During a well child visit, the parents of a client who has an autosomal dominant disorder, inform the nurse that they do not plan on having any more children since the next child is likely to inherit the disorder.
How should the nurse respond?

Confirm that the risk of inheriting the disorder decreases by 50% with each child the couple has.

Encourage the couple to reconsider their decision since the inheritance pattern may be sex linked.

Acknowledge that the next child will inherit the disorder since the first child did not.

Explain that each individual future child has a 50% chance of inheriting the disorder.

Answer and Explanation

The Correct Answer is D

Choice A rationale

Each pregnancy is an independent event with its own set of probabilities. The risk of inheriting an autosomal dominant disorder does not decrease or increase with subsequent children. The probability is determined by the parental genotype, and it remains a constant fifty percent chance for each child born to an affected parent.

Choice B rationale

The question explicitly states that the disorder is autosomal dominant, meaning it is not sex-linked. Therefore, the inheritance pattern is not dependent on the sex of the child. It affects both male and female offspring with equal probability, and it is crucial to provide accurate genetic counseling based on the specific inheritance pattern.

Choice C rationale

The inheritance of an autosomal dominant disorder is probabilistic, not deterministic. Each child has a separate and independent 50% chance of inheriting the mutated gene. The outcome for a previous child does not influence the genetic outcome for a future child, as each pregnancy is a separate genetic event.

Choice D rationale

An autosomal dominant disorder means that a single copy of the mutated gene is sufficient to cause the disorder. Since one parent is affected, they have a fifty percent chance of passing on the mutated allele to each of their children. The other parent, who is unaffected, can only pass on the normal allele, resulting in a fifty percent chance for the disorder.

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Correct Answer is ["A","B","D","F"]

Explanation

Choice A rationale: Increased maternal presence supports the emotional attachment critical in early childhood development. Children aged 3–5 thrive on stability in primary caregiver interactions, which promotes a secure base for psychosocial growth as described by Bowlby’s attachment theory. Prolonged hospital stays disrupt normal social development and increase vulnerability to stress-related behaviors including withdrawal, hyperactivity, or regression. Encouraging maternal visitation can regulate cortisol levels and reduce sympathetic nervous system activation, easing elevated heart rate and blood pressure responses.

Choice B rationale: Daily engagement with a child life specialist introduces structured therapeutic play, which activates dopamine pathways involved in reward and coping, alleviating anxiety and fostering resilience. Through play, children process emotions and gain mastery over their environment. In hospitalized children, routine play reduces hospitalization stress, enhances emotional regulation, and supports neurological development. Play therapy can modulate cortisol secretion and stabilize autonomic responses, improving adaptive behavior and maintaining cognitive milestones even amid medical stressors.

Choice C rationale: Sedatives suppress the central nervous system and may temporarily reduce behavioral outbursts, but they do not address emotional root causes. Their use in young children must be cautiously considered due to immature hepatic and renal systems impacting drug metabolism and clearance. Behavioral symptoms stemming from emotional distress require psychosocial intervention. Additionally, sedatives may blunt coping mechanisms, increase risk of dependency, and interfere with neurodevelopment by affecting GABAergic transmission in critical developmental windows.

Choice D rationale: Video call communication preserves attachment continuity by maintaining the child’s connection with the primary caregiver despite physical absence. This interaction stimulates emotional pathways involving oxytocin release, which counters cortisol-mediated stress reactions. Visual and auditory reassurance promotes emotional security and can regulate sleep, appetite, and behavior. Studies in pediatric populations show virtual interactions reduce anxiety scores, support social-emotional stability, and reinforce familiarity in environments with prolonged caregiver separation.

Choice E rationale: Limiting staff interactions may reduce sensory input but risks worsening emotional isolation and decreasing opportunities for positive human engagement. Hospitalized children benefit from social contact that can scaffold emotional support, model coping, and promote developmental stimulation. Overstimulation is better addressed through individualized care plans with environmental modifications rather than social restriction. Neurobiologically, human engagement activates mirror neurons and oxytocin pathways essential for trust and emotional growth.

Choice F rationale: Consistent staffing fosters relational stability, trust formation, and psychological safety. It supports secure attachment dynamics in substitute caregiver contexts, particularly when primary attachment figures are intermittently present. Familiar caregiver interactions reduce anxiety, support routine predictability, and facilitate therapeutic rapport. Neurodevelopmental models show that repeated positive interpersonal contact in early childhood promotes limbic system regulation and reduces behavioral dysregulation often triggered by caregiver inconsistency.

A. "The ointment will dilate the pupil so the red reflex can be visualized.”. B. "The ointment will prevent a herpes infection.”. C. "The ointment will clear the infant's vision.”. D. "The ointment will prevent eye infections.”. . . .

Correct Answer is D

Explanation

Choice A rationale

Ophthalmic ointments like erythromycin or tetracycline do not have properties that dilate the pupils. Their chemical composition is designed to inhibit bacterial growth. Pupillary dilation is typically achieved with mydriatic agents, which are not included in these prophylactic treatments. The red reflex is a normal finding and not the purpose of the medication.

Choice B rationale

While the ointment is effective against certain sexually transmitted infections, a herpes simplex virus infection is a viral infection. The prophylactic ophthalmic ointments are bacteriostatic or bactericidal, specifically targeting bacterial pathogens like Neisseria gonorrhoeae and Chlamydia trachomatis. They are not effective in preventing viral infections.

Choice C rationale

The ointment is a thick, viscous substance that can temporarily cause blurred vision immediately after administration. It does not clear the infant's vision; rather, it is a prophylactic measure to prevent a severe infection that could lead to corneal scarring and blindness. The visual effect is temporary and not therapeutic.

Choice D rationale

Prophylactic ophthalmic ointment, typically erythromycin or tetracycline, is administered to all newborns to prevent ophthalmia neonatorum, which is an eye infection caused by bacteria such as Neisseria gonorrhoeae and Chlamydia trachomatis. These bacteria can be transmitted from the mother's birth canal and can cause serious eye damage, including blindness.

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During a well child visit, the parents of a client who has an autosomal dominant disorder, inform the nurse that they do not plan on having any more children since the next child is likely to inherit the disorder. How should the nurse respond?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a 4-year-old male client with a history of prematurity and organ transplants in the pediatric unit. Exhibits Which interventions should the nurse implement to address the client’s emotional distress? (Select all that apply.)

Correct Answer is ["A","B","D","F"]

Explanation

A father watching the admission of his newborn to the nursery notices that eye ointment is placed in the infant's eyes. He asks the nurse what the purpose of the ointment is. Which response by the nurse will best explain the purpose for administering the ointment?

Correct Answer is D

Explanation

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A 4-year-old child returns home after day surgery for a tonsillectomy. When the nurse calls the parent that evening to check on the child, the parent tells the nurse that the child said, “I'm too sick to feed myself. Will you feed me?” Which response should the nurse provide to this parent?

During a well child visit, the parents of a client who has an autosomal dominant disorder, inform the nurse that they do not plan on having any more children since the next child is likely to inherit the disorder.
How should the nurse respond?