Nokea
A 16-year-old male with cystic fibrosis is hospitalized for 2 weeks for IV antibiotics. Which action will most enhance his psychosocial development?
- A. Fax his teacher and have homework sent in.
- B. Encourage his friends to visit him in the hospital.
- C. Encourage frequent visits from his grandparents.
- D. Allow him unlimited phone use to contact friends.
Correct Answer: B
Rationale: Peer interactions are crucial during adolescence; having friends visit helps him feel connected and 'normal.'
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Antivenins should be considered in the treatment of all of the following EXCEPT
- A. rattlesnake envenomations
- B. scorpion envenomations
- C. black widow envenomations
- D. stonefish envenomations
Correct Answer: E
Rationale: Hymenoptera envenomations (e.g., bee stings) typically do not require antivenin, as they are managed with supportive care.
What is the first action the nurse should take?
- A. Start an IV lines for fluids
- B. Get an ECG
- C. Place a Foley catheter
- D. Check for neurologic status
Correct Answer: D
Rationale: The first action the nurse should take is to check for neurologic status. This is essential in assessing the patient's level of consciousness, orientation, motor function, and pupil responses. It helps determine if the patient is experiencing neurological issues such as a stroke, which would require immediate medical attention. Checking neurologic status is a priority because it guides the nurse in identifying the next steps for the patient's care.
Which is an important consideration for the nurse when changing dressings and applying topical medication to a child's abdomen and leg burns?
- A. Apply topical medication with clean hands.
- B. Wash hands and forearms before and after dressing change.
- C. If dressings adhere to the wound, soak in hot water before removal.
- D. Apply dressing so that movement is limited during the healing process.
Correct Answer: B
Rationale: Washing hands and forearms before and after a dressing change is crucial for maintaining proper hygiene and preventing the spread of infection. This practice helps to reduce the risk of introducing harmful microorganisms to the burn wounds, which could lead to complications. It is important for the nurse to wash their hands and forearms thoroughly using proper hand hygiene techniques before touching the child's wounds or applying topical medications. By following the principles of infection control, the nurse can help promote proper wound healing and prevent potential complications in the child's recovery process.
A healthy 4-year-old child has a left flank mass. Computerized tomography (CT) scan of the abdomen shows a localized renal mass. Radical nephrectomy is performed; the histology shows clear cell sarcoma of the kidney. The MOST appropriate next step in the management is
- A. CT scan of the chest
- B. CT scan of the brain
- C. bone scan
- D. magnetic resonance imaging (MRI) of the brain
Correct Answer: C
Rationale: Clear cell sarcoma of the kidney has a propensity to metastasize to bones, making a bone scan essential.
Mr. RR is being prepared for surgery. Nursing care would include:
- A. Careful assessment of neurologic signs to establish baseline data for post-operative care
- B. Planning activities for Mr. RR
- C. Administration of an SS enema to prevent post-operative impaction
- D. Explaining to Mr. RR post-operative complications
Correct Answer: A
Rationale: Nursing care for a patient being prepared for surgery includes conducting a careful assessment of neurologic signs to establish baseline data for post-operative care. Assessing the patient's neurologic status preoperatively is important for early detection of any post-operative complications such as changes in consciousness, sensation, or movement. This baseline data will be used to monitor and evaluate the patient's recovery and response to the surgery, anesthesia, and post-operative care interventions. Planning activities, administering enemas, and explaining post-operative complications are also important aspects of nursing care but assessing neurologic signs is the priority in this scenario.