a prolapsed umbilical cord is dangerous because the

ATI LPN

LPN Pediatrics

1. Why is a prolapsed umbilical cord dangerous?

A. The cord may be wrapped around the baby's neck, causing strangulation.
B. The cord might pull the placenta from the uterine wall during delivery.
C. The baby's head may compress the cord, cutting off its supply of oxygen.
D. The mother may die of hypoxia due to compromised placental blood flow.

Correct answer: C

Rationale: A prolapsed umbilical cord is dangerous because the baby's head may compress the cord, cutting off its supply of oxygen. This compression can lead to oxygen deprivation, potentially causing significant harm to the baby. Immediate medical intervention is crucial in such cases to prevent adverse outcomes.

2. The mother of an 11-year-old girl confides to the nurse that her child has no interest in school activities, exercise, or even family outings. The most appropriate response by the nurse would be:

A. I would recommend that she see a counselor at school.
B. I would not worry; she will grow out of it.
C. Many girls this age go through a time of malaise and disinterest.
D. If she still feels the same way when you come back for the next well-child visit, I will recommend a therapist.

Correct answer: A

Rationale: When a child shows a lack of interest in various activities, including school, exercise, and family outings, it is essential to address the underlying reasons. Recommending that the child see a counselor at school is crucial to explore potential issues and provide appropriate support and guidance. This approach can help identify any emotional, social, or behavioral concerns the child may be experiencing and facilitate early intervention and support. Choice B is incorrect because dismissing the mother's concerns and assuming the child will grow out of it without addressing the issue is not appropriate. Choice C is incorrect because while some children may go through phases of disinterest, it is essential to investigate further rather than generalizing. Choice D is incorrect because waiting until the next visit without taking proactive steps to address the current lack of interest may delay necessary support and intervention.

3. Which intervention is not appropriate for the hospitalized adolescent?

A. Allowing the adolescent to assist with procedures when possible.
B. Encouraging them to discuss their thoughts and feelings about the hospitalization.
C. Encouraging them to remain in the room throughout the hospitalization to ensure adequate rest periods.
D. Encouraging peer visitation.

Correct answer: C

Rationale: Encouraging the adolescent to remain in the room throughout the hospitalization to ensure adequate rest periods is not appropriate. It is crucial for adolescents to have opportunities for physical activity and social interaction to promote their well-being during hospitalization. Allowing them to assist with procedures when possible can empower them and provide a sense of control. Encouraging discussions about their thoughts and feelings helps address their emotional needs. Facilitating peer visitation fosters social support, which is beneficial for their well-being. Therefore, choice C is the least appropriate as it restricts important aspects of the adolescent's development and coping mechanisms during hospitalization.

4. The nurse is preparing new parents for discharge with their newborn. The father asks the nurse why the baby's head is so pointed and puffy-looking. What is the best response by the nurse?

A. His head is molded from fitting through the birth canal. It will become more round.
B. We refer to that as 'cone head,' which is a temporary condition that goes away.
C. It might mean that your baby sustained brain damage during birth, and could have delays.
D. I think he looks just like you. Your head is much the same shape as your baby's.

Correct answer: A

Rationale: The corrected response 'His head is molded from fitting through the birth canal. It will become more round.' is the best answer as it explains the physiological reason for the baby's appearance after birth. It reassures the father that the pointed and puffy-looking head is a normal part of the birthing process and will resolve on its own. Choice B is incorrect because while 'cone head' is a term used colloquially, it does not provide a detailed explanation. Choice C is incorrect and should be avoided as it introduces unnecessary worry by suggesting brain damage. Choice D is not an appropriate response as it doesn't address the father's concern or provide accurate information about newborn physiology.

5. A mother of a 6-year-old actively playing child, diagnosed with type 1 diabetes mellitus a year ago, calls a clinic nurse and reports that the child has been sick. She checked the child's urine, which was positive for ketones. What should the nurse instruct the mother to do?

A. Administer an additional dose of regular insulin
B. Come to the clinic immediately
C. Encourage the child to drink liquids
D. Hold the next dose of insulin

Correct answer: C

Rationale: Encouraging the child to drink liquids is essential in managing ketones in urine. Increased fluid intake can help prevent dehydration and aid in flushing out ketones, which is crucial in managing diabetic ketoacidosis, a serious complication of uncontrolled diabetes.