A 15-year-old patient is to receive antihemophilic factor (Factor VIll) replacement therapy. He asks the nurse, "Why does this always happen to me? How come my sisters don't have hemophilia?”. The nurse's response should be based on the understanding that hemophilia is characteristic of which type of hereditary disorder?

X-linked dominant.

Autosomal recessive.

Autosomal dominant.

X-linked recessive.

Answer and Explanation

The Correct Answer is D

Choice A rationale:

X-linked dominant disorders are characterized by a mutation on the X chromosome that results in the expression of the trait in both males and females. Hemophilia, however, is more commonly associated with males, which is not consistent with an X-linked dominant pattern.

Choice B rationale:

Autosomal recessive disorders require the inheritance of two mutated alleles, one from each parent, to express the trait. Hemophilia does not follow this pattern, as the patient's sisters do not have the condition despite having affected parents.

Choice C rationale:

Autosomal dominant disorders only require the inheritance of one mutated allele from an affected parent to express the trait. Hemophilia does not align with an autosomal dominant pattern, as the patient's sisters would likely be affected if it were.

Choice D rationale:

Hemophilia is a classic example of an X-linked recessive disorder. The gene responsible for producing clotting factor is located on the X chromosome, and males have only one X chromosome, making them more susceptible to the disorder. Females, with two X chromosomes, usually act as carriers unless both X chromosomes carry the mutation.

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Correct Answer is B

Explanation

Choice A rationale:

Returning to the hospital if the child spits up blood is a correct response as it indicates the recognition of potential postoperative bleeding.

Choice B rationale:

Giving the child cherry gelatin, even though it's the child's favorite, might not be appropriate after a tonsillectomy/adenoidectomy, as certain foods can irritate the healing throat.

Choice C rationale:

Returning to the hospital if the child develops difficulty breathing is a necessary step to address any respiratory distress.

Choice D rationale:

Having the child rinse her mouth frequently with water to prevent a bad breath odor is a suitable suggestion to maintain oral hygiene and comfort after surgery. In all three scenarios, the rationale for the correct answers revolves around patient safety, comfort, and appropriate post-operative care. The incorrect choices in each question either introduce potential complications, misunderstandings, or actions that might compromise the patient's well-being.

A. Replacing the dressing if bleeding is noted. B. Positioning the child in a flat-lying position. C. Monitoring the pulses distal to the site. D. Checking the vital signs every 15 minutes.

Correct Answer is B

Explanation

Choice A rationale:

Replacing the dressing if bleeding is noted is appropriate as it helps maintain a clean and sterile site post-catheterization.

Choice B rationale:

Positioning the child in a flat-lying position immediately after cardiac catheterization is incorrect. The child should be placed in a specific position, such as semi-Fowler's, to avoid complications and promote comfort.

Choice C rationale:

Monitoring the pulses distal to the site is essential to assess circulation and potential complications after the procedure.

Choice D rationale:

Checking the vital signs every 15 minutes is appropriate post-catheterization to detect any hemodynamic changes or complications.

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Naxlex Comprehensive Predictor Exams

The nurse is providing discharge instructions to the parent of a patient who had a tonsillectomy/adenoidectomy. Which statement would indicate that the parent needs further teaching?

Correct Answer is B

Explanation

A nurse takes all of these actions when caring for a 13-year-old who just returned from a cardiac catheterization. Which action is incorrect and requires further discussion?

Correct Answer is B

Explanation

A 3-year-old patient who is admitted to the hospital for the treatment of a skull fracture has clear liquid draining from his nose. In consideration of the patient's injury, which action should the nurse take initially?

A patient is admitted from the emergency room with laryngotracheobronchitis. The patient has a brassy cough, stridor, and substernal retractions. The child is receiving an intravenous infusion and is placed in a mist tent. Which observation would indicate a worsening of the patient's condition?

Which statement indicates a child's family needs further instruction about the postoperative care following a pyloromyotomy?

Which nursing intervention should a nurse expect to perform on a 7-year-old child diagnosed with mild dehydration secondary to diarrhea?

A nurse should plan to assess a child receiving Baclofen from an intrathecal pump for which effect?

A mother visits her critically ill infant daily. Which comment most strongly suggests this mother is successfully progressing in attachment to her infant?

A patient has an elevated serum creatinine level. Based on this information, the nurse should consult with the health care provider before administration of which medication?

A patient with a fractured right femur is placed in Bryant's traction. Which observation would indicate that the function of the traction is compromised?