Nokea
A 3-year-old child from a suburban community presents with vomiting, diarrhea, and blurred vision. Physical examination reveals an afebrile child with pinpoint pupils, salivation, and muscular fasciculations. The child's lawn was treated yesterday for insects. Which of the following tests will establish the correct diagnosis?
- A. Blood-lead level
- B. 24-hour urine mercury level
- C. Plasma cholinesterase level
- D. Urine malathion level
Correct Answer: C
Rationale: The symptoms suggest organophosphate poisoning, which can be confirmed by measuring plasma cholinesterase levels, as organophosphates inhibit this enzyme.
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Which of the following is a discharge criterion from the PACU for a patient following surgery?
- A. Oxygen saturation above 90%
- B. IV narcotics given less than 15 minutes ago
- C. Oxygen saturation below 90%
- D. IV narcotics given less than 30 minutes ago
Correct Answer: A
Rationale: Oxygen saturation above 90% is a discharge criterion from the PACU (Post-Anesthesia Care Unit) for a patient following surgery. This indicates that the patient is effectively exchanging oxygen and carbon dioxide, which is essential for proper respiratory function. Adequate oxygenation is crucial for the patient to be safely discharged from the PACU and transitioned to a regular hospital room or home. Monitoring oxygen saturation helps ensure that the patient's respiratory status is stable before leaving the PACU. If a patient's oxygen saturation is below 90%, further assessment and interventions may be necessary before discharge is considered.
Which of the ff actions should the nurse perform before a client with impaired physical mobility gets up?
- A. Use parallel bars or a walker
- B. Use incontinence pads
- C. Apply an abdominal binder
- D. Use a footboard
Correct Answer: A
Rationale: Before a client with impaired physical mobility gets up, the nurse should ensure that the appropriate assistive device is available and properly set up for the client to use. Using parallel bars or a walker provides support and stability, helping the client maintain balance and prevent falls while standing and walking. This would be the most suitable action to take before assisting the client in getting up to ensure their safety and mobility. Applying incontinence pads, an abdominal binder, or using a footboard are not directly related to the immediate need of assisting the client with impaired physical mobility in getting up.
The nurse is using the FLACC scale to rate the pain level in a 9-month-old. Which is the nurse's best response to the father's question of what the FLACC scale is?
- A. It estimates a child's level of pain utilizing vital sign information.
- B. It estimates a child's level of pain based on parents' perception.
- C. It estimates a child's level of pain utilizing behavioral and physical responses.
- D. It estimates a child's level of pain utilizing a numeric scale from 0 to 5.
Correct Answer: C
Rationale: The FLACC scale uses observable behavioral and physical responses (facial expression, leg movement, activity, cry, and consolability) to estimate pain.
As the nurse collects data on a patient, which of the following is a symptom that may be found that the patient with anaphylaxis may be experiencing?
- A. Dermatitis
- B. Sinusitis
- C. Delirium
- D. Wheezing
Correct Answer: D
Rationale: Wheezing is a common symptom of anaphylaxis, along with other signs such as difficulty breathing, chest tightness, coughing, and throat swelling. Wheezing is caused by the constriction of the airways due to the body's extreme immune response to the allergen, leading to difficulty in breathing and wheezing sounds during respiration. It is important for healthcare professionals to recognize wheezing as a symptom of anaphylaxis and respond promptly with appropriate interventions, such as administering epinephrine and providing respiratory support.
The nurse understands that for the parathyroid hormone to exert its effect, what must be present?
- A. Decreased phosphate level
- B. Functioning thyroid gland
- C. Adequate vitamin D level
- D. Increased calcium level
Correct Answer: D
Rationale: Parathyroid hormone (PTH) is released by the parathyroid glands in response to low calcium levels in the blood. Its primary function is to regulate calcium and phosphorus levels in the body. When calcium levels in the blood are low, PTH is released, leading to increased calcium levels by stimulating the release of calcium from the bones, increasing calcium absorption in the intestines, and promoting calcium reabsorption in the kidneys. Therefore, for PTH to exert its effect, increased calcium levels must be present.