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After a Whippie procedure for cancer of the pancreas, a client is to receive the following intravenous (IV) fluids over 24 hours; 1000 ml D5W; 0.5 liter normal saline; 1500 ml D5NS. In addition, an antibiotic piggyback in 50 ml D5W is ordered every 8 hours. The nurse calculates that the clients IV fluid intake Tor 24 hours will be:
- A. 3150ml
- B. 3650 ml
- C. 3200 ml
- D. 3750ml
Correct Answer: C
Rationale: To calculate the total IV fluid intake for 24 hours, we will add up the volume of each type of fluid ordered.
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Which blood product replaces missing clotting factors in the patient who has a bleeding disorder?
- A. Platelets
- B. Albumin
- C. Packed RBC
- D. Cryoprecipitate
Correct Answer: D
Rationale: Cryoprecipitate is a blood product that contains concentrated amounts of clotting factors, including fibrinogen, Factor VIII, Factor XIII, and von Willebrand factor. These clotting factors are essential for the formation of blood clots, and when a patient has a bleeding disorder such as hemophilia or von Willebrand disease, cryoprecipitate is used to replace the missing or deficient clotting factors. Platelets are used to help with clot formation in cases of thrombocytopenia, albumin is used to treat low albumin levels in conditions like liver disease, and packed RBCs are used to treat anemia by providing oxygen-carrying red blood cells. However, for a patient with a bleeding disorder needing replacement of missing clotting factors, cryoprecipitate is the most appropriate blood product.
Place the following four nursing actions for the new laryngectomee in correct order of priority? i.Assist with ambulation ii.Set up a visit from a well-adjusted laryngectomee iii.Maintain a patent airway iv.Control postoperative pain
- A. 1, 2, 3, 4
- B. 3, 4, 1, 2
- C. 2, 3, 4, 1
- D. 4, 1, 2, 3
Correct Answer: C
Rationale: 1. Setting up a visit from a well-adjusted laryngectomee should be the first priority. This action will provide emotional support and guidance from someone who has gone through a similar experience, which can be extremely beneficial for the new laryngectomee in adjusting to their new situation and learning coping strategies.
You are examining a 12-year-old female adolescent with a small nevus in the thigh; the mother is concerned regarding the future development of melanoma. All the following findings raise suspicion of melanoma EXCEPT
- A. enlarging nevus
- B. changing colors
- C. irregular margins
- D. easily bleeds
Correct Answer: E
Rationale: Spitz nevus is a benign mimic of melanoma and does not raise suspicion.
A newborn with hypospadias: The parents ask if circumcision is an option. Which is the best response?
- A. Circumcision is a fading practice and is now contraindicated.
- B. Circumcision is recommended to prevent infection.
- C. Circumcision is an option but should be delayed, as the foreskin may be needed for surgical repair.
- D. Circumcision can never be performed in a child with hypospadias.
Correct Answer: C
Rationale: In hypospadias, preserving the foreskin may be beneficial for repair, so circumcision is usually delayed.
Which statement is descriptive of renal transplantation in children?
- A. It is an acceptable means of treatment after age 10 years.
- B. It is the preferred means of renal replacement therapy in children.
- C. Children can receive kidneys only from other children.
- D. The decision for transplantation is difficult because a relatively normal lifestyle is not possible.
Correct Answer: B
Rationale: Renal transplantation is considered the preferred means of renal replacement therapy in children with end-stage renal disease. This is because transplantation offers the best long-term outcomes and quality of life for children compared to other forms of renal replacement therapy such as dialysis. Children who undergo successful renal transplantation tend to have improved growth, development, and overall health compared to those who remain on dialysis. Transplantation can provide children with the opportunity to live a relatively normal and healthy life, making it the preferred treatment option in pediatric patients with end-stage renal disease.