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A baby, exhibiting no obvious signs of congestive heart failure, has been diagnosed with a small ventricular septal defect. Which of the following information should the nurse explain to the baby's parents?
- A. The baby will likely need open-heart surgery within a week.
- B. The defect will likely close without therapy.
- C. The defect likely developed early in the second trimester.
- D. The baby will likely be placed on high-calorie formula.
Correct Answer: B
Rationale: The nurse should explain to the baby's parents that the ventricular septal defect will likely close without therapy. Small ventricular septal defects have a high likelihood of closing on their own as the child grows. Surgical intervention is usually not necessary for small defects, especially when the baby does not exhibit signs of congestive heart failure. It is important for the parents to be aware of the natural course of the defect and to follow up with the healthcare provider for monitoring and management.
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A nurse is recommending strategies to a group of school-age children for prevention of obesity. Which should the nurse include? (Select all that apply.)
- A. Eat breakfast daily.
- B. Limit fruits and vegetables.
- C. Have frequent family meals with parents present.
- D. Eat frequently at restaurants.
Correct Answer: A
Rationale: Eating breakfast daily is important for maintaining a healthy weight as it kick starts the metabolism and prevents overeating later in the day.
A client metastatic ovarian cancer is prescribed cisplatin (Platinol). Before administering the first dose, the nurse reviews the client's medication history for drugs that may interact with cisplatin. Which drug may cause significant interactions when given concomitantly with cisplatin?
- A. Erythromycin
- B. A cephalosporin
- C. A tetracycline
- D. An amino glycoside Situation: A client with ovarian cancer is prescribed hydroxyurea (Hydrea), an antimetabolite drug.
Correct Answer: D
Rationale: Amino glycosides, such as gentamicin or amikacin, can interact significantly with cisplatin, leading to increased risk of kidney damage or hearing loss. Both amino glycosides and cisplatin are known to have nephrotoxic and ototoxic effects independently. When combined, the risk of these side effects is potentiated, making it important to monitor renal function and hearing closely when these drugs are co-administered. Therefore, it is crucial to avoid the concomitant use of amino glycosides with cisplatin in order to prevent harmful drug interactions and reduce the risk of adverse effects in the client with metastatic ovarian cancer.
The physician orders furosemide (Lasix) 40 mg IV STAT for an acutely fluid-overloaded patient. Why was the IV route likely chosen?
- A. Furosemide can be administered only by the IV route.
- B. IV is the route of choice for rapid administration.
- C. IV dosing is more accurate.
- D. IV furosemide has a fewer side effects than oral.
Correct Answer: B
Rationale: The IV route was likely chosen for the administration of furosemide (Lasix) in this acutely fluid-overloaded patient because IV is the route of choice when rapid administration is needed. When given intravenously, the medication is able to produce a quicker and more immediate diuretic effect compared to oral administration, allowing for more rapid relief of fluid overload symptoms. This can be crucial in emergency situations where the patient's condition requires fast intervention.
In fetal period, all are true EXCEPT
- A. 10 weeks - midgut returns to abdomen
- B. 12 weeks - external genitalia formed
- C. 24 weeks - surfactant production begun
- D. 26 weeks - face clearly recognizable
Correct Answer: D
Rationale: Face recognition typically occurs earlier than 26 weeks.
Which is the most critical physiologic change required of the newborn?
- A. Closure of fetal shunts in the heart
- B. Stabilization of fluid and electrolytes
- C. Body-temperature maintenance
- D. Onset of breathing
Correct Answer: D
Rationale: The most critical physiologic change required of the newborn is the onset of breathing. Prior to birth, the fetus receives oxygen from the mother's blood through the placenta. However, once the newborn is delivered, it needs to begin breathing on its own to support oxygen exchange and remove carbon dioxide from the body. The respiratory system must transition from a fluid-filled state in the womb to an air-filled state outside the womb. The onset of breathing is essential for the newborn's survival and initiates the process of oxygenation of tissues and removal of carbon dioxide, which are vital for metabolism and overall physiological functioning. While closure of fetal shunts, stabilization of fluid and electrolytes, and body-temperature maintenance are also important changes that occur in the newborn, the onset of breathing is the most critical to ensure proper oxygenation of the body's tissues.