A nurse is assessing a newborn who has Trisomy 21 (Down's Syndrome). Which of the following are common characteristics? (Select all that apply.)

Large ears

Protruding tongue

Transverse palmar creases

Muscular hypertonicity

Low birth weight

Answer and Explanation

Correct Answer : B,C

B. A protruding tongue, often due to a small mouth and poor muscle tone (hypotonia), is a common feature of Down syndrome. This tongue appearance can contribute to difficulties with feeding and speech development.

C. Instead of a single palmar crease (known as a simian crease), individuals with Down syndrome often have transverse palmar creases. This occurs in about 45-50% of cases and is considered a characteristic feature.

A. While large ears are not typically listed as a common feature, individuals with Down's Syndrome may have unusually shaped or small ears.

D. Hypertonicity refers to increased muscle tone or stiffness. In Down syndrome, however, hypotonia (reduced muscle tone) is more common, especially in infancy. Therefore, muscular hypertonicity is not typically associated with Down syndrome.

E While low birth weight can occur in some infants with Down syndrome, it is not a universal characteristic. In fact, some infants with Down syndrome may be born at average or even slightly higher birth weights.

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Correct Answer is D

Explanation

D. This response is appropriate for a breastfeeding mother with a family history of food allergies. Peanuts are among the common allergenic foods, and some guidelines recommend that mothers with a family history of food allergies or infants at high risk of developing allergies consider avoiding peanuts and other allergenic foods during breastfeeding. This cautious approach aims to reduce the risk of allergic sensitization in the infant.

A. Increased sleepiness alone is not a reliable indicator of a food allergy in infants. Common symptoms of a food allergy in breastfed infants include rash, hives, vomiting, diarrhea, or respiratory symptoms. Sleep patterns alone are not diagnostic of food allergies.

B. Rice cereals are generally well-tolerated and are commonly recommended as a first solid food for infants due to their hypoallergenic properties. They are not typically problematic during lactation unless the mother or infant has a specific sensitivity or allergy to rice.

C. The foods a breastfeeding mother consumes can indeed affect breast milk composition. Certain foods can transfer flavors to breast milk and may potentially cause reactions in sensitive infants. If the mother consumes allergenic foods like peanuts, cow's milk, or eggs, small amounts of allergenic proteins can pass into breast milk and potentially trigger allergic reactions in susceptible infants.

A. Prepare the client for emergency cesarean section. B. Recheck the client's temperature in 4 hr. C. Assess the odor of the amniotic fluid. D. Administer glucocorticoids intramuscularly.

Correct Answer is C

Explanation

C. Foul-smelling amniotic fluid (often described as having a strong, unpleasant odor) can indicate infection. It provides additional information to support the suspicion of chorioamnionitis.

A. This option is not immediately necessary based solely on an elevated temperature. Emergency cesarean section is indicated for fetal distress or obstetrical emergencies like placental abruption. However, without those indications, it is premature to proceed directly to cesarean section solely due to maternal fever.

B. Delaying action for 4 hours is not appropriate in this scenario. A fever in a pregnant woman with ruptured membranes warrants immediate evaluation and treatment to prevent complications such as maternal sepsis and neonatal infection.

D. Glucocorticoids are administered to enhance fetal lung maturity in cases of preterm birth between 24 and 34 weeks of gestation, not in response to maternal fever. Therefore, this action is not appropriate in this situation.

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A nurse is assessing a newborn who has Trisomy 21 (Down's Syndrome). Which of the following are common characteristics? (Select all that apply.)

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is postpartum and is breastfeeding. The client states that she is concerned about dietary precautions since she has a family history of food allergies. The nurse offers which of the following responses?

Correct Answer is D

Explanation

A nurse admits a woman who is at 38 weeks of gestation and in early labor with ruptured membranes. The nurse determines that the client's oral temperature is 38.9° C (102° F). Besides notifying the provider, which of the following is an appropriate nursing action?

Correct Answer is C

Explanation

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