Nokea
An adult has been treated for pulmonary tuberculosis and is being discharged home with his wife and two young children. His wife asks how TB is passed from one person to another so she can prevent anyone from catching it. How should the nurse respond?
- A. You should wear gloves when handling his linen and bedding
- B. You should keep the windows and doors closed so as not to spread the droplets
- C. He must be careful to cough into a handkerchief that is washed in hot water or discarded
- D. Make sure to boil all water before drinking or using it
Correct Answer: C
Rationale: Tuberculosis is primarily spread through the air when an infected person coughs, sneezes, speaks, or sings, releasing bacteria-containing droplets into the air. Therefore, it is important for the individual with TB to cover their mouth and nose when coughing or sneezing to prevent the spread of the bacteria. By coughing into a disposable tissue or a handkerchief that can be washed in hot water, the risk of spreading the infection to others is significantly reduced. This measure helps minimize the transmission of the disease within the household and community.
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Although melanoma is relatively rare in children, some risk factors may increase its incidence. All the following are risk factors for development of melanoma EXCEPT
- A. positive family history of melanoma
- B. dark-skinned child
- C. hairy nevus
- D. dysplastic nevus
Correct Answer: B
Rationale: Dark-skinned individuals have a lower risk of melanoma.
Marichu is admitted to the hospital because of hepatic failure and was prescribed with lactulose (Duphalac). The primary action of this drug is:
- A. prevent constipation
- B. decrease resident intestinal flora
- C. increase intestinal peristalsis
- D. prevent portal hypertension
Correct Answer: B
Rationale: Lactulose (Duphalac) is a synthetic sugar that is not absorbed in the small intestine but is broken down by bacteria in the colon into short-chain fatty acids and low molecular weight organic acids. The primary action of lactulose is to decrease resident intestinal flora. This reduces the production of ammonia in the colon and leads to acidification of the colonic contents. By doing so, lactulose helps in treating hepatic encephalopathy, a condition associated with hepatic failure where ammonia levels are elevated in the body. It works by promoting the excretion of ammonia through the stool, thereby reducing the toxic effects of ammonia on the brain.
A child newly diagnosed with diabetes mellitus has been stabilized with insulin injections daily. A nurse prepares discharge teaching plan regarding the insulin. The teaching plan should reinforce which of the following concepts?
- A. Always keep insulin vials refrigerated
- B. Increase the amount of insulin before exercise
- C. Ketones in the urine signify a need for less insulin
- D. Systematically rotate injection sites
Correct Answer: D
Rationale: The correct concept that should be reinforced in the teaching plan is to systematically rotate injection sites. Rotating injection sites helps prevent lipodystrophy - changes in fat tissue due to repeated injections in the same spot. This can ensure that the insulin is properly absorbed and prevent complications. It is important for the child and their family to understand the importance of rotating injection sites to maintain good insulin absorption and reduce the risk of complications.
Which characteristics could the nurse expect when observing Mr. Gil? a.Transient ischemic attacks
- A. Remissions & exacerbations
- B. Rapid deterioration of mental functioning because of arteriosclerosis
- C. Slowly progressive deficits in intellect, which may be noted for a long time HEMATOLOGY SITUATION: Aisa, is a 4-year old with severe anemia. She is seen by the nurse in the clinic.
Correct Answer: C
Rationale: The question is asking about the characteristics the nurse might expect to observe in Mr. Gil. Given the information provided, Mr. Gil's possible condition can be related to a slowly progressive deficit in intellect. This might manifest as cognitive decline, memory issues, and other intellectual challenges over an extended period of time. This description aligns with conditions such as dementia or Alzheimer's disease, which are characterized by a gradual decline in cognitive abilities rather than rapid deterioration (as in option B) or transient episodes (as in option A). Therefore, option C is the most likely characteristic the nurse could expect when observing Mr. Gil.
An infant with bladder exstrophy has had a continent urinary reservoir placed. Which discharge instruction should be included?
- A. Allow your child to sleep on the abdomen for comfort.
- B. Avoid contact with latex-containing surfaces (e.g., playgrounds with rubber) to prevent allergic reactions.
- C. Encourage a varied diet to prevent allergies.
- D. Provide brightly colored objects to stimulate development.
Correct Answer: B
Rationale: Children with urologic malformations are prone to latex allergies; parents should be advised to avoid latex exposure.