After a lecture on the assessment of the newborn skin, the instructor asks students which condition would require further investigation
Which response if given by the students would indicate that further teaching is necessary? (Select all that apply.) a. Port wine stains d. Petechiae
b. Mongolian spots e. Cutis marmorata
c. Plethora f. Extensive lesions
B, E
Further teaching is needed if the students responded Mongolian spots or cutis marmorata. Both of these are normal findings. Findings which need further investigation include port wine stains, plethora, petechiae, and extensive lesions.
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The nurse should always be careful to avoid overextending or overflexing an infant's neck because
A) a vagal response may be stimulated. B) airways are easily collapsible. C) the immature bones may fracture easily. D) the movement may affect perfusion.
When planning care for a child with idiopathic thrombocytopenic purpura, you plan to teach her
A) what foods are high in folic acid. B) not to pick or irritate her nose. C) to use mainly cold water to wash. D) to apply a soothing cream to lesions.
The nurse is making a home visit to an older adult who has severe rheumatoid arthritis with flexion contractures of all four extremities. She is confined to bed. What nursing diagnosis is appropriate in relation to safety?
a. Risk for Poisoning c. Risk for Trauma b. Risk for Suffocation d. Risk for Disuse Syn-drome
A family desires genetic testing for their adolescent. What response by the clinic nurse is appropriate?
1. "The child is a minor and cannot give consent." 2. "It is not advisable because insurance does not pay for this test." 3. "Let me discuss this with the adolescent and then we can discuss it more fully." 4. "There is a chance the adolescent might be discriminated against because of the test."