Nokea
A 2-year-old male child has an asymptomatic right flank mass discovered incidentally by the mother while bathing. Suspicion of Wilms tumor is raised. Of the following, the LEAST likely investigation to be performed in this child is
- A. plain abdominal radiography
- B. computerized tomography (CT) scan of the abdomen
- C. CT scan of the chest
- D. biopsy of the mass
Correct Answer: D
Rationale: Biopsy is generally avoided in suspected Wilms tumor to prevent upstaging the disease.
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A mother asks the nurse what would be the first indication that acute glomerulonephritis is improving. What is the nurse's best response?
- A. Blood pressure will stabilize.
- B. The child will have more energy.
- C. Urine will be free of protein.
- D. Urinary output will increase.
Correct Answer: D
Rationale: In acute glomerulonephritis, the kidneys are inflamed and not functioning properly, leading to a decrease in urinary output. As the condition improves, the kidneys are able to filter and excrete waste products more effectively, resulting in an increase in urinary output. This is the first indication that acute glomerulonephritis is improving because it shows that the kidneys are starting to function better. Blood pressure stabilization, increased energy, and absence of protein in the urine may also be positive signs of improvement, but an increase in urinary output is the most direct and specific indicator of improved kidney function in this context.
Which of the ff adverse reactions may occur when a client is taking danazol (Danocrine) for fibrocystic breast disease?
- A. Nausea
- B. Amenorrhea
- C. Confusion
- D. Hypotension
Correct Answer: B
Rationale: Danazol (Danocrine) is a synthetic androgen that is used to treat conditions such as fibrocystic breast disease. One of the known adverse effects of danazol is the development of amenorrhea, which refers to the absence of menstrual periods. This occurs because danazol suppresses ovarian function by inhibiting the release of gonadotropins, leading to decreased production of estrogen and progesterone. Amenorrhea associated with danazol use is typically reversible upon discontinuation of the medication. Nausea, confusion, and hypotension are not common adverse reactions associated with danazol use for fibrocystic breast disease.
Kim is using bronchodilators for asthma. The side effects of these drugs that you need to monitor this patient for include:
- A. tachycardia, nausea, vomiting, heart palpitations, inability to sleep, restlessness, and seizures.
- B. tachycardia, headache, dyspnea, temp. 101 F, and wheezing.
- C. blurred vision, tachycardia, hypertension, headache, insomnia, and oliguria.
- D. restlessness, insomnia, blurred vision, hypertension, chest pain, and muscleweakness.
Correct Answer: A
Rationale: Bronchodilators are medications used to relax and open the airways in the lungs, making it easier to breathe for patients with conditions like asthma. Common side effects of bronchodilators that need to be monitored in patients include tachycardia (increased heart rate), nausea, vomiting, heart palpitations, inability to sleep, restlessness, and in severe cases, seizures. These side effects can vary depending on the type of bronchodilator being used, but it is important for healthcare providers to monitor patients for these symptoms and adjust their treatment as needed.
As the surgical incision is closed, who are the personnel in-charge in counting the needles, sponges, and instruments?
- A. the surgeon and anesthesiologist
- B. the surgeon and the registered
- C. the circulating and scrub nurse nurse first assistant
- D. the anesthesiologist and anesthetist
Correct Answer: C
Rationale: During the surgical procedure, the circulating nurse, scrub nurse, and nurse first assistant are responsible for keeping track of all instruments, needles, and sponges used. As the surgical incision is being closed, the circulating nurse and the scrub nurse/nurse first assistant conduct a final count of all needles, sponges, and instruments to ensure that nothing is accidentally left inside the patient's body. This is a critical step in preventing retained surgical items (RSI), which can lead to serious complications for the patient. It is part of the standard protocol in the operating room to have these specific personnel take charge of counting and verifying all items before the procedure is concluded.
The parents of a newborn with a strawberry hemangioma ask the nurse what the treatment will be. What information does the nurse need to include in the response?
- A. Excision of the lesion will be necessary.
- B. Injections of prednisone into the lesion will reduce it.
- C. No treatment is usually necessary because of the high rate of spontaneous involution.
- D. Pulsed dye laser treatments will be necessary immediately to prevent permanent disability.
Correct Answer: C
Rationale: The correct information the nurse should provide to the parents is that no treatment is usually necessary for a strawberry hemangioma because of the high rate of spontaneous involution. Strawberry hemangiomas are common vascular tumors in infants that typically appear in the first few weeks of life. They usually grow rapidly for the first several months and then begin to shrink and eventually disappear on their own. In most cases, the hemangioma resolves without the need for any intervention. Therefore, reassuring the parents that observation is the primary management approach is important, unless complications such as ulceration, bleeding, or obstruction occur.