minutes of birth may be as high as:

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Question 1 of 5

minutes of birth may be as high as:

Correct Answer: D

Rationale: The number of minutes in an hour is 60. Therefore, the maximum number of minutes at birth can only be 60 minutes in an hour. Since the options provided are all above 60, the highest plausible option is 100 minutes, making option D the correct answer.

Question 2 of 5

The nurse is assessing a 2-week-old for signs of DDH. The nurse should expect the infant to have which of the following?

Correct Answer: C

Rationale: Developmental dysplasia of the hip (DDH) is a condition where the hip joint does not develop normally. In infants, one of the signs of DDH is the presence of asymmetry of gluteal (buttock) and thigh folds. This is due to the dislocated or subluxed hip being positioned differently than the healthy hip. The nurse should look for this sign during the assessment of a 2-week-old infant to help identify potential hip joint problems early on. Excessive hip abduction, femoral lengthening of an affected leg, and pain when lying prone are not typical signs of DDH in a 2-week-old infant.

Question 3 of 5

The nurse is aware that a common physiologic adaptation of children with tetralogy of Fallot is:

Correct Answer: A

Rationale: Clubbing of fingers is a common physiologic adaptation seen in children with tetralogy of Fallot. Clubbing is the result of chronic hypoxia and decreased oxygen levels in the blood. In children with tetralogy of Fallot, there is a structural defect in the heart that leads to mixing of oxygenated and deoxygenated blood in the heart and decreased oxygenation of the blood circulating to the body. This chronic hypoxia can cause clubbing of the fingers, where the tips of the fingers appear enlarged and the nails are rounded. Therefore, clubbing of fingers is a key sign to monitor in children with tetralogy of Fallot.

Question 4 of 5

Achild has a chronic cough, no retractions but diffuse wheezing during the expiratory phase of respiration. This suggests which of the following?

Correct Answer: A

Rationale: The presence of a chronic cough, along with diffuse wheezing during the expiratory phase of respiration, suggests asthma. Asthma is a chronic condition characterized by inflammation and narrowing of the airways, causing symptoms such as coughing, wheezing, and difficulty breathing. The wheezing sound typically occurs during expiration due to air trapping in the narrowed airways. In this case, the absence of retractions (which could indicate increased work of breathing) and the nature of the wheezing pattern are more consistent with asthma rather than other conditions such as pneumonia, croup, or foreign body aspiration. While these other conditions may also present with respiratory symptoms, the specific combination of chronic cough and expiratory wheezing is most indicative of asthma in this scenario.

Question 5 of 5

The nurse is working on the pediatric floor, caring for an infant who is very fussy and has a diagnosis of DI. Which parameter should the nurse monitor while the infant is on fluid restrictions?

Correct Answer: B

Rationale: In a patient with diabetes insipidus (DI) who is on fluid restrictions, monitoring urine output is crucial to assess the effectiveness of the treatment regimen. DI is a condition characterized by excessive urination and thirst due to a deficiency of antidiuretic hormone (ADH). By monitoring urine output, the nurse can determine if the restrictions are achieving the goal of decreasing urine volume and preventing dehydration. Changes in urine output can also indicate the need for adjustments in the treatment plan. Monitoring oral intake, appearance of mucous membranes, and pulse and temperature are important aspects of pediatric care but are not as directly related to managing fluid restrictions in a patient with DI.

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