Sunshine, age 13, has had a lumbar puncture to examine the CSF to determine if bacterial infection exists. The best position to keep her in after the procedure is:

Correct Answer: C

Rationale: The best position to keep Sunshine in after a lumbar puncture is in the supine position for several hours. This position helps prevent a post-lumbar puncture headache, which is a common complication of the procedure. Keeping Sunshine supine helps reduce the chances of leaking CSF and minimizes the risk of developing a headache due to decreased CSF pressure. Additionally, it is vital to encourage increased fluid intake post-procedure to help replenish the lost CSF and prevent dehydration.

Correct Answer: C

Rationale: Cerebral palsy is the most common permanent disability in childhood among the options provided. It is a group of disorders that affect movement and muscle coordination due to damage or abnormal development in the brain. Cerebral palsy can occur before, during, or shortly after birth, and it is a lifelong condition that impacts a child's ability to move, maintain balance, and posture. Scoliosis, muscular dystrophy, and developmental dysplasia of the hip (DDH) are also significant conditions that can lead to disabilities in children, but they are not as prevalent as cerebral palsy in terms of permanent disabilities in childhood.

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.