A 2-month-old premature infant born at 30 weeks gestation is scheduled for an inguinal hernia repair. Which of the following preoperative findings would BEST predict an increased risk of postoperative apnea?

Correct Answer: A

Rationale: The correct answer is A) Hemoglobin 7 gm/dL. In premature infants, particularly those born at 30 weeks gestation, a low hemoglobin level indicates anemia. Anemia can lead to decreased oxygen-carrying capacity in the blood, which increases the risk of postoperative apnea, especially when the infant is under stress during surgery. Option B) Glucose 61 mg/dL is not the best predictor of postoperative apnea in this scenario. While hypoglycemia can be concerning in infants, it is not directly related to an increased risk of apnea post hernia repair. Option C) Room air SpO2 92% is also not the best predictor of postoperative apnea. While oxygen saturation is important, a value of 92% may not necessarily predict postoperative apnea in this context. Option D) N/A is not a relevant option for this question. Educationally, understanding the importance of preoperative assessments in premature infants is crucial in providing safe and effective care. Anemia can significantly impact oxygen delivery to tissues, making it a key factor to consider in predicting postoperative complications like apnea in this population. This knowledge helps healthcare providers tailor their care to meet the specific needs of premature infants undergoing surgery.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) The varicella vaccine is not usually administered before 1 year of age. This response is correct because the Centers for Disease Control and Prevention (CDC) recommend that the varicella vaccine be given to children at 12-15 months of age. Administering the vaccine before 1 year of age may not provide adequate protection due to the immaturity of the infant's immune system. Option A is incorrect because vaccinated children are less likely to develop a severe case of chickenpox, not a mild one. Option C is incorrect as it does not provide the necessary information about the appropriate age for the vaccine. Option D is incorrect because while a booster dose is needed, it is typically given between 4-6 years of age, not at 18 months. Educationally, it is important for nurses to have a strong understanding of vaccine schedules and guidelines to ensure that children receive vaccinations at the appropriate ages for optimal protection against preventable diseases. This knowledge is crucial for promoting public health and preventing outbreaks of vaccine-preventable illnesses in pediatric populations.

Correct Answer: C

Rationale: In a child with glomerulonephritis, the finding that requires immediate attention is severe headache and photophobia (Option C). This indicates a potential complication of increased intracranial pressure, which can be life-threatening. Headache and photophobia are symptoms of hypertensive encephalopathy, a serious complication of uncontrolled hypertension seen in glomerulonephritis. Option A is incorrect because although high blood pressure (170/90) is concerning, it is not the most critical finding in this scenario. Option B, with Coca-Cola-colored urine and decreased urine output, is indicative of hematuria and proteinuria, common in glomerulonephritis but does not pose an immediate threat to the child's life like increased intracranial pressure. Option D, refusal to eat and poor appetite, is a common symptom in many illnesses but does not warrant immediate attention compared to the neurological symptoms described in Option C. Educationally, it is crucial for nursing students to prioritize and recognize urgent signs and symptoms in pediatric patients with renal disorders like glomerulonephritis. Understanding the potential complications and knowing how to prioritize care based on the severity of symptoms is essential for providing safe and effective nursing care in these situations.

Correct Answer: B

Rationale: In prenatal screening for neural tube defects, alpha-fetoprotein (AFP) is often elevated. AFP is a protein produced by the fetal liver and yolk sac, and elevated levels can indicate neural tube defects like spina bifida or anencephaly. This is because these defects allow AFP to leak into the amniotic fluid and maternal circulation. Human chorionic gonadotropin (HCG) is a hormone produced during pregnancy, but it is not specifically associated with neural tube defects. Estriol is a hormone produced by the placenta and fetus, but its levels are not typically elevated in cases of neural tube defects. Inhibin is a hormone involved in the regulation of the menstrual cycle and pregnancy but is not used as a marker for neural tube defects. Educationally, understanding the rationale behind prenatal screening tests is crucial for nursing students and healthcare professionals working in maternity and pediatric care. Recognizing the significance of elevated AFP levels can help in identifying potential neural tube defects early in pregnancy, allowing for appropriate interventions and support for the mother and baby. This knowledge ensures comprehensive care and better outcomes for both the pregnant woman and the fetus.