Question 1

The nurse is caring for an infant with dysplasia of the hip (DDH).Which clinical manifestations should the nurse expect to observe? (Select all that apply. )&#10;A) Positive Ortolani click&#10;B) Unequal gluteal folds&#10;C) Negative Babinski sign&#10;D) Trendelenburg sign&#10;E) Telescoping of the affected limb

Accepted Answer

Positive Ortolani click and unequal gluteal folds are clinical manifestations of DDH.

Question 2

What is the clinical finding most likely to be exhibited in an infant diagnosed with erythroblastosis fetalis?&#10;A) Edema&#10;B) Immature red blood cells&#10;C) Enlargement of the heart&#10;D) Ascites

Accepted Answer

Erythroblastosis fetalis is a condition in which maternal antibodies attack fetal red blood cells, leading to their destruction and resulting in anemia. The bone marrow responds by producing more immature red blood cells (erythroblasts) in an attempt to compensate for the loss. Therefore, immature red blood cells are the most likely clinical finding exhibited in an infant diagnosed with erythroblastosis fetalis.

Question 3

A neonate is born with mild clubfeet.When the parents ask the nurse how this will be corrected,how should the nurse respond?&#10;A) Traction is tried first.&#10;B) Surgical intervention is needed.&#10;C) Frequent,serial casting is tried first.&#10;D) Children outgrow this condition when they learn to walk.

Accepted Answer

Frequent, serial casting is the first-line treatment for mild clubfeet in neonates. Traction is not typically used in the initial treatment, and surgery is only considered in more severe cases that do not respond to other treatments. While some children may outgrow the condition, it is important to initiate treatment to prevent long-term complications.

Question 4

When attempting to screen and educate parents regarding the treatment of developmental dysplasia of the hip (DDH),which intervention should the nurse perform?&#10;A) Be able to perform the Ortolani and Barlow tests.&#10;B) Teach double or triple diapering for added support.&#10;C) Explain to the parents the need for serial casting.&#10;D) Carefully monitor infants for DDH at follow-up visits.

Accepted Answer

The nurse should carefully monitor infants for DDH at follow-up visits to ensure early detection and management. The Ortolani and Barlow tests are typically performed by a physician, double or triple diapering is not recommended, and serial casting is not a standard initial treatment for DDH.

Question 5

To explain hemolytic disorders in the newborn to new parents,the nurse who cares for the newborn population must be aware of the physiologic characteristics related to these conditions.What is the most common cause of pathologic hyperbilirubinemia?

A) Hepatic disease
B) Hemolytic disorders
C) Postmaturity
D) Congenital heart defect

Accepted Answer

Hemolytic disorders, such as Rh or ABO incompatibility, are the most common cause of pathologic hyperbilirubinemia in the newborn. This occurs because the breakdown of red blood cells releases bilirubin into the bloodstream at a rate that exceeds the infant's ability to clear it.

Question 6

Which statement regarding hemolytic diseases of the newborn is most accurate?&#10;A) Rh incompatibility matters only when an Rh-negative child is born to an Rh-positive mother.&#10;B) ABO incompatibility is more likely than Rh incompatibility to precipitate significant anemia.&#10;C) Exchange transfusions are frequently required in the treatment of hemolytic disorders.&#10;D) The indirect Coombs' test is performed on the mother before birth;the direct Coombs' test is performed on the cord blood after birth.

Accepted Answer

The indirect Coombs' test is used to screen for antibodies in the mother's blood that could cross the placenta and cause hemolysis in the fetus, while the direct Coombs' test is used to detect antibodies bound to the surface of red blood cells in the newborn, indicating hemolysis has occurred.

