A nurse assisting with the discharge plan of care for a group of children. For which of the following children should the nurse recommend a referral Speech therapy?
A toddler who has a new diagnosis of cystic fibrosis
An infant who is postoperative following a cleft palate repair
A school-age child who has chronic asthma
An adolescent who has juvenile idiopathic arthritis
The Correct Answer is B
A. A toddler who has a new diagnosis of cystic fibrosis: Cystic fibrosis primarily affects the respiratory and gastrointestinal systems due to abnormal chloride transport and thick mucus production. While long-term illness can influence development, speech articulation is not directly impaired by the underlying pathophysiology of cystic fibrosis.
B. An infant who is postoperative following a cleft palate repair: A cleft palate alters normal oral cavity structure, affecting resonance, articulation, and proper sound production. Even after surgical repair, children are at risk for speech delays. Early referral to speech therapy supports proper phonation, articulation development, and prevention of compensatory speech patterns.
C. A school-age child who has chronic asthma: Asthma is characterized by airway inflammation, bronchoconstriction, and reversible airflow limitation. Although severe episodes may temporarily affect vocal quality, chronic asthma does not structurally impair speech production mechanisms. Management focuses on bronchodilators and anti-inflammatory therapy.
D. An adolescent who has juvenile idiopathic arthritis: Juvenile idiopathic arthritis primarily affects synovial joints, leading to inflammation, pain, and reduced mobility. Interdisciplinary care often includes physical and occupational therapy to maintain joint function. Speech production is not compromised unless there is rare temporomandibular joint involvement.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. The client cannot withhold consent once it is given: Clients retain the right to withdraw consent for treatment at any time, even in a mental health facility. Involuntary commitment does not eliminate autonomy over medical decisions, and healthcare providers must respect ongoing consent or refusal for treatments when the client is capable of making decisions.
B. The client is not permitted to refuse medications: Clients have the right to refuse medications unless a court order or emergency situation justifies involuntary administration. Informed refusal is a protected legal right, and coercion without due process violates patient autonomy and legal protections.
C. The client should be in the most restrictive environment: Legal and ethical standards require that clients be treated in the least restrictive environment that meets their safety and treatment needs. Placement in the most restrictive setting is not mandated and may only occur if necessary for protection or treatment efficacy.
D. The client is permitted to have visits by clergy: Clients retain the right to access spiritual care and communicate with clergy, regardless of involuntary commitment status. This right is protected under mental health law and supports the client’s freedom of religion and access to personal support systems.
Correct Answer is D
Explanation
A. 2+ deep tendon reflex: A reflex rating of 2+ is normal and indicates adequate neuromuscular function. In a client receiving magnesium sulfate, this suggests that magnesium levels are within the therapeutic range and are not causing toxicity.
B. Facial flushing: Facial flushing is a common side effect of magnesium sulfate due to vasodilation. While uncomfortable, it is not dangerous and typically does not require intervention unless accompanied by other signs of toxicity.
C. Respiratory rate 13/min: A respiratory rate above 12/min is generally considered within normal limits for adults. Magnesium toxicity becomes concerning when the respiratory rate drops below 12/min, indicating central nervous system depression.
D. Urine output 20 mL/hr: Magnesium sulfate is excreted primarily by the kidneys, and low urine output (<30 mL/hr) increases the risk of magnesium accumulation and toxicity. Reporting this finding allows the provider to adjust the infusion rate or evaluate renal function to prevent serious complications.
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