Nokea
A 5-year-old girl Hannah is recently diagnosed with Kawasaki disease. Apart from the identified symptoms of the disease, she may also likely develop which of the following?
- A. Sepsis
- B. Meningitis
- C. Mitral valve disease
- D. Aneurysm formation 45
Correct Answer: D
Rationale: Kawasaki disease is an inflammatory condition that primarily affects medium-sized blood vessels, including the coronary arteries. If not promptly and effectively treated, about 25% of untreated cases can lead to the development of coronary artery aneurysms. These aneurysms can increase the risk of serious complications such as myocardial infarction and sudden death. Therefore, it is crucial to closely monitor and manage the cardiovascular complications in patients with Kawasaki disease, particularly the risk of aneurysm formation.
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What is the care priority for a newborn with bladder exstrophy and a malformed pelvis?
- A. Change the diaper frequently and assess for skin breakdown.
- B. Keep the exposed bladder open in a warm, dry environment.
- C. Offer formula for growth and fluid management.
- D. Cluster care to allow the child uninterrupted sleep and strength for upcoming surgical repair.
Correct Answer: D
Rationale: Minimizing disturbances (clustering care) helps prevent infection and allows the infant to conserve energy before surgical repair.
Scoliosis That Greater 40 Degree Curvature Is Usually Treated By :
- A. Exercise
- B. Spinal fusion surgery
- C. Bracing
- D. Casting
Correct Answer: B
Rationale: When scoliosis progresses to a greater than 40-degree curvature, it is often treated with spinal fusion surgery. This surgical procedure involves fusing together the vertebrae in the curved part of the spine to correct the curvature. Spinal fusion surgery is typically recommended for severe cases of scoliosis to halt the progression of the curve and prevent further complications such as lung and heart problems. Other treatment options like exercise, bracing, and casting may be more suitable for milder cases or as a preventative measure in certain situations.
An agitated, confused client arrives in the emergency department. The client's history includes type 1 diabetes mellitus, hypertension, and angina pectoris. Assessment reveals pallor, diaphoresis, headache, and intense hunger. A stat blood glucose sample measures 42mg/dl, and the client is treated for an acute hypoglycemic reaction. After recovery, the nurse teaches the client to treat hypoglycemia by ingesting:
- A. 2 to 5 of a simple carbohydrate.
- B. 18 to 20 g of a simple carbohydrat
- C. 10 to 15 g of a simple carbohydrate.
- D. 25 to 30 g of a simple carbohydrate.
Correct Answer: C
Rationale: When treating hypoglycemia, it is important to provide a quick source of sugar to raise blood glucose levels rapidly. Consuming 10 to 15 grams of a simple carbohydrate is appropriate for treating mild to moderate hypoglycemia. Examples of foods that contain approximately 10 to 15 grams of simple carbohydrates include four glucose tabs, 4 ounces of fruit juice, 5 to 6 pieces of hard candy, or 1 tablespoon of honey. It is also recommended to recheck blood glucose levels after 15 minutes and have a snack or meal to prevent glucose levels from dropping again.
Osteosarcoma is the most common primary malignant bone tumor in children and adolescents; it has multiple subtypes and requires different modalities of treatment including surgery and chemotherapy. Of the following, the subtype of osteosarcoma which is treated by surgery alone is
- A. fibroblastic
- B. chondroblastic
- C. parosteal
- D. periosteal
Correct Answer: D
Rationale: Periosteal osteosarcoma is often treated with surgery alone if margins are clear.
While examining a 2-year-old child, Nurse Galina sees that the anterior fontanel is open. She should:
- A. Notify the doctor
- B. Look for other signs of abuse
- C. Recognize this as a normal finding
- D. Ask about a family history of Tay-Sachs disease
Correct Answer: C
Rationale: Nurse Galina should recognize an open anterior fontanel as a normal finding in a 2-year-old child. The anterior fontanel is a soft spot on a baby's skull where the skull bones have not yet fused together. It usually closes by the time a child is 18 to 24 months old. The open fontanel at 2 years of age is within the normal range of closure, and it is not a cause for concern in this case. No need to notify the doctor, look for other signs of abuse, or ask about a family history of Tay-Sachs disease based on this finding.