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The nurse is conducting discharge teaching about signs and symptoms of heart failure to parents of an infant with a repaired tetralogy of Fallot. Which signs and symptoms should the nurse include? (Select all that apply.)
- A. Warm flushed extremities
- B. Weight loss
- C. Decreased urinary output
- D. Sweating (inappropriate)
Correct Answer: C
Rationale: C. Decreased urinary output: This can be a sign of fluid retention, which is a common symptom of heart failure. Infants with heart failure may have decreased urine output as the body tries to retain fluid to help compensate for the heart's decreased ability to pump effectively.
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All the following are recognizable teratogens EXCEPT
- A. ethanol
- B. antiepileptic medications
- C. toxoplasmosis
- D. hypothermia
Correct Answer: D
Rationale: Hypothermia is not traditionally considered a teratogen compared to others listed.
What orders would likely be included fro a client diagnosed with multiple myeloma?
- A. Bed rest
- B. Fluid restriction
- C. Corticosteroid therapy
- D. Calcium replacement therapy
Correct Answer: C
Rationale: Corticosteroid therapy is commonly used in the treatment of multiple myeloma. It is often part of the initial treatment plan for this disease and is used to help control the cancer cells by reducing inflammation and immune responses. Corticosteroids can help manage symptoms such as pain and complications related to the disease. Bed rest, fluid restriction, and calcium replacement therapy may not be directly indicated for multiple myeloma treatment.
A patient with a history of haemophilia A arrives in the emergency department complaining of a "funny feeling" in his elbow. The patient states that he thinks he is bleeding into the joint. Which response by the nurse is correct?
- A. Palpate the patient's elbow to assess for swelling.
- B. Notify the physician immediately and expect an order for factor VIII.
- C. Prepare the patient for an x-ray examination to determine whether bleeding is occurring.
- D. Apply heat to the patient's elbow and wait for the physician to examine the patient.
Correct Answer: B
Rationale: For a patient with a history of hemophilia A complaining of a "funny feeling" in the elbow, suspecting bleeding into the joint, the correct response by the nurse is to notify the physician immediately and expect an order for factor VIII. Hemophilia A is a genetic disorder characterized by a deficiency in clotting factor VIII, leading to prolonged bleeding. In this case, immediate medical intervention in the form of factor VIII replacement therapy is crucial to control and manage the bleeding episode. Urgent treatment aims to prevent complications such as joint damage and to promote hemostasis in patients with hemophilia. Palpating the elbow, preparing for an x-ray, or applying heat are not the appropriate initial actions when managing a suspected bleeding episode in a patient with hemophilia.
The nurse is assessing a newborn who had undergone vaginal delivery. Which of the following findings is least likely to be observed in a normal newborn?
- A. uneven head shape
- B. respirations are irregular, abdominal, 30-60 bpm
- C. (+) Moro reflex
- D. heart rate is 80 bpm
Correct Answer: D
Rationale: The heart rate of a normal newborn is typically 120 to 160 bpm. Therefore, a heart rate of 80 bpm would be least likely to be observed in a normal newborn. This finding may indicate bradycardia, which should be further evaluated and managed by the healthcare provider. Other options such as an uneven head shape, irregular respirations, (+) Moro reflex are common and expected in newborns.
Deteriorating insulation is found in the ceilings of a local school built in 195Parents and teachers are extremely concerned that it may be asbestos, and they call on you, the local pediatrician, to give advice in an open meeting. What advice would you give?
- A. Immediately remove all of the insulation.
- B. Confirm the presence of asbestos by laboratory evaluation, and do nothing further.
- C. Confirm the presence of asbestos by laboratory evaluation. If asbestos is confirmed, call a certified engineer for expert assessment.
- D. Reassure the parents that the hazards of asbestos have been overstated.
Correct Answer: C
Rationale: Asbestos should be confirmed by laboratory testing, and if present, a certified engineer should assess the situation to determine the safest course of action.