Nokea
A 10-year-old client contracted severe acute respiratory syndrome (SARS) when traveling abroad with her parents. The nurse knows she must put on personal protective equipment to protect herself while providing care. Based on the mode of SARS transmission, which personal protective should the nurse wear?
- A. Gloves
- B. Gown and gloves
- C. Gown, gloves, and mask
- D. Gown, gloves, mask, and eye goggles or eye shield
Correct Answer: D
Rationale: SARS is transmitted through droplets, so full protective gear, including eye protection, is necessary to prevent infection.
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A client is brought to the ED by ambulance in cardiac arrest with cardiopulmonary resuscitation (CPR) in progress. The client is intubated and is receiving 100% oxygen per self-inflating (ambu) bag. The nurse determines that the client is cyanotic, cold, and diaphoretic. Which assessment is most important for the nurse to obtain?
- A. Breath sounds over bilateral lung fields.
- B. Carotid pulsation during compressions
- C. Deep tendon reflexes
- D. Core body temperature
Correct Answer: A
Rationale: Assessing breath sounds ensures that the endotracheal tube is properly placed and that ventilation is effective, which is critical in a cardiac arrest situation.
Polycythaemia:
- A. Is a common cause of jaundice in the newborn
- B. Is significant if haematocrit > 65% on a capillary sample
- C. May cause apnoeas
- D. Exchange transfusion is the treatment of choice in symptomatic cases
Correct Answer: B
Rationale: Polycythaemia is considered significant if the haematocrit exceeds 65% on a capillary sample, as it can lead to hyperviscosity and related complications.
Which is an important nursing consideration when suctioning a young child who has had heart surgery?
- A. Perform suctioning at least every hour.
- B. Suction for no longer than 30 seconds at a time.
- C. Administer supplemental oxygen before and after suctioning.
- D. Expect symptoms of respiratory distress when suctioning.
Correct Answer: C
Rationale: If suctioning is indicated, supplemental oxygen is administered with a manual resuscitation bag before and after the procedure to prevent hypoxia. Suctioning should be done only as indicated, not on a routine basis. The child should be suctioned for no more than 5 seconds at one time. Symptoms of respiratory distress are avoided by using appropriate technique.
Clubbing is found in:
- A. Crohn's disease
- B. Bronchiectasis
- C. Rheumatic fever
- D. Infective endocarditis
Correct Answer: B
Rationale: Clubbing is commonly associated with chronic respiratory conditions such as bronchiectasis, due to chronic hypoxia and inflammation.
A client who had a biliopancreatic diversion procedure (BDP) 3 months ago is admitted with severe dehydration. Which assessment finding warrants immediate intervention by the nurse?
- A. Strong foul-smelling flatus
- B. Gastroccult positive emesis
- C. Complaint of poor night vision
- D. Loose bowel movements
Correct Answer: B
Rationale: Gastroccult positive emesis indicates gastrointestinal bleeding, which requires immediate intervention to prevent further complications.