Which of the following is the most common permanent disability in childhood?
- A. Scoliosis
- B. Muscular dystrophy
- C. Cerebral palsy
- D. Developmental dysplasia of the hip (DDH)
Correct Answer: C
Rationale: Cerebral palsy is the most common permanent disability in childhood among the options provided. It is a group of disorders that affect movement and muscle coordination due to damage or abnormal development in the brain. Cerebral palsy can occur before, during, or shortly after birth, and it is a lifelong condition that impacts a child's ability to move, maintain balance, and posture. Scoliosis, muscular dystrophy, and developmental dysplasia of the hip (DDH) are also significant conditions that can lead to disabilities in children, but they are not as prevalent as cerebral palsy in terms of permanent disabilities in childhood.
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Which of the following immunoglobulins is first produced during an acute infection?
- A. IgG
- B. IgE
- C. IgM
- D. IgD
Correct Answer: C
Rationale: IgM is the first immunoglobulin produced during an acute infection. It is the first class of antibodies secreted by B cells in response to an antigenic challenge. IgM antibodies are produced initially in primary immune responses and play a crucial role in activating the complement system. IgG is produced after IgM and is the most abundant immunoglobulin in the secondary immune response. IgE is responsible for allergic reactions, and IgD's function is not fully understood but is believed to be involved in the activation of B cells.
Nurse Lorna is assessing infantile reflexes in a 9-month-old baby; which of the following would she identify as normal?
- A. Persistent rooting
- B. Bilateral parachute
- C. Absent moro reflex
- D. Unilateral grasp
Correct Answer: B
Rationale: The parachute reflex typically emerges around 9 months of age and is considered a normal reflex in infants. This reflex is characterized by the infant extending their arms to protect themselves when they feel like they are falling. This is an important protective reflex that helps a child develop their sense of balance and coordination. Persistent rooting is not a normal reflex in a 9-month-old baby, as it typically disappears by 4 months of age. The Moro reflex is typically present in infants and involves an outstretched movement of the arms when startled, so its absence would not be considered normal at this age. A unilateral grasp is also not a normal reflex at 9 months, as infants should be able to show coordinated bilateral movements by this age.
How can the nurse help monitor effectiveness of therapy for the patient with a pneumothorax and chest-drainage system?
- A. Palpate for crepitus
- B. Document color and amount of sputum
- C. Auscultate lung sounds
- D. Monitor suction level
Correct Answer: C
Rationale: The nurse can help monitor the effectiveness of therapy for a patient with a pneumothorax and chest drainage system by auscultating lung sounds. Auscultation can provide information about the air movement within the lungs and any changes in lung sounds, such as decreased or absent breath sounds on the affected side, which may indicate improvement or deterioration in the patient's condition. By regularly assessing lung sounds, the nurse can track the progress of the therapy and make informed decisions about the patient's care and treatment plan. Palpating for crepitus, documenting sputum characteristics, and monitoring suction levels are important aspects of care but are not specifically focused on assessing the effectiveness of therapy for a pneumothorax.
The parent of a 7-year-old with continued bed-wetting at night says they've tried getting the child up at 11:30 p.m. Which is the best next step?
- A. There is a medication (DDAVP) that may help decrease urine volume.
- B. Be firm and show how much work is involved in changing sheets.
- C. Limit fluids in the evening and consider a reward system for dry nights.
- D. Bed-wetting alarms are available and effective.
Correct Answer: C
Rationale: Reducing evening fluids and using positive reinforcement (reward system) are effective and developmentally appropriate strategies.
The MOST common behavioral sleep disorder in a 4-month-old baby who needs to be rocked to sleep is
- A. early signs of ADHD
- B. primary restless legs syndrome
- C. sleep terrors
- D. sleep-onset association disorder
Correct Answer: D
Rationale: Sleep-onset association disorder involves reliance on specific conditions to fall asleep.