Nokea
A child has been diagnosed with valvular disease following rheumatic fever (RF). During patient teaching, the nurse discusses the child’s long-term prophylactic therapy with antibiotics for dental procedures, surgery, and childbirth. The parents Indicate they understand when they say:
- A. “She will need to take the antibiotics until she turns 18 years old.â€
- B. “She will need to take the antibiotics for 5 years after the last attack.â€
- C. “She will need to take the antibiotics for 10 years after the last attack.â€
- D. “She will need to take the antibiotics for the rest of her life.â€
Correct Answer: D
Rationale: Lifelong antibiotic prophylaxis is recommended for individuals with valvular disease following rheumatic fever to prevent recurrent infections and further cardiac damage.
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In homo cystinuria:
- A. Homocysteine accumulates just proximal to the enzyme defect
- B. Osteoporosis is a recognised feature
- C. Oral contraceptive pills with oestrogens are contraindicated
- D. Dislocation of lens is a feature
Correct Answer: D
Rationale: Dislocation of the lens is a well-documented feature of homocystinuria due to the accumulation of homocysteine, which affects connective tissue.
What is the recommended hourly maintenance fluid rate (water) for a 20 kg child?
- A. 50 ml/hour
- B. 60 ml/hour
- C. 80 ml/hour
- D. 100 ml/hour
Correct Answer: B
Rationale: The recommended hourly maintenance fluid rate for a 20 kg child is 60 ml/hour, calculated using the formula: 100 ml/kg for the first 10 kg + 50 ml/kg for the next 10 kg.
The healthcare provider prescribes an IV solution of regular insulin (Hummulin-R) 100 units in 250 ml of 0.45% saline to infuse at 12 units/hour. The nurse should program the infusion pump to deliver how many ml/hour?
- A. 30
- B. 3
- C. 40
- D. 15
Correct Answer: A
Rationale: To calculate the infusion rate in ml/hour, the nurse needs to divide the prescribed units per hour by the concentration of insulin. 12 units/hour ÷ (100 units/250 ml) = 30 ml/hour.
During a paracentesis, two liters of fluid are removed from the abdomen of a client with ascites. A drainage bag is placed, and 50 ml of clear, straw-colored fluid drains within the first hour. What action should the nurse implement?
- A. Palpate for abdominal distention
- B. Send fluid to the lab for analysis
- C. Continue to monitor the fluid output
- D. Clamp the drainage tube for 5 minutes
Correct Answer: C
Rationale: Monitoring fluid output is essential to assess for complications such as reaccumulation of fluid or bleeding.
Membranous glomerulonephritis:
- A. Is typically associated with immune complex deposition
- B. Presents with nephritic syndrome
- C. Is associated with highly selective proteinuria
- D. Deposits of IgG on the glomerular membrane
Correct Answer: A
Rationale: Membranous glomerulonephritis is characterized by immune complex deposition, particularly IgG, on the glomerular basement membrane, leading to proteinuria.