Nokea
The nurse is administering a number of therapeutic interventions for neonates, infants, and children on the pediatric unit. Which intervention contributes to an increase in chronic illness seen in early childhood?
- A. Administering antibiotics to prevent lethal infections
- B. Vaccinating children to prevent childhood diseases
- C. Using mechanical ventilation for premature infants
- D. Using corticosteroids as a treatment for asthma
Correct Answer: C
Rationale: Using mechanical ventilation and medications to foster lung development in premature infants increases their survival rate. Yet the infants who survive are often faced with myriad chronic illnesses.
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What is the priority action for a newborn with a positive Coombs test?
- A. Begin phototherapy immediately
- B. Monitor for jaundice progression
- C. Administer immunoglobulin therapy
- D. Initiate exchange transfusion procedures
Correct Answer: B
Rationale: Monitoring jaundice progression is crucial for managing hemolytic disease.
The nurse is caring for a child brought to the emergency department by a babysitter. The child needs an emergency appendectomy and the parents cannot be contacted. What would be the nurse's best response to this situation?
- A. Have the babysitter sign the consent form even if she does not have signed papers to do so.
- B. Have the primary care physician for the child sign the consent form.
- C. Document failed attempts to obtain consent to allow emergency care.
- D. Delay medical care until the child's next of kin can be contacted.
Correct Answer: C
Rationale: Health care providers can provide emergency treatment to a child without consent if they have made reasonable attempts to contact the child's parent or legal guardian.
A nurse on a labor unit is admitting a client who reports painful contractions. The nurse determines that the contractions have a duration of 1 min and a frequency of 3 min. The nurse obtains the following vital signs: fetal heart rate 130/min, maternal heart rate 128/min and maternal blood pressure 92/54 mm Hg. Which of the following is the priority action for the nurse to take?
- A. Notify the provider of the findings.
- B. Position the client with one hip elevated.
- C. Ask the client if she needs pain medication.
- D. Have the client void.
Correct Answer: A
Rationale: The priority action for the nurse in this situation is to notify the provider of the vital signs and the client's condition. The maternal blood pressure of 92/54 mm Hg is low, which can indicate hypotension. Hypotension during labor can lead to decreased perfusion to both the mother and baby, potentially causing harm. Therefore, the provider needs to be notified promptly so that appropriate interventions can be initiated to address the maternal hypotension and ensure the well-being of both the mother and the baby. Positioning the client with one hip elevated, asking about pain medication, and having the client void can be important interventions, but they are not the priority in this situation where maternal hypotension is a concern.
A newborn's birth was prolonged because the shoulders were very wide. The nurse performing the assessment would be particularly observant for a problem with the:
- A. Moro reflex
- B. Plantar reflex
- C. Babinski reflex
- D. Stepping reflex
Correct Answer: A
Rationale: The Moro reflex is a normal infantile reflex that is typically present at birth and disappears around 4-6 months of age. This reflex is triggered by a sudden loss of support or a loud noise, causing the infant to throw back the head and extend the arms in a gesture as if trying to grab something. In a situation where the newborn's birth was prolonged due to wide shoulders, there is a higher risk of injury to the brachial plexus (nerves that control arm movement) during delivery. Damage to the brachial plexus can result in weakness or paralysis of the affected arm, and this may impact the Moro reflex as it involves the arms' movement. Therefore, the nurse would be particularly observant for any abnormality or lack of response in the Moro reflex as it may indicate potential nerve injury related to the difficult birth.
The family is the basic unit of society. Which statement correctly illustrates the importance of this concept related to how society functions?
- A. Healthy, well-functioning families provide members of all ages with fulfilling, supporting relationships.
- B. The family serves as a place that encourages members to autonomously function in pursuit of personal pleasures.
- C. Society functions best when families determine how they will interface with others without having to deal with the overall consequences.
- D. Work is an important part of family function but is not necessary for success if one member can fulfill multiple roles.
Correct Answer: A
Rationale: The family is the basic unit of society. In order for this to work well, members of the family must work together. Families make a central contribution to enhance the quality of our society.