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Which additional congenital malformation is expected in 80% of infants with a myelomeningocele?
- A. Cerebral palsy
- B. Hydrocephalus
- C. Meningitis
- D. Neuroblastoma
Correct Answer: B
Rationale: Hydrocephalus is present in 80% of infants affected by a myelomeningocele.
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Which is a priority nursing intervention for the cognitively impaired child?
- A. The family will provide good nutrition.
- B. The family will provide loving interactions.
- C. Stimulation will improve.
- D. There will be contact with peers.
Correct Answer: B
Rationale: Nursing interventions focus on promoting optimal development and loving interactions with family.
How should the nurse measure urinary output for an infant with dehydration?
- A. Attaching a urine collecting bag
- B. Wringing out the diaper
- C. Weighing the diaper
- D. Inserting a catheter
Correct Answer: C
Rationale: Wet diapers are weighed to assess the amount of output.
A child with Duchenne muscular dystrophy rises from the floor by walking up the thighs with the hands. How should the nurse record this observation?
- A. Hand assistance
- B. Leg crawling
- C. Gowers sign
- D. Bright sign
Correct Answer: C
Rationale: Using the hands to walk up the thighs is known as the Gowers sign.
What other congenital defects are common in children with Down syndrome?
- A. Hypospadias
- B. Pyloric stenosis
- C. Heart defects
- D. Hip dysplasia
Correct Answer: C
Rationale: Many children with Down syndrome have congenital heart defects.
Which signs/symptoms would be considered classical signs of meningeal irritation?
- A. Positive Kernig sign, diarrhea, and headache
- B. Negative Brudzinski sign, positive Kernig sign, and irritability
- C. Positive Brudzinski sign, positive Kernig sign, and photophobia
- D. Negative Kernig sign, vomiting, and fever
Correct Answer: C
Rationale: Classical manifestations of meningitis include positive Kernig and Brudzinski signs.