Nokea
The nurse is admitting a newborn with hypospadias to the nursery. The nurse expects which finding in this newborn?
- A. Absence of a urethral opening is noted.
- B. Penis appears shorter than usual for age.
- C. The urethral opening is along the dorsal surface of the penis.
- D. The urethral opening is along the ventral surface of the penis.
Correct Answer: D
Rationale: Hypospadias is a congenital condition where the opening of the urethra is located on the ventral surface of the penis instead of the tip. This results in the ventral placement of the urethral meatus compared to the normal dorsal position. It can typically be visually identified when examining the newborn's genitalia. A key characteristic of hypospadias is the abnormal positioning of the urethral opening, which distinguishes it from other conditions affecting the male genitalia.
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Children with ALL who carry poor outcome include all the following EXCEPT
- A. age younger than 1 year and older than 10 year
- B. T-cell immunophenotype
- C. hyperdiploidy chromosomal abnormality
- D. initial leukocyte count of > 50,000
Correct Answer: C
Rationale: Hyperdiploidy is generally associated with a favorable prognosis in ALL, unlike other listed factors.
Where do the lesions of atopic dermatitis (eczema) most commonly occur in the infant? (Select all that apply.)
- A. Cheeks
- B. Buttocks
- C. Extensor surfaces of arms and legs
- D. Back
Correct Answer: A
Rationale: In infants with atopic dermatitis (eczema), the lesions most commonly occur on the cheeks (option A) and the extensor surfaces of the arms and legs (option C). The cheeks are a common site of involvement due to increased exposure to irritants and saliva from drooling. The extensor surfaces of the arms and legs are also frequently affected due to scratching and rubbing against clothing. While atopic dermatitis can occur in other areas such as the buttocks, back, and trunk, the cheeks and extensor surfaces are the most common locations in infants.
Which of the following is an intraoperative outcome for a patient undergoing an inguinal hernia repair?
- A. Verbalizes fears
- B. Demonstrates leg exercises
- C. Maintains skin integrity
- D. Explains deep breathing exercises
Correct Answer: C
Rationale: Intraoperative outcomes refer to the immediate goals and conditions that are assessed during a surgical procedure. Maintaining skin integrity is a crucial intraoperative outcome for a patient undergoing an inguinal hernia repair surgery. This outcome focuses on ensuring that the patient's skin remains intact, without any damage or breakdown during the surgical procedure. It involves proper positioning of the patient, adequate support to vulnerable areas, and meticulous monitoring of the skin throughout the surgery to prevent any pressure injuries or skin trauma. Other outcomes listed, such as verbalizing fears, demonstrating leg exercises, and explaining breathing exercises, are more pertinent to preoperative or postoperative care rather than intraoperative outcomes.
A client is admitted to an acute care facility with a myocardial infarction. During the admission history, the nurse learns that the client also has hypertension and progressive systemic sclerosis. For a client with this disease, the nurse is most likely to formulate which nursing diagnosis?
- A. Risk for impaired skin integrity
- B. Imbalanced nutrition: Risk for more than
- C. Constipation body requirements
- D. Ineffective thermoregulation
Correct Answer: A
Rationale: For a client with progressive systemic sclerosis, also known as Scleroderma, the nurse is most likely to formulate a nursing diagnosis related to the risk for impaired skin integrity. Scleroderma is a chronic connective tissue disease that can lead to changes in skin texture and thickness, making the skin more prone to breakdown, ulcers, and impaired wound healing. Therefore, assessing and addressing the risk for impaired skin integrity is essential to prevent complications in clients with Scleroderma. While the other options may also be relevant considerations for this client, the priority nursing diagnosis in this case would be related to maintaining skin integrity.
Patients with Guillain-Barre Syndrome should be closely monitored. Which of the ff. parameters is most important to be checked regularly for acute complications?
- A. BUN and creatinine
- B. Hgb and Hct
- C. ABG
- D. Serum potassium
Correct Answer: C
Rationale: Patients with Guillain-Barre Syndrome are at risk for respiratory complications due to muscle weakness and paralysis, particularly affecting the respiratory muscles. Monitoring arterial blood gas (ABG) levels is crucial in assessing respiratory function and detecting respiratory failure early in these patients. ABG levels provide information on oxygenation, ventilation, and acid-base balance, which are essential parameters to monitor closely in patients with Guillain-Barre Syndrome to prevent respiratory compromise and potential respiratory failure. Regular ABG monitoring helps healthcare providers intervene promptly if respiratory abnormalities develop, ensuring timely treatment and preventing serious complications.