Nokea
A child is diagnosed with a Greenstick Fracture. Which of the following most accurately describes the broken bone?
- A. compound fracture of the fibula
- B. a partial break in a long bone
- C. fracture of the growth plate of the ulna near the wrist
- D. Colles fracture of the tibia
Correct Answer: B
Rationale: A Greenstick Fracture is commonly found in children due to their bones being more flexible. This type of fracture occurs when a bone bends and partially breaks, resembling what happens when a green stick from a tree is bent in half. Therefore, the most accurate description of a Greenstick Fracture is 'a partial break in a long bone.' Choice A, 'compound fracture of the fibula,' is incorrect as a Greenstick Fracture is not a compound fracture. Choice C, 'fracture of the growth plate of the ulna near the wrist,' is incorrect as it describes a different type of fracture. Choice D, 'Colles fracture of the tibia,' is incorrect as it refers to a specific type of fracture in a different bone.
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While suctioning the endotracheal tube of an adult client, what level of pressure should the nurse apply?
- A. 70-80 mmHg
- B. 100-120 mmHg
- C. 150-170 mmHg
- D. 200 mmHg
Correct Answer: B
Rationale: When suctioning the endotracheal tube of an adult client, the nurse should set the suction apparatus at a level no higher than 150 mmHg, with a preferable level between 100 and 120 mmHg. Suction pressure that is too high can contribute to the client's hypoxia. Alternatively, too low suction pressure may not clear adequate amounts of secretions. Choice A (70-80 mmHg) is too low and may not effectively clear secretions. Choices C (150-170 mmHg) and D (200 mmHg) are too high and can potentially harm the client by causing hypoxia or damaging the airway.
Which of the following glands found in the skin secretes a liquid called Sebum?
- A. Apocrine Glands
- B. Sebaceous Glands
- C. Lacrimal Glands
- D. Sweat Glands
Correct Answer: B
Rationale: Sebum is a liquid secreted by glands in the skin known as sebaceous glands. Sebum's primary function is to lubricate the skin and help maintain its integrity. Apocrine glands secrete a different type of sweat that is odorless but can develop an odor when combined with bacteria on the skin. Lacrimal glands produce tears to keep the eyes moist, and sweat glands secrete sweat to regulate body temperature through evaporation. Therefore, the correct answer is Sebaceous Glands because they specifically secrete sebum, distinguishing them from the other gland types mentioned.
In children suspected to have a diagnosis of diabetes, which one of the following complaints would be most likely to prompt parents to take their school-age child for evaluation?
- A. Polyphagia
- B. Dehydration
- C. Bedwetting
- D. Weight loss
Correct Answer: C
Rationale: The correct answer is 'Bedwetting.' One of the initial symptoms of type 1 diabetes in children is bedwetting. Parents are likely to notice bedwetting in a school-age child, prompting them to seek evaluation. Polyphagia (excessive hunger) and weight loss are also common symptoms of diabetes but may not be as readily noticeable to parents compared to bedwetting. Dehydration is a consequence of diabetes rather than an early symptom that would prompt parents for evaluation.
A 15-year-old female who ingested 15 tablets of maximum strength acetaminophen 45
minutes ago is rushed to the emergency department. Which of these orders should the
nurse do first?
- A. Gastric lavage
- B. Administer acetylcysteine (Mucomyst) orally
- C. Start an IV Dextrose 5% with 0.33% normal saline to keep the vein open
- D. Have the patient drink activated charcoal mixed with water
Correct Answer: A
Rationale: Acetaminophen overdose is extremely toxic to the liver causing
hepatotoxicity. Early symptoms of hepatic damage include nausea, vomiting,
abdominal pain, and diarrhea. If not treated immediately, hepatic necrosis occurs
and may lead to death. Removing as much of the drug as possible is the first step in
treatment for acetaminophen overdose, this is best done through gastric lavage.
Gastric lavage (irrigation) and aspiration consist of flushing the stomach with fluids
and then aspirating the fluid back out. This procedure is done in life-threatening
cases such as acetaminophen toxicity and only if less than one (1) hour has
occurred after ingestion.
The mother of a child with hepatitis A tells the home care nurse that she is concerned because the child's jaundice seems worse. What is the nurse's best response?
- A. You need to change the child's diet.
- B. The child probably is infectious again.
- C. The jaundice may worsen before it resolves.
- D. You need to call the primary health care provider.
Correct Answer: C
Rationale: The best response for the nurse in this situation is to explain to the mother that jaundice may seem to worsen before it eventually gets better. This is a common occurrence in hepatitis A. Option A about changing the child's diet is irrelevant to the concern raised by the mother and not supported by evidence. Option B suggesting the child is infectious again is incorrect and may cause unnecessary alarm as jaundice does not indicate reinfection. Option D, advising the mother to call the primary health care provider, is premature as the nurse can first provide education and reassurance regarding the expected course of jaundice in hepatitis A.