Nokea
A child has a Glasgow Coma Scale of 3, HR of 88 beats per minute and regular, respiratory rate of 22, BP of 78/52, and blood sugar of 35 mg/dL. The nurse asks the caregiver about accidental ingestion of which drug?
- A. Calcium channel blocker
- B. Beta blocker
- C. ACE inhibitor
- D. ARB
Correct Answer: B
Rationale: Beta blockers affect the heart and also block beta receptors in the liver, reducing glycogen release and causing hypoglycemia. The low HR and BP support beta blocker ingestion.
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While assessing a client with degenerative joint disease, the nurse observes Heberden's nodes, large prominences on the client's fingers that are reddened. The client reports that the nodes are painful. Which action should the nurse take?
- A. Review the client's dietary intake of high-protein foods
- B. Notify the healthcare provider of the finding immediately
- C. Discuss approaches to the chronic pain control with the client
- D. Assess the client's radial pulses and capillary refill time
Correct Answer: C
Rationale: Chronic pain management is a priority in clients with degenerative joint disease and Heberden's nodes.
A client uses triamcinolone (Kenalog), a corticosteroid ointment, to manage pruritus caused by a chronic skin rash. The client calls the clinic nurse to report increased erythema with purulent exudate at the site. Which action should the nurse implement?
- A. Schedule an appointment for the client to see the healthcare provider
- B. Advise the client to apply more corticosteroid cream
- C. Recommend using an antibiotic ointment.
- D. Instruct the client to stop using the medication for 24 hours.
Correct Answer: A
Rationale: Increased erythema and purulent exudate suggest infection. The client needs evaluation and possible treatment with antibiotics.
All are true about TAPSE (Tricuspid Annular Plane Systolic Excursion), except
- A. Normal TAPSE is >17 mm
- B. Reliable measure of RV systolic function
- C. Can be measured using either M-mode or 2D echo
- D. TAPSE is measured at septal aspect of tricuspid annulus
Correct Answer: D
Rationale: TAPSE is measured at the lateral aspect of the tricuspid annulus, not the septal aspect.
Regarding intussusception in childhood:
- A. Incidence is most common in children over 3 years of age
- B. Barium enema is the investigation of choice
- C. Patient commonly presents with constant abdominal pain
- D. It is associated with Henoch-Schoenlein purpura
Correct Answer: D
Rationale: Intussusception is associated with Henoch-Schoenlein purpura, a condition that can cause inflammation and bleeding in the small blood vessels.
All of the following are true regarding attention deficit hyperactivity disorder (ADHD), except
- A. Dopamine transporter gene (DAT1) and dopamine 4 receptor gene (DRD4) are implicated in the diagnosis
- B. Impaired fine motor movement and poor coordination are 'soft' but specific signs of ADHD
- C. Developmentally inappropriate behavior must commence before 7 years of age and present for at least 6 months
- D. Maternal lead exposure is associated with ADHD
Correct Answer: B
Rationale: Impaired fine motor movement and poor coordination are not specific signs of ADHD; they are nonspecific and can occur in other conditions.