Nokea
The parents of a 3-year-old boy who has Duchenne muscular dystrophy (DMD) ask, 'how can our son have this disease? We are wondering if we should have any more children.' What information should the nurse provide these parents?
- A. This is an inherited X-linked recessive disorder, which primarily affects male children in the family.
- B. The male infant had a viral infection that went unnoticed and untreated, leading to muscle damage.
- C. The lack of the protein dystrophin in the mother can impact the muscle groups of males.
- D. Damage to the spinal cord due to birth trauma from a breech vaginal birth weakens the muscles.
Correct Answer: A
Rationale: The nurse should inform the parents that Duchenne muscular dystrophy is an X-linked recessive disorder, which primarily affects male children in the family. This genetic condition is caused by a mutation in the dystrophin gene located on the X chromosome. Females are usually carriers of the gene mutation and may pass it on to their sons. Daughters of carrier mothers have a 50% chance of being carriers themselves. Understanding the genetics of DMD can help the parents make informed decisions about family planning and genetic counseling.
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During a routine assessment of a 3-year-old at a community health center, the healthcare professional should be alert for signs of autism spectrum disorder. Which behavior by the child should prompt further evaluation for a possible autistic spectrum disorder?
- A. Engages in odd repetitive behaviors
- B. Shows indifference to verbal stimulation
- C. Strokes the hair of a hand-held doll
- D. Has a history of temper tantrums
Correct Answer: A
Rationale: Engaging in odd repetitive behaviors is a hallmark sign of autism spectrum disorder in children. These behaviors can include repetitive movements, insistence on sameness, or specific routines. Recognizing and addressing these behaviors early can help in providing appropriate interventions and support for the child.
During a follow-up clinical visit, a mother tells the nurse that her 5-month-old son, who had surgical correction for tetralogy of Fallot, has rapid breathing, often takes a long time to eat, and requires frequent rest periods. The infant is not crying while being held, and his growth is in the expected range. Which intervention should the nurse implement?
- A. Stimulate the infant to cry to produce cyanosis
- B. Auscultate the heart and lungs while the infant is held
- C. Evaluate the infant for failure to thrive
- D. Obtain a 12-lead electrocardiogram
Correct Answer: B
Rationale: Auscultating the heart and lungs while the infant is held can provide important diagnostic information in assessing the cardiac and respiratory status of the infant who had surgical correction for tetralogy of Fallot. This intervention can help the nurse identify any abnormal heart or lung sounds, which may indicate complications or issues that need further evaluation or intervention.
The nurse is caring for a 15-year-old adolescent who is admitted with a diagnosis of bulimia nervosa. The adolescent's vital signs are stable, but the nurse notes that the client has dry skin and appears thin. What is the nurse's priority action?
- A. Initiate a structured eating plan for the client
- B. Establish a therapeutic relationship with the client
- C. Monitor the client's electrolyte levels
- D. Provide education on healthy eating habits
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
An 8-year-old male client with nephrotic syndrome is receiving salt-poor human albumin IV. Which findings indicate to the nurse that the child is manifesting a therapeutic response?
- A. Decreased urinary output
- B. Decreased periorbital edema
- C. Increased periods of rest
- D. Weight gain of 0.5 kg/day
Correct Answer: B
Rationale: In nephrotic syndrome treatment, decreased periorbital edema is a positive therapeutic response as it indicates a reduction in fluid retention. Periorbital edema is a common symptom of nephrotic syndrome due to fluid accumulation, so a decrease in this swelling signifies an improvement in the condition.
When observing a distraught mother scolding her 3-year-old son for wetting his pants in the hallway of a pediatric unit, what initial action should the nurse take?
- A. Suggest that the mother consult a pediatric nephrologist.
- B. Provide disposable training pants while calming the mother.
- C. Refer the mother to a community parent education program.
- D. Inform the mother that toilet training is slower for boys.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.