Nokea
A child with a diagnosis of asthma is being evaluated for medication management. What is an important assessment for the nurse to perform?
- A. Assess the child's sleep patterns
- B. Assess the child's dietary intake
- C. Assess the child's academic performance
- D. Assess the child's behavior at home
Correct Answer: B
Rationale: Assessing the child's dietary intake is crucial in managing asthma as certain foods can trigger or worsen symptoms. Monitoring dietary habits helps identify any potential triggers and ensures proper nutrition, which can impact asthma control. Assessing sleep patterns, academic performance, or behavior at home may provide valuable information in a general health assessment, but when specifically managing asthma, dietary intake assessment is the most relevant.
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A 6-year-old child with asthma is admitted to the hospital with an acute exacerbation. What is the priority nursing intervention?
- A. Administering a bronchodilator
- B. Administering an antihistamine
- C. Administering a corticosteroid
- D. Administering oxygen
Correct Answer: A
Rationale: Administering a bronchodilator is the priority intervention for a child experiencing an acute asthma exacerbation. Bronchodilators help to dilate the airways, making breathing easier and relieving acute symptoms of asthma. Antihistamines are not the first-line treatment for asthma exacerbations; they are more commonly used for allergic reactions. Corticosteroids are beneficial in reducing inflammation in asthma but are usually administered after bronchodilators to provide long-term control. Oxygen therapy may be necessary in severe cases of asthma exacerbation, but bronchodilators take precedence in improving airway patency and respiratory distress.
The nurse is assessing a 3-year-old boy whose parents brought him to the clinic when they noticed that the right side of his abdomen was swollen. What finding would suggest this child has a neuroblastoma?
- A. The child has a maculopapular rash on his palms.
- B. The parents report that their son is vomiting and not eating well.
- C. The parents report that their son is irritable and not gaining weight.
- D. Auscultation reveals wheezing with diminished lung sounds.
Correct Answer: B
Rationale: Vomiting and poor appetite can be symptoms of neuroblastoma, a malignancy that affects the adrenal glands and sympathetic nervous system. A maculopapular rash on the palms (Choice A) is not typically associated with neuroblastoma. Irritability and poor weight gain (Choice C) may be non-specific findings and do not specifically point towards neuroblastoma. Auscultation findings of wheezing with diminished lung sounds (Choice D) are more indicative of respiratory conditions rather than neuroblastoma.
What is a common finding that the nurse can identify in most children with symptomatic cardiac malformations?
- