A nurse is reinforcing teaching with the parents of a 1-week-old infant who has Down syndrome. Which of the following statements should t nurse include?
"Your baby has an increased risk for a heart defect."
"Expect your baby to need factor replacement therapy every month."
"Expect your baby to grow in height more rapidly than weight."
"Your baby should have no issues with eyesight."
The Correct Answer is A
A. "Your baby has an increased risk for a heart defect.": Infants with Down syndrome have a significantly higher risk for congenital heart defects, such as atrioventricular septal defects (AVSD) and ventricular septal defects (VSD). It is important for the parents to be aware of this risk and have the infant screened by a cardiologist.
B. "Expect your baby to need factor replacement therapy every month.": Factor replacement therapy is typically associated with hemophilia, not Down syndrome. Down syndrome is a genetic condition that affects development, but it is not clotting disorders.
C. "Expect your baby to grow in height more rapidly than weight.": Infants with Down syndrome often experience growth delays, but there is no specific expectation that height will outpace weight.
D. "Your baby should have no issues with eyesight.": Children with Down syndrome are at higher risk for vision problems, including strabismus, refractive errors, and cataracts. Regular eye exams are important for early detection and management of these issues.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"dropdown-group-1":"D","dropdown-group-2":"A"}
Explanation
Rationale for Correct Choices:
- Dextrose 5% in sodium chloride with 20 mEq potassium chloride/L at 75 mL/hr: The prescription for dextrose 5% with potassium chloride at 20 mEq/L should be clarified because the child's potassium level is elevated at 6.2 mEq/L (normal range is 3.4 to 4.7 mEq/L). Administering additional potassium could worsen hyperkalemia, which could lead to dangerous complications like arrhythmias.
- Laboratory values: The child's potassium level is already high, and adding more potassium via IV fluids could increase the risk of severe hyperkalemia. The nurse should clarify this prescription to avoid potential harm.
Rationale for Incorrect Choices:
- Piperacillin and tazobactam 4g IV every 8 hr: This antibiotic is appropriate for treating pneumonia in a child with cystic fibrosis. No issues with laboratory values or contraindications are present in this case, so clarification is unnecessary.
- Dornase alfa 2.5 mg inhalation every day: Dornase alfa is used to break down mucus in the lungs of children with cystic fibrosis, and it is prescribed appropriately for this patient. The child’s current condition and medications do not warrant clarification for this prescription.
- Pancrelipase 8,000 units with meals: Pancrelipase is indicated for the child’s cystic fibrosis to assist with digestion, and the prescribed dosage seems appropriate for the child’s weight and condition.
- Albuterol nebulizer 2.5 mg inhalation every 4 hr: Albuterol is used for airway clearance, which is appropriate for managing the child's respiratory symptoms. No clarification is needed for this prescription based on the current findings.
- Vital signs: While the child's heart rate and temperature are elevated, they are within expected ranges for the child’s condition (fever, pneumonia, and cystic fibrosis). There is no immediate need for clarification of medications based on vital signs alone.
- Scheduled therapapy: The child is scheduled for chest physiotherapy and airway clearance therapy, which are standard treatments for cystic fibrosis and pneumonia. There is no issue with the scheduled therapies that requires clarification of the medications.
- Diet: The child has been prescribed a high-protein, high-fat diet to support nutritional needs, especially important in cystic fibrosis. The diet does not require any clarification in relation to the prescribed medications.
- Pre-existing conditions: The child’s pre-existing condition of cystic fibrosis is already taken into account in the prescribed treatments, and no adjustment is needed based on the conditions present.
Complete the following sentence by using the lists of options.
The nurse should recommend to
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"C"}
Explanation
Rationale for Correct Choices:
- Check the child's oropharynx: The child has had a tonsillectomy and is showing signs of possible bleeding, indicated by the small amount of bleeding in the posterior pharynx and bright red emesis (vomiting of blood). The nurse should check the oropharynx to assess the amount and source of the bleeding, as this could indicate a complication post-surgery.
- Obtaining a set of vital signs: After vomiting bright red emesis, it is crucial to assess the child's vital signs to monitor for signs of bleeding or shock. Changes in vital signs, especially increased heart rate or decreased blood pressure, could indicate significant blood loss.
Rationale for Incorrect Choices:
- Offer the child a red popsicle: Red-colored foods are generally avoided post-tonsillectomy as they can obscure or be mistaken for blood. More importantly, offering anything by mouth is contraindicated during active bleeding due to the risk of aspiration and potentially dislodging clots.
- Place the child in a supine position: The child should be positioned in a way that allows for the drainage of blood and secretions, ideally with the head elevated. Placing the child in a supine position could cause blood to pool in the throat, increasing the risk of aspiration.
- Encouraging the child to cough and deep breathe: Encouraging coughing and deep breathing immediately after tonsillectomy is not recommended, as it could dislodge a clot or exacerbate bleeding.
- Requesting a prescription for codeine: Although the child is experiencing some pain (rated 3/10), the primary concern at this point is bleeding, not pain. Pain management should be adjusted but the focus should be on addressing the bleeding first.