A. Continuing to offer a special formula to limit gagging is not a standard approach in the care of infants with cerebral palsy. The choice of formula should be based on the child's nutritional needs, and any feeding difficulties should be addressed by a healthcare professional.

B. Maintaining immobility of the limbs with splints is not recommended. Encouraging movement and mobility is important for the development and well-being of children with cerebral palsy.

C. Preserve muscle tone to prevent joint contractures.

Cerebral palsy is a condition that can lead to problems with muscle tone and movement. Preserving muscle tone is important to prevent joint contractures, which can limit mobility and cause pain. Physical therapy and exercises can help maintain muscle tone and joint flexibility in children with cerebral palsy.

D. Focusing on cognitive rather than motor skills is not appropriate. Motor skills are a crucial aspect of development for children with cerebral palsy. The approach should encompass both cognitive and motor skill development as appropriate for the child's age and abilities.

A. Engaging the child in games with other children is important for social development, but it depends on the child's individual readiness and comfort level with social interactions. It's crucial to consider the child's temperament and developmental stage.

B. Encourage the child to feed himself finger foods.

At 18 months of age, children are typically developing their fine motor skills and independence. Encouraging self-feeding with finger foods is a developmentally appropriate activity. It promotes independence, fine motor skill development, and a positive feeding experience.

C. Allowing the child to walk independently on the nursing unit is appropriate if the child is developmentally ready and safe to do so. It promotes gross motor skill development and independence.

D. Holding and cuddling the child often is important for emotional and social development. However, the frequency and style of interaction should be individualized based on the child's preferences and needs. Some children may prefer more independence at this age.

A. "That big soft spot will be covered in bone by the end of the second month" is not accurate. The closure usually occurs later than the second month.

B. "The big soft spot will close at around 24 months of age" is an overestimation of the typical closure time. It is usually closed earlier than 24 months.

C. "The big soft spot is usually closed between 12 and 18 months of age."

The anterior fontanel is the soft spot located on the baby's head, and its closure is a natural part of an infant's development. The timing of closure can vary from one child to another. However, the typical range for the closure of the anterior fontanel is between 12 and 18 months of age. This information provides a general guideline for parents while acknowledging the natural variability in child development.

D. "Babies' soft spots close at different times depending on their growth rate" is true to some extent, but providing a general range (option C) is more informative for parents.

A. Positive Western blot test: A positive Western blot test confirms HIV infection but doesn't provide information about the current immune status or progression of the disease.

B. CD4-T-cell count 180 cells/mm³.

The CD4-T-cell count is a crucial indicator of a person's immune system function, and it's a primary marker used to monitor the progression of HIV infection. A CD4 count of 180 cells/mm³ is significantly below the normal range (which is typically higher), indicating immunosuppression and an increased risk of opportunistic infections. Maintaining and improving immune function is a top priority in the care of clients with HIV.

C. Platelets 150,000/mm³: Platelet counts are important, but they are not the primary indicator for assessing the progression of HIV.

D. WBC 5.000/mm³: The white blood cell count (WBC) is important for assessing overall immune function, but it doesn't provide the same specific information about the immune system status as the CD4-T-cell count.

A. Explaining to the teenager that he is lucky to receive good care does not address his emotional and social needs adequately and may minimize his feelings.

B. Arranging for a video conference with his teacher and ensuring schoolwork is available is important but does not address his desire to be with friends or his emotional needs.

C. Asking the child-life specialist to help find activities to distract the teenager can be helpful for providing emotional support but may not address his concerns about being with friends and feeling frustrated.

D. Arrange a multi-disciplinary team meeting, including the teenager and his family, to discuss the situation and set goals together.

In this challenging situation, it's important to involve the patient and their family in decision-making and goal-setting. Advanced osteosarcoma with metastasis to the lungs is a serious and potentially terminal illness. The teenager's feelings and wishes should be respected and taken into consideration. A multi-disciplinary team meeting allows for open communication, including the patient, family, healthcare providers, and specialists, to discuss the situation, the patient's preferences, and the overall care plan.

