Nokea
Which is the most common cause of acute renal failure in children?
- A. Pyelonephritis
- B. Tubular destruction
- C. Urinary tract obstruction
- D. Inadequate perfusion
Correct Answer: D
Rationale: Inadequate perfusion, usually due to conditions such as shock or severe dehydration, is the most common cause of acute renal failure in children. Reduced blood flow to the kidneys impairs their ability to function properly and filter waste products from the blood. This can lead to a rapid decline in kidney function and the development of acute renal failure. Other potential causes such as pyelonephritis, tubular destruction, and urinary tract obstruction can also result in acute renal failure, but inadequate perfusion is the most common trigger, especially in pediatric patients.
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The nurse is caring for a high-risk newborn with an umbilical catheter in a radiant warmer. The nurse notes blanching of the feet. Which is the most appropriate nursing action?
- A. Elevate feet 15 degrees.
- B. Place socks on newborn.
- C. Wrap feet loosely in prewarmed blanket.
- D. Report findings immediately to the practitioner.
Correct Answer: C
Rationale: When the nurse notes blanching of the feet in a high-risk newborn with an umbilical catheter in a radiant warmer, the most appropriate nursing action is to wrap the feet loosely in a prewarmed blanket. Blanching indicates poor circulation to the area, which can be a result of cold stress or constriction of blood vessels. By wrapping the feet in a prewarmed blanket, the nurse can help to restore adequate blood flow to the feet and improve circulation. This action addresses the potential cause of the blanching and promotes the newborn's comfort and well-being.
Mrs. Zeno continues to become a weaker despite .treatment with neostigmine. Edrophonium HCL is ordered:
- A. For its synergestic effect
- B. Because of the client's resistance to
- C. To rule out cholinergic crisis Neostigmine
- D. To confirm the diagnosis of myasthenia
Correct Answer: C
Rationale: Edrophonium HCL is ordered to rule out cholinergic crisis caused by possible overdose of neostigmine. In myasthenia gravis, patients are normally given neostigmine to help improve muscle strength by prolonging the effect of acetylcholine at the neuromuscular junction. However, if too much neostigmine is given, it can lead to a cholinergic crisis characterized by excess stimulation at the neuromuscular junction. Edrophonium HCL is a fast-acting drug that can help differentiate between a myasthenic crisis (worsening of symptoms due to under-dosing of anti-cholinesterase medication like neostigmine) and a cholinergic crisis (worsening of symptoms due to over-dosing). By administering edrophonium HCL, the healthcare provider can observe the patient's response and determine if the weakness is due to under-treatment or over-treatment with
A postpartum nurse is providing instructions to the mother of a newborn infant with hyperbilirubinemia who is being breastfed. The nurse provides which most appropriate instructions to the mother?
- A. Switch to bottle feeding the baby for 2 weeks
- B. Stop the breast feedings and switch to bottle-feeding permanently
- C. Feed the newborn infant less frequently
- D. Continue to breastfeed every 2-4 hours.
Correct Answer: D
Rationale: The most appropriate instruction for a mother of a newborn infant with hyperbilirubinemia who is being breastfed is to continue to breastfeed every 2-4 hours. Breastfeeding should be initiated within 2 hours after birth and continued every 2-4 hours thereafter. Breast milk helps to promote the passage of meconium (the dark green stools of the newborn) and reduce the risk of hyperbilirubinemia. It is important to continue breastfeeding to establish and maintain a good milk supply, promote bonding between mother and baby, and provide important nutrients to the newborn. Switching to bottle feeding or feeding the newborn infant less frequently is not recommended in this case.
The lungs regulate acid-base balance b₃y⻠all of the following except:
- A. Excreting HCO into the blood
- B. Controlling carbon dioxide levels
- C. Slowing ventilation
- D. Increasing ventilation
Correct Answer: C
Rationale: The lungs help regulate acid-base balance primarily by controlling carbon dioxide levels through ventilation. When carbon dioxide levels increase in the blood, the lungs increase ventilation to exhale more carbon dioxide and maintain the acid-base balance. Slowing ventilation (Option C) would not help in regulating the acid-base balance as it would lead to a buildup of carbon dioxide in the blood, causing respiratory acidosis. Excreting HCO into the blood (Option A) helps maintain acid-base balance by regulating bicarbonate levels, and increasing ventilation (Option D) is the mechanism through which the lungs primarily adjust acid-base balance.
An 8-month-old infant has a hypercyanotic spell while blood is being drawn. What is the priority nursing action?
- A. Assess for neurologic defects
- B. Place the child in the knee-chest position
- C. Begin cardiopulmonary resuscitation
- D. Prepare family for imminent death
Correct Answer: B
Rationale: When an 8-month-old infant has a hypercyanotic spell, the priority nursing action is to place the child in the knee-chest position. This position helps to increase venous return to the heart and improve systemic circulation, which can relieve the cyanosis by decreasing right-to-left shunting of blood. Placing the child in the knee-chest position helps optimize oxygenation and circulation, which is crucial during a hypercyanotic spell. Assessing for neurologic defects, beginning cardiopulmonary resuscitation, or preparing the family for imminent death are not the priority actions during a hypercyanotic spell in this scenario.