An insulin-dependent diabetic delivered a 10-pound male. When the baby is brought to the nursery, the priority of care is to

Correct Answer: D

Rationale: The priority of care when a baby born to an insulin-dependent diabetic mother is brought to the nursery is to check the baby's serum glucose level and administer glucose if it is less than 40 mg/dL. Babies born to diabetic mothers, especially those with poorly controlled blood sugar levels, are at risk for hypoglycemia (low blood sugar) due to the sudden drop in glucose supply after delivery. Hypoglycemia can be dangerous for newborns and can lead to serious complications if left untreated. Therefore, monitoring the baby's serum glucose levels and providing appropriate intervention, such as administering glucose if necessary, is critical to ensure the baby's well-being.

Correct Answer: A

Rationale: Complete resection with microscopic residual disease typically warrants adjuvant chemotherapy.

Correct Answer: B

Rationale: Hand-foot syndrome, also known as dactylitis, is a common manifestation of sickle cell anemia. It is characterized by painful swelling and inflammation of the hands and feet, often resulting in a purplish discoloration due to decreased blood flow and oxygen delivery to the affected areas. This condition typically affects the soft tissues and joints of the hands and feet, leading to pain, swelling, and limited mobility. Unequal growth of fingers and toes, webbing between fingers and toes, and deformities of the wrists and ankles are not typically associated with hand-foot syndrome in sickle cell anemia.

Correct Answer: C

Rationale: Placing an undershirt between the skin and the Pavlik harness is done to prevent skin abrasions and irritation caused by the harness rubbing directly against the skin. The undershirt acts as a protective layer, reducing the likelihood of skin sensitivity or damage due to the continuous contact with the harness. This is particularly important for infants or young children who may have delicate skin that is more prone to irritation. By using an undershirt, caregivers can help ensure greater comfort for the child while wearing the Pavlik harness and reduce the risk of any skin-related complications.

Correct Answer: B

Rationale: Chorea is the result of central nervous system manifestations. Chorea is a movement disorder characterized by involuntary, brief, random, and irregular muscle movements that are often seen in neurological conditions such as Huntington's disease. The central nervous system is responsible for controlling and coordinating movements, so any dysfunction in the central nervous system can lead to movement disorders like chorea. Therefore, chorea is directly related to central nervous system manifestations, unlike congestive heart failure, valve damage, or pericarditis which are primarily related to cardiovascular issues.

Correct Answer: C

Rationale: Bronchiectasis is a condition characterized by the abnormal widening and thickening of the bronchial tubes, leading to a build-up of mucus. One of the common assessment findings in clients with bronchiectasis is the expectoration of small amounts of sputum. This is due to the increased mucus production and impaired clearance from the airways. The sputum may be foul-smelling and may contain pus or blood due to chronic infection and inflammation in the bronchial tubes.

Correct Answer: D

Rationale: Prolonged aspirin therapy can lead to a rare side effect known as aspirin-induced hearing loss, which manifests as bilateral hearing loss. This adverse reaction is typically associated with higher doses of aspirin and longer durations of use. It is important for healthcare providers to monitor for signs of hearing loss in patients receiving long-term aspirin therapy, especially those with rheumatoid arthritis or other inflammatory conditions, to prevent irreversible damage to the hearing. Weight gain, respiratory acidosis, and fine motor tremors are not commonly associated with prolonged aspirin therapy.

Correct Answer: C

Rationale: A neonatal heart rate of 170 is above the normal range (90-160 bpm), which is concerning for dehydration.

Correct Answer: A

Rationale: Medulloblastoma is notorious for extraneural spread, particularly to bones and bone marrow.