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RN Nursing Care of Children Online Practice 2019 A
1. Chemicals, agents, or factors that cause physical defects in the developing embryo and are most harmful during organogenesis are:
- A. Teratogens
- B. Heterozygous
- C. Inborn errors
- D. Multifactorial
Correct answer: A
Rationale: Teratogens are substances that can cause congenital abnormalities, especially during the first trimester when organogenesis occurs. Choice A, Teratogens, is the correct answer as it specifically refers to substances that cause physical defects in the developing embryo. Choices B, Heterozygous, C, Inborn errors, and D, Multifactorial, are incorrect as they do not directly relate to substances that cause physical defects in embryos during organogenesis.
2. Which of the following is a hallmark sign of intussusception in children?
- A. Bilious vomiting
- B. "Currant jelly" stools
- C. Abdominal distention
- D. Constipation
Correct answer: B
Rationale: "Currant jelly" stools, consisting of mucus and blood, are characteristic of intussusception in children. It occurs due to the telescoping of a segment of the intestine into an adjacent segment, leading to obstruction and subsequent mucosal ischemia, causing the passage of bloody mucus in the stool. Bilious vomiting can be seen in other conditions like bowel obstruction, abdominal distention can be present but is not as specific, and constipation is less likely in the presentation of intussusception.
3. The parents of a newborn with an umbilical hernia ask about treatment options. The nurse's response should be based on which knowledge?
- A. Surgery is recommended as soon as possible.
- B. The defect usually resolves spontaneously by 3 to 5 years of age.
- C. Aggressive treatment is necessary to reduce its high mortality.
- D. Taping the abdomen to flatten the protrusion is not recommended.
Correct answer: B
Rationale: The correct answer is B. Most umbilical hernias in newborns resolve on their own by 3 to 5 years of age without the need for surgical intervention, unless complications arise. Surgery is not typically recommended for umbilical hernias in newborns due to the high rate of spontaneous resolution. Aggressive treatment is not necessary as umbilical hernias are typically benign and not associated with high mortality. Taping the abdomen is not recommended as it can cause skin irritation and does not speed up the resolution of the hernia.
4. The nurse is conducting discharge teaching with the parent of a 7-year-old child with minimal change nephrotic syndrome (MCNS). What statement by the parent indicates a correct understanding of the teaching?
- A. My child needs to stay home from school for at least 1 more month.
- B. I should not add additional salt to any of my child's meals.
- C. My child will not be able to participate in contact sports while receiving corticosteroid therapy.
- D. I should measure my child's urine after each void and report the 24-hour amount to the healthcare provider.
Correct answer: B
Rationale: Avoiding additional salt is crucial to help manage edema in children with MCNS. While monitoring urine output is important, the other statements either misinterpret the need for prolonged school absence or misunderstand the risk associated with contact sports during steroid therapy.
5. What is a classic sign of congenital hypothyroidism in newborns?
- A. Jaundice
- B. Hypothermia
- C. Prolonged jaundice
- D. Excessive crying
Correct answer: C
Rationale: Prolonged jaundice is a classic sign of congenital hypothyroidism in newborns. In congenital hypothyroidism, the thyroid gland does not produce enough thyroid hormones, leading to symptoms like jaundice, poor feeding, constipation, and lethargy. While jaundice itself is a common condition in newborns, the term 'prolonged jaundice' specifically points towards the underlying thyroid issue. Hypothermia and excessive crying are not typically associated with congenital hypothyroidism.
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