A neonate is born with bilateral mild talipes equinovarus (club foot). When the parents ask the nurse how this will be corrected, the nurse should give which explanation?
Infants outgrow this condition when they learn to walk.
Surgical intervention is needed.
Traction with foot manipulation is used.
Frequent serial casting is tried first.
The Correct Answer is D
Choice A reason:
Infants do not outgrow clubfoot when they learn to walk. Clubfoot is a congenital deformity that requires medical intervention to correct. Without treatment, the condition can lead to significant disability and difficulty in walking1. The goal of treatment is to correct the foot’s position and function, allowing the child to walk normally.
Choice B reason:
Surgical intervention is not the first line of treatment for clubfoot. While surgery may be necessary in severe cases or if other treatments fail, the initial approach typically involves non-surgical methods. The Ponseti method, which includes serial casting and gentle manipulation, is the preferred initial treatment. Surgery is considered only if these methods do not achieve the desired results.
Choice C reason:
Traction with foot manipulation is not a standard treatment for clubfoot. The primary non-surgical treatment involves the Ponseti method, which includes serial casting and gentle manipulation of the foot3. This method has been shown to be highly effective in correcting clubfoot without the need for traction.
Choice D reason:
Frequent serial casting is the first line of treatment for clubfoot. The Ponseti method, which involves weekly casting and gentle manipulation of the foot, is the most widely used and effective treatment for clubfoot. This method gradually corrects the foot’s position over several weeks, followed by bracing to maintain the correction4. Serial casting is preferred because it is non-invasive and has a high success rate.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","D"]
Explanation
Choice A reason:
Facial edema is a common clinical manifestation of nephrotic syndrome in children. This occurs due to the retention of fluid in the tissues, which is a result of the kidneys leaking protein into the urine (proteinuria). The loss of protein reduces the oncotic pressure in the blood vessels, leading to fluid accumulation in the interstitial spaces, particularly noticeable around the eyes and face.
Choice B Reason:
Cloudy smoky brown-colored urine is not typically associated with nephrotic syndrome. This symptom is more indicative of hematuria, which is the presence of blood in the urine. Hematuria is more commonly seen in conditions such as glomerulonephritis rather than nephrotic syndrome.
Choice C Reason:
Weight loss is not a characteristic symptom of nephrotic syndrome. In fact, children with nephrotic syndrome often experience weight gain due to fluid retention. The accumulation of fluid in the body can lead to an increase in weight, rather than a loss.
Choice D Reason:
Frothy appearing urine is a hallmark sign of nephrotic syndrome. The frothiness is due to the high levels of protein being excreted in the urine (proteinuria). When protein is present in the urine, it can cause the urine to appear foamy or frothy.
Correct Answer is ["A","B","C","D","E","F","G","H","I"]
Explanation
The correct answer is
A. Unable to roll over back to front
B. Head lag
C. Feeding difficulties
D. Floppy posture
E. Arms are stiff
F. Does not smile
G. Unable to sit without support
H. Irritable and cries often
I. Unable to pass an object between hands
Choice A reason
Unable to roll over back to front: At 3 months, infants typically start to develop the ability to roll over from their stomach to their back. Rolling over from back to front usually occurs later, around 4 to 6 months. However, the inability to roll over at all by 3 months could indicate developmental delays or muscle weakness, which requires follow-up.
Choice B Reason
Head lag: By 3 months, infants should have enough neck muscle strength to hold their head up when pulled to a sitting position. Persistent head lag at this age can be a sign of developmental delay or neuromuscular disorders, necessitating further evaluation.
Choice C Reason
Feeding difficulties: Infants should be able to suck and swallow effectively by 3 months. Feeding difficulties can lead to inadequate nutrition and growth, and may indicate underlying issues such as gastrointestinal problems or neurological disorders. This requires prompt attention and intervention.
Choice D Reason
Floppy posture: A 3-month-old should start to show more control over their body movements and have a more stable posture. Floppy posture, also known as hypotonia, can be a sign of various conditions, including genetic disorders, muscle diseases, or central nervous system issues. It is important to investigate the cause of hypotonia.
Choice E Reason
Arms are stiff: Stiffness in the arms, or hypertonia, can indicate neurological problems such as cerebral palsy or other motor disorders. It is crucial to assess the underlying cause of increased muscle tone and provide appropriate interventions.
Choice F Reason
Does not smile: Social smiling typically begins around 6 to 8 weeks of age. If a 3-month-old does not smile, it could be a sign of developmental delay, visual impairment, or other social and emotional issues. This warrants further assessment to determine the cause.
Choice G Reason
Unable to sit without support: While sitting without support is not expected until around 6 months, the inability to show any signs of trying to sit or maintain a sitting position with support at 3 months could indicate developmental delays. This should be monitored and addressed if necessary.
Choice H Reason
Irritable and cries often: Excessive irritability and frequent crying can be signs of discomfort, pain, or underlying medical conditions such as infections, gastrointestinal issues, or neurological problems. It is important to identify and address the cause of the infant’s distress.
Choice I Reason
Unable to pass an object between hands: By 3 months, infants should start to develop hand-eye coordination and the ability to grasp objects. The inability to pass an object between hands may indicate developmental delays or motor skill issues, which require further evaluation.
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