A neonate, 16 hours old, is in the NICU for respiratory distress. A chest X-Ray reveals heart failure. Lab results indicate: AB positive blood type, a positive Coomb’s test, serum bilirubin 16mg/dl, and severe anemia. The vital signs are 98.6 (F), HR 166, R 70. The infant is jaundiced from face to sole of feet and has generalized edema. What condition does the infant have?

Kernicterus.

Severe cardiac anomaly.

Respiratory distress syndrome.

Hydrops fetalis.

Answer and Explanation

The Correct Answer is D

Choice A rationale
Kernicterus is a rare type of brain damage that occurs in a newborn with severe jaundice. It happens when a substance in the blood, bilirubin, builds up to very high levels and spreads into the brain tissues. This condition can cause athetoid cerebral palsy and hearing loss. Kernicterus also causes problems with vision and teeth and sometimes can cause intellectual disabilities. However, the symptoms provided do not align with this condition.
Choice B rationale
A severe cardiac anomaly could cause heart failure and respiratory distress, but it would not explain the positive Coomb’s test, high bilirubin levels, severe anemia, jaundice, and generalized edema.
Choice C rationale
Respiratory distress syndrome (RDS) is a common problem in premature babies. It causes babies to need extra oxygen and help with breathing. RDS occurs most often in babies born before the 28th week of pregnancy and can be a problem for babies born before 37 weeks of pregnancy. It’s caused by a lack of a slippery substance called surfactant, which helps the lungs inflate with air and keeps them from collapsing. However, the symptoms provided do not align with this condition.
Choice D rationale
Hydrops fetalis is a severe, life-threatening problem of severe edema (swelling) in the fetus and newborn. It is also called hydrops. There are two types of hydrops fetalis: immune and nonimmune. Immune hydrops fetalis is a complication of a severe form of Rh incompatibility, which can be prevented. Nonimmune hydrops fetalis occurs as a result of other diseases, such as infections, heart or lung defects, liver disease, or genetic disorders, which aligns with the symptoms provided.

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Correct Answer is D

Explanation

Choice A rationale
Sporadic vaginal bleeding accompanied by chronic pelvic pain is not typically associated with a woman who has had multiple pregnancies and is admitted for repair of cystocele and rectocele.
Choice B rationale
Heavy leukorrhea with vulvar pruritus is not typically associated with a woman who has had multiple pregnancies and is admitted for repair of cystocele and rectocele.
Choice C rationale
Menstrual irregularities and hirsutism on the chin are not typically associated with a woman who has had multiple pregnancies and is admitted for repair of cystocele and rectocele.
Choice D rationale
Stress incontinence with a feeling of low abdominal pressure is a common symptom in women who have had multiple pregnancies and are admitted for repair of cystocele and rectocele. Multiple pregnancies can weaken the pelvic floor muscles, leading to conditions like cystocele and rectocele. Stress incontinence, where urine leaks out with increased abdominal pressure (such as when coughing, sneezing, or lifting), is a common symptom of these conditions.

A. Give the infant a high protein diet. B. Provide the infant with a diet containing small amounts of phenylalanine. C. Early introduction of cow’s milk may be necessary before 1 year of age. D. Follow up with a pediatric cardiologist.

Correct Answer is B

Explanation

Choice A rationale
Giving an infant with a positive PKU test a high protein diet is not recommended. This is because phenylalanine, which cannot be broken down by individuals with PKU, is found in high-protein foods.
Choice B rationale
Parents of infants with a positive PKU test should provide the infant with a diet containing small amounts of phenylalanine. This is because while phenylalanine is harmful in large amounts to individuals with PKU, it is still an essential amino acid that the body needs in small amounts.
Choice C rationale
Early introduction of cow’s milk is not necessary before 1 year of age for infants with a positive PKU test. In fact, cow’s milk is high in phenylalanine and should be avoided.
Choice D rationale
Following up with a pediatric cardiologist is not specifically related to the dietary management of PKU. While regular medical supervision is important for children with PKU, it does not necessarily have to be with a cardiologist.

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Naxlex Comprehensive Predictor Exams

What would the nurse expect to find when taking the health history of a woman admitted for repair of cystocele and rectocele, who has nine living children?

Correct Answer is D

Explanation

What should the parents of infants with a positive phenylketonuria (PKU) test be instructed to do?

Correct Answer is B

Explanation

A client comes to the clinic with abdominal pain. Based on her history, the nurse suspects endometriosis. When reviewing the woman’s history, the nurse would LEAST likely identify which factor as a possible risk?

When assessing a woman who has been unable to conceive, which factor would the nurse least likely identify as a potential risk in her history?

Which of the following are hormonal methods of contraception? (Select all that apply)

A patient inquires about the gamete intrafallopian transfer (GIFT) procedure. What would be an appropriate response for the nurse to make?

A newborn is suspected of having fetal alcohol syndrome. Which finding would the nurse expect to assess?

A client with polycystic ovarian syndrome (PCOS) is receiving oral contraceptives as part of her treatment plan. When discussing this treatment with the client, the nurse would discuss which rationale for this therapy?

After teaching a woman how to perform breast self-examination, which statement would indicate that the nurse’s instructions were successful?

What behaviors are often exhibited by newborns whose mothers are substance abusers?