Nokea
The nurse notices that a 10-month-old infant being seen in the clinic is wearing expensive, inflexible, high-top shoes. The nurse should explain that:
- A. soft and flexible shoes are generally better.
- B. high-top shoes are necessary for support.
- C. inflexible shoes are necessary to prevent in-toeing and out-toeing.
- D. this type of shoe will encourage the infant to walk sooner.
Correct Answer: A
Rationale: Soft and flexible shoes are generally better for infants who are learning to walk. Infants have soft and pliable bones in their feet that are still developing, so it is important for them to wear shoes that allow natural movement and flexibility. High-top shoes and inflexible shoes may restrict the natural movement of the foot and can hinder the infant's ability to develop balance and coordination while learning to walk. It is important for infants to wear shoes that are comfortable, lightweight, and provide some protection without restricting their foot movements.
You may also like to solve these questions
A nurse is counseling parents of a child beginning to show signs of being overweight. The nurse accurately relates which body mass index (BMI)-for-age percentile indicates a risk for being overweight?
- A. 10th percentile
- B. 9th percentile
- C. 85th percentile
- D. 95th percentile
Correct Answer: D
Rationale: The body mass index (BMI)-for-age percentile indicating a risk for being overweight is the 95th percentile. This means that if a child's BMI falls at or above the 95th percentile for their age group, they are classified as overweight. This percentile is used as a cutoff point to identify children at risk of being overweight and to guide intervention strategies such as lifestyle changes, increased physical activity, and dietary modifications. Parents should work with healthcare providers to address their child's weight status and implement appropriate measures to promote a healthy lifestyle.
Which screening test for colorectal cancer should the nurse recommend?
- A. Carcinoembryonic antigen (CEA) test
- B. Annual digital examination after age 50
- C. Barium enema after age 50
- D. Proctosigmoidoscopy after age 50
Correct Answer: D
Rationale: The nurse should recommend a proctosigmoidoscopy for colorectal cancer screening in individuals over the age of 50. This procedure allows for the visualization of the lower part of the colon and rectum, which are common sites for precancerous and cancerous lesions to develop. Proctosigmoidoscopy can help identify abnormalities early on, allowing for prompt intervention and treatment. This screening method helps in detecting colorectal cancer or pre-cancerous polyps at an early stage when they are more easily treatable. Regular screening is essential for early detection and prevention of colorectal cancer. Other screening tests such as carcinoembryonic antigen (CEA) test, annual digital examination, and barium enema are not recommended as primary screening methods for colorectal cancer.
Nurse Katriz is planning a client education program for sickle cell disease (SCD); what topics should be included in the plan of care?
- A. Aerobic exercise to improve oxygenation
- B. Fluid restraint to 1 qt (1 L)/day
- C. A high-iron, high-protein diet
- D. Proper hand washing and infectionavoidance
Correct Answer: D
Rationale: People with sickle cell disease (SCD) are at a higher risk of infections due to their impaired immune system. Infections can trigger a sickle cell crisis, which can be life-threatening. Therefore, proper hand washing and infection avoidance are crucial components of the care plan for clients with SCD. This topic should be included in Nurse Katriz's client education program to help reduce the risk of infections and promote better health outcomes for individuals with SCD.
Clinical manifestations of Huntington's disease include:
- A. Abnormal involuntary movements (chorea)
- B. Intellectual decline
- C. Emotional disturbances
- D. All of the above
Correct Answer: D
Rationale: Huntington's disease is a progressive neurological disorder that affects movement, cognition, and behavior. The three main clinical manifestations of Huntington's disease are abnormal involuntary movements (chorea), intellectual decline, and emotional disturbances. Chorea is characterized by involuntary jerky movements that are often random and unpredictable. Intellectual decline includes difficulties with cognitive functions such as planning, organizing, and remembering. Emotional disturbances may manifest as irritability, depression, anxiety, or mood swings. Overall, individuals with Huntington's disease experience a wide range of symptoms that impact both their physical and mental well-being.
If a client with increased pressure (ICP) demonstrates decorticate posturing, the nurse will observe:
- A. Flexion of both upper and lower extremities
- B. Extension of elbows and knees, plantar flexion of feet, and flexion of the wnsts
- C. Flexion of elbows, extension of the knees, and plantar flexion of the feet
- D. Extension of upper extremities, flexion of lower extremities
Correct Answer: B
Rationale: Decorticate posturing is characterized by flexion of elbows, wrists, and fingers; extension of elbows and knees; plantar flexion of the feet. This type of posturing typically indicates severe damage to the cerebral hemispheres or impairment of the corticospinal tract. When a client with increased intracranial pressure (ICP) displays decorticate posturing, it suggests significant brain injury and dysfunction. This abnormal posturing is a classic sign that requires immediate medical attention and intervention.