Nokea
A 3-month-old, former 29-week-premature infant has been scheduled for repair of bilateral inguinal hernias. The infant had received mechanical ventilation for the first 6 days of life and had apnea of prematurity that resolved 5 weeks ago. The infant is feeding well and gaining weight and has no requirement for supplemental oxygen. The hematocrit is 28. The HMO clerk approves the surgery on an outpatient basis. All of the following are true EXCEPT
- A. risk of postoperative apnea is increased by anemia
- B. accepted standard of care includes overnight inpatient apnea monitoring for this infant after general anesthesia because of a significant risk of postoperative apnea
- C. postponing the surgery incurs a small but real risk of incarceration, with complications that may include bowel obstruction and infarction of testes or ovaries
- D. after a spinal anesthetic, monitoring for apnea is not required, and the infant can be sent home from the postanesthetic care unit on the day of surgery
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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All the following are long-term complications of intravenous cyclophosphamide EXCEPT
- A. bone marrow suppression
- B. bladder cancer
- C. leukemia
- D. infertility
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A healthcare professional is reviewing the laboratory results of a child who has nephrotic syndrome. Which of the following findings should the professional expect?
- A. Hypoalbuminemia
- B. Hyperkalemia
- C. Polyuria
- D. Hyperglycemia
Correct Answer: A
Rationale: In nephrotic syndrome, there is excessive loss of protein in the urine, leading to hypoalbuminemia. This results in decreased oncotic pressure, causing fluid to shift into the interstitial spaces, leading to edema. Hyperkalemia, polyuria, and hyperglycemia are not typically associated with nephrotic syndrome.
Reye's syndrome is a rare and severe illness affecting children and teenagers. Its development has been linked with the use of aspirin and which of the following?
- A. Meningitis
- B. Encephalitis
- C. Strep throat
- D. Varicella
Correct Answer: D
Rationale: Reye's syndrome is a rare but serious condition that primarily affects children and teenagers. It is characterized by swelling in the liver and the brain. The development of Reye's syndrome has been linked with the use of aspirin during viral infections, particularly influenza and varicella (chickenpox). Therefore, the correct answer is D. Varicella. It is crucial to avoid giving aspirin to children and teenagers during these viral infections to reduce the risk of developing Reye's syndrome.
Which histological feature differentiates Crohn's disease from ulcerative colitis?
- A. Crypt abscesses
- B. Granulomata
- C. Lymphocytic infiltrate
- D. Paneth cells
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
When caring for a child with hyponatremia, a nurse delegates care to a licensed vocational nurse (LVN) and instructs the LVN to promptly report which clinical manifestation?
- A. Seizures
- B. Respiratory distress
- C. Hyperthermia
- D. Bradycardia
Correct Answer: A
Rationale: Seizures are a significant concern in severe hyponatremia as they indicate potential neurological complications and the need for urgent intervention to prevent further harm to the child. Prompt reporting of seizures allows for timely assessment and appropriate treatment to ensure the child's safety and well-being.