Nokea
A 1-year old boy presents with high grade fever and conjunctivitis for 4 days followed by generalized maculopapular rash. One of his elder siblings had similar complaints 10 days back. The most likely diagnosis is?
- A. Rubella
- B. Kawasaki disease
- C. Scarlet fever
- D. Measles
Correct Answer: D
Rationale: Measles presents with high-grade fever, conjunctivitis, and a maculopapular rash appearing after a few days of illness, often following a similar illness in a sibling.
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Mr. Mariano was on his way home from a party. Apparently, he got drunk and lost his balance and suffered a vehicular accident. Upon arrival at the hospital, the nurse noticed that his only injury is an open fracture of the left humerus. Which assessment finding by the nurse is critical?
- A. status of client's tetanus immunization
- B. current blood alcohol level
- C. support systems available at home to assist with care
- D. last time client voided
Correct Answer: A
Rationale: In this situation where Mr. Mariano has an open fracture of the left humerus, the nurse's critical assessment finding should be the status of the client's tetanus immunization. An open fracture poses a risk of infection, and tetanus is a concern due to the potential exposure to bacteria from the environment causing tetanus. Tetanus is a serious bacterial infection that affects the nervous system and can be fatal if not treated promptly. Knowing the client's tetanus immunization status will help determine the need for a tetanus booster to prevent this potentially life-threatening infection. Blood alcohol level, support systems at home, and voiding time are important assessments as well, but in the case of an open fracture, the priority is to assess the risk of tetanus infection.
A patient has chronic respiratory acidosis related to long-standing lung disease. Which of the following problems is the cause?
- A. Hyperventilation
- B. Loss of acid by kidneys
- C. Hypoventilation
- D. Loss of base by kidneys CARING FOR CLIENTS REQUIRING INTRAVENOUS THERAPY
Correct Answer: C
Rationale: Chronic respiratory acidosis is a condition where there is an excess of carbon dioxide (CO2) in the blood due to inadequate exhalation of CO2. This typically occurs as a result of hypoventilation, which is characterized by breathing at an abnormally slow rate or shallow depth. In patients with long-standing lung disease, the ability to effectively exchange gases in the lungs is compromised, leading to a buildup of CO2 in the bloodstream and subsequent respiratory acidosis. Hyperventilation, on the other hand, would result in a decrease in CO2 levels in the blood, while the loss of acid or base by the kidneys is related to metabolic acidosis or alkalosis, not respiratory acidosis. Therefore, in this case, the primary problem causing chronic respiratory acidosis is hypoventilation.
A 50-year old male was brought toi the emergency department with a diagnosis of diabetes insipidus. The client had a posterior pituitary tumor. The nursing diagnosis most appropriate for this client is:
- A. fluid volume excess
- B. incontinence, bowel
- C. fluid volume deficit
- D. diarrhea
Correct Answer: C
Rationale: Diabetes insipidus is a condition characterized by excessive thirst and excretion of large amounts of dilute urine, resulting in fluid volume deficit. The posterior pituitary tumor in this case is likely causing decreased secretion of antidiuretic hormone (ADH), leading to the inability of the kidneys to concentrate urine and retain water. This imbalance results in the loss of fluid, leading to dehydration and electrolyte imbalances. Therefore, the most appropriate nursing diagnosis for this client is fluid volume deficit, as the priority is to address the dehydration and restore fluid balance to prevent further complications.
Mr. Sison had an above the knee amputation (AKA). He is taught to use crutches while prosthesis is being adjusted. The nurse instruct the client to support her weight primarily on which areas?
- A. axilla
- B. upper arms
- C. elbows
- D. hands
Correct Answer: C
Rationale: When using crutches after an above the knee amputation, it is important for the client to support their weight primarily on their elbows. Placing the weight on the elbows helps to prevent pressure on the axilla (armpit area), which can lead to nerve damage and discomfort. Supporting weight on the elbows also provides better stability and control while using crutches, allowing the client to move more safely and comfortably. Additionally, distributing the weight onto the elbows helps to avoid potential strain and injury to the hands or upper arms.
A client with allergic rhinitis is prescribed loratadine (Claritin). On a follow-up visit, the client tells the nurse, "I take one 10-mg of Claritin with a glass of water two times daily". The nurse concludes that the client requires additional teaching about this medication because:
- A. Loratadine isn't available in 10mg tablets
- B. Loratadine should be taken on an empty stomach
- C. Loratadine should be taken once daily for allergenic rhinitis
- D. Claritin isn't the trade name for loratadine
Correct Answer: C
Rationale: Loratadine (Claritin) is typically taken once daily for allergic rhinitis. Taking it two times daily as stated by the client is unnecessary and indicates a lack of understanding about the appropriate dosing schedule for this medication. Claritin is indeed the trade name for loratadine, and it is available in 10mg tablets, but the issue here is the incorrect dosing frequency.