Common Birth Defects Practice questions

When developing a plan of care for a child with early Duchennes muscular dystrophy, which nursing goal is the priority? A. encourage early wheelchair use B. foster social interactions C. Maintain function of unaffected muscles D. Prevent circulatory impairment

C. Maintain function of unaffected muscles

When positioning a neonate with an unrepaired myelomeninogocele, which position is most appropriate? A. supine with the hips at 90 degree flexion B. Right side- lying position with the knees flexed C. Prone with hips in abduction D. supine in semi fowlers position with chest and abdomen elevated

C. Prone with hips in abduction

When developing the discharge plan for the parents of an infant who has gone a myelomeningocele repair, what information is the most important for the nurse to include? A. a list of available hospital services B. Schedule for daily home health care C. chaplain referral for psychological support D. Daily care required by the infant

D. Daily care required by the infant

A parent asks the nurse about using a car seat for a toddler who is in a hip spica case. The nurse should tell the parent A. " you can use a seat belt because of the spica cast." B. " you will need a specially designed care sear for your toddler." C. "You can still use the carseat you already have." D. "You will need to get a social release from the police so that a car seat will not be needed."

B. " you will need a specially designed care sear for your toddler."

After surgical repair of a myelomeningocele, which position should the nurse use to prevent musculoskeletal deformity in the infant? A. Place the feet in flexion B. Allow the hips to be abducted C. Maintain knees in the neutral position D. Place the legs in adduction

B. Allow the hips to be abducted

When developing the teaching plan for parents using the pavlik harness with their child, what should be the nurses initial step? A. Assess the parents current coping strategies B. Determine the parents knowledge about the device C. Provide the parents with written instructions D. Give the parents a list of community resources

B. Determine the parents knowledge about the device

After placing an infant with myelomeningocele in an Isolette shortly after birth, which indicator should the nurse use as the best way to determine the effectiveness of this intervention? A. The partial pressure of arterial oxygen remains between 94 and 100 mm Hg B. The axilary temperature remains between 97 F and 98 F C. The bilirubin level remains stable. D. Weight increases by about 1 oz per day

B. The axilary temperature remains between 97 F and 98

The nurse reports to the healthcare provider signs ion increased ICP in an infant with a myelomeningocele who has which finding? A. minimal lower extremity movement B. a high pitched cry C. Overflow voiding only D. a fontanelle that bulges with crying

B. a high pitched cry

The nurses teaching the parents o a child with myelomeningocele how to prevent urinary tract infections. What should the care plan include for this child? Select all that apply. A. provide meticulous skin care B. use credes maneuver to empty the bladder C. Encourage frequent emptying of the bladder D. Assure adequate fluid intake E. use tight fitting diapers around the meatus

B. use credes maneuver to empty the bladder C. Encourage frequent emptying of the bladder D. Assure adequate fluid intake

After teaching the parents of an infant with clubfoot requiring application of a plaster cast how to care for the cast., which statement would indicate that the parents have understood the teaching? A. "If the cast becomes soiled we will clean it with soap and water." B. " we will elevate the leg with the cast on pillows so the leg is above heart level." C. " we will check the color and temperature pf the toes pf the casted leg frequently." D. "The petals on the edge of the cast can be removed after the firt 24 hours."

C. " we will check the color and temperature pf the toes pf the casted leg frequently."

A 16 month old child is seen in the clinic for a check for the first time. The nurse notices that the toddler limps when walking. Which would be appropriate to use when assessing this toddler for DDH A. Ortolanis maneuver B. Barlow maneuver C. Adams Position D. Trendelenburgs sign

D. Trendelenburgs sign

The mother of a child with Duchennes Muscular dystrophy asks about the chance that her next child will have the disease. The nurse responds based on the understanding of what information? A. Sons have a 50% chance of being affected B. Daughters have a 1 in 4 chance if being carriers C. Each child has a 1 in 4 chance of developing the disease D. Each child has 50% chance of being a carrier

A. Sons have a 50% chance of being affected

When developing the plan of care for an infant diagnosed with myelomeningocele and the parents who have just been informed of the infants diagnosis, which action should the nurse include as the priority when the parents visit the infant for the first time? A. Emphasize the infants normal and positive features B. Encourage the parents to discuss their fears and concerns C. reinforce the HCPs explanation of the defect D. Have the parents feed their infant

A. Emphasize the infants normal and positive features

The parents of an infant with myelomeningocele ask the nurse about their Childs future mental ability. What is the nurses best response? A. "About one third have an intellectual disability , but it is to early too tell about your child B. About two thirds have an intellectual disability significantly retarded, and you will know soon if this will occur." C."Your child will probably be of normal intelligence since he demonstrates signs of it now." D. " you will need to talk to the HCP about that, but you can ask later."

