A 2-year-old child with trisomy 21 (Down syndrome) is brought to the clinic for a
routine evaluation. Which assessment finding suggests the presence of a common
complication often experienced by those with Down syndrome?
A.Presence of a systolic murmur
B.New onset of patchy alopecia
C.Complaints of long bone pain
D.Recent projectile vomiting - CORRECT ANSWER - ANS: A
,Congenital heart disease occurs in 40% to 50% of children with trisomy 21 (Down
syndrome). Defects of the atrial or ventricular septum that create systolic murmurs (A)
are the most common heart defects associated with this congenital anomaly. (B, C,
and D) are not recognized as common complications of trisomy 21.
A 3-month-old infant returns from surgery with elbow restraints and a Logan's bow
over a cleft lip suture line. Which intervention should the nurse implement to maintain
suture line integrity during the initial postoperative period?
A.Place the infant upright in an infant seat position.
B.Provide mittens with the use of elbow restraints.
C.Use soft rubber catheters for nasal suctioning.
,D.Apply water-soluble lubricant to the suture line. - CORRECT ANSWER - ANS: A
The use of an infant seat simulates a supine position with the head elevated (A) and
also prevents aspiration. Prone positioning should be avoided to prevent disruption of
the protective Logan's bow and prevent the infant from rubbing the face on the bed
surface. Mittens (B) are not necessary and decrease the ability to provide sensory
comfort, such as hand holding. Nasal suctioning (C) should be avoided to prevent
trauma or dislodging clots at the surgical site. Water-soluble lubricant (D) will dry the
suture line and cause crusting, which predisposes the suture line to poor healing and
scarring.
A 3-month-old infant weighing 10 lb 15 oz has an axillary temperature of 98.9° F. What
caloric amount does this child need?
, A.400 calories/day
B.500 calories/day
C.600 calories/day
D.700 calories/day - CORRECT ANSWER - ANS: C
An infant requires 108 calories/kg/day. The first step is to change 10 lb 15 oz to 10.9
lb. Then convert pounds to kilograms by dividing pounds by 2.2, which is 10.9/2.2 =
4.954 kg, rounded to 5 kg. The second step is to multiply 108 calories/kg/day (108 × 5
= 540 calories/day). However, this infant requires 10% more calories because of the 1°
F temperature elevation. Ten percent of 540 (calories/day) is 54 and 540 + 54 = 594.
This infant will require approximately 600 calories/day (C). (A, B, and D) are incorrect.
routine evaluation. Which assessment finding suggests the presence of a common
complication often experienced by those with Down syndrome?
A.Presence of a systolic murmur
B.New onset of patchy alopecia
C.Complaints of long bone pain
D.Recent projectile vomiting - CORRECT ANSWER - ANS: A
,Congenital heart disease occurs in 40% to 50% of children with trisomy 21 (Down
syndrome). Defects of the atrial or ventricular septum that create systolic murmurs (A)
are the most common heart defects associated with this congenital anomaly. (B, C,
and D) are not recognized as common complications of trisomy 21.
A 3-month-old infant returns from surgery with elbow restraints and a Logan's bow
over a cleft lip suture line. Which intervention should the nurse implement to maintain
suture line integrity during the initial postoperative period?
A.Place the infant upright in an infant seat position.
B.Provide mittens with the use of elbow restraints.
C.Use soft rubber catheters for nasal suctioning.
,D.Apply water-soluble lubricant to the suture line. - CORRECT ANSWER - ANS: A
The use of an infant seat simulates a supine position with the head elevated (A) and
also prevents aspiration. Prone positioning should be avoided to prevent disruption of
the protective Logan's bow and prevent the infant from rubbing the face on the bed
surface. Mittens (B) are not necessary and decrease the ability to provide sensory
comfort, such as hand holding. Nasal suctioning (C) should be avoided to prevent
trauma or dislodging clots at the surgical site. Water-soluble lubricant (D) will dry the
suture line and cause crusting, which predisposes the suture line to poor healing and
scarring.
A 3-month-old infant weighing 10 lb 15 oz has an axillary temperature of 98.9° F. What
caloric amount does this child need?
, A.400 calories/day
B.500 calories/day
C.600 calories/day
D.700 calories/day - CORRECT ANSWER - ANS: C
An infant requires 108 calories/kg/day. The first step is to change 10 lb 15 oz to 10.9
lb. Then convert pounds to kilograms by dividing pounds by 2.2, which is 10.9/2.2 =
4.954 kg, rounded to 5 kg. The second step is to multiply 108 calories/kg/day (108 × 5
= 540 calories/day). However, this infant requires 10% more calories because of the 1°
F temperature elevation. Ten percent of 540 (calories/day) is 54 and 540 + 54 = 594.
This infant will require approximately 600 calories/day (C). (A, B, and D) are incorrect.
