When teaching a class about trisomy 21, the instructor would identify the cause of this disorder as:
- A. nondisjunction.
- B. X-linked recessive inheritance.
- C. genomic imprinting.
- D. autosomal dominant inheritance.
Correct Answer: A
Rationale: Trisomy 21, also known as Down syndrome, is caused by nondisjunction, which is an error in cell division that leads to the presence of an extra chromosome 21. This additional chromosome alters the normal genetic makeup, resulting in the characteristics associated with Down syndrome. Therefore, the correct answer is nondisjunction (Choice A). Choices B, C, and D are incorrect because Trisomy 21 is not caused by X-linked recessive inheritance, genomic imprinting, or autosomal dominant inheritance. Understanding the specific genetic mechanism involved in Trisomy 21 is crucial for grasping the basis of this chromosomal disorder.
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When caring for a child and family who just moved out of a dangerous neighborhood, which of the following approaches is appropriate to the family stress theory?
- A. Determining who the decision maker is
- B. Assessing the child's coping abilities
- C. Finding out how siblings feel
- D. Explaining procedures to siblings
Correct Answer: B
Rationale: Assessing the child's coping abilities is appropriate when applying the family stress theory because it helps understand how well the child is managing the stress of the situation. This assessment can provide insights into the child's emotional well-being and resilience, enabling healthcare providers to offer appropriate support. Choices A, C, and D are less relevant in the context of family stress theory. Determining who the decision-maker is may be important but is not directly related to assessing the child's coping abilities. Finding out how siblings feel and explaining procedures to siblings may be valuable aspects of care but are not specifically aligned with the core principles of the family stress theory, which focus on understanding and addressing stress within the family unit.
The nurse is developing a plan of care for a 7-year-old boy with diabetes insipidus. What is the priority nursing diagnosis?
- A. Deficient fluid volume related to dehydration
- B. Excess fluid volume related to edema
- C. Deficient knowledge related to fluid intake regimen
- D. Imbalanced nutrition related to excess weight
Correct Answer: A
Rationale: The priority nursing diagnosis for a 7-year-old boy with diabetes insipidus is deficient fluid volume related to dehydration. Diabetes insipidus causes excessive thirst and urination, leading to fluid imbalance and potential dehydration. Choice B, excess fluid volume related to edema, is not a priority as diabetes insipidus is characterized by fluid loss, not retention. Choice C, deficient knowledge related to fluid intake regimen, may be important but is not the priority when the child is at risk of dehydration. Choice D, imbalanced nutrition related to excess weight, is not directly associated with the primary concern of fluid volume imbalance in diabetes insipidus.
In planning care for a 7-year-old boy with diabetes insipidus, what is the priority nursing diagnosis?
- A. Deficient fluid volume related to dehydration
- B. Excess fluid volume related to edema
- C. Deficient knowledge related to fluid intake regimen
- D. Imbalanced nutrition, more than body requirements related to excess weight
Correct Answer: A
Rationale: The priority nursing diagnosis for a 7-year-old boy with diabetes insipidus is deficient fluid volume related to dehydration. Diabetes insipidus leads to excessive urination and fluid loss, which can result in dehydration. This diagnosis should take precedence as restoring fluid balance is crucial in managing this condition. Choices B, C, and D are less of a priority in this case. Excess fluid volume related to edema is not typically associated with diabetes insipidus. Deficient knowledge about fluid intake and imbalanced nutrition related to excess weight may be important but addressing the dehydration and fluid volume deficit is the most critical aspect in the immediate care of a child with diabetes insipidus.
A nurse is planning an initial home care visit to a mother who gave birth to a high-risk infant. For what time of day should the nurse schedule the visit to be most productive?
- A. When the husband is out of the home.
- B. At a time when the mother is feeding the infant.
- C. At a time that is convenient for the family.
- D. When the nurse can spend time with the family.
Correct Answer: C
Rationale: Scheduling the visit at a time that is convenient for the family is crucial for ensuring the family's receptiveness and availability, making the visit more productive. Choosing a time when the mother is feeding the infant (choice B) may not necessarily align with the family's overall convenience and may disrupt the feeding routine. Similarly, scheduling the visit when the husband is out of the home (choice A) might not be optimal as it may exclude an important family member and potentially impact the support system. While spending time with the family (choice D) is important, the primary focus should be on accommodating the family's schedule to maximize the effectiveness of the visit.
A healthcare professional is reviewing the clinical records of infants and children with cardiac disorders who developed heart failure. What did the professional determine is the last sign of heart failure?
- A. Tachypnea
- B. Tachycardia
- C. Peripheral edema
- D. Periorbital edema
Correct Answer: C
Rationale: Peripheral edema is often considered the last sign of heart failure in infants and children. It indicates significant fluid retention and circulatory compromise. Tachypnea (increased respiratory rate) and tachycardia (increased heart rate) are early signs of heart failure due to inadequate cardiac output. Periorbital edema, while a sign of excess fluid, typically occurs earlier in the progression of heart failure compared to peripheral edema.