Nokea
A 1-year-old child develops right eye ptosis, miosis, and loss of sweating; you suspect neuroblastoma. The MOST valuable investigation to confirm the diagnosis is
- A. CT scan of the neck and chest
- B. CT scan of the abdomen
- C. CT scan of the brain
- D. magnetic resonance imaging (MRI) of the brain
Correct Answer: A
Rationale: CT scan of the neck and chest can help identify a primary neuroblastoma mass in the adrenal gland or sympathetic chain.
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A client is hospitalized with oat cell carcinoma of the lung. To manage severe pain, the physician prescribes a continuous I.V. infusion of morphine. Which formula should the nurse use to check that the morphine dose is appropriate for the client?
- A. 1 mg/kg of body weight
- B. 5 mg/70kg of body weight
- C. 5 mg/kg of body weight
- D. 10mg/70kg of body weight
Correct Answer: C
Rationale: When calculating the appropriate dose of morphine for a client, the nurse should consider the client's body weight. The most commonly used formula for calculating the appropriate dose of morphine is 0.1 to 0.2 mg/kg of body weight for hourly dosing or 2.5 to 10 mg/kg/day for continuous infusions.
A 19-year-old student develops symptoms of respiratory alkalosis related to an anxiety attack. Which nursing intervention is appropriate?
- A. Make sure his oxygen is being administered as ordered.
- B. Have him breathe into a paper bag.
- C. Place him in a semi-fowler's position.
- D. Have him do coughing and deep breathing exercises.
Correct Answer: B
Rationale: The appropriate nursing intervention for a 19-year-old student experiencing symptoms of respiratory alkalosis related to an anxiety attack is to have him breathe into a paper bag. Breathing into a paper bag can help increase the level of carbon dioxide in the body, which can help correct respiratory alkalosis. This technique helps to rebalance the level of carbon dioxide in the blood and alleviate the symptoms of alkalosis caused by hyperventilation during the anxiety attack. It is important to monitor the student's condition and ensure that he is using the paper bag correctly to avoid any potential risks associated with this intervention. Additionally, providing reassurance and support during this episode can also be beneficial in helping the student to manage his anxiety and respiratory alkalosis.
Which manifestation is more specific to occur in anaplastic large cell lymphoma (ALCL) than other types of non-Hodgkin lymphoma?
- A. primary bone marrow involvement
- B. intestinal involvement
- C. CNS involvement
- D. primary mediastinal involvement
Correct Answer: D
Rationale: Primary mediastinal involvement is a hallmark feature of ALCL.
A child with a Wilms tumor is scheduled for surgery. Which best describes the procedure?
- A. Only the affected kidney will be removed.
- B. Both kidneys will be removed.
- C. Only the tumor mass will be excised.
- D. The tumor is removed, and a biopsy of the unaffected kidney is done.
Correct Answer: A
Rationale: The standard treatment for Wilms tumor is a nephrectomy of the affected kidney while preserving the other kidney.
The nurse is aware that a healthy newborn's respirations are:
- A. Regular, abdominal, 40-50 per minute, deep
- B. Irregular, abdominal, 30-60 per minute, shallow
- C. Irregular, initiated by chest wall, 30-60 per minute, deep
- D. Regular, initiated by the chest wall, 40-60 per minute, shallow
Correct Answer: B
Rationale: A healthy newborn's respirations are typically irregular, abdominal, with a rate of 30-60 per minute, and tend to be shallow. Newborns have immature respiratory centers in their brain, leading to irregular breathing patterns compared to adults. Their breathing is usually abdominal due to their diaphragmatic breathing pattern. The normal respiratory rate for a newborn can fluctuate between 30-60 breaths per minute, with shallow breathing being characteristic of their physiology. Regular shallow breathing with occasional periods of apnea is considered normal in newborns and should not be a cause for concern.