Nokea
The MOST common cause of sleeping difficulty in the first 2 months of life is
- A. gastro-esophageal reflux
- B. colic
- C. formula intolerance
- D. developmentally self-resolving sleeping behavior
Correct Answer: B
Rationale: Colic is a frequent cause of sleep difficulties in young infants.
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Daya's child is scheduled for surgerydue to myelomeningocele; the primary reason for surgical repair is which of thefollowing?
- A. To prevent hydrocephalus
- B. To reduce the risk of infection
- C. To correct the neurologic defect
- D. To prevent seizure disorders
Correct Answer: C
Rationale: The primary reason for surgical repair of myelomeningocele is to correct the neurologic defect caused by this type of birth defect. Myelomeningocele is a form of spina bifida where the spinal cord and its covering are exposed through an opening in the spine. Surgical closure of the defect is performed to protect the spinal cord and nerves, prevent further damage, and potentially improve long-term outcomes for the child. While preventing complications like hydrocephalus or infection may be important secondary goals of the treatment, the main objective of surgery for myelomeningocele is to address the underlying neurologic defect itself.
When the LPN is assisting the patient to use an incentive spirometer, which of the following actions by the patient indicates that the patient needs further teaching on how to use the spirometer?
- A. Taking two normal breaths before use.
- B. Sitting upright before use.
- C. Inhaling deeply to reach target.
- D. Exhaling deeply to reach target.
Correct Answer: D
Rationale: When using an incentive spirometer, the patient should inhale deeply to reach the target volume indicated by the marker. Exhaling deeply does not achieve the objective of the incentive spirometer, which is to encourage deep inhalation. If the patient exhales deeply to reach the target, further teaching and clarification about the proper technique of using the spirometer are needed. The correct technique involves inhaling deeply to expand the lungs and help improve lung function.
The patient is having difficulty coping with her new diagnosis of lymphoma. Which response by the nurse is most helpful?
- A. "Don't worry. You'll be okay."
- B. "The treatments you are receiving will make you feel better very soon."
- C. "Who do you usually go to when you have a problem?"
- D. "Have you made end-of-life decisions?"
Correct Answer: C
Rationale: Option C, "Who do you usually go to when you have a problem?" is the most helpful response by the nurse in this situation. This response allows the patient to identify her support system and opens up a conversation about coping mechanisms and sources of emotional support. It helps the nurse understand who the patient leans on during difficult times and enables the nurse to involve these individuals in providing support and encouragement to the patient as she copes with her new diagnosis of lymphoma. By exploring the patient's typical sources of support, the nurse can assist in strengthening her coping mechanisms and emotional well-being during this challenging time.
What is oral candidiasis (thrush) in the newborn?
- A. Bacterial infection that is life threatening in the neonatal period
- B. Bacterial infection of mucous membranes that responds readily to treatment
- C. Yeastlike fungal infection of mucous membranes that is relatively common
- D. Benign disorder that is transmitted from mother to newborn during the birth process only
Correct Answer: C
Rationale: Oral candidiasis, also known as thrush, is a yeastlike fungal infection of the mucous membranes in the mouth. It is relatively common in newborns, as their immune systems are still developing and can be easily affected by the overgrowth of Candida fungi. Thrush can present as white patches or plaques on the tongue, gums, or inner cheeks. It is important to treat oral thrush to prevent any discomfort for the newborn and potential complications such as difficulty feeding or spreading of the infection.
When doing the first assessment of a male newborn, the nurse notes that the scrotum is large, edematous, and pendulous. This should be interpreted as a(n):
- A. normal finding.
- B. hydrocele.
- C. absence of testes.
- D. inguinal hernia.
Correct Answer: B
Rationale: A hydrocele presents as a fluid-filled sac surrounding the testes within the scrotum. In newborns, it is a common finding due to the open connection between the peritoneal cavity and the scrotum that may allow fluid to accumulate. This can result in a large, edematous, and pendulous scrotum. Hydroceles are usually benign and tend to resolve on their own within the first year of life. In contrast, the absence of testes (cryptorchidism) would be identified as the inability to palpate the testes in the scrotum or inguinal canal. An inguinal hernia would present as a bulge in the inguinal area caused by a loop of intestine protruding through a weak spot in the abdominal wall.