Which is the central factor responsible for respiratory distress syndrome?

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Question 1 of 5

Which is the central factor responsible for respiratory distress syndrome?

Correct Answer: A

Rationale: Respiratory distress syndrome is primarily caused by deficient surfactant production in premature infants. Surfactant is a substance that coats the alveoli in the lungs and helps to reduce surface tension, preventing the collapse of the alveoli during exhalation. In premature infants, the lungs may not have produced enough surfactant, leading to difficulty in breathing and inadequate oxygen exchange. This results in respiratory distress syndrome, which is characterized by severe breathing problems in newborns. Overproduction of surfactant, overdeveloped alveoli, or absence of alveoli are not central factors in the development of respiratory distress syndrome.

Question 2 of 5

The nurse must assess a 10-month-old infant. The infant is sitting on the father's lap and appears to be afraid of the nurse and of what might happen next. Which initial action by the nurse would be most appropriate?

Correct Answer: D

Rationale: Talking softly to the infant while taking him from his father would be the most appropriate initial action by the nurse in this situation. This approach allows the nurse to maintain communication with the infant to provide comfort and minimize fear or anxiety. By using a gentle tone and reassuring words, the nurse can help establish a sense of safety for the infant as he is transitioned from his father's lap to the examination table. This gradual and supportive approach is likely to facilitate a smoother assessment process and help build trust with the infant and the family.

Question 3 of 5

The nurse observes yellow staining in the sclera of eyes, soles of feet, and palms of hands. How should the nurse document these findings?

Correct Answer: C

Rationale: Jaundice is the yellow discoloration of the skin, sclera (white part of the eyes), soles of feet, and palms of hands that occurs due to elevated levels of bilirubin in the blood. Bilirubin is a yellow pigment produced during the breakdown of red blood cells and is normally processed by the liver and excreted in bile. When the liver is unable to process bilirubin effectively, it can accumulate in the blood and cause jaundice. Therefore, the nurse should document these findings as jaundice, which is a sign of liver dysfunction or other underlying health issues that need further assessment and management.

Question 4 of 5

During examination of a toddler's extremities, the nurse notes that the child is bowlegged. What should the nurse recognize regarding this finding?

Correct Answer: A

Rationale: Bowlegged appearance in a toddler is not considered normal and should prompt further investigation by a healthcare provider. Bowlegs, also known as genu varum, can be caused by various underlying conditions such as vitamin D deficiency, rickets, or genetic factors. It is important to determine the cause of bowleggedness in order to provide appropriate treatment or interventions to promote proper development of the child's legs. Bowleggedness on its own is not considered a normal variation in toddler development and warrants further assessment.

Question 5 of 5

A parent asks the nurse "at what age do most infants begin to fear strangers?" The nurse should give which response?

Correct Answer: C

Rationale: Most infants begin to exhibit fear or stranger anxiety around 6 months of age. This is a normal developmental stage where infants become more aware of their surroundings and become wary of unfamiliar people. Infants may become anxious or cry when approached by strangers, showing that they prefer familiar faces like parents or caregivers. This behavior typically peaks between 6 to 9 months and gradually decreases as the child grows older and gains more social experience.

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