Nokea
To help limit the development of hyperbilirubinemia in the neonate, the plan of care should include:
- A. Monitoring for the passage of meconium each shift
- B. Instituting phototherapy for 30 minutes every 6 hours
- C. Substituting breastfeeding for formula during the 2nd day after birth
- D. Supplementing breastfeeding with glucose water during the first 24 hours
Correct Answer: A
Rationale: The plan of care to help limit the development of hyperbilirubinemia in the neonate should include monitoring for the passage of meconium each shift. Meconium passage indicates proper functioning of the gastrointestinal tract and normal elimination of bilirubin, which helps prevent its build-up and subsequent development of jaundice. Monitoring for meconium passage ensures that the baby is adequately processing and excreting bilirubin, reducing the risk of hyperbilirubinemia. It is a key aspect of managing neonatal jaundice and promoting the health of the newborn.
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A newborn with hypospadias: The parents ask if circumcision is an option. Which is the best response?
- A. Circumcision is a fading practice and is now contraindicated.
- B. Circumcision is recommended to prevent infection.
- C. Circumcision is an option but should be delayed, as the foreskin may be needed for surgical repair.
- D. Circumcision can never be performed in a child with hypospadias.
Correct Answer: C
Rationale: In hypospadias, preserving the foreskin may be beneficial for repair, so circumcision is usually delayed.
Although children with Wilms tumor have a favorable prognosis, there are some adverse prognostic factors in children with Wilms tumor EXCEPT
- A. large tumors
- B. anaplastic histology
- C. loss of heterozygosity at chromosome 1p and 16q
- D. young age at diagnosis
Correct Answer: D
Rationale: Young age at diagnosis is generally associated with a favorable prognosis.
The age at which the infant can achieve early head control with bobbing motion when pulled to sit is
- A. 2 months
- B. 3 months
- C. 4 months
- D. 6 months
Correct Answer: A
Rationale: Head control typically begins developing around 2 months.
It is considered as the bluntly rounded portion of the heart
- A. Base
- B. Pericardium
- C. Aorta
- D. Apex
Correct Answer: D
Rationale: The apex is the bluntly rounded portion of the heart located at the bottom. It is formed by the tip of the left ventricle and points slightly downward and to the left. The apex is essential in detecting the point of maximum intensity of the heartbeat, known as the apical impulse or point of maximal impulse (PMI). This is where the heart beats closest to the chest wall and can be felt or heard during a physical examination. The base of the heart, on the other hand, is the broader superior part of the heart where the major blood vessels enter and exit. The pericardium is the tough sac enclosing the heart, and the aorta is the main artery that carries oxygen-rich blood from the heart to the body.
Which of the ff nursing interventions is required when caring for a client after cardiac surgery who is at risk for ineffective tissue perfusion?
- A. Restrict fluid intake
- B. Ensure that the client avoids prolonged sitting
- C. Position lower extremities below level of heart
- D. Instruct the client to avoid leg exercises
Correct Answer: C
Rationale: When caring for a client after cardiac surgery who is at risk for ineffective tissue perfusion, it is important to promote optimal blood flow to the tissues. Positioning the lower extremities below the level of the heart helps to facilitate venous return and improve circulation to the extremities. This position helps reduce the workload on the heart and promotes better perfusion to the tissues, ultimately aiding in the prevention of complications related to ineffective tissue perfusion. The other options (A. Restrict fluid intake, B. Ensure that the client avoids prolonged sitting, D. Instruct the client to avoid leg exercises) are not directly related to improving tissue perfusion and may not be appropriate interventions in this situation.