ESSENTIALS OF PEDIATRIC NURSING 4TH EDITION KYLE CARMAN TEST BANK CHAPTER 3 GROWTH AND DEVELOPMENT OF THE NEWBORN AND INFANT MULTIPLE CHOICE

ESSENTIALS OF PEDIATRIC NURSING 4TH EDITION KYLE CARMAN TEST BANK CHAPTER 3 GROWTH AND DEVELOPMENT OF THE NEWBORN AND INFANT MULTIPLE CHOICE 1. Which is defined as a vaguely outlined area of edematous tissue situated over the portion of the scalp that presents in a vertex delivery? a. Caput succedaneum b. Hydrocephalus c. Cephalhematoma d. Subdural hematoma ANS: A A vaguely outlined area of edematous tissue situated over the portion of the scalp that presents in a vertex delivery is the definition of a caput succedaneum. The swelling consists of serum and/or blood accumulated in the tissues above the bone, and it may extend beyond the bone margin. Hydrocephalus is caused by an imbalance in production and absorption of cerebrospinal fluid. When production exceeds absorption, fluid accumulates within the ventricular system, causing dilation of the ventricles. A cephalhematoma has sharply demarcated boundaries that do not extend beyond the limits of the (bone) suture line. A subdural hematoma is located between the dura and the cerebrum. It would not be visible on the scalp. PTS: 1 DIF: Cognitive Level: Remember REF: 229 TOP: Integrated Process: Nursing Process: Assessment MSC: Area of Client Needs: Health Promotion and Maintenance 2. Which finding on a newborn assessment should the nurse recognize as suggestive of a clavicle fracture? a. Negative scarf sign b. Asymmetric Moro reflex c. Swelling of fingers on affected side d. Paralysis of affected extremity and muscles ANS: B A newborn with a broken clavicle may have no symptoms. The Moro reflex, which results in sudden extension and abduction of the extremities followed by flexion and adduction of the extremities, will most likely be asymmetric. The scarf sign that is used to determine gestational age should not be performed if a broken clavicle is suspected. Swelling of fingers on affected side and paralysis of affected extremity and muscles are not indicative of a fractured clavicle. PTS: 1 DIF: Cognitive Level: Analyze REF: 230 TOP: Integrated Process: Nursing Process: Assessment MSC: Area of Client Needs: Health Promotion and Maintenance 3. The parents of a newborn ask the nurse what caused the babys facial nerve paralysis. The nurses response is based on knowledge that this is caused by a(n): a. genetic defect. b. birth injury. c. spinal cord injury. d. inborn error of metabolism. ANS: B Estudy Pressure on the facial nerve during delivery may result in injury to cranial nerve VII, which can occur with birth injury. A genetic defect, spinal cord injury, or inborn error of metabolism would not cause facial paralysis. PTS: 1 DIF: Cognitive Level: Understand REF: 231 TOP: Integrated Process: Teaching/Learning MSC: Area of Client Needs: Health Promotion and Maintenance 4. A mother is upset because her newborn has erythema toxicum neonatorum. The nurse should reassure her that this is: a. easily treated. b. benign and transient. c. usually not contagious. d. usually not disfiguring. ANS: B Erythema toxicum neonatorum, or newborn rash, is a benign, self-limiting eruption of unknown cause that usually appears within the first 2 days of life. The rash usually lasts about 5 to 7 days. No treatment is indicated. Erythema toxicum neonatorum is not contagious. Successive crops of lesions heal without pigmentation. PTS: 1 DIF: Cognitive Level: Apply REF: 232 TOP: Integrated Process: Teaching/Learning MSC: Area of Client Needs: Health Promotion and Maintenance 5. What is oral candidiasis (thrush) in the newborn? a. Bacterial infection that is life threatening in the neonatal period b. Bacterial infection of mucous membranes that responds readily to treatment c. Yeastlike fungal infection of mucous membranes that is relatively common d. Benign disorder that is transmitted from mother to newborn during the birth process only ANS: C Oral candidiasis, characterized by white adherent patches on the tongue, palate, and inner aspects of the cheeks, is not uncommon in newborns. Candida albicans is the usual causative organism. Oral candidiasis is usually a benign disorder in the newborn, often confined to the oral and diaper regions. It is caused by a yeastlike organism and is treated with good hygiene, application of a fungicide, and correction of any underlying disorder. Thrush can be transmitted in several ways, including by maternal transmission during delivery; person-to-person transmission; and contaminated bottles, hands, or other objects. PTS: 1 DIF: Cognitive Level: Understand REF: 232 TOP: Integrated Process: Nursing Process: Implementation MSC: Area of Client Needs: Health Promotion and Maintenance 6. Nursing care of the newborn with oral candidiasis (thrush) includes: a. avoiding use of pacifier. b. removing characteristic white patches with a soft cloth. c. continuing medication for a prescribed number of days. d. applying medication to oral mucosa, being careful that none is ingested. ANS: C The medication must be continued for the prescribed number of days. To prevent relapse, therapy should continue for at least 2 days after the lesions disappear. Pacifiers can be Estudy used. The pacifier should be replaced with a new one or boiled for 20 minutes once daily. One of the characteristics of thrush is that the white patches cannot be removed. The medication is applied to the oral mucosa and then swallowed to treat Candida organisms in the gastrointestinal tract. PTS: 1 DIF: Cognitive Level: Apply REF: 233 TOP: Integrated Process: Nursing Process: Planning MSC: Area of Client Needs: Physiologic Integrity 7. Which is a bright red, rubbery nodule with a rough surface and a well-defined margin that may be present at birth? a. Port-wine stain b. Juvenile melanoma c. Cavernous hemangioma d. Strawberry hemangioma ANS: D Strawberry hemangiomas or capillary hemangiomas are benign cutaneous tumors that involve capillaries only. They are bright red, rubbery nodules with rough surfaces and well-defined margin. They may or may not be apparent at birth but enlarge during the first year of life and tend to resolve spontaneously by age 2 to 3 years. Port-wine stain is a vascular stain that is a permanent lesion and is present at birth. Initially it is a pink, red, or, rarely, purple stain of the skin that is flat at birth and thickens, darkens, and proportionately enlarges as the child grows. Melanoma is not differentiated into juvenile and adult forms. A cavernous hemangioma involves deeper vessels in the dermis and has a bluish red color and poorly defined margins. PTS: 1 DIF: Cognitive Level: Understand REF: 234 TOP: Integrated Process: Nursing Process: Assessment MSC: Area of Client Needs: Health Promotion and Maintenance 8. The parents of a newborn with a strawberry hemangioma ask the nurse what the treatment will be. The nurses response should be based on knowledge that: a. excision of the lesion will be necessary. b. injections of prednisone into the lesion will reduce it. c. no treatment is usually necessary because of the high rate of spontaneous involution. d. pulsed dye laser treatments will be necessary immediately to prevent permanent disability. ANS: C There is a high rate of spontaneous resolution, so treatment is usually not indicated for hemangiomas. Surgical removal would not be indicated. If steroids are indicated, then systemic prednisone is administered for 2 to 3 weeks. The pulse dye laser is used in the uncommon situation of potential visual or respiratory impairment. PTS: 1 DIF: Cognitive Level: Apply REF: 234 TOP: Integrated Process: Teaching/Learning MSC: Area of Client Needs: Health Promotion and Maintenance 9. Which term refers to a newborn born before completion of week 37 of gestation, regardless of birth weight? a. Postterm b. Premature c. Low birth weigh