the parents of a child with sickle cell anemia ask why their child did not have a sickle cell crisis until he was approximately 6 months old how shoul
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ATI Nursing Care of Children

1. The parents of a child with sickle cell anemia ask why their child did not have a sickle cell crisis until he was approximately 6 months old. How should the nurse respond?

Correct answer: C

Rationale: The correct answer is C. Fetal hemoglobin (HbF) is present in high levels during early infancy, inhibiting sickling unlike adult hemoglobin (HbS). As the levels of HbF decrease and HbS increases, the risk of sickling and crises becomes more pronounced, typically after 6 months of age. Choice A is incorrect because it assumes the crisis went unnoticed, which is not supported by medical knowledge. Choice B is incorrect as it questions the child's diagnosis rather than explaining the phenomenon of delayed crises. Choice D is incorrect as it does not provide the parents with the necessary information regarding their query.

2. The nurse is planning care for a patient with a different ethnic background. Which should be an appropriate goal?

Correct answer: A

Rationale: Adapting ethnic practices to health needs respects the patient's cultural background while ensuring that care is effective and culturally sensitive.

3. When auscultating an infant's lungs, the nurse detects diminished breath sounds. What should the nurse interpret this as?

Correct answer: C

Rationale: Diminished breath sounds in an infant are an abnormal finding and warrant further investigation to rule out conditions like atelectasis or pneumonia.

4. Which condition is most commonly associated with a 'sunset sign' in infants?

Correct answer: A

Rationale: The 'sunset sign,' characterized by downward-driven eyes, is most commonly associated with hydrocephalus. This condition causes increased intracranial pressure, leading to the eyes appearing to be forced downward. Meningitis (choice B) typically presents with symptoms such as fever, headache, and a stiff neck, but not the 'sunset sign.' Cerebral palsy (choice C) is a group of disorders affecting movement and muscle coordination, not directly related to the 'sunset sign.' Encephalitis (choice D) is inflammation of the brain, which can cause symptoms like fever, headache, and confusion, but not the specific downward eye gaze seen in the 'sunset sign.'

5. What is a classic sign of congenital hypothyroidism in newborns?

Correct answer: C

Rationale: Prolonged jaundice is a classic sign of congenital hypothyroidism in newborns. In congenital hypothyroidism, the thyroid gland does not produce enough thyroid hormones, leading to symptoms like jaundice, poor feeding, constipation, and lethargy. While jaundice itself is a common condition in newborns, the term 'prolonged jaundice' specifically points towards the underlying thyroid issue. Hypothermia and excessive crying are not typically associated with congenital hypothyroidism.

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