Rationalization 4H Finals Legaspi

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  • 8/8/2019 Rationalization 4H Finals Legaspi

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    1. A. Hypoglycemia is a common problem of babies of diabetic mothers. The normal blood glucose is 80 100mg/dL thus 40 mg/dl is considered low.

    2. A. Uranoplasty is done before speech pattern is developed.3. B. Tap water enema is contraindicated in these infants because it causes rapid fluid shifting. Isotonic enemas

    are done instead.

    4. B. In pyloric stenosis, the obstruction is gradual because the pyloric muscle does not hypertrophy at onesingle time. Vomiting progresses from less frequent to more frequent, from spitting to projectile, from just

    previously taken milk to blood-tinge mucous. It is usually non-bile-stained because the obstruction is before

    the duodenum. The infant will always be hungry and will definitely not show hesitancy. The olive-shaped

    mass in pyloric stenosis is palpated at the right of the umbilicus, not at the xiphoid process.

    5. B. Comforting the child ASAP will prevent crying, thus, minimizing tension to the suture line. Positioning onprone is contraindicated since the child may rub the suture line on the linen of the bed. Dropper is used in

    feeding post-op. In cleaning the wound, a cotton applicator is used, not the washcloth.

    6. B. Bedrest for 24 hours is advised post cardiac catheterization to prevent bleeding and cardiac arrhythmias.7. C. Excessive drooling and immediate regurgitation of feedings are manifestations of esophageal atresia.8. B. Fluid and electrolyte has higher priority than nutrition, growth and development and family coping.9. D. Intussusception is a pediatric surgical emergency and should be treated STAT to prevent strangulation and

    necrosis of the bowels.10. D. Pressure must be kept off the spinal sac. As there is paralysis of the lower extremities, these should be

    abducted. Trendelenburgs is contraindicated in hydrocephalus.

    11. B. Squatting position is normal response to a cyanotic heart defect. This position increases pulmonary bloodflow because it changes the relationship between systemic and pulmonary vascular resistance. The squatting

    alone should increase O2 level so administration of oxygen may not be necessary. Trendelenburg position

    will decrease pulmonary blood flow and makes it harder to breathe. His cardiopulmonary status would not

    allow him to walk around the room at this time.

    12. A. Another major symptom of rheumatic fever is arthritis.13. B. Antibiotic prophylaxis is needed prior to any invasive procedure such as dental work to prevent

    endocarditis in patients with rheumatic fever.

    14. D. She is capable of turning her head from side to side, thus pressing the call bell with her cheek is the onlypossible way to call the nurse.

    15. C. Heart rate of infants is normally greater than 100. No dysrhythmias indicates no toxicity to digoxin.16. A. There is increased excretion of chloride in the sweat of children with cystic fibrosis. A chloride level of

    over 60 mEq/L is diagnostic for the disease.

    17. B. The testes remain in the abdomen beyond the age of 5, damage resulting from exposure to internal bodytemperature can result in sterility.

    18. D. In hypospadias, the urethral opening may be anywhere along the underside of the penis. This dislocationmay be accompanied by genital edema and fibrous penile dislocation, which may be difficult to identify

    sexually. If uncorrected, the boy will have problems controlling his urinary stream when he has outgrown

    diapers.

    19. C. Observing the child void in a straight stream while standing is the expected successful outcome ofhypospadias repair. The penis may be swollen and discolored after surgery and voiding may be

    uncomfortable initially. Having a stable BP is always important but its presence does not indicate successful

    surgical repair of hypospadias.

    20. D. The clinical manifestations of viral meningitis include fever, irritability and stiffness of the neck (nuchalrigidity). Petechiae and hypothermia are not seen.

    21. A. Photophobia and hypersensitivity to environmental stimuli are common manifestations of meningealirritation and infection. Comfort measures include providig an environment that is quiet and has minimal

    stressful stimuli. Viral meningitis is not contagious so contact with family members is not contraindicated.

    22. D. All of the other choices are correct ways to prevent spread of infection.

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