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A chest radiograph film is ordered for a child with suspected cardiac problems. The child's parent asks the nurse, "What will the radiograph show about the heart?" What knowledge about the x-ray should the nurse include in the response to the parents?
- A. Bones of chest but not the heart
- B. Measurement of electrical potential generated from heart muscle
- C. Permanent record of heart size and configuration
- D. Computerized image of heart vessels and tissues
Correct Answer: C
Rationale: A chest radiograph film, commonly known as a chest X-ray, shows a permanent record of the size and configuration of the heart. It can provide information about the overall size and shape of the heart, the presence of any abnormalities (such as an enlarged heart), and the position of the heart within the chest cavity. While a chest X-ray can also show the bones of the chest, it is primarily used to visualize the heart and lungs. It does not measure electrical potential generated from heart muscle (which would be seen on an ECG) or show a computerized image of heart vessels and tissues (which would typically require more advanced imaging techniques such as a CT scan or MRI).
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A client requires minor surgery for removal of a basal cell tumor. The anesthesiologist administers the anesthetic ketamine hydrochloride (Ketalar), 60g IV. After Ketamine administration, the nurse should monitor the client for:
- A. Muscle rigidity and spasms
- B. Hiccups
- C. Extrapyramidal reactions
- D. Respiratory depression
Correct Answer: A
Rationale: Ketamine hydrochloride (Ketalar) is a dissociative anesthetic that can cause muscle rigidity and spasms as a side effect. This is known as a dose-dependent reaction to ketamine administration. Monitoring for muscle rigidity and spasms is important to ensure the client's safety and to provide appropriate management if this adverse effect occurs. It is essential for the nurse to closely observe the client for any signs of muscle rigidity and spasms after the administration of ketamine.
which of the following is the primary objective of care for the child with nephrosis?
- A. reduce blood pressure.
- B. reduce excretion of urinary protein.
- C. increase excretion of urinary protein.
- D. increase ability of tissues to retain fluid.
Correct Answer: B
Rationale: The primary objective of care for a child with nephrosis, also known as nephrotic syndrome, is to reduce the excretion of urinary protein. Nephrosis is a condition characterized by excessive loss of protein through the urine, leading to hypoalbuminemia and edema. By reducing the excretion of urinary protein, healthcare providers aim to minimize protein loss and improve the child's nutritional status and overall health. This can be achieved through medications such as corticosteroids, diuretics, and other treatments that help to decrease proteinuria and manage symptoms associated with nephrosis. Additionally, dietary modifications and monitoring for complications such as infection and thrombosis are important aspects of care for children with nephrosis.
Mrs. Go is suspected of experiencing respiratory distress from a left-sided pneumothorax. She should be positioned:
- A. in a semi-fowler's position
- B. trendelenburg position
- C. prone position
- D. on the right side
Correct Answer: A
Rationale: Mrs. Go, who is suspected of experiencing respiratory distress from a left-sided pneumothorax, should be positioned in a semi-fowler's position. This position involves elevating the head of the bed to approximately 30 to 45 degrees. Placing the patient in a semi-fowler's position helps improve lung expansion, facilitates breathing, and promotes optimal oxygenation. It can also help prevent the collapse of the affected lung and assist in reducing the symptoms associated with pneumothorax. Trendelenburg position (B) and prone position (C) are not recommended for pneumothorax as they can worsen the condition by putting additional pressure on the affected lung. Placing the patient on the right side (D) would not specifically address the respiratory distress caused by a left-sided pneumothorax. Therefore, the most appropriate position for Mrs. Go in this situation is the semi-fowler's position.
When assessing the external ear, the nurse palpates a small protrusion of the helix called a Darwin tubercle. The nurse would document this finding as which of the following?
- A. A normal finding
- B. An abnormal finding
- C. A normal finding only in the older adult
- D. An abnormal finding only in the older adult
Correct Answer: A
Rationale: A Darwin tubercle is a small, painless, hereditary nodule located on the helix of the ear. It is a normal anatomical variation and is present in varying degrees in the general population, regardless of age. Therefore, it would be documented as a normal finding during the assessment of the external ear.
What should be included in the plan of care for a preschool-age child who is admitted in a vasoocclusive sickle cell crisis (pain episode)?
- A. Pain management
- B. Administration of heparin
- C. Factor VIII replacement
- D. Electrolyte replacement
Correct Answer: A
Rationale: Pain management is a crucial component in the plan of care for a preschool-age child admitted with a vasoocclusive sickle cell crisis. Sickle cell disease causes blood vessels to become blocked, leading to ischemia and pain. Managing pain promptly and effectively is necessary to improve the child's comfort level and prevent complications. Pain management strategies typically involve the use of analgesic medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or opioids, tailored to the child's age and weight. Additionally, non-pharmacological interventions like distraction techniques and positioning can help in reducing pain and promoting relaxation in children during a sickle cell crisis.