According to the heparin protocol, a patient is to receive 70 units per kilogram IV before a continuous heparin infusion is started.

For a patient weighing 60 kilograms, how many units of heparin should be administered? Whole number.

Choice A rationale

The Apgar score is a rapid method, performed at one and five minutes after birth, to quickly assess the newborn's immediate adjustment to extrauterine life by evaluating five signs: heart rate, respiratory effort, muscle tone, reflex irritability, and color. It is an index of immediate postnatal transition and resuscitation need, but it does not correlate with or assess the infant's gestational age or physical maturity.

Choice B rationale

The Ballard score, a common assessment tool, systematically evaluates both the neuromuscular maturity (e.g., posture, square window, scarf sign) and physical maturity (e.g., skin texture, lanugo, plantar creases, breast development, ear cartilage, and genitalia) of a newborn. The total score is then used to estimate the infant's gestational age with a high degree of correlation, which is vital for providing appropriate clinical care.

Choice C rationale

Phenylketonuria (PKU) screening is a metabolic test performed as part of the newborn screening panel, usually after 24 hours of feeding, to detect the absence of the enzyme phenylalanine hydroxylase. This test is crucial for early detection of a treatable inborn error of metabolism but has no correlation with or utility in assessing the physical or neurological maturity of the newborn or estimating gestational age.

Choice D rationale

Length and weight measurements, along with head circumference, are standard anthropometric assessments used to track growth and compare the newborn's size relative to its estimated gestational age (e.g., small, appropriate, or large for gestational age). While important for growth monitoring, these measurements alone do not provide a comprehensive assessment of neurological or physical maturity for precise gestational age estimation. —.

Choice A rationale

A child with a diagnosed latex sensitivity, especially one with a history of myelomeningocele which carries a high risk, should absolutely wear medical alert identification. This ensures that emergency medical personnel and others are immediately aware of the allergy to prevent exposure to potentially life-threatening latex products.

Choice B rationale

It is crucial to inform all caregivers, including school nurses, teachers, and daycare providers, about the child's latex allergy. This allows them to implement proper avoidance strategies in their respective environments and recognize early signs of a reaction, ensuring the child's safety outside the home.

Choice C rationale

The statement that a product's label always indicates whether it is latex-free is incorrect and indicates a need for further teaching. Many items contain "hidden" latex, and labeling may not be mandatory or always comprehensive, requiring parents to exercise extreme caution and directly inquire about product composition.

Choice D rationale

Complete avoidance of all contact with products containing natural rubber latex is the only definitive way to prevent an allergic reaction in a sensitized child. Exposure, even to airborne particles from latex-containing materials, can trigger reactions ranging from mild skin irritation to severe anaphylaxis.