What physiologic state(s) produces the clinical manifestations of nervous system stimulation and excitement, such as overexcitability, nervousness, and tetany?
- A. Metabolic acidosis
- B. Respiratory alkalosis
- C. Metabolic and respiratory acidosis
- D. Metabolic and respiratory alkalosis
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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The nurse is selecting a site to begin an intravenous infusion on a 2-year-old child. The superficial veins on his hand and arm are not readily visible. What intervention should increase the visibility of these veins?
- A. Gently tap over the site.
- B. Apply a cold compress to the site.
- C. Raise the extremity above the level of the body
- D. Use a rubber band as a tourniquet for 5 minutes.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A father calls the clinic because he found his young daughter squirting Visine eyedrops into her mouth. What is the most appropriate nursing action?
- A. Reassure the father that Visine is harmless.
- B. Direct him to seek immediate medical treatment.
- C. Recommend inducing vomiting with ipecac.
- D. Advise him to dilute Visine by giving his daughter several glasses of water to drink.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Which information about hemophilia will the nurse include in the teaching plan for the parents of a child diagnosed with hemophilia?
- A. Autosomal dominant disorder in which the blood clotting factors are deficient.
- B. X-linked recessive inherited disorder in which blood clotting factors are deficient.
- C. X-linked recessive inherited disorder involving decreased platelets causing prolonged bleeding.
- D. Autosomal recessive disorder in which the blood clotting factors are deficient.
Correct Answer: B
Rationale: The correct answer is B: Hemophilia is an X-linked recessive disorder, primarily affecting males and passed from mothers to sons. It involves a deficiency in clotting factors, leading to prolonged bleeding. Choice A is incorrect as hemophilia is not autosomal dominant. Choice C is incorrect as hemophilia does not involve platelets. Choice D is incorrect as hemophilia is not autosomal recessive.
An awake, alert 4-year-old child has just arrived at the emergency department after an ingestion of aspirin at home. The practitioner has ordered activated charcoal. The nurse administers charcoal in which manner?
- A. Giving half of the solution and then repeating the other half in 1 hour
- B. Mixing with a flavorful beverage in an opaque container with a straw
- C. Serving it in a clear plastic cup so the child can see how much has been drunk
- D. Administering it through a nasogastric tube because the child will not drink it because of the taste
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
What is the most critical physiologic change required of newborns at birth?
- A. Transition from fetal to neonatal breathing
- B. Body temperature maintenance
- C. Stabilization of fluid and electrolytes
- D. Closure of fetal shunts in the heart
Correct Answer: A
Rationale: The correct answer is A: Transition from fetal to neonatal breathing. The onset of breathing is the most immediate and critical physiologic change required for the transition to extrauterine life. Factors that interfere with this normal transition increase fetal asphyxia, which is a condition of hypoxemia, hypercapnia, and acidosis. While body temperature maintenance, stabilization of fluid and electrolytes, and closure of fetal shunts in the heart are crucial changes in the transition to extrauterine life, breathing and the exchange of oxygen for carbon dioxide must take precedence as they are essential for newborn survival.