Nokea
A 3-week-old neonate is brought to the emergency department because of a three-day history of intermittent vomiting. His mother reports that he has not urinated for eight hours. On physical examination, his eyes are sunken. Which of the following will MOST likely require correction before surgery is performed?
- A. Hypochloremia
- B. Hyperkalemia
- C. Hypernatremia
- D. N/A
Correct Answer: A
Rationale: Hypochloremia is often associated with dehydration and metabolic alkalosis, which may need correction before surgery.
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The twelve-year-old boy has fractured his arm because of a fall from his bike. After the injury has been casted, the nurse knows it is most important to perform all of the following assessments on the area distal to the injury except:
- A. capillary refill.
- B. radial and ulnar pulse.
- C. finger movement
- D. skin integrity
Correct Answer: B
Rationale: Assessing the radial and ulnar pulses is crucial in evaluating the circulation of blood to the hand. However, in this scenario of a fractured arm, the injury is distal to the hand (further away from the body). It is more critical to check capillary refill, finger movement, and skin integrity in the area distal to the injury to ensure there is no compromise to the blood flow, nerve function, or skin integrity following the injury. Checking the radial and ulnar pulse would be more relevant if the injury was closer to the wrist area, as it would directly impact these pulses.
Granulocytic sarcoma masses are commonly seen in which type of the following malignancies?
- A. neuroblastoma
- B. rhabdomyosarcoma
- C. soft tissue sarcoma
- D. AML
Correct Answer: D
Rationale: Granulocytic sarcoma is most commonly associated with acute myeloid leukemia (AML).
Which is a function of brown adipose tissue (BAT) in the newborn?
- A. Provides ready source of calories in the newborn period
- B. Insulates the body against lowered environmental temperature
- C. Protects the newborn from injury during the birth process
- D. Generates heat for distribution to other parts of body
Correct Answer: D
Rationale: Brown adipose tissue (BAT) is specialized adipose tissue found in newborns and hibernating mammals, whose primary function is to generate heat through non-shivering thermogenesis. This heat generation is essential for maintaining body temperature in newborns, especially as they have a larger surface area-to-volume ratio, which results in greater heat loss compared to adults. BAT produces heat by metabolizing stored lipids and disrupting the normal process of cellular respiration, leading to the production of heat instead of ATP. The heat generated by BAT is then distributed throughout the body to help maintain a stable core body temperature in newborns, who are not yet able to regulate their body temperature as effectively as adults.
A male client is suspected of an immune system disorder. Which of the ff important factors will the nurse document while assessing the client?
- A. The client's diet
- B. The client's family member's history of
- C. The client's drug history chronic diseases
- D. The client's ability to produce antibodies
Correct Answer: D
Rationale: Assessing the client's ability to produce antibodies is a crucial factor in determining immune system function. Antibodies are proteins produced by the immune system to help fight off infections and other harmful substances. In a male client suspected of an immune system disorder, understanding his ability to produce antibodies can provide valuable insights into the functionality of his immune system. This assessment can help healthcare providers identify potential deficiencies or abnormalities in the immune response, leading to appropriate diagnosis and treatment strategies.
For a patient with gastroesophageal reflux symptoms, the purpose of esophageal pH monitoring is to evaluate for:
- A. esophagitis from the reflux.
- B. frequency of the reflux.
- C. gastric emptying delays.
- D. possible obstructions.
Correct Answer: B
Rationale: Esophageal pH monitoring measures the frequency and duration of acid exposure in the esophagus, helping diagnose GERD.