A nurse is caring for a child with spina bifida and an associated complication of hydrocephalus with neurological damage.
Which of the following conditions should the nurse expect to accommodate during care?

Hearing loss.

Speech problems.

Frequent seizures.

Difficulty walking.

Cognitive delays.

Answer and Explanation

Correct Answer : B,D,E

Choice A rationale

While hearing loss can occur in some individuals with spina bifida due to associated anomalies or complications like meningitis, it is not as universally expected as other neurological impairments. The primary impact of hydrocephalus and neurological damage often manifests in areas directly related to brain development and function, making hearing loss a less common direct consequence.

Choice B rationale

Neurological damage associated with hydrocephalus and spina bifida frequently affects brain regions responsible for speech production and language processing. This can lead to various speech problems, including dysarthria or apraxia of speech, due to impaired motor control or cognitive deficits impacting linguistic expression and comprehension.

Choice C rationale

Frequent seizures are a potential complication of hydrocephalus and neurological damage due to abnormal electrical activity in the brain caused by structural anomalies or increased intracranial pressure. However, while possible, they are not as universally present in all cases as other common motor and cognitive impairments, making them a less frequent expectation.

Choice D rationale

Spina bifida often involves malformations of the spinal cord, directly impacting nerve function to the lower extremities. Hydrocephalus, by causing increased intracranial pressure and brain damage, can further impair motor control pathways. This combination frequently leads to motor deficits, resulting in varying degrees of difficulty walking or complete paralysis.

Choice E rationale

Hydrocephalus, especially when associated with neurological damage, can significantly impair cognitive development due to increased intracranial pressure and damage to brain tissue. This can manifest as delays in various cognitive domains, including learning, memory, problem-solving, and executive functions, impacting overall intellectual functioning.

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Correct Answer is ["0.5"]

Explanation

Step 1 is to convert milligrams (mg) to micrograms (mcg). 0.05 mg × 1000 mcg/mg = 50 mcg.

Step 2 is to determine the number of tablets to administer. 25 mcg ÷ (50 mcg/tablet) = 0.5 tablets. The nurse would administer 0.5 tablets.

A. Elevated sodium level that must be reported to the healthcare provider immediately. B. Probable error in the laboratory analysis which needs to be repeated. C. Expected electrolyte abnormality in clients with chronic renal failure. D. Possible hemodilution effect secondary to excessive water retention.

Correct Answer is D

Explanation

Choice A rationale

A normal serum sodium level ranges from 135 to 145 mEq/L. A value of 120 mEq/L is significantly below the normal range, indicating hyponatremia, not an elevated level. Therefore, reporting it as elevated would be incorrect.

Choice B rationale

While laboratory errors can occur, a serum sodium level of 120 mEq/L in a client with chronic renal failure is a plausible finding due to impaired fluid and electrolyte balance, making a repeat analysis not the immediate primary interpretation without further clinical context.

Choice C rationale

While electrolyte abnormalities are common in chronic renal failure, a serum sodium of 120 mEq/L is a low sodium level (hyponatremia), not necessarily an "expected" abnormality in the sense of being benign or typical without specific context. It reflects a significant imbalance.

Choice D rationale

Chronic renal failure often leads to fluid retention due to impaired kidney excretion. This excessive water retention dilutes the body's sodium concentration, leading to a condition known as dilutional hyponatremia, where the total body sodium may be normal or even elevated, but its concentration is lowered by the excess fluid.

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A nurse is caring for a child with spina bifida and an associated complication of hydrocephalus with neurological damage. Which of the following conditions should the nurse expect to accommodate during care?

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Naxlex Comprehensive Predictor Exams

A client is to receive Levothyroxine 25 mcg PO daily. Levothyroxine unit dose available is 0.05 mg/tablet. What would the nurse administer?

Correct Answer is ["0.5"]

Explanation

The nurse has identified the problem of Fluid Volume Excess for a client with chronic renal failure. The laboratory report indicates a serum sodium level of 120 mEq/L. The nurse interprets this finding as a:

Correct Answer is D

Explanation

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A nurse is caring for a child with spina bifida and an associated complication of hydrocephalus with neurological damage.
Which of the following conditions should the nurse expect to accommodate during care?