Nokea
When discussing cerebral palsy with the parents of a newly diagnosed child, which information is correct?
- A. Cerebral palsy is a nonprogressive disease caused by damage to the brain.
- B. Brain surgery commonly helps or even cures children with cerebral palsy.
- C. Physical therapy is of little value to a child with cerebral palsy.
- D. Cerebral palsy is the result of injury to the sensory areas of the brain.
Correct Answer: A
Rationale: Cerebral palsy is a nonprogressive neurological disorder caused by brain damage, often before or during birth, affecting motor function but not worsening over time.
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Which clinical manifestation of the client's full-thickness burns would the nurse detect during an assessment?
- A. Moderate level of pain due to exposed nerve endings
- B. Eschar formation throughout the area of the burn
- C. The appearance of blister formation throughout the area of the burn
- D. Noted tissue destruction extending to the subcutaneous layer
Correct Answer: D
Rationale: Full-thickness burns involve destruction of all skin layers, including the subcutaneous layer, resulting in a leathery or charred appearance. Pain is minimal due to nerve destruction, and blisters are characteristic of partial-thickness burns.
What is the diameter of fetal skull that presents at vulva during normal labour:
- A. Suboccipitofrontal.
- B. Mentovertical.
- C. Suboccipitobregmatic.
- D. Occipitofrontal.
- E. Metoposterior.
Correct Answer: C
Rationale: In normal vertex presentation the suboccipitobregmatic diameter (9.5 cm) is the smallest and presents at the vulva during delivery. Other diameters are larger or associated with abnormal presentations.
Before beginning a newborn’s physical assessment,the nurse reviews the newborn’s medical record and sees this notation: “31 weeks’ gestation.” Considering this information the nurse determines that a physical assessment of the infant should reveal which finding?
- A. Flexion of all four extremities
- B. The ability to suck
- C. The absence of lanugo
- D. Vernix covering the infant
Correct Answer: D
Rationale: "Preterm infants (31 weeks) are covered with vernix caseosa. Flexion is minimal sucking is absent before 33 weeks and lanugo is extensive."
If the client asks the nurse for instructions on safe condom use, which information needs to be stressed?
- A. Condoms should be stored in a warm, dry place to prevent damage.
- B. Condoms are generally lubricated with mineral oil or petroleum jelly.
- C. A condom should be applied before the penis becomes erect.
- D. During application, a ½†space should be left at the end of the condom.
Correct Answer: D
Rationale: Leaving a ½†space at the condom's tip prevents breakage by allowing room for semen, a critical aspect of safe condom use to ensure effectiveness.
While caring for the small-for-gestational-age newborn (SGA),the nurse notes slight tremors of the extremities a high-pitched cry and an exaggerated Moro reflex. In response to these assessment findings what should be the nurse’s first action?
- A. Assess the infant’s blood sugar level.
- B. Document the findings in the infant’s medical record.
- C. Immediately inform the pediatrician of the symptoms.
- D. Assess the infant’s axillary temperature.
Correct Answer: A
Rationale: SGA infants risk hypoglycemia due to low glycogen stores causing tremors high-pitched cry and exaggerated reflexes. Checking blood sugar is the priority action.