Nokea
A child is brought to the emergency department experiencing an anaphylactic reaction to a bee sting. While an airway is being established, the nurse should prepare which medication for immediate administration?
- A. Diphenhydramine (Benadryl)
- B. Dobutamine (Dobutarex)
- C. Epinephrine (Adrenalin)
- D. Calcium chloride (calcium chloride)
Correct Answer: C
Rationale: In the management of anaphylaxis, the immediate medication of choice for administration is epinephrine. Epinephrine is a potent vasoconstrictor and bronchodilator which helps restore blood pressure and open up the airways during an anaphylactic reaction. It is the first-line treatment to reverse the potentially life-threatening effects of an allergic reaction. Other medications, like diphenhydramine or dobutamine, may be used as adjuncts later in the treatment, but epinephrine is crucial for immediate administration to stabilize the child's condition.
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A 52-year old female tells the nurse that she has found a painless lump in her right breast during her monthly self-examination. Which assessment finding would strongly suggest that this client's lump is cancerous?
- A. Eversion of the right nipple and mobile
- B. Mobile mass that is soft and easily mass delineated
- C. Non-mobile mass with irregular edges
- D. Non palpable right axillary lymph nodes
Correct Answer: C
Rationale: A non-mobile mass with irregular edges is a strong indicator of a cancerous lump in the breast. Cancerous lumps often feel fixed or attached to the surrounding tissue and may have irregular shapes rather than smooth, round contours. The lack of mobility and irregular edges increase suspicion for malignancy and warrant further investigation, such as imaging studies and biopsies. It is important for this patient to follow up with a healthcare provider promptly for further evaluation and appropriate management.
A nurse prepares to administer a vitamin K injection to a newborn infant. The mother asks the nurse why her newborn infant needs the injection. The best response by the nurse would be:
- A. "You infant needs vitamin K to develop immunity."
- B. "The vitamin K will protect your infant from being jaundiced."
- C. "Newborn infants are deficient in vitamin K, and this injection prevents your infant from abnormal bleeding."
- D. "Newborn infants have sterile bowels, and vitamin K promotes the growth of bacteria in the bowel."
Correct Answer: C
Rationale: The correct response by the nurse is C. Newborn infants are born with low levels of vitamin K because they do not have enough of the gut bacteria necessary to produce it. Vitamin K plays a crucial role in blood clotting, and without enough of it, newborns are at risk of a bleeding disorder called vitamin K deficiency bleeding (VKDB). The vitamin K injection given to newborns helps prevent this disorder by providing them with the necessary vitamin K to ensure proper blood clotting. It is important for the mother to understand that this injection is essential for her infant's health and well-being to prevent complications related to vitamin K deficiency.
Although the etiology of hepatoblastoma is unknown, there are many associated risk factors for development of hepatoblastoma EXCEPT
- A. Beckwith-Wiedemann syndrome
- B. familial adenomatous polyposis syndrome
- C. prematurity
- D. low birth weight
Correct Answer: E
Rationale: Hepatitis C infection is not a recognized risk factor for hepatoblastoma.
While obtaining a health history, the nurse learns that the client is allergic to bee stings. When obtaining the client's medication history, the nurse should determine if the client keeps which medication on hand?
- A. Diphenhydramine hydrochloride (Benadryl)
- B. Guaifenesin (Robitussin)
- C. Pseudoephedrine hydrochloride (Sudafed)
- D. Loperamide (Imodium)
Correct Answer: A
Rationale: The nurse should determine if the client keeps diphenhydramine hydrochloride (Benadryl) on hand because it is an antihistamine medication commonly used to treat allergic reactions, including those caused by bee stings. In the event of a bee sting reaction, diphenhydramine can help reduce itching, swelling, and other symptoms associated with the allergy. It is important for individuals who are allergic to bee stings to have diphenhydramine readily available for prompt treatment in case of an allergic reaction.
When performing nursing care for a neonate after a birth, which intervention has the highest nursing priority?
- A. Obtain a dextrostix
- B. Give the initial bath
- C. Give the vitamin K injection
- D. Cover the neonates head with a cap
Correct Answer: C
Rationale: The highest nursing priority when performing nursing care for a neonate after birth is giving the vitamin K injection. Vitamin K is essential for blood clotting, and neonates are born with low levels of this vitamin, putting them at risk for bleeding disorders. Administering the vitamin K injection helps prevent serious bleeding complications such as Vitamin K Deficiency Bleeding (VKDB). It is crucial to give this injection as soon as possible after birth to ensure the neonate receives adequate protection. Covering the neonate's head with a cap may help maintain body temperature but is not as critical as administering the vitamin K injection. Obtaining a dextrostix or giving the initial bath are important aspects of newborn care but do not take precedence over the administration of vitamin K.