The nurse caring for an adolescent patient with a diagnosis of goiter knows that goiter is most often caused by?
- A. Kawasaki's disease
- B. Takayasu Disease
- C. Matsuzaki Disease
- D. Hashimoto Disease
Correct Answer: D
Rationale: The correct answer is D: Hashimoto Disease. Goiter is most commonly caused by Hashimoto Disease, which is an autoimmune condition where the body attacks the thyroid gland, leading to inflammation and enlargement of the gland. This results in the development of a goiter. Kawasaki's disease (A), Takayasu Disease (B), and Matsuzaki Disease (C) are not typically associated with the development of goiter. A summary of why the other choices are incorrect: A is a systemic vasculitis, B is a type of vasculitis involving the aorta and its main branches, and C is a fictional disease.
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Which should be the major consideration in selecting toys for a child who is cognitively impaired?
- A. Age appropriateness
- B. Ability to teach useful skills
- C. Safety
- D. Ability to provide exercise
Correct Answer: C
Rationale: The major consideration in selecting toys for a cognitively impaired child should be safety (Choice C). Safety is crucial as children with cognitive impairments may have difficulty understanding potential dangers or using toys appropriately. Age appropriateness (Choice A) is important, but safety should take precedence. Teaching useful skills (Choice B) can be beneficial but may not be the primary focus. Providing exercise (Choice D) is valuable, but ensuring safety should come first.
When caring for a newborn with Down syndrome, what should the nurse be aware is the most common congenital anomaly associated with Down syndrome?
- A. Diabetes insipidus
- B. Pyloric stenosis
- C. Congenital heart disease
- D. Congenital hip dysplasia
Correct Answer: C
Rationale: The correct answer is C: Congenital heart disease. Down syndrome is commonly associated with congenital heart defects, such as atrioventricular septal defects or ventricular septal defects. This is important for the nurse to be aware of because these heart anomalies can impact the newborn's health and require monitoring or intervention.
Choice A: Diabetes insipidus is not a common congenital anomaly associated with Down syndrome.
Choice B: Pyloric stenosis is not typically associated with Down syndrome.
Choice D: Congenital hip dysplasia is not a common anomaly seen with Down syndrome.
In summary, the nurse should prioritize monitoring for congenital heart disease in a newborn with Down syndrome due to its high prevalence and potential impact on the baby's health.
You are the nurse caring for a 3-year-old, 33-pound child on digoxin. The safe dose range for digoxin is 20-40 mcg/kg/day. The order is for digoxin to be given IV every 12 hours, what is the maximum safe single dose the child should receive?
- A. 300 mcg
- B. 600 mcg
- C. 660 mcg
- D. 1320 mcg
Correct Answer: A
Rationale: The correct answer is A: 300 mcg. To determine the maximum safe single dose, we first need to calculate the total daily safe dose range for the child. The child's weight is 33 pounds, which is approximately 15 kg (1 kg = 2.2 lbs). The safe dose range is 20-40 mcg/kg/day, so for a 15 kg child, the total daily safe dose range would be 300-600 mcg/day. Since the medication is given every 12 hours, the maximum safe single dose would be half of the total daily dose, which is 300 mcg. This ensures that the child stays within the safe dose range for digoxin. Choice B (600 mcg) exceeds the maximum daily safe dose, choice C (660 mcg) exceeds the daily safe dose range, and choice D (1320 mcg) is way above the safe dose range for the child's weight.
A child with a history of diabetes mellitus presents with sweating, confusion, and slurred speech. The nurse suspects the cause is:
- A. Hyperglycemia
- B. Hyperkalemia
- C. Hyponatremia
- D. Hypoglycemia
Correct Answer: D
Rationale: The correct answer is D: Hypoglycemia. In a child with a history of diabetes mellitus, sweating, confusion, and slurred speech indicate low blood sugar levels. Hypoglycemia can lead to neuroglycopenic symptoms like confusion and slurred speech. Hyperglycemia (choice A) would present with polyuria, polydipsia, and fruity breath. Hyperkalemia (choice B) can cause muscle weakness and cardiac arrhythmias. Hyponatremia (choice C) typically presents with weakness, fatigue, and confusion. In this case, the symptoms point towards hypoglycemia as the most likely cause.
A nurse is caring for a 2-year-old toddler. Which of the following food choices should the nurse recommend to promote independence in eating?
- A. Banana Slices
- B. Grapes
- C. Hot dog
- D. Popcorn
Correct Answer: A
Rationale: The correct answer is A: Banana Slices. Toddlers can easily pick up banana slices with their fingers, promoting independence in self-feeding. Bananas are soft and easy to chew, reducing the risk of choking compared to grapes, hot dogs, and popcorn, which are common choking hazards for young children. Grapes and hot dogs can easily get stuck in a toddler's throat due to their shape and texture. Popcorn is a choking hazard due to its hard and small size. Therefore, recommending banana slices is the safest and most developmentally appropriate choice for promoting independence in eating for a 2-year-old toddler.