Question 7

Which nursing diagnosis is most appropriate for a newborn diagnosed with a diaphragmatic hernia?&#10;A) Potential for impaired parent-infant attachment&#10;B) Inadequate nutrition&#10;C) Potential for infection&#10;D) Reduced gas exchange

Accepted Answer

A diaphragmatic hernia is a congenital defect where the diaphragm does not develop properly, allowing abdominal organs to move into the chest cavity and compress the lungs, resulting in reduced gas exchange. This can lead to respiratory distress and hypoxemia, which would make reduced gas exchange the most appropriate nursing diagnosis for this newborn. While potential for impaired parent-infant attachment, inadequate nutrition, and potential for infection may also be relevant, they are not as directly related to the primary physiological concern in this case.

Question 8

The condition,hypospadias,encompasses a wide range of penile abnormalities.Which information should the nurse provide to the anxious parents of an affected newborn?&#10;A) Mild cases involve a single surgical procedure.&#10;B) Infant should be circumcised.&#10;C) Repair is performed as soon as possible after birth.&#10;D) No correlation exists between hypospadia and testicular cancer.

Accepted Answer

Mild cases of hypospadias typically involve a single surgical procedure to correct the abnormality.

Question 9

The most widespread use of postnatal testing for genetic disease is the routine screening of newborns for inborn errors of metabolism (IEM).Which conditions are considered metabolic disorders? (Select all that apply. )

A) Phenylketonuria (PKU)
B) Galactosemia
C) Congenital hypothyroidism (CH)
D) Cytomegalovirus (CMV)
E) Rubella

Accepted Answer

Metabolic disorders involve abnormalities in the chemical reactions that occur within cells. Phenylketonuria (PKU), Galactosemia, and Congenital hypothyroidism (CH) are all metabolic disorders that can be screened for in newborns. Cytomegalovirus (CMV) and Rubella are viral infections and not considered metabolic disorders.

Question 10

Which statement regarding congenital anomalies of the cardiovascular and respiratory systems is correct?&#10;A) Cardiac disease may demonstrate signs and symptoms of respiratory illness.&#10;B) Screening for congenital anomalies of the respiratory system need only be performed for infants experiencing respiratory distress.&#10;C) Choanal atresia can be corrected with the use of a suction catheter to remove the blockage.&#10;D) Congenital diaphragmatic hernias are diagnosed and treated after birth.

Accepted Answer

Cardiac disease can present with respiratory symptoms due to the close relationship between the heart and lungs, as heart problems can lead to pulmonary congestion and respiratory distress.

Question 11

What is the highest priority nursing intervention for an infant born with myelomeningocele?&#10;A) Protect the sac from injury.&#10;B) Prepare the parents for the child's paralysis from the waist down.&#10;C) Prepare the parents for closure of the sac when the child is approximately 2 years of age.&#10;D) Assess for cyanosis.

Accepted Answer

The answer of What is the highest priority nursing intervention...

Question 12

Most congenital anomalies of the central nervous system (CNS)result from defects in the closure of the neural tube during fetal development.Which factor has the greatest impact on this process?&#10;A) Maternal diabetes&#10;B) Maternal folic acid deficiency&#10;C) Socioeconomic status&#10;D) Maternal use of anticonvulsant

Accepted Answer

The answer of Most congenital anomalies of the central nervous...

Question 13

Cleft lip or palate is a common congenital midline fissure,or opening,in the lip or palate resulting from the failure of the primary palate to fuse.Multiple genetic and,to a lesser extent,environmental factors may lead to the development of a cleft lip or palate.Which factors are included? (Select all that apply. )

A) Alcohol consumption
B) Female gender
C) Use of some corticosteroid medications
D) Maternal cigarette smoking
E) Antibiotic use in pregnancy

Accepted Answer

The answer of Cleft lip or palate is a common...

Question 14

Which infant is most likely to express Rh incompatibility?&#10;A) Infant of an Rh-negative mother and a father who is Rh positive and homozygous for the Rh factor&#10;B) Infant who is Rh negative and a mother who is Rh negative&#10;C) Infant of an Rh-negative mother and a father who is Rh positive and heterozygous for the Rh factor&#10;D) Infant who is Rh positive and a mother who is Rh positive

Accepted Answer

The answer of Which infant is most likely to express...

Deck 36: Hemolytic Disorders and Congenital Anomalies