A newborn has been admitted to the intensive care unit with a diagnosis of myelomeningocele. The nurse could expect which of the following with the disorder?

Partial to complete paralysis in the lower extremities

Unilateral port-wine birthmark

A protruding sac containing abdominal contents

A fusion of cranial suture lines

Answer and Explanation

The Correct Answer is A

A. Myelomeningocele is a type of spina bifida where there is a protrusion of the meninges and spinal cord through a defect in the vertebrae. This condition can result in partial to complete paralysis in the lower extremities due to the involvement of the spinal cord.

B. A unilateral port-wine birthmark is typically associated with conditions like Sturge-Weber syndrome, not myelomeningocele.

C. A protruding sac containing abdominal contents is characteristic of omphalocele, not myelomeningocele.

D. Fusion of cranial suture lines is not associated with myelomeningocele but rather with craniosynostosis.

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Correct Answer is B

Explanation

A. Mild illnesses like nasopharyngitis (a common cold) do not typically contraindicate vaccination, so there is no need to delay immunization.

B. It is essential to evaluate for allergies to vaccine components, such as gelatin or neomycin, which could contraindicate the administration of the varicella vaccine.

C. The first dose of the varicella vaccine is recommended at 12-15 months of age, not at 4 years of age, so it is appropriate to administer it during this well-check.

D. The varicella vaccine is administered subcutaneously, not intramuscularly, so this is not the correct route for administration.

A. When hearing a loud noise, the infant cries and extends both arms and legs. B. When stroking the outer edge of the sole of the infant's foot, the toes fan upward and out. C. When infant's head is turned to one side, extension of the same side arm and leg occurs. D. When stroking the cheek, the infant turns toward that side of stimulation.

Correct Answer is B

Explanation

A. The Moro reflex, where the infant cries and extends both arms and legs in response to a loud noise, typically disappears by 4-6 months of age and would not be expected at 8 months.

B. The Babinski reflex, where the toes fan upward and out when the outer edge of the sole is stroked, is normal in infants and usually disappears by 12-24 months of age.

C. The tonic neck reflex (fencing reflex) typically disappears around 4-6 months of age, so it would not be expected in an 8-month-old.

D. The rooting reflex, where the infant turns their head toward the side of stimulation when the cheek is stroked, typically disappears by 3-4 months of age.

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A newborn has been admitted to the intensive care unit with a diagnosis of myelomeningocele. The nurse could expect which of the following with the disorder?

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