Nokea
12-year-old Caroline has recurring nephrotic syndrome; which of the following areas of potential disturbances should be a prime consideration when planning ongoing nursing care?
- A. Body image
- B. Sexual maturation
- C. Muscle coordination
- D. Intellectual development
Correct Answer: A
Rationale: For 12-year-old Caroline with recurring nephrotic syndrome, body image should be a prime consideration when planning ongoing nursing care. Nephrotic syndrome can cause physical changes such as weight gain, swelling, and changes in appearance due to the disease process and treatment side effects like corticosteroids. These physical changes can impact a child's self-esteem and body image, especially during the sensitive pre-adolescent period. As a result, addressing Caroline's body image concerns through open communication, providing support, promoting self-acceptance, and involving her in decision-making regarding her care can significantly impact her emotional well-being and overall quality of life.
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During starvation, the body slows metabolic processes and growth to minimize the need for nutrients. With the rapid reinstitution of feeding after starvation refeeding syndrome may occur. Of the following, the major changes that may occur with refeeding syndrome typically affect
- A. electrolytes
- B. serum proteins
- C. hormones
- D. liver enzymes
Correct Answer: A
Rationale: Refeeding syndrome primarily affects electrolytes, particularly phosphorus, potassium, and magnesium, which can become dangerously depleted due to rapid shifts in metabolism.
Several hours after returning from surgery, the nurse tells the patient that she is ordered to be ambulated. The patient asks, "Why?" Which of the following complications would the nurse correctly explain can be prevented by early postoperative ambulation?
- A. Increased peristalsis
- B. Coughing
- C. Pneumonia
- D. Wound healing  A1 PASSERS TRAINING, RESEARCH, REVIEW & DEVELOPMENT COMPANY MEDICAL SURGICAL NURSING SET K
Correct Answer: C
Rationale: Early postoperative ambulation is important for preventing complications such as pneumonia. When a patient remains immobile for an extended period after surgery, they are at an increased risk of developing pneumonia due to decreased lung expansion and secretions pooling in the lungs. Ambulation helps improve lung function, promote better oxygenation, and prevent respiratory complications like pneumonia. In contrast, increased peristalsis helps prevent constipation, coughing helps prevent respiratory complications as well, and wound healing is not directly related to the need for early postoperative ambulation.
A 6 months old boy presents with respiratory distress and feeding difficulty. On examination heart rate is 130/min and there is a pansystolic murmur at left lower sternal border. What is the most likely diagnosis?
- A. Mitral regurgitation
- B. Mitral valve prolapse
- C. Ventricular septal defect
- D. Coarctation of aorta
Correct Answer: C
Rationale: Ventricular septal defect (VSD) commonly presents with a pansystolic murmur and symptoms of congestive heart failure in infancy.
Which type of diabetes mellitus (DM) most likely results from heterogenous risk factors, making it preventable?
- A. Type 1
- B. Type 2
- C. Type 1 and 2
- D. Gestational diabetes
Correct Answer: B
Rationale: Type 2 diabetes mellitus (DM) most likely results from heterogeneous risk factors, such as obesity, unhealthy diet, sedentary lifestyle, genetic predisposition, and other lifestyle factors. By addressing these risk factors through lifestyle modifications, such as maintaining a healthy diet and regular exercise, the development of Type 2 DM can often be prevented or delayed. On the other hand, Type 1 diabetes is primarily an autoimmune condition where the body mistakenly attacks insulin-producing cells in the pancreas, and it is not preventable. Gestational diabetes occurs during pregnancy and is influenced by hormonal changes during pregnancy and other factors, making it less preventable through lifestyle changes alone. Thus, Type 2 diabetes is the type that is most preventable through lifestyle modifications.
which of the following is true concerning rheumatic fever?
- A. it is usually associated with glomerulonephritis
- B. symptoms disappear shortly after the fever abate and the temperature returns to normal
- C. the child should resume normal activities as soon as she feels well
- D. it usually follows a streptococcal infection
Correct Answer: D
Rationale: Rheumatic fever is an inflammatory disease that can develop as a complication of inadequately treated streptococcal infections, especially streptococcal throat infections caused by group A streptococcus bacteria. The bacteria trigger an abnormal immune response in susceptible individuals, leading to the development of rheumatic fever. The other choices are not accurate. Glomerulonephritis is a separate condition associated with certain types of streptococcal infections but not with rheumatic fever. Symptoms of rheumatic fever can persist even after the fever has subsided, and it is important for children with rheumatic fever to follow proper treatment and rest guidelines as advised by healthcare providers. It is crucial for individuals with rheumatic fever to avoid activities that could strain the heart until the condition has been properly managed.