Nokea
A 2-year-old child presents with a peeling, erythematous rash on the hands and feet. The mother reports that he has become ill tempered and refuses to walk about, preferring to lie in bed. Physical examination reveals an irritable, pale child with photophobia. Temperature is 98.5°F, heart rate is 80/minute, and respiratory rate is 23/minute. Tremor of the tongue is evident. Further history and follow-up evaluation reveal that the child's elder brothers have been playing with liquid mercury. Which is the most likely diagnosis?
- A. Measles
- B. Fifth disease
- C. Kawasaki disease
- D. Acrodynia
Correct Answer: D
Rationale: Acrodynia, also known as pink disease, is caused by chronic mercury exposure. The symptoms described, including the rash, irritability, photophobia, and tremor, are consistent with mercury poisoning.
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In terms of gross motor development, which should the nurse expect a 5-month-old infant to do? (Select all that apply.)
- A. Roll from abdomen to back.
- B. Put feet in mouth when supine.
- C. Roll from back to abdomen.
- D. Sit erect without support.
Correct Answer: A
Rationale: At 5 months old, an infant would typically be able to roll from abdomen to back (Choice A). This is an important gross motor skill that develops during this stage. Additionally, putting their feet in their mouth when lying on their back (Choice B) is also a common movement seen at this age. Both these actions demonstrate the increasing strength and coordination of the infant's muscles as they develop and explore their physical abilities. Rolling from back to abdomen (Choice C) and sitting erect without support (Choice D) typically develop later, around 6-7 months and 8-9 months, respectively. Moving from prone to sitting position (Choice E) and adjusting posture to reach an object (Choice F) are usually mastered around 8-9 months as well.
Katie is admitted to the intensive care unit of Nurseslabs Medical Center for diabetic ketoacidosis; which of the following is of primary importance when caring for the child?
- A. Giving I.V. NPH insulin in high doses
- B. Evaluating the child for cardiac abnormalities
- C. Limiting fluids to prevent aggravating cerebral edema
- D. Monitoring and recording the child's vital signs for hypertension
Correct Answer: B
Rationale: When caring for a child with diabetic ketoacidosis in the intensive care unit, evaluating the child for cardiac abnormalities is of primary importance. Diabetic ketoacidosis can lead to electrolyte imbalances, such as hypokalemia, which can result in cardiac complications, such as arrhythmias and cardiac arrest. Monitoring the child's cardiac function, including obtaining an electrocardiogram (EKG) and assessing for signs of heart failure, is essential in managing and preventing potential cardiac complications in this critical condition. While the other options are important considerations in the care of a child with diabetic ketoacidosis, evaluating the child for cardiac abnormalities takes precedence due to the life-threatening implications of cardiac complications in this setting.
An adult is diagnosed with disseminated intravascular coagulation. The nurse should identify that the client is at risk for which of the following nursing diagnosis?
- A. Risk for increased cardiac output related to fluid volume excess
- B. Disturbed sensory perception related to bleeding into tissues
- C. Alteration in tissue perfusion related to bleeding and diminished blood flow
- D. Risk for aspiration related to constriction of the respiratory musculature
Correct Answer: C
Rationale: Disseminated intravascular coagulation (DIC) is a serious condition that involves widespread activation of coagulation leading to microthrombi formation in blood vessels throughout the body. This process can lead to consumption of clotting factors and platelets, causing both bleeding and thrombosis. In the context of DIC, there is a risk for altered tissue perfusion due to the combination of bleeding and microthrombi formation, which can impair blood flow to vital organs and tissues. This condition can ultimately result in organ dysfunction and failure, making it a significant concern in the care of a client with DIC. Therefore, the correct nursing diagnosis for a client with DIC is alteration in tissue perfusion related to bleeding and diminished blood flow.
A healthy 20-day-old male examination reveals a palpable liver margin below the right costal margin; lab findings: white blood count, 18700/mm3; hemoglobin, 8.8 g/dl; blast cells, 10%; the BEST approach for the management is consistent with acute myeloproliferative disorder
- A. intensive chemotherapy
- B. low dose chemotherapy pulses
- C. bone marrow transplantation
- D. close follow up
Correct Answer: A
Rationale: Intensive chemotherapy is the standard approach for managing acute myeloproliferative disorders.
The nurse is teaching a group of women to perform breast self-examination. The nurse should explain that the purpose of performing the examination is to discover:
- A. Cancerous lumps.
- B. Changes from previous self-examinations.
- C. Areas of thickness or fullness.
- D. Fibrocystic masses.
Correct Answer: A
Rationale: The primary purpose of performing breast self-examination is to detect any abnormal changes in the breast tissue, including the presence of cancerous lumps. By regularly examining their breasts, women can become familiar with the normal look and feel of their breasts, making it easier to identify any new lumps or other changes that may indicate a potential problem, such as breast cancer. Detecting cancerous lumps early through self-examination can lead to early detection and improved treatment outcomes. It is important for women to perform breast self-examinations regularly and report any concerning findings to their healthcare provider for further evaluation.