Nokea
A 1-year-old with acute renal failure (ARF) is edematous with minimal urine output. Vital signs: HR 146, BP 176/92, RR 42; the child has nasal flaring and retractions. Despite oral Kayexalate, serum potassium continues to rise. Which treatment will most benefit the child?
- A. Additional rectal Kayexalate.
- B. Intravenous furosemide.
- C. Endotracheal intubation and ventilatory assistance.
- D. Placement of a Tenckhoff catheter for peritoneal dialysis.
Correct Answer: D
Rationale: When ARF deteriorates and electrolyte imbalances worsen, peritoneal dialysis (via a Tenckhoff catheter) is indicated.
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The nurse is assessing a newborn who had undergone vaginal delivery. Which of the following findings is least likely to be observed in a normal newborn?
- A. uneven head shape
- B. respirations are irregular, abdominal, 30-60 bpm
- C. (+) Moro reflex
- D. heart rate is 80 bpm
Correct Answer: D
Rationale: The heart rate of a normal newborn is typically 120 to 160 bpm. Therefore, a heart rate of 80 bpm would be least likely to be observed in a normal newborn. This finding may indicate bradycardia, which should be further evaluated and managed by the healthcare provider. Other options such as an uneven head shape, irregular respirations, (+) Moro reflex are common and expected in newborns.
During thoracentesis, which of the following nursing intervention will be most crucial?
- A. Place patient in a quiet and cool room
- B. Maintain strict aseptic technique
- C. Advice patient to sit perfectly still during needle insertion until it has been withdrawn from the chest
- D. Apply pressure over the puncture site as soon as the needle is withdrawn
Correct Answer: B
Rationale: Maintaining strict aseptic technique during thoracentesis is the most crucial nursing intervention. Thoracentesis is a procedure where a needle is inserted into the pleural space to obtain a sample of fluid for diagnostic purposes or to drain excess fluid for therapeutic relief. It is essential to prevent the introduction of pathogens or contaminants into the pleural space, as this can lead to serious complications such as infection. By following strict aseptic technique, the risk of complications can be minimized, ensuring the safety and well-being of the patient undergoing the procedure.
In addition to antibiotics, which of the ff. recommendations can the nurse make to increase comfort in a patient experiencing sinusitis? Choose all answers that are correct. i. Coughing and deep breathing iv. Room humidifier ii. Sinus irrigation v. Percussion and postural drainage iii. Hot moist packs vi. Semi-fowler's position
- A. 1 ,2 and 5
- B. 1, 3, 4 and 5
- C. 3, 4 and 6
- D. 2, 4, 5 and 6
Correct Answer: B
Rationale: #NAME?
You are evaluating a 9-year-old boy child with ALL who recently develops relapse; an important statement that should be mentioned to his parents is
- A. testicular relapse occurs in the majority of boys with ALL
- B. such relapse occurs as painful swelling of one or both testes
- C. the diagnosis is confirmed by ultrasonography
- D. the majority of affected boys can be successfully retreated, and the survival rate is good
Correct Answer: D
Rationale: Most boys with testicular relapse can be successfully treated, and their overall survival remains favorable.
Which of the ff nursing actions is helpful for older clients who are experiencing lens changes associated with aging?
- A. Offering teaching aids with larged-sized letters
- B. Suggesting reduced visual activity such as reading or watching television
- C. Suggesting use of eye drops for comfort
- D. Suggesting use of glasses or contact lenses CARING FOR CLIENTS WITH EYE DISORDERS
Correct Answer: D
Rationale: As people age, changes in the lens of the eye can lead to difficulty focusing on close objects, a condition known as presbyopia. Suggesting the use of glasses or contact lenses can help older clients compensate for these age-related lens changes and improve their visual acuity for tasks such as reading or other close-up activities. Glasses or contact lenses prescribed by an eye care professional can provide the appropriate magnification needed to address the visual changes associated with aging, promoting comfort and maintaining independence for older clients.