Cherry, the mother of an 11-month-old girl, Elizabeth, is in the clinic for her daughter's immunizations. She expresses concern to the nurse that Elizabeth cannot yet walk. The nurse correctly replies that, according to the Denver Developmental Screen, the median age for walking is:

Correct Answer: A

Rationale: The Denver Developmental Screening Test states that the median age for walking is around 12 months. This means that about half of all typically developing children will begin to walk by this age. It is important to note that there is a wide range of normal development, and not all children will hit these milestones at the same time. If Cherry's 11-month-old daughter, Elizabeth, is not yet walking, it does not necessarily indicate a developmental delay as long as she is meeting other milestones within a reasonable timeframe.

Correct Answer: D

Rationale: Performing neurovascular checks is the priority nursing action immediately after applying a spica cast on Baby Betty. A spica cast is used to immobilize the hips and thighs, which can affect circulation and nerve function in the lower extremities. Neurovascular checks involve assessing the circulation, sensation, and movement of the affected limb to ensure there are no signs of impaired circulation or nerve damage. It is crucial to monitor for any signs of compartment syndrome, such as pain, numbness, tingling, or decreased pulse, which could indicate a vascular compromise. Timely identification of any neurovascular compromise is essential to prevent complications and ensure the baby's safety and well-being.

Correct Answer: D

Rationale: Pyloric stenosis is a condition in infants where there is a tightening of the muscle at the outlet of the stomach, causing obstruction of food passage into the small intestine. One of the hallmark symptoms of pyloric stenosis is projectile vomiting, in which the vomit is forceful and shoots out a significant distance. This distinguishes it from regular regurgitation or spitting up, which are more common in infants for other reasons. Nurse Nancy would likely note this symptom while assessing a child with pyloric stenosis.

Correct Answer: D

Rationale: The Jatene procedure is a surgical technique used to correct Transposition of the Great Arteries (TGA). In this procedure, the great arteries (aorta and pulmonary artery) are switched back to their correct positions. The aorta is connected to the left ventricle, and the pulmonary artery is connected to the right ventricle. This correction allows for oxygen-rich blood to flow from the left side of the heart to the body, and oxygen-poor blood to flow from the right side of the heart to the lungs for oxygenation. The Jatene procedure is preferred over other methods like the Rashkind procedure, Rastelli procedure, or pulmonary artery banding for this specific purpose of correcting the high-pressure circulation seen in TGA.

Correct Answer: C

Rationale: Obstruction of the airway in a patient with asthma is primarily caused by inflammation and narrowing of the airways due to a combination of factors such as thick mucus, swelling of bronchial membranes, and contraction of muscles surrounding the bronchi. Destruction of the alveolar wall is not a direct cause of airway obstruction in asthma patients; alveolar wall destruction is typically associated with conditions like emphysema. In asthma, the primary mechanisms contributing to airway obstruction are related to inflammation, mucus production, and bronchoconstriction.