Nokea
A 2-year-old is noted to be drinking from a container filled with kerosene. He immediately coughs, becomes tachypneic, and is brought to the hospital. The best approach to his treatment is to
- A. induce emesis
- B. perform nasogastric tube lavage
- C. instill mineral oil
- D. administer steroids
Correct Answer: E
Rationale: Inducing emesis or performing gastric lavage can increase the risk of aspiration. The best approach is supportive care, including oxygen and monitoring.
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Although children with Wilms tumor have a favorable prognosis, there are some adverse prognostic factors in children with Wilms tumor EXCEPT
- A. large tumors
- B. anaplastic histology
- C. loss of heterozygosity at chromosome 1p and 16q
- D. young age at diagnosis
Correct Answer: D
Rationale: Young age at diagnosis is generally associated with a favorable prognosis.
A client has the following blood lab values: platelets 50,000/ul, RBC's 3.5 (X 106), hemoglobin 10 g/dl, hematocrit 30 percent, WBCs 10,000/ul. Which nursing instruction should be included in the teaching plan?
- A. Bleeding precautions
- B. Isolation to prevent infection
- C. Seizure precautions
- D. Control of pain with analgesics
Correct Answer: A
Rationale: The client's platelet count of 50,000/ul is significantly low (normal range is around 150,000-450,000/ul). A low platelet count places the client at risk for bleeding tendencies. Therefore, the most appropriate nursing instruction to include in the teaching plan is bleeding precautions. This would involve educating the client on measures to prevent bleeding such as avoiding activities that may cause injury, using a soft toothbrush, avoiding tight clothing, and being cautious while shaving.
Which part of the brain controls breathing?
- A. Medulla
- B. Cerebrum
- C. Cerebellum
- D. Thalamus
Correct Answer: A
Rationale: The medulla oblongata, located in the brainstem, is responsible for controlling essential autonomic functions such as breathing, heart rate, and blood pressure. Specifically, the medulla regulates the rhythm and depth of breathing by sending signals to the respiratory muscles, including the diaphragm and intercostal muscles. In response to changing levels of oxygen and carbon dioxide in the blood, the medulla adjusts the breathing rate to maintain proper oxygenation of the body tissues. Damage to the medulla can result in respiratory failure, highlighting its critical role in controlling breathing.
Which is an accurate description of a Kasai procedure?
- A. A palliative procedure in which the bile duct is attached to a loop of bowel to assist with bile drainage.
- B. A curative procedure that connects the bile duct to the bowel.
- C. A curative procedure where the bile duct is banded.
- D. A palliative procedure where the bile duct is banded.
Correct Answer: A
Rationale: The Kasai procedure is a palliative surgery for biliary atresia that helps restore bile flow and delays the need for liver transplantation.
A preterm newborn of 36 weeks of gestation is admitted to the NICU. Approximately 2 hours after birth, the newborn begins having difficulty breathing, with grunting, tachypnea, and nasal flaring. Which is important for the nurse to recognize?
- A. This is a normal finding.
- B. This is not significant unless cyanosis is present.
- C. Improvement should occur within 24 hours.
- D. Further evaluation is needed.
Correct Answer: D
Rationale: The presentation of a preterm newborn with difficulty breathing, grunting, tachypnea, and nasal flaring is concerning and should not be considered a normal finding. This could indicate respiratory distress, which is common in preterm infants due to immature lung development. It is important for the nurse to recognize these symptoms as they may signify a potential underlying respiratory issue that requires further evaluation and intervention. Prompt assessment and management are crucial in ensuring the best outcomes for the newborn. Therefore, further evaluation by the healthcare team is warranted in this situation to determine the cause of the respiratory distress and provide appropriate treatment.