Which is the priority nursing intervention for an infant diagnosed with myelomeningocele?

Educating caregivers on sensory impairment.

Preventing infection.

Correction of joint contractures.

Measuring daily head circumference.

Answer and Explanation

The Correct Answer is B

Choice A rationale:

While educating caregivers on sensory impairment is important for an infant with myelomeningocele, preventing infection takes precedence as the priority nursing intervention.

Choice B rationale:

The correct answer. Preventing infection at the site of the myelomeningocele is crucial to avoid potentially life-threatening complications, such as meningitis. The exposed neural tissue poses a significant infection risk.

Choice C rationale:

Correcting joint contractures is important but is a secondary concern compared to preventing infection, which can have more immediate and severe consequences.

Choice D rationale:

Measuring daily head circumference is important to monitor for hydrocephalus in these infants, but preventing infection remains the higher priority.

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Correct Answer is B

Explanation

Choice A rationale:

The red blood cell count is not typically elevated in leukemia. Leukemia primarily affects the white blood cells and their precursors in the bone marrow.

Choice B rationale:

Leukemia involves uncontrolled proliferation of white blood cells. An elevated white blood cell count, especially with abnormal cell types, can support the diagnosis of leukemia.

Choice C rationale:

Platelet count abnormalities are common in leukemia, but an elevated platelet count is more often associated with other conditions such as essential thrombocytosis, not necessarily leukemia.

Choice D rationale:

Hematocrit measures the volume of red blood cells in the blood and is not directly indicative of leukemia. Leukemia primarily affects white blood cells and does not significantly impact hematocrit levels.

A. X-linked dominant. B. Autosomal recessive. C. Autosomal dominant. D. X-linked recessive.

Correct Answer is D

Explanation

Choice A rationale:

X-linked dominant disorders are characterized by a mutation on the X chromosome that results in the expression of the trait in both males and females. Hemophilia, however, is more commonly associated with males, which is not consistent with an X-linked dominant pattern.

Choice B rationale:

Autosomal recessive disorders require the inheritance of two mutated alleles, one from each parent, to express the trait. Hemophilia does not follow this pattern, as the patient's sisters do not have the condition despite having affected parents.

Choice C rationale:

Autosomal dominant disorders only require the inheritance of one mutated allele from an affected parent to express the trait. Hemophilia does not align with an autosomal dominant pattern, as the patient's sisters would likely be affected if it were.

Choice D rationale:

Hemophilia is a classic example of an X-linked recessive disorder. The gene responsible for producing clotting factor is located on the X chromosome, and males have only one X chromosome, making them more susceptible to the disorder. Females, with two X chromosomes, usually act as carriers unless both X chromosomes carry the mutation.

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Which is the priority nursing intervention for an infant diagnosed with myelomeningocele?

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Naxlex Comprehensive Predictor Exams

A 4-year-old patient is brought to the clinic because the child has not recovered from a respiratory infection. The patient is pale and lethargic. Leukemia is suspected. Which lab value, if elevated, would support the diagnosis of leukemia?

Correct Answer is B

Explanation

Correct Answer is D

Explanation

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