Nurse Lorna is assessing infantile reflexes in a 9-month-old baby; which of the following would she identify as normal?

Correct Answer: B

Rationale: The parachute reflex typically emerges around 9 months of age and is considered a normal reflex in infants. This reflex is characterized by the infant extending their arms to protect themselves when they feel like they are falling. This is an important protective reflex that helps a child develop their sense of balance and coordination. Persistent rooting is not a normal reflex in a 9-month-old baby, as it typically disappears by 4 months of age. The Moro reflex is typically present in infants and involves an outstretched movement of the arms when startled, so its absence would not be considered normal at this age. A unilateral grasp is also not a normal reflex at 9 months, as infants should be able to show coordinated bilateral movements by this age.

Correct Answer: B

Rationale: Celiac disease is an autoimmune disorder triggered by gluten, a protein found in wheat, barley, and rye. The small intestine's lining is damaged when someone with celiac disease eats gluten, which impairs the absorption of nutrients. Therefore, it is crucial for individuals with celiac disease to avoid wheat and other gluten-containing grains to manage their condition effectively. Sourcers of gluten, like wheat products, need to be eliminated from the diet to prevent symptoms and complications for those with celiac disease. Therefore, teaching the parents of a child diagnosed with celiac disease to avoid wheat would be an essential part of managing the condition.

Correct Answer: B

Rationale: The ductus arteriosus is a fetal blood vessel that connects the pulmonary artery to the aorta. Its main function is to bypass the non-functional fetal lungs by shunting blood from the pulmonary artery (which carries deoxygenated blood) directly to the systemic circulation, specifically the aorta. This allows oxygenated blood from the placenta to be distributed to the body's organs and tissues without having to first pass through the lungs for oxygen exchange. After birth, when the baby begins to breathe and oxygenate its blood through the lungs, the ductus arteriosus normally closes within the first few days to weeks of life.

Correct Answer: C

Rationale: Cystic fibrosis (CF) is caused by mutations in the CFTR gene, leading to altered transport of sodium and chloride ions in and out of epithelial cells. This results in the production of secretions that are low in sodium chloride, leading to thickened mucus. The abnormally thick, abundant secretions from mucous glands in the respiratory tract can obstruct the airways, leading to chronic, diffuse obstructive pulmonary disease in almost all patients with CF. This process impairs mucociliary clearance, predisposing individuals to recurrent lung infections, inflammation, and ultimately bronchiectasis. This mechanism is a key factor in the pathophysiology of cystic fibrosis-associated obstructive lung disease.

Correct Answer: A

Rationale: Adequate cardiac output is a measure of how well the heart is able to pump blood effectively to meet the body's metabolic demands. An adequate cardiac output ensures sufficient oxygen and nutrients are delivered to the tissues and organs. One of the most reliable indicators of adequate cardiac output is urine output. A urine output of at least 1 mL/kg/hour, which translates to around 30 mL/hour in a 5-year-old child, indicates adequate perfusion and renal function. In heart failure, decreased cardiac output may lead to decreased renal perfusion, resulting in a decreased urine output, so a stable or increased urine output suggests adequate cardiac output.