A. "About one third have an intellectual disability , but it is to early too tell about your child

The nurse teaches the parent of a young child with Duchennes Muscular dystrophy about the disease and its management. Which statement by the parent indicates successful teaching? A. "My son will profanely be unable to walk independently by the time he is 9-11 years old." B. "Muscle relaxants are effective for some children: I hope they can help my son." C. " when my son is a little older, he can have surgery to improve his ability to walk." D. "I need to her my son be as active as possible to prevent progression of the disease."

A. "My son will profanely be unable to walk independently by the time he is 9-11 years old."

Parents bring a 10 month old boy with myelomeningocele and hydrocephalus with a ventricular peritoneal shunt to the emergency department. His symptoms include vomitting, poor feeding, lethargy and irritability. What interventions by the nurse are most appropriate? Select all that apply. A. Weight the child B. Listen to bowel sounds C. Palpate Anterior fontanelle D. Obtain Vital signs E. Assess pitch and quality of the Childs cry.

A. Weight the child B. Listen to bowel sounds D. Obtain Vital signs E. Assess pitch and quality of the Childs cry.

The nurse is discharging a baby with clubfoot who has had a cast applied. The nurse should provide additional teaching to the parents of they state: A. "I should call if I see changes in the color of the toes underneath the cast." B." I should use a pillow to elevate my childs foot as he sleep." C. "My baby will need a series of cast to fix her foot." D. " Having a cast should not prevent me from holding my baby."

B." I should use a pillow to elevate my childs foot as he sleep."

Which statement by the parent of an infant with a repaired upper lumbar myelomeningocele indicates that the parent understands the nurses teaching at the time of discharge? A. " I can aptly heating pad to his lower back." B. "I will be user to keep him away from other children." C. "I will call the hip if his urine has a funny smell." D. "I will prop him on pillows to keep him from rolling over."

C. "I will call the hip if his urine has a funny smell."

The parents of a neonate born with congenital clubfoot expresses feelings of helplessness and guilt are exhibiting anxiety about how the neonate will be treated. Which action by the nurse would be most appropriate initially? A. Ask them to share these concerns with the HCP B. Arrange a meeting with other parents who's infants had successful clubfoot treatment C. Discuss the problem with the parents and the current feelings that they are experiencing D. Suggest that they make an appointment to talk things over with a counselor

C. Discuss the problem with the parents and the current feelings that they are experiencing

When teaching the family of an older infant who has had a spica case applied for DDH, which information should the nurse include when describing abduction stabilizer bar? A. it can be adjusted to a position of comfort B. It is used to lift the child C. It adds strength to the case D. It is necessary to turn the child

C. It adds strength to the case

When interacting with the parent of a child wo has Duchennes muscular dystrophy, the nurse observes behavior indicating that the parent may feel guilty about the childs condition. The nurse interprets this behavior as guilt stemming from which factor? A. The terminal nature of the disease B. The dependent behavior of the child C. The genetic mode of transmission D. The sudden onset of the disease

C. The genetic mode of transmission

A nurse is making an initial visit to a family with a 3 year ild child with early duchennes muscular dystrophy. Which finding is expected when assessing the child? A. Contractures of the large joints B. Enlarged calf muscles C. difficulty riding a tricycle D. Atrophied muscles

C. difficulty riding a tricycle

The nurse teaches the parents of an infant with DDH of how to handle their child in a Pavlik Harness. Which care is most appropriate? A. Fit the diaper underneath the straps B. Leave the harness off while the infant sleeps C. Check for skin redness every other day D. Put powder on the skin under the straps every day.

A. Fit the diaper underneath the straps

A preschooler with a history of repaired lumbar myelomeninogcele is in the emergency department with wheezing and skin rash. Which questions should the nurse ask the parent first? A. " is your child taking any medications?" B. "who brought your child to the emergency department?" C. "is your child allergic to bananas or any other food?" D. "what re you doing to treat your Childs skin rash?"

C. "is your child allergic to bananas or any other food?"

The mother of an infant with myelomeningocele asks if her baby is likely to have any other defects, The nurse responds based on the understanding that myelomeningocele is commonly associated with which disorder? A. excessive cerebrospinal fluid within the cranial cavity B. Abnormally small head C. Congenital absence of the cranial vault D. Overriding of the cranial sutures

A. excessive cerebrospinal fluid within the cranial cavity