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Which is the most accurate genetic explanation for a family with hemophilia?
- A. It is an X-linked recessive disorder
- B. It is an autosomal recessive disorder
- C. It is equally distributed among males and females
- D. It is a Y-linked dominant disorder
Correct Answer: A
Rationale: The correct answer is A: It is an X-linked recessive disorder. Hemophilia is caused by a mutation in genes located on the X chromosome. Males inherit the disorder from their mothers, as they only inherit one X chromosome. Females can be carriers if they inherit one mutated X chromosome. Autosomal recessive disorders (choice B) require both parents to pass on the mutated gene. Hemophilia is not equally distributed among males and females (choice C) because males are more likely to exhibit symptoms. Y-linked disorders (choice D) are inherited only by males and are passed from father to son.
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A nurse is performing education for the guardians of an HIV positive teen. Which statement indicates the need for further teaching?
- A. It is important for her to have normal growth and development.
- B. Adherence to antiretroviral therapy is needed.
- C. We will need to inform the school about her infection.
- D. She should get her annual flu shot at the doctor's office.
Correct Answer: C
Rationale: The correct answer is C. It is not necessary to inform the school about the teen's HIV infection due to confidentiality laws protecting the teen's privacy. Revealing this information could lead to stigma and discrimination. The other statements are all important for the teen's health and well-being. A: Normal growth and development are crucial for overall health. B: Adherence to antiretroviral therapy is necessary to manage the HIV infection. D: Annual flu shots are recommended to prevent complications.
A child is admitted with possible coarctation of the aorta. The admitting nurse reviews the admitting orders for the child and should question which of the following orders?
- A. Regular diet appropriate for the age
- B. Blood pressure of the upper and lower extremities every 4 hours
- C. Monitor intake and output
- D. Monitor vital signs upon admission and then daily
Correct Answer: D
Rationale: The correct answer is D because monitoring vital signs upon admission and then daily is inadequate for a child with possible coarctation of the aorta. Coarctation of the aorta can lead to significant changes in blood pressure and circulation. Close monitoring is crucial to detect any sudden changes that may indicate complications. Blood pressure should be monitored frequently, especially after any interventions or changes in condition. Regular monitoring of vital signs is essential for early detection of potential issues. Choices A, B, and C are all important aspects of care for this child and should not be questioned.
When should children with cognitive impairments be referred for stimulation and educational programs?
- A. As young as possible
- B. As soon as they have the ability to demonstrate verbal communication
- C. At age 3 when schools are required to provide services
- D. At age 5 when schools are required to provide services
Correct Answer: A
Rationale: The correct answer is A: As young as possible. Early intervention for children with cognitive impairments is crucial for optimal development. Early stimulation and educational programs can significantly improve outcomes. The brain's plasticity is highest in early childhood, making it the most effective time for interventions. Waiting until age 3 or 5 (choices C and D) may lead to missed opportunities for crucial development. Choice B limits the intervention to verbal communication, overlooking other important areas. Therefore, referring children as young as possible (choice A) is the best approach to ensure they receive the necessary support and resources early on.
A nurse is caring for a school-age child who is 2 hr postoperative following a cardiac catheterization. The nurse observes blood on the child's dressing. Which of the following actions should the nurse take?
- A. Apply intermittent pressure 2.5 cm (1 in) below the percutaneous skin site.
- B. Apply continuous pressure 2.5 cm (1 in) above the percutaneous skin site.
- C. Apply continuous pressure 2.5 cm (1 in) below the percutaneous skin site.
- D. Apply intermittent pressure 2.5 cm (1 in) above the percutaneous skin site.
Correct Answer: C
Rationale: Correct Answer: C
Rationale: Applying continuous pressure 2.5 cm below the percutaneous skin site will help control bleeding by promoting clot formation at the catheter insertion site. This pressure point is closer to the source of bleeding, ensuring better hemostasis and preventing further complications.
Summary:
A: Applying intermittent pressure below the site is incorrect as continuous pressure is more effective in achieving hemostasis.
B: Applying continuous pressure above the site is incorrect as it does not target the bleeding source directly.
D: Applying intermittent pressure above the site is incorrect as continuous pressure is preferred for controlling bleeding.
E, F, G: No information provided.
Which actions by the school nurse is important in the prevention of rheumatic fever?
- A. Encourage routine cholesterol screenings
- B. Conduct routine blood pressure screenings
- C. Refer children with sore throats for throat cultures
- D. Recommend aspirin instead of acetaminophen for minor discomforts
Correct Answer: C
Rationale: The correct answer is C: Refer children with sore throats for throat cultures. This is important in preventing rheumatic fever as it helps identify and treat streptococcal infections promptly, which can lead to rheumatic fever if left untreated. Encouraging routine cholesterol screenings (A) and conducting routine blood pressure screenings (B) are not directly related to preventing rheumatic fever. Recommending aspirin instead of acetaminophen (D) can actually be harmful in children with viral infections, increasing the risk of Reye's syndrome.