Nokea
A 4-year-old child is admitted with a tentative diagnosis of Kawasaki disease. Which of the following laboratory findings is most likely to be found in this child?
- A. Leukocytosis.
- B. Thrombocytopenia.
- C. Decreased sedimentation rate.
- D. Hypoalbuminemia.
Correct Answer: A
Rationale: Kawasaki disease is commonly associated with leukocytosis, reflecting the inflammatory process characteristic of the condition.
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Which type of anemia is diagnosed with a Schilling test?
- A. Aplastic
- B. Pernicious
- C. Megaloblastic
- D. Iron deficiency
Correct Answer: B
Rationale: The Schilling test is used to determine the cause of vitamin B12 deficiency, a potential precursor to pernicious anemia. This test involves the use of a small oral dose of radioactive B12 and a large nonradioactive intramuscular dose. A 24-hour urine specimen is then collected to measure the amount of radioactivity in the urine, and thus radioactive B12. This test is not helpful in diagnosing aplastic, megaloblastic, or iron-deficiency anemia.
A client with acute myocardial infarction receives therapy with alteplase. Which finding indicates to the nurse that the client is experiencing a possible complication?
- A. Epistaxis
- B. Vomiting
- C. ECG changes
- D. Absent pedal pulses
Correct Answer: A
Rationale: Bleeding is an adverse effect of altepase therapy. The bleeding can be superficial or internal and can be spontaneous. None of the remaining options are side or adverse effects of altepase therapy.
The nurse is assessing a child admitted with a diagnosis of rheumatic fever. Which significant question should the nurse ask the child's parent during the assessment?
- A. Has your child had difficulty urinating?
- B. Has your child been exposed to anyone with chickenpox?
- C. Has any family member had a sore throat within the past few weeks?
- D. Has any family member had a gastrointestinal disorder in the past few weeks?
Correct Answer: C
Rationale: Rheumatic fever characteristically presents 2 to 6 weeks after an untreated or partially treated group A beta-hemolytic streptococcal infection of the respiratory tract. Initially the nurse determines whether any family member has had a sore throat or unexplained fever within the past few weeks. The remaining options are unrelated to the assessment findings of rheumatic fever.
The nurse talks to students at a high school about sexually transmitted infections (STIs). Which effective methods of preventing STIs does the nurse include in the discussion? Select all that apply.
- A. Some birth control pills prevent STIs.
- B. STIs do not transmit through oral sex.
- C. Diaphragms are a barrier against STIs.
- D. Abstinence prevents transmission of STIs.
- E. Proper condom use provides STI protection.
- F. Multiple sex partners increase the risk of STIs.
Correct Answer: D,E,F
Rationale: Effective measures to avoid STIs include abstinence, using condoms properly, and avoiding multiple partners, and the nurse should provide this factual information to the high school students. The nurse also includes information about ineffective methods of preventing STIs, including birth control pills, oral sex, and diaphragms.
The nurse is teaching a client with gout about dietary management. Which of the following foods should the client avoid?
- A. Spinach.
- B. Cherries.
- C. Organ meats.
- D. Whole grains.
Correct Answer: C
Rationale: Organ meats are high in purines, which increase uric acid levels and should be avoided in gout.