Nursing Elites

1. Which information about hemophilia will the nurse include in the teaching plan for the parents of a child diagnosed with hemophilia?

• A. Autosomal dominant disorder in which the blood clotting factors are deficient.
• B. X-linked recessive inherited disorder in which blood clotting factors are deficient.
• C. X-linked recessive inherited disorder involving decreased platelets causing prolonged bleeding.
• D. Autosomal recessive disorder in which the blood clotting factors are deficient.

Correct answer: B

Rationale: The correct answer is B: Hemophilia is an X-linked recessive disorder, primarily affecting males and passed from mothers to sons. It involves a deficiency in clotting factors, leading to prolonged bleeding. Choice A is incorrect as hemophilia is not autosomal dominant. Choice C is incorrect as hemophilia does not involve platelets. Choice D is incorrect as hemophilia is not autosomal recessive.

2. The nurse is preparing a child for possible alopecia from chemotherapy. What information should the nurse give regarding alopecia?

• A. Hair usually regrows in two years.
• B. When hair regrows, it may have a slightly different color or texture.
• C. Expose your head to sunlight to minimize alopecia.
• D. Wearing hats and scarves are preferred to wearing a wig.

Correct answer: B

Rationale: The correct answer is B. Hair loss from chemotherapy is usually temporary, and when it regrows, it may have a different color or texture. Sun exposure should be minimized, as the scalp may be more sensitive. Wearing hats and scarves can provide comfort and protection, but there is no preference over wearing a wig. Choice A is incorrect because hair regrowth after chemotherapy varies from person to person and usually occurs sooner than two years. Choice C is incorrect as sun exposure should be minimized to protect the sensitive scalp. Choice D is incorrect as the preference between wearing hats, scarves, or a wig is subjective and depends on the individual's comfort and preferences.

3. After 8 weeks in the neonatal intensive care unit, Chris will soon be discharged. His parents seem apprehensive and worry that he may still be in danger. What is this considered by the nurse?

• A. A common parental reaction
• B. Suggestive of maladaptation
• C. A reason to postpone discharge
• D. Suggestive of inadequate bonding

Correct answer: A

Rationale: Parents become apprehensive and worried as the time for discharge approaches, which is a common parental reaction. They often have concerns and insecurities about caring for their infant. The worry about potential dangers is a normal adaptive response reflecting the parents' concern for their child's well-being. It is essential for healthcare providers to acknowledge these feelings and support parents in gaining confidence in caring for their infant. Choices B, C, and D are incorrect because the parents' apprehension in this context is a typical emotional response and not indicative of maladaptation, a reason to postpone discharge, or inadequate bonding.

4. A toddler’s mother calls the nurse because she thinks her son has swallowed a button type of battery. He has no signs of respiratory distress. The nurse’s response should be based on which premise?

• A. An emergency laparotomy is very likely.
• B. The location needs to be confirmed by radiographic examination.
• C. Surgery will be necessary if the battery has not passed in the stool in 48 hours.
• D. Careful observation is essential because an ingested battery cannot be accurately detected.

Correct answer: B

Rationale: Radiographic examination is essential to confirm the location of the battery, as it can cause significant damage, particularly if lodged in the esophagus. Immediate surgery may be required depending on its location and the potential for causing harm.

5. What findings would the nurse consider normal in assessing the anterior fontanel of a neonate?

• A. Closed anterior fontanel
• B. Sunken anterior fontanel
• C. Bulging anterior fontanel
• D. Pulsating anterior fontanel

Correct answer: D

Rationale: The correct answer is D: Pulsating anterior fontanel. The fontanel should feel flat, firm, and well demarcated. Pulsations are frequently visible at the anterior fontanel, which is a normal finding in a neonate. A closed anterior fontanel, as mentioned, is a potential sign of a major abnormality. A sunken or bulging fontanel (when the infant is quiet) may be indicative of distress or a major abnormality. Therefore, options A, B, and C are considered abnormal findings when assessing the anterior fontanel of a neonate.

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