Nokea
An infant with a congenital heart defect is being given gavage feedings. The parents ask the nurse why this is necessary. How should the nurse respond?
- A. It limits the chance of vomiting.
- B. It allows the feeding to be administered rapidly.
- C. The energy that would have been expended on sucking is conserved.
- D. The quantity of nutritional liquid can be regulated better than with a bottle.
Correct Answer: C
Rationale: The correct answer is C: 'The energy that would have been expended on sucking is conserved.' Gavage feedings are necessary for infants with congenital heart defects as they help conserve the infant's energy by eliminating the need for sucking, which can be taxing for infants with cardiac issues. Choice A is incorrect because gavage feedings are not primarily used to limit vomiting. Choice B is incorrect as the speed of administration is not the main reason for gavage feedings in this case. Choice D is incorrect because the regulation of the quantity of nutritional liquid is not the primary rationale for gavage feedings in infants with congenital heart defects.
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When you attempt to assess a 22-year-old woman who has been sexually assaulted, and she orders you not to touch her, your most appropriate initial action should be to
- A. ask the patient to sign a release form
- B. ask a female EMT-B to attempt to assess the patient
- C. explain to the patient that she must be examined
- D. transport the patient without performing an assessment
Correct Answer: B
Rationale: In this scenario, the patient has requested not to be touched, indicating a need for sensitivity and understanding. Asking a female EMT-B to attempt to assess the patient is the most appropriate initial action as it respects the patient's need for privacy, comfort, and potentially reduces re-traumatization. Asking the patient to sign a release form (Choice A) is not suitable as it disregards the patient's immediate concerns. Explaining to the patient that she must be examined (Choice C) may further distress her and violate her autonomy. Transporting the patient without performing an assessment (Choice D) ignores the patient's expressed wishes and may lead to inadequate care.
A group of students is reviewing information about the various types of insulin used to treat type 1 diabetes. The students demonstrate understanding of the information when they identify which of these insulins as having the longest duration.
- A. Lispro
- B. Regular
- C. NPH
- D. Glargine
Correct Answer: D
Rationale: The correct answer is Glargine (Lantus) as it has the longest duration of action among the insulins listed, lasting 12 to 24 hours. Lispro (Humalog) and Regular (short-acting) insulins have shorter durations of action, typically lasting 3 to 6 hours. NPH (Neutral Protamine Hagedorn) insulin has an intermediate duration of action, lasting around 12 to 18 hours. Therefore, choices A, B, and C are incorrect in the context of insulin duration.
What is the most important intervention for a nurse to implement for a child with sickle cell anemia admitted to the hospital during a vaso-occlusive crisis?
- A. Administering oxygen
- B. Ensuring adequate hydration
- C. Monitoring vital signs
- D. Administering pain medication
Correct Answer: B
Rationale: Ensuring adequate hydration is crucial during a vaso-occlusive crisis in sickle cell anemia as it helps to reduce the viscosity of the blood and prevent further sickling of the cells. While administering oxygen may be necessary in some cases, ensuring hydration takes precedence as it directly impacts the underlying pathophysiology of the crisis. Monitoring vital signs is important for ongoing assessment but does not directly address the crisis as hydration does. Administering pain medication is important for pain relief but does not address the primary issue of vaso-occlusion and is not the most crucial intervention in this scenario.
What are the most common signs and symptoms of leukemia related to bone marrow involvement?
- A. petechiae, infection, fatigue
- B. headache, papilledema, irritability
- C. muscle wasting, weight loss, fatigue
- D. decreased intracranial pressure, psychosis, confusion
Correct Answer: A
Rationale: Petechiae, infection, and fatigue are common signs and symptoms of leukemia related to bone marrow involvement. Petechiae are small red or purple spots on the skin caused by bleeding under the skin due to low platelet counts. Infection susceptibility increases due to decreased white blood cells from compromised bone marrow function. Fatigue is a common symptom of anemia resulting from decreased red blood cell production. Choices B, C, and D are incorrect as they do not align with the typical signs and symptoms of leukemia associated with bone marrow dysfunction.
A nurse is teaching the parents of a child with a diagnosis of epilepsy about seizure precautions. What should the nurse include in the teaching?
- A. Keep a diary of seizure activity
- B. Administer antiepileptic medication only when a seizure occurs
- C. Restrict the child's activities to prevent seizures
- D. Teach seizure first aid to family members
Correct Answer: D
Rationale: Teaching seizure first aid to family members is essential as it empowers them to respond effectively during a seizure. Keeping a diary of seizure activity is important for tracking patterns and triggers but is not directly related to immediate safety. Administering antiepileptic medication only when a seizure occurs is not recommended as medications should be administered as prescribed by healthcare providers. Restricting the child's activities to prevent seizures is not appropriate as children with epilepsy should be encouraged to lead active lives while taking necessary precautions.