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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During preoperative teaching for a client who will undergo subtotal thyroidectomy, the nurse should include which statement?
- A. "The head of your bed must remain flat for 24 hours after surgery."
- B. "You should avoid deep breathing and coughing after surgery."
- C. "You won't be able to swallow for the first day or two."
- D. "You must avoid hyperextending your neck after surgery."
Correct Answer: D
Rationale: The correct statement to include during preoperative teaching for a client undergoing subtotal thyroidectomy is "You must avoid hyperextending your neck after surgery." This is important because hyperextending the neck can put strain on the suture line and may lead to dehiscence (wound opening). It is crucial for the client to avoid any activities or positions that could compromise the surgical site and hinder proper healing.
Which of the ff symptoms is observed in the client with Right Sided Heart Failure?
- A. Dependent pitting edema
- B. Orthopnea
- C. Exertional dyspnea
- D. Hemoptysis CARING FOR CLIENTS UNDERGOING CARDIOVASCULAR SURGERY
Correct Answer: A
Rationale: Right-sided heart failure is characterized by the inability of the right side of the heart to pump blood effectively, leading to fluid accumulation in the systemic venous system. This fluid overload typically manifests as signs of congestion in the peripheral tissues. Dependent pitting edema is a classic symptom of right-sided heart failure, where swelling is noted in the lower extremities and sacral area, worsening later in the day due to the effects of gravity. Orthopnea (B) and exertional dyspnea (C) are more indicative of left-sided heart failure, where congestion occurs in the pulmonary system. Hemoptysis (D) refers to coughing up blood and is not a classic symptom of heart failure but may be seen in conditions such as pulmonary embolism or infection.
All the following are recognizable teratogens EXCEPT
- A. ethanol
- B. antiepileptic medications
- C. toxoplasmosis
- D. hypothermia
Correct Answer: D
Rationale: Hypothermia is not traditionally considered a teratogen compared to others listed.
An 11-month-old girl infant is found to have low weight and height consistent with FTT. She was exclusively breast feeding till the age of 4 month, and then artificial milk-formula was added. She has had a normal growth pattern till the age of 6 month when the mother introduced juices and cereals. Examination is unremarkable apart from significant decline of normal growth pattern. Of the following, the MOST likely cause is
- A. failed breast feeding
- B. improper formula preparation
- C. congenital syndromes
- D. congenital infections
Correct Answer: B
Rationale: Improper formula preparation can lead to inadequate nutrition, causing FTT. This scenario suggests a dietary issue rather than congenital or infectious causes.
Major treatment modalities for breast cancer are:
- A. Surgery, remove the primary tumor
- B. Radiotherapy, destroy microscopic diseases
- C. Chemotherapy, systematically destroys cancer cells
- D. All of these
Correct Answer: D
Rationale: The major treatment modalities for breast cancer include surgery, radiotherapy, and chemotherapy. Each of these modalities plays a crucial role in the treatment plan for breast cancer patients: