Nokea
A 2-month-old is diagnosed with hip dysplasia. The parent asks you how long will the child be in the hip Spica Cast. How should you respond?
- A. Not longer than 4 months.
- B. The child will be placed in a Pavlik Harness for 3 to 5 months.
- C. Following the osteotomy, the child remains in a cast for 5 months.
- D. Between 2 and 4 months.
Correct Answer: B
Rationale: Hip dysplasia in infants is often managed initially with a Pavlik Harness, which helps maintain the hips in the correct position for optimum development. The Pavlik Harness is typically worn for a period of 3 to 5 months, depending on the severity of the hip dysplasia and the response to treatment. If the dysplasia is more severe or does not respond well to the Pavlik Harness, further interventions such as hip spica casting or surgery may be required, but the initial treatment is usually with the Pavlik Harness.
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A client was brought to the emergency room with complains of difficulty of breathing. What can lead the nurse to suspect that the client is experiencing acute respiratory distress syndrome (ARDS)?
- A. paO2 of 95, pCO2 of 43, x-ray showing enlarged heart, bradycardia
- B. Thick green sputum production, paO2 of 74, pH of 7.41
- C. restlessness, suprasternal retractions, paO2 of 62
- D. wheezes, slow, deep respirations, pCO2 of 52, pH of 7.35
Correct Answer: C
Rationale: Acute respiratory distress syndrome (ARDS) is a severe form of acute respiratory failure characterized by rapidly progressive dyspnea, hypoxemia, and noncardiogenic pulmonary edema. The key signs of ARDS include severe respiratory distress, low partial pressure of oxygen (paO2), and bilateral infiltrates on chest x-ray. In the given scenario, the client presenting with restlessness and suprasternal retractions along with a paO2 level of 62 indicates severe respiratory distress and hypoxemia, which are consistent with ARDS. Therefore, option C is the most indicative of ARDS among the choices provided.
A nurse notes that a 10-month-old infant has a larger head circumference than chest. The nurse interprets this as a normal finding because the head and chest circumference become equal at which age?
- A. 1 month
- B. 6 to 9 months
- C. 1 to 2 years
- D. to 3 years
Correct Answer: B
Rationale: It is considered normal for a baby's head circumference to be larger than their chest circumference during the first few months of life. Generally, a baby's head grows more rapidly than their chest, which causes the head circumference to be larger. By around 6 to 9 months of age, the head and chest circumference measurements typically become equal. This is part of the normal growth and development pattern in infants.
An adolescent girl asks the school nurse for advice because she has dysmenorrhea. She says that a friend recommended she try an over-the-counter nonsteroidal anti-inflammatory drug (NSAID). The nurse's response should be based on which statement?
- A. Aspirin is the drug of choice for the treatment of dysmenorrhea.
- B. Over-the-counter NSAIDs are rarely strong enough to provide adequate pain relief.
- C. NSAIDs are effective because of their analgesic effect.
- D. NSAIDs are effective because they inhibit prostaglandins, leading to reduction in uterine activity.
Correct Answer: D
Rationale: NSAIDs are effective for treating dysmenorrhea because they work by inhibiting prostaglandins, which are responsible for causing increased uterine activity and thus pain during menstruation. By reducing prostaglandin levels, NSAIDs help to decrease uterine contractions and consequently alleviate menstrual cramps. This mechanism of action makes NSAIDs an appropriate and effective choice for managing dysmenorrhea.
The nurse is caring for a client who had a thyroidectomy and is at risk for hypocalcemia. What should the nurse do?
- A. Monitor laboratory values daily for an elevated thyroid-stimulating hormone
- B. Observe for swelling of the neck, tracheal deviation, and severe pain
- C. Evaluate the quality of the client's voice postoperatively, noting any dastric changes
- D. Observe for muscle twitching and numbness or tingling of the lips, fingers, and toes
Correct Answer: D
Rationale: The nurse should observe for muscle twitching and numbness or tingling of the lips, fingers, and toes in a client who had a thyroidectomy and is at risk for hypocalcemia. Hypocalcemia is a potential complication following thyroidectomy because the parathyroid glands may be inadvertently removed or damaged during the surgery, leading to decreased calcium levels in the blood. Symptoms of hypocalcemia include muscle twitching (especially in the face), and numbness or tingling around the lips, fingers, and toes. Prompt recognition of these symptoms is crucial as severe hypocalcemia can lead to more serious complications, such as seizures and laryngospasm. Monitoring for these signs allows the nurse to intervene early and prevent further complications.
A 17-year-old boy is admitted in sickle cell crisis. Which of the ff. events most likely contributed to the onset of the crisis?
- A. He started a new job last week.
- B. He had seafood for dinner last night.
- C. He walked home in a cold rain
- D. He has not exercised for a week. yesterday.
Correct Answer: C
Rationale: Walking home in a cold rain can trigger a sickle cell crisis in individuals with sickle cell disease. Exposure to cold temperatures or getting wet can lead to vasoconstriction, causing the blood vessels to narrow and slow down blood flow. This reduced blood flow can increase the likelihood of sickle cells sticking together and blocking blood vessels, leading to pain and tissue damage characteristic of a sickle cell crisis. It is essential for individuals with sickle cell disease to avoid exposure to extreme temperatures, including cold rain, to prevent the onset of a crisis.