A nurse recognizes that the most likely initial clinical finding in infants with sickle cell disease is:
Jaundice of the skin and eyes
Fever without a source
Swelling of the hands and feet
Failure to thrive
The Correct Answer is C
A. Jaundice can occur due to hemolysis but is not usually the earliest or most specific initial finding.
B. Fever may occur with infection, but it is not typically the first sign of sickle cell disease in infants.
C. Swelling of the hands and feet (dactylitis) is often the earliest clinical manifestation in infants, caused by vaso-occlusion from sickled cells.
D. Failure to thrive may develop later due to chronic illness but is not usually the initial finding.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Persistent primitive reflexes (such as the Moro, tonic neck, or grasp reflex) are a hallmark finding in young children with cerebral palsy. Normally, these reflexes disappear as the nervous system matures. Their persistence indicates delayed or abnormal neurological development, which is common in cerebral palsy.
B. Children with cerebral palsy often demonstrate abnormal muscle tone, which may be spastic (increased tone), hypotonic (low tone), or fluctuate between both. Normal tone is not expected.
C. Symmetrical, well-coordinated movements are typically impaired. Children may show asymmetry, abnormal posture, or involuntary movements.
D. Gross motor skill development is often delayed or abnormal due to impaired muscle coordination and tone.
Correct Answer is C
Explanation
A. Applying diaper cream only at bedtime does not provide adequate protection. Barrier creams (such as zinc oxide or petroleum jelly) should be applied with each diaper change to protect the skin from prolonged contact with urine and stool.
B. Keeping the diaper area moist promotes skin breakdown and increases the risk of fungal and bacterial overgrowth. The goal is to keep the area clean and dry.
C. Changing the diaper every 2 to 3 hours (or sooner if soiled) helps minimize skin exposure to irritants, reducing the likelihood of diaper dermatitis. Frequent changes, along with gentle cleaning and use of barrier ointments, are the most effective preventive strategies.
D. Using scented wipes can irritate the sensitive skin of infants. Unscented wipes or plain water with a soft cloth are preferred.
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