Which of the following findings may lead a nurse to suspect spina bifida?

High levels of cerebrospinal fluid (CSF)

Increased intracranial pressure (ICP)

Indications of infection

Presence of a small dimple and a tuft of hair over the lower lumbar region.

Answer and Explanation

The Correct Answer is D

A. High levels of cerebrospinal fluid (CSF): Spina bifida is a neural tube defect involving incomplete closure of the vertebral column rather than abnormal CSF production. Elevated CSF levels are not a defining feature and are not used as a screening indicator. CSF abnormalities are more relevant to hydrocephalus assessment.

B. Increased intracranial pressure (ICP): Elevated ICP may occur secondary to associated conditions such as hydrocephalus, but it is not an initial or direct sign of spina bifida. The defect itself is identified by spinal and cutaneous findings. ICP changes develop later if complications arise.

C. Indications of infection: Infection is a potential complication if neural tissue is exposed, but it is not an initial indicator prompting suspicion of spina bifida. Early recognition relies on visible spinal or skin markers. Infection suggests a secondary problem rather than the congenital defect.

D. Presence of a small dimple and a tuft of hair over the lower lumbar region: Cutaneous stigmata such as a sacral dimple, hair tuft, or discoloration are classic indicators of underlying spinal dysraphism. These findings warrant further evaluation for spina bifida occulta. They are key clues during newborn and infant assessment.

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Correct Answer is D

Explanation

A. Delayed motor skills: Thyroid hormone deficiency can impair muscle tone and coordination, leading to delayed gross and fine motor development. Motor delays are common but may improve with treatment initiation. They are not the most severe long-term consequence if the condition remains untreated.

B. Delayed social interactions: Social development may be affected secondary to overall developmental delay, but it is not the primary or most critical impact of untreated congenital hypothyroidism. Social deficits often reflect underlying cognitive impairment rather than isolated thyroid effects. Early hormone replacement can mitigate these concerns.

C. Delayed language development: Language delay is frequently observed due to impaired neurologic maturation and slowed cognitive processing. While significant, language skills are influenced by broader cognitive function. Addressing thyroid deficiency early helps prevent long-term speech and language deficits.

D. Delayed cognitive abilities: Thyroid hormone is essential for brain development, particularly in early childhood when neuronal growth and myelination are most active. Untreated congenital hypothyroidism can result in permanent intellectual disability. Cognitive impairment represents the most serious and irreversible developmental consequence.

A. "Preschool-aged children thrive on routine, so you shouldn't change their eating." B. "As long as they're getting the appropriate calories, you don't need to change their diet." C. "Preschool-aged children are finicky eaters, so there isn't much you can do except provide what they will eat." D. "You can offer different foods for them to choose from to provide variety."

Correct Answer is D

Explanation

A. "Preschool-aged children thrive on routine, so you shouldn't change their eating.": While routine is important, offering a variety of healthy foods within that routine helps promote balanced nutrition rather than maintaining the same limited options.

B. "As long as they're getting the appropriate calories, you don't need to change their diet.": Focusing only on calories overlooks the importance of nutrient quality, variety, and balanced food groups, which are critical for growth and development at this age.

C. "Preschool-aged children are finicky eaters, so there isn't much you can do except provide what they will eat.": Labeling children as finicky may discourage proactive strategies; parents can influence dietary habits through structured choices and positive reinforcement.

D. "You can offer different foods for them to choose from to provide variety.": Allowing children to choose from a variety of healthy options encourages autonomy, supports positive eating behaviors, and exposes them to new tastes and nutrients, which aligns with evidence-based recommendations for preschool nutrition.

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Which of the following findings may lead a nurse to suspect spina bifida?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

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Correct Answer is D

Explanation

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