Nokea
A 5 months child is brought for routine care. During auscultation of heart you find a short systolic murmur at left upper sternal border with soft 2nd heart sound. The most likely diagnosis is?
- A. Ventricular septal defect
- B. Atrial septal defect
- C. Patent ductus arteriosus
- D. Pulmonary stenosis
Correct Answer: B
Rationale: Atrial septal defect (ASD) often presents with a systolic ejection murmur at the left upper sternal border and a fixed split second heart sound.
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Ms. CC's laboratory values indicate hemoconcentration secondary to fluid loss. Which of the following intravenous solutions would be most appropriate during initial fluid replacement therapy?
- A. 10% dextrose and saline
- B. 5% dextrose and water
- C. 5% dextrose and water with 60 mEq
- D. Distilled water KCl
Correct Answer: A
Rationale: In hemoconcentration due to fluid loss, the primary goal is to rapidly expand the intravascular volume and correct the deficit. The most appropriate intravenous solution for initial fluid replacement therapy in this case is 10% dextrose and saline. This solution is isotonic, which means it has an osmolarity close to that of blood and is effective in quickly restoring intravascular volume without causing significant shifts in electrolytes. The saline component helps to replenish lost electrolytes while the dextrose provides energy and helps prevent hypoglycemia. The combination of dextrose and saline is beneficial for addressing both intravascular volume depletion and dehydration causing hemoconcentration.
which of the following is a characteristic in a child with acute lymphocytic leukemia?
- A. fatigability
- B. persistent fever of unknown cause
- C. tendency to bruise easily
- D. all of the above are correct
Correct Answer: D
Rationale: Children with acute lymphocytic leukemia commonly present with a combination of symptoms which can include fatigability, persistent fever of unknown cause, and a tendency to bruise easily. Fatigue is a common complaint in children with leukemia due to anemia caused by decreased production of healthy red blood cells. Persistent fevers can be a sign of infection, anemia, or other complications related to leukemia. Additionally, children with leukemia may have a low platelet count, leading to easy bruising or bleeding tendencies. Therefore, all of the characteristics mentioned in the options are correct for a child with acute lymphocytic leukemia.
A 5 months child is brought for routine care. During auscultation of heart you find a short systolic murmur at left upper sternal border with soft 2nd heart sound. The most likely diagnosis is?
- A. Ventricular septal defect
- B. Atrial septal defect
- C. Patent ductus arteriosus
- D. Pulmonary stenosis
Correct Answer: B
Rationale: Atrial septal defect (ASD) often presents with a systolic ejection murmur at the left upper sternal border and a fixed split second heart sound.
When the nurse interviews an adolescent, which is especially important?
- A. Focus the discussion on the peer group.
- B. Allow an opportunity to express feelings.
- C. Emphasize that confidentiality will always be maintained.
- D. Use the same type of language as the adolescent.
Correct Answer: B
Rationale: When the nurse interviews an adolescent, allowing an opportunity for the adolescent to express their feelings is especially important. Adolescents are at a stage in life where they are developing their own identity and dealing with a range of emotions. Providing a safe space for them to open up about their thoughts and feelings can help the nurse better understand and address their needs. This can also build a trustful relationship between the nurse and the adolescent, leading to more effective communication and care.
Which of the ff would help a client with an allergic skin reaction to reduce itching and maintain skin intact? Choose all that apply
- A. Humidifying the environment
- B. Avoiding a skin lubricant
- C. Bathing with a bar soap that contains lye
- D. Wearing cotton gloves, esp during sleep
Correct Answer: D
Rationale: Wearing cotton gloves, especially during sleep, would help protect the skin from further irritation caused by scratching during the night. Cotton is a breathable fabric that is gentle on the skin and can help prevent further damage or itching. It also helps in maintaining the skin intact by creating a barrier between the skin and external irritants, thus reducing the chances of exacerbating the allergic reaction.