is the last fontanel to close, with closure typically occurring by around 18 months of age. Monitoring the closure of the fontanel is important as it can provide valuable information about the baby's hydration status and overall development.
Which of the following immunoglobulins is first produced during an acute infection?
- A. IgG
- B. IgE
- C. IgM
- D. IgD
Correct Answer: C
Rationale: IgM is the first immunoglobulin produced during an acute infection. It is the first class of antibodies secreted by B cells in response to an antigenic challenge. IgM antibodies are produced initially in primary immune responses and play a crucial role in activating the complement system. IgG is produced after IgM and is the most abundant immunoglobulin in the secondary immune response. IgE is responsible for allergic reactions, and IgD's function is not fully understood but is believed to be involved in the activation of B cells.
The parent of a 7-year-old with continued bed-wetting at night says they've tried getting the child up at 11:30 p.m. Which is the best next step?
- A. There is a medication (DDAVP) that may help decrease urine volume.
- B. Be firm and show how much work is involved in changing sheets.
- C. Limit fluids in the evening and consider a reward system for dry nights.
- D. Bed-wetting alarms are available and effective.
Correct Answer: C
Rationale: Reducing evening fluids and using positive reinforcement (reward system) are effective and developmentally appropriate strategies.
the therapeutic management of children with b-thalassemia major consists primarily of which of the following?
- A. oxygen therapy.
- B. adequate hydration.
- C. supplemental iron .
- D. frequent blood transfusions .
Correct Answer: D
Rationale: The primary therapeutic management of children with beta-thalassemia major involves frequent blood transfusions. This is necessary because beta-thalassemia major is a severe form of thalassemia where there is a significant reduction in the production of hemoglobin. Blood transfusions help to increase the levels of normal hemoglobin in the body, improving symptoms related to anemia and preventing complications such as growth failure and organ damage. Other treatments such as iron chelation therapy to manage iron overload and supportive measures like adequate hydration are also important, but frequent blood transfusions are the cornerstone of managing beta-thalassemia major.