Nokea
A 4-year-old fell from a third-story window and landed on her head. She is semiconscious with slow, irregular breathing and bleeding from her mouth. After performing a jaw-thrust maneuver with simultaneous stabilization of her head, what should you do next?
- A. suction the oropharynx
- B. insert a nasopharyngeal airway
- C. initiate positive pressure ventilations
- D. place the patient in the recovery position
Correct Answer: A
Rationale: In this scenario, the 4-year-old is presenting with signs of airway compromise due to the fall. After performing a jaw-thrust maneuver to open the airway while stabilizing the head to prevent further injury, the next step should be to suction the oropharynx. Suctioning helps to clear any blood or secretions from the mouth and throat, ensuring a clear airway for proper breathing. Inserting a nasopharyngeal airway or initiating positive pressure ventilations would be premature without first ensuring the airway is clear. Placing the patient in the recovery position is not indicated at this point as the focus should be on managing the airway.
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Which treatment is instituted for the therapeutic management of minimal change nephrotic syndrome?
- A. corticosteroids
- B. antihypertensive agents
- C. long-term diuretics
- D. increased fluids to promote diuresis
Correct Answer: A
Rationale: Corticosteroids are the mainstay of treatment for minimal change nephrotic syndrome as they help reduce inflammation and decrease proteinuria. Antihypertensive agents are used to manage high blood pressure often associated with kidney disease but are not the primary treatment for this condition. Long-term diuretics are not typically used in the management of minimal change nephrotic syndrome as they can worsen fluid and electrolyte imbalances. Increasing fluids to promote diuresis is not recommended in this condition as it can lead to further fluid retention and edema.
While teaching a parent how to prevent accidents while caring for a 6-month-old infant, what motor development ability should be emphasized?
- A. Sits up
- B. Rolls over
- C. Crawls short distances
- D. Stands while holding on to furniture
Correct Answer: B
Rationale: The correct answer is B: Rolls over. At 6 months, most infants can roll over, increasing the risk of falls. It is important to emphasize to the parent the need for careful supervision to prevent accidents. While choices A, C, and D are also milestones in infant motor development, rolling over at this age poses a higher risk of accidents due to the increased mobility and potential for falls.
When teaching a class about trisomy 21, the instructor would identify the cause of this disorder as:
- A. nondisjunction.
- B. X-linked recessive inheritance.
- C. genomic imprinting.
- D. autosomal dominant inheritance.
Correct Answer: A
Rationale: The correct answer is A: nondisjunction. Trisomy 21, also known as Down syndrome, is caused by nondisjunction, which is an error in cell division leading to an extra copy of chromosome 21. This additional genetic material alters the course of development and causes the characteristics associated with Down syndrome. Choices B, C, and D are incorrect. X-linked recessive inheritance refers to genetic disorders carried on the X chromosome, genomic imprinting involves gene expression based on parental origin, and autosomal dominant inheritance relates to disorders caused by a dominant gene on one of the non-sex chromosomes. In the case of trisomy 21, the cause is specifically related to the error in chromosome division, making nondisjunction the most appropriate answer.
A healthcare professional is assessing a child with suspected pertussis. What clinical manifestation is the healthcare professional likely to observe?
- A. Dry, hacking cough
- B. Inspiratory stridor
- C. Nasal congestion
- D. Severe coughing spells
Correct Answer: D
Rationale: Severe coughing spells are a hallmark clinical manifestation of pertussis. Pertussis, also known as whooping cough, is characterized by paroxysms of rapid, consecutive coughs followed by a distinctive 'whoop' sound as the patient gasps for air. This intense coughing can lead to vomiting, exhaustion, and sometimes a characteristic 'whoop' sound. Inspiratory stridor (Choice B) is more commonly associated with croup, not pertussis. Nasal congestion (Choice C) is not a typical feature of pertussis. While a cough is present in pertussis, the specific type of cough described in Choice A (dry, hacking cough) is not the predominant feature observed in pertussis.
A nurse is planning an initial home care visit to a mother who gave birth to a high-risk infant. For what time of day should the nurse schedule the visit to be most productive?
- A. When the husband is out of the home.
- B. At a time when the mother is feeding the infant.
- C. At a time that is convenient for the family.
- D. When the nurse can spend time with the family.
Correct Answer: C
Rationale: Scheduling the visit at a time that is convenient for the family is crucial for ensuring the family's receptiveness and availability, making the visit more productive. Choosing a time when the mother is feeding the infant (choice B) may not necessarily align with the family's overall convenience and may disrupt the feeding routine. Similarly, scheduling the visit when the husband is out of the home (choice A) might not be optimal as it may exclude an important family member and potentially impact the support system. While spending time with the family (choice D) is important, the primary focus should be on accommodating the family's schedule to maximize the effectiveness of the visit.