Nokea
A 3-day-old neonate has a large, soft, painless mass involving the head and neck region that mostly transilluminate; CT scan reveals a cystic mass involving the neck and intrathoracic mediastinum. The BEST modality for treatment of this neonate is
- A. surgical resection
- B. injection sclerosing agent
- C. laser therapy
- D. systemic interferon therapy
Correct Answer: A
Rationale: Surgical resection is the definitive treatment for cystic hygroma.
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Which of the ff. statements would the nurse understand is true when assessing normal auditory acuity using the Rinne test?
- A. The patient perceives sound equally in both ears.
- B. Air conduction is heard longer than bone conduction in both ears.
- C. Bone conduction is heard longer than air conduction in both ears.
- D. The patient's left ear will perceive the sound better than the right ear.
Correct Answer: B
Rationale: In the Rinne test, a tuning fork is placed first on the mastoid bone behind the ear to test bone conduction, and then beside the ear to test air conduction. A normal finding in the Rinne test is when air conduction (heard beside the ear) is longer than bone conduction (heard on the mastoid bone) in both ears. This indicates that sound waves travel through the air better than through bone. If air conduction is heard longer than bone conduction, it suggests normal auditory acuity.
When caring for the child with Kawasaki disease, the nurse should know which information?
- A. A child's fever is usually responsive to antibiotics within 48 hours.
- B. The principal area of involvement is the joints.
- C. Aspirin is contraindicated.
- D. Therapeutic management includes administration of gamma globulin and aspirin.
Correct Answer: D
Rationale: Kawasaki disease is an acute febrile illness that primarily affects children. The therapeutic management of Kawasaki disease includes the administration of gamma globulin and aspirin. Intravenous immunoglobulin (IVIG) or gamma globulin is given as a single dose to reduce the risk of coronary artery abnormalities, while aspirin is used for its anti-inflammatory effects. It is important to note that aspirin should not be given to children with viral infections due to the risk of Reye syndrome. Therefore, option D is the correct choice in this case.
The nurse, in assessing the adequacy of a client's fluid replacement during the first 2 to 3 days following full- thickness burns to the trunk and right thigh, would be aware that the most significant data would be obtained from recording
- A. Weights every day .
- B. Blood pressure every 15 minutes
- C. Urinary output every hour
- D. Extent of peripheral edema every 4 hours
Correct Answer: C
Rationale: Monitoring urinary output every hour is crucial in assessing the adequacy of fluid replacement in a client with full-thickness burns. Burn injuries can result in a significant loss of fluid and electrolytes due to increased capillary permeability and excessive fluid shift from the intravascular space to the interstitial space. Adequate fluid replacement is essential to maintain tissue perfusion, prevent hypovolemia, and support organ function. By closely monitoring the urinary output every hour, the nurse can assess renal perfusion, fluid balance, and the effectiveness of fluid resuscitation. A decrease in urinary output can indicate inadequate fluid replacement, while an increase may suggest fluid overload. This information is important in guiding adjustments to the fluid replacement therapy to ensure optimal outcomes for the client. Weights, blood pressure measurements, and assessment of peripheral edema are also important data to monitor in a burn client, but urinary output is the most significant indicator of fluid balance in
A newborn begins to cough, choke, and becomes cyanotic while feeding. What is the nurse's immediate action?
- A. Inform the physician.
- B. Have the mother stop feeding and observe.
- C. Remove the infant from the mother, place the infant in the crib for assessment, obtain oxygen saturation, and administer blow-by oxygen immediately.
- D. Continue feeding while monitoring.
Correct Answer: C
Rationale: Immediate removal from the feeding situation and rapid assessment with oxygen support is critical for airway safety.
The adolescent patient has symptoms of meningitis: nuchal rigidity, fever, vomiting, and lethargy. The nurse knows to prepare for the following test:
- A. blood culture.
- B. throat and ear culture.
- C. CAT scan.
- D. lumbar puncture.
Correct Answer: D
Rationale: The symptoms described (nuchal rigidity, fever, vomiting, and lethargy) suggest possible meningitis, which is an inflammation of the meninges, the membranes surrounding the brain and spinal cord. One of the key diagnostic tests for meningitis is a lumbar puncture, also known as a spinal tap. During a lumbar puncture, cerebrospinal fluid (CSF) is collected from the space around the spinal cord and analyzed for signs of infection, inflammation, or other abnormalities. This test helps confirm or rule out a diagnosis of meningitis and identify the specific infectious agent causing the illness. Other tests, such as blood cultures, may also be done to further evaluate the infection, but a lumbar puncture is essential for diagnosing meningitis in this case.