Which explanation by the nurse is most accurate?
- A. Your child's condition, which involves a 35-degree curvature, may improve without treatment.
- B. Your child may develop problems with bladder control without treatment.
- C. Your child may develop problems with bowel control without treatment.
- D. Your child may develop breathing problems without treatment.
Correct Answer: D
Rationale: A 35-degree scoliosis curvature is significant and, without treatment, may progress, potentially compressing the lungs and causing breathing difficulties.
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The nurse is concerned that a newborn may have congenital hydrocephalus. Which finding did the nurse likely observe on assessment?
- A. Bulging anterior fontanel
- B. Head and chest circumference equal
- C. A narrowed posterior fontanel
- D. Low-set ears
Correct Answer: A
Rationale: A bulging anterior fontanel suggests hydrocephalus due to increased intracranial pressure. Equal head/chest circumferences narrow posterior fontanel and low-set ears are normal or unrelated.
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."
Which finding by the nurse strongly indicates that a child is experiencing hypokalemia?
- A. Full, bounding pulses
- B. Muscle weakness
- C. Elevated blood pressure
- D. Hyperactive bowel sounds
Correct Answer: B
Rationale: Hypokalemia causes muscle weakness due to impaired muscle contraction, a key manifestation resulting from low potassium levels affecting neuromuscular function.
18 years old P1 presents in outpatient department ten days after delivery with tender hot painful swelling in right breast. She also complains of fever with rigors. What will be the most likely management:
- A. Antibiotics.
- B. Analgesics.
- C. Incision & drainage.
- D. Conservative management.
- E. Lactation inhibition.
Correct Answer: C
Rationale: The symptoms suggest a breast abscess which requires incision and drainage for effective treatment especially with systemic symptoms like fever. Antibiotics alone are insufficient for an abscess and other options are inappropriate.
Which statement by the parents indicates they understand the home care needs for a child with sickle cell anemia?
- A. We'll limit our child's fluid intake to prevent swelling.
- B. We'll encourage our child to rest during sickle cell crises.
- C. We'll give our child aspirin for fever.
- D. We'll avoid taking our child to the doctor for regular checkups.
Correct Answer: B
Rationale: Encouraging rest during sickle cell crises reduces oxygen demand and prevents exacerbation of vaso-occlusive episodes, indicating understanding of home care needs.