A. Varying the child's schedule each day may add unnecessary stress and disrupt the child's sense of routine and stability, which is important during a hospitalization.

B. Providing a daily session with a play therapist may be valuable but does not directly address the child's developmental need for competence and mastery.

C. Encourage the client to complete school work.

Erikson's psychosocial stage theory suggests that children at the age of 10 are in the "Industry vs. Inferiority" stage. During this stage, children strive to develop a sense of competence and mastery in various activities. Encouraging the child to complete school work aligns with this stage, as it fosters a sense of accomplishment, competence, and success, which is crucial for their psychosocial development.

D. Discouraging visits from the client's friends would not support the child's social and emotional well-being during the hospitalization, and social connections are important for psychosocial development.

A. Fever: Osteomyelitis is often associated with fever as it is an infectious process that can cause an elevated body temperature.

B. Unwillingness to move the affected extremity: Children with osteomyelitis may experience pain and discomfort, leading to a reluctance to move the affected limb.

C. A previous closed fracture of an extremity is not typically a direct assessment finding for osteomyelitis. Osteomyelitis is more commonly associated with infections that can spread to the bone, and a previous fracture may not always be present.

D. Redness and swelling at the site: Osteomyelitis can cause local inflammation, leading to redness and swelling at the affected area.

E. Severe pain: Pain is a common symptom of osteomyelitis, and it can be severe, leading to the child's unwillingness to move the affected extremity.

A. Checking urine for glucose and protein is not directly related to the care of a child with a VP shunt. The focus is on monitoring the child for signs of complications related to the shunt.

B. Administering narcotics for pain control may be indicated if the child is in pain, but it is not the primary action and should be determined based on the child's pain assessment.

C. Testing cerebrospinal (CSF) fluid leakage for protein is not typically a nursing responsibility in the immediate postoperative period. Leakage of CSF should be reported to the healthcare provider, and diagnostic tests would be conducted by medical staff as needed.

D. Monitor for increased temperature.

Monitoring for an increased temperature is essential because postoperative fever could be an early sign of infection or complications related to the VP shunt. Infection and shunt malfunction are potential risks in the postoperative period.

To calculate the number of tablets to administer, you need to convert the dose to micrograms (mcg) to match the tablet strength:

0.175 mg is equivalent to 175 mcg (since 1 mg = 1000 mcg).

Now, divide the required dose (175 mcg) by the strength of the available tablets (88 mcg/tablet):

175 mcg ÷ 88 mcg/tablet ≈ 1.9886

Rounding to the nearest whole number, you should administer 2 tablets per dose.

A. Anemia: Anemia is not a classic hematologic characteristic of nephrotic syndrome. Anemia may occur in other medical conditions or as a secondary effect of chronic kidney disease.

B. Hypolipidemia: Nephrotic syndrome often leads to the loss of lipids in the urine, resulting in low levels of lipids (such as cholesterol) in the blood.

C. Hyperlipidemia: Nephrotic syndrome is associated with hypolipidemia, not hyperlipidemia.

D. Hypoproteinemia: Nephrotic syndrome is characterized by significant protein loss in the urine, leading to low levels of protein in the blood, including low levels of albumin.

E. Hypoglycemia: Hypoglycemia is related to low blood sugar levels and is not a classic hematologic characteristic of nephrotic syndrome.

A. Identity versus role confusion is typically associated with adolescence.

B. Autonomy versus a sense of shame and doubt is associated with the toddler years.

C. Initiative versus guilt.

Erikson's theory of psychosocial development includes various stages, and each stage corresponds to a specific age range and a unique psychosocial challenge. The preschool age group, typically from around 3 to 6 years old, is associated with the stage of "Initiative versus guilt." During this stage, children begin to explore their environment, take on new challenges, and start to develop a sense of initiative. They seek to make choices, set goals, and make plans, which is a crucial aspect of their development during the preschool years. However, if their efforts are met with excessive criticism or control, they may develop feelings of guilt.

D. Trust versus mistrust is associated with infancy.

A. Obtaining a throat culture and B. visualizing the epiglottis with a tongue depressor are not safe actions for the nurse to perform without appropriate medical equipment and expertise. These actions can trigger a sudden airway obstruction in a child with epiglottitis. The priority is to ensure airway patency and seek immediate medical assistance.

C. Place the child in an upright position.

Suspected epiglottitis is a medical emergency that can result in rapid airway obstruction. Placing the child in an upright position helps improve airflow by allowing the throat to open and reduces the risk of complete airway obstruction. It's important not to perform invasive procedures (such as throat culture or visualization of the epiglottis) without proper medical equipment and expertise, as these actions can lead to worsening airway obstruction.

D. Transporting the child to radiology for a throat x-ray is not appropriate in this situation, as it may delay necessary interventions to secure the airway.

Applying a warm soak to the knee (option A) or using a compression wrap (option C) is generally not recommended for vaso-occlusive crises. These measures could potentially worsen the pain or cause complications.

B. Administering Acetaminophen.

Vaso-occlusive crises are a common complication of sickle cell disease, and they can lead to severe pain. Acetaminophen (Tylenol) is an appropriate choice for pain management in this situation. It is a non-steroidal anti-inflammatory drug (NSAID) that can help alleviate pain.

Decreasing the amount of intravenous fluids (option D) may be indicated if fluid overload is suspected, but it is not the primary intervention for pain relief during a vaso-occlusive crisis. Pain control is the priority in these situations.

A. Introducing new foods every day does not allow sufficient time to monitor for adverse reactions.

B. Waiting 8 to 10 days between introducing new foods is a longer interval than typically recommended. It may unnecessarily delay the introduction of a variety of foods to the infant's diet.

C. 5 to 7 days.

When introducing new foods to an infant, it's important to do so gradually to monitor for any potential allergic reactions or sensitivities. Waiting 5 to 7 days between introducing new foods allows for observation of any adverse reactions, such as allergies or digestive issues. This approach helps in identifying the specific food responsible for any adverse reactions and ensures the infant's safety.

D. Waiting 2 to 3 days is too short of an interval to adequately monitor for adverse reactions. Waiting 5 to 7 days provides a better balance between introducing new foods and monitoring for potential issues.

A. Diabetes Insipidus is associated with reduced ADH levels, leading to excessive urination and dehydration, not hyponatremia.

B. Acromegaly results from excessive growth hormone (not ADH) secretion, causing abnormal growth of tissues and bones.

C. Addison's disease involves the adrenal glands and the insufficient production of cortisol and aldosterone, not ADH-related hyponatremia.

D. Syndrome of Inappropriate Antidiuretic Hormone (SIADH).

SIADH is a disorder characterized by the excessive release of antidiuretic hormone (ADH) from the posterior pituitary gland, leading to increased water reabsorption by the kidneys. This results in diluted blood and hyponatremia (low sodium levels) due to the retention of water. Patients with SIADH often experience fluid overload and related symptoms.

A. Increased pulse rate.

Iron deficiency anemia can lead to a reduced oxygen-carrying capacity in the blood. As a compensatory mechanism, the heart may pump faster to deliver more oxygen to tissues. This can result in an increased pulse rate. Children with iron deficiency anemia may also experience weakness, fatigue, and pallor.

B. Increased blood pressure is not a common symptom of iron deficiency anemia. In fact, iron deficiency anemia can often lead to lower blood pressure due to the reduced oxygen-carrying capacity of the blood.

C. Warm skin is not a typical symptom of iron deficiency anemia. Skin temperature may not be directly affected by this condition.

D. Cyanosis of the nail beds is not a symptom of iron deficiency anemia. Cyanosis refers to bluish discoloration of the skin or mucous membranes due to reduced oxygen levels in the blood, which is more commonly associated with respiratory or cardiovascular issues. Iron deficiency anemia primarily affects the oxygen-carrying capacity of the blood but does not lead to cyanosis.

A. Fatigue: Children with ALL often experience fatigue and weakness due to decreased red blood cell and platelet production as a result of bone marrow involvement by leukemia cells.

C. Pallor: Pallor, or paleness, is a common finding in children with ALL because of anemia (reduced red blood cell count).

E. Multiple bruises: Children with ALL may have an increased tendency to bruise and bleed due to low platelet counts, making them susceptible to easy bruising and petechiae.

The other options, B (Generalized edema) and D (Jaundice), are not typical clinical findings associated with ALL. Generalized edema is not a common symptom, and jaundice (yellowing of the skin and eyes) is more commonly associated with liver conditions, not leukemia.

A. Praise them for the care they are giving their child.

Families facing the impending loss of a child need compassion and support. Praising them for the care they are giving their child acknowledges their efforts and reinforces their role in providing comfort to the child. This can help build trust and rapport between the family and healthcare providers during this difficult time.

B. Informing the family that they should have taken better care of their child is judgmental and hurtful. It does not provide the emotional support the family needs.

C. Telling the family to wait until after the death to discuss feelings is not helpful. Open communication and addressing feelings should be encouraged throughout the process.

D. Telling them that the staff will perform all of the final care may come across as impersonal. Involving the family in the care of their dying child can be an important part of the grieving and healing process.

A. Metabolic alkalosis is not a common acid-base imbalance associated with ARF. Instead, metabolic acidosis is more commonly observed due to the retention of metabolic waste products.

B. Water and sodium (Na) retention: In ARF, the kidneys are unable to effectively filter and excrete waste products and excess fluids. This leads to the retention of water and sodium, contributing to fluid overload.

C. Anemia: ARF can lead to decreased erythropoietin production by the kidneys, which can result in anemia due to reduced red blood cell production.

D. Hyperkalemia: The impaired kidney function in ARF may result in the inability to regulate potassium levels. Elevated levels of potassium (hyperkalemia) can be a dangerous complication.

E. Increased urinary output is not a typical finding in ARF. Instead, the hallmark of ARF is a reduction in urine output or oliguria.

A. Administration of a systemic oral antibiotic and a topical antibiotic may be used, but this option does not address the removal of crusts, which is essential for preventing complications.

B. Administration of a systemic and a topical antifungal is not appropriate for impetigo, as impetigo is caused by bacteria, not fungi.

C. Using an oil-based soap for bathing is not recommended, as it may not effectively remove crusts and pustules associated with impetigo, and it does not have antimicrobial properties necessary for treatment.

D. Removal of crusts with an antimicrobial liquid.

Impetigo is a contagious bacterial skin infection, typically caused by Staphylococcus aureus or Streptococcus pyogenes. It often presents with crusts and pustules on the skin. To prevent complications, it's important to keep the affected areas clean and free from crusts. Gently removing crusts with an antimicrobial liquid and clean cloth helps prevent the spread of infection, allows topical antibiotics to work effectively, and reduces the risk of complications.

A. Shunted past the pulmonary circulation, causing pulmonary hypoxia: This option is not the primary reason for dyspnea in PDA. While there is shunting, it doesn't directly cause pulmonary hypoxia.

B. Circulated through the lungs again, causing pulmonary circulatory congestion: This option is partially correct but does not address the primary reason for dyspnea, which is the bypassing of the left side of the heart.

C. Circulated through the ductus from the pulmonary artery to the aorta, bypassing the left side of the heart.

In patent ductus arteriosus (PDA), a fetal blood vessel called the ductus arteriosus fails to close after birth. This allows oxygenated blood from the left atrium to be shunted directly from the aorta to the pulmonary artery, bypassing the normal route through the left side of the heart and into the systemic circulation. The shunting of oxygenated blood back into the pulmonary circulation can lead to increased pulmonary blood flow and circulatory congestion, causing symptoms such as dyspnea.

D. Shunted past cardiac arteries, causing myocardial hypoxia: PDA primarily affects the pulmonary circulation and left side of the heart, not the coronary arteries. Myocardial hypoxia is not the primary mechanism of dyspnea in PDA.

A. Alertness as such weight loss is not expected: This response may unnecessarily alarm the mother when, in fact, some weight loss in the early days is normal.

B. Reassurance as this is a normal weight loss.

It is normal for newborns to lose some weight during the first few days of life. The loss is often related to fluid loss, changes in feeding patterns, and initial adjustment to life outside the womb. A loss of one-half pound in a 2-day-old neonate is generally considered within the normal range. It's important for the nurse to reassure the new mother that this weight loss is expected and not a cause for alarm. Newborns typically start to regain their birth weight within a week or two. This reassurance can help ease the mother's distress and anxiety.

C. Alarm as this is a drastic weight loss: Characterizing this weight loss as "drastic" is not accurate or helpful and would likely increase the mother's anxiety.

D. Concern as this may be an indicator of inadequate nutrition: Jumping to the conclusion of inadequate nutrition without further assessment and evidence is premature and may unnecessarily worry the mother. It's important to start with reassurance and then investigate if there are concerns about nutrition.

A. "The body's response to gluten causes the intestine to become more porous and hang on to more of the fat-soluble vitamins, leading to vitamin toxicity." This answer is not accurate. The issue in celiac disease is malabsorption, not vitamin toxicity.

B. "The body's response to gluten causes damage to the mucosal cells in the intestines leading to absorption problems."

Celiac disease is an autoimmune disorder in which the ingestion of gluten (a protein found in wheat, barley, and rye) leads to damage of the mucosal cells in the small intestine. This damage, in turn, can lead to malabsorption of essential nutrients, including vitamins, minerals, and other important components of the diet. It is important for individuals with celiac disease to avoid gluten-containing foods to prevent ongoing damage to the intestinal mucosa and improve nutrient absorption.

C. "The body's response to consumption of anything containing gluten is to create special cells called villi, which leads to more diarrhea." This statement is not accurate. Celiac disease leads to damage to the villi (finger-like projections) in the small intestine, not the creation of special cells. It can lead to diarrhea but is not the primary cause.

D. "The body's response to gluten causes damage to the mucosal cells, leading to malabsorption of water and hard, constipated stools." This response is not accurate. Celiac disease is more commonly associated with diarrhea and malabsorption, not constipation and malabsorption of water.

A. Get 8 hours of sleep at night and take naps during the day:

While adequate sleep is generally important for overall health, it may not be the most critical factor for a patient with aplastic anemia. Aplastic anemia primarily affects blood cell production, and managing infection risk and blood counts are more crucial in this context.

B. Practice yoga and meditation to decrease stress and anxiety:

Stress reduction techniques, such as yoga and meditation, can be beneficial for anyone's overall well-being, but it's not the top priority for someone with aplastic anemia. Managing stress is essential, but again, reducing the risk of infections and maintaining adequate blood counts are more critical.

C. Eat animal protein and dark leafy vegetables each day:

Proper nutrition is essential for patients with aplastic anemia, as it can help support the production of red blood cells and maintain overall health. However, while a balanced diet is important, avoiding infections and minimizing exposure to contagions is more pressing.

D. Avoid exposure to others with acute infection:

This is the most crucial concept for patients with aplastic anemia. Aplastic anemia leads to a weakened immune system, making the patient highly susceptible to infections. Exposure to individuals with acute infections can be life-threatening for these patients. Preventing infections and maintaining adequate blood counts are paramount in the care of individuals with aplastic anemia.