Maternity and Pediatric Nursing 4th Edition Test Bank

Maternity and Pediatric Nursing 4th Edition Test Bank Related

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Which of the following dietary interventions prevents the precipitation of calcium renal stones?

  • A. High fiber diet
  • B. Increased protein intake
  • C. High fluid intake
  • D. Intake of zinc
Correct Answer: C

Rationale: High fluid intake is the dietary intervention that prevents the precipitation of calcium renal stones. By increasing fluid intake, particularly water, the urine gets diluted, thus reducing the concentration of substances that can lead to the formation of kidney stones, including calcium. Drinking enough water can also help to flush out any potential stone-forming minerals or substances before they have a chance to crystallize and form stones in the kidney. It is recommended to have an adequate fluid intake of around 2 to 3 liters per day to reduce the risk of calcium stone formation in the kidneys. High fiber diet, increased protein intake, and intake of zinc do not directly prevent the precipitation of calcium renal stones as effectively as maintaining high fluid intake.

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A mother of a term neonate asks what the thick, white, cheesy coating is on his skin. Which correctly describes this finding?

  • A. Lanugo
  • B. Milia
  • C. Nevus flammeus
  • D. Vernix 6
Correct Answer: D

Rationale: The thick, white, cheesy coating on the skin of a newborn baby is called vernix caseosa. It is a substance produced by the fetal sebaceous glands and is meant to protect the baby's skin while in the amniotic fluid. Vernix helps to maintain the skin's hydration, provides a barrier against infection, and aids in the transition from the wet intrauterine environment to the dry extrauterine world. It is usually found on the skin of term newborns but can be present in preterm babies as well. As the baby is exposed to air and dries off, the vernix will naturally diminish.

The client with myasthenia gravis has become increasingly weaker. The physician prepares to identify whether the client is reacting to an overdose of the medication (cholinergic crisis) or an increasing severity of the disease (myasthenic crisis). An injection of edrophonium (Tensilon) is administered. Which of the following would indicate that the client is in cholinergic crisis?

  • A. No change in the condition
  • B. An improvement of the weakness
  • C. Complaints of muscle spasms
  • D. A temporary worsening of the condition
Correct Answer: D

Rationale: Administering edrophonium (Tensilon) to a client with myasthenia gravis helps differentiate between cholinergic crisis and myasthenic crisis. In cholinergic crisis, which is caused by excessive acetylcholine levels due to an overdose of anticholinesterase medications, the client may experience a temporary worsening of symptoms such as muscle weakness, respiratory distress, and other cholinergic effects. This temporary worsening is due to the increase in acetylcholine levels, leading to overstimulation of nicotinic and muscarinic receptors. On the other hand, in myasthenic crisis, which is caused by insufficient acetylcholine at the neuromuscular junction, administering edrophonium would lead to an improvement in muscle weakness. Therefore, if the client experiences a temporary worsening of symptoms after receiving edrophonium, it indicates cholinergic crisis.

The child who can hop on one foot, copies circles, and brushes teeth without help has achieved the developmental age of

  • A. 2 yr
  • B. 3 yr
  • C. 4 yr
  • D. 5 yr
Correct Answer: B

Rationale: These skills are typically developed by age 3.

What does a nurse assess postoperatively in a client with a nasal fracture?

  • A. Allergic reaction
  • B. Extreme sense of smell
  • C. Airway obstruction
  • D. Stridor
Correct Answer: C

Rationale: Postoperatively in a client with a nasal fracture, a nurse would assess for airway obstruction. Nasal fractures can cause swelling, bleeding, and obstruction of the nasal passages, which could potentially compromise the client's ability to breathe. Monitoring for signs of airway compromise, such as difficulty breathing, stridor, or other respiratory distress, is crucial in the postoperative period to ensure prompt intervention if necessary. Assessing for airway patency is a priority to prevent any serious complications related to impaired breathing. While allergic reaction, extreme sense of smell, or stridor may occur in some cases, airway obstruction is the most critical concern that requires immediate attention to maintain the client's respiratory function.

In children with asthma, which of the following preoperative preparations is LEAST likely to be necessary?

  • A. Increase in beta-agonist dosage
  • B. Addition of systemic steroids
  • C. Bronchodilator therapy
  • D. None of the above
Correct Answer: D

Rationale: In stable asthmatic patients, additional interventions like systemic steroids or increased beta-agonist doses are not always necessary unless there are signs of exacerbation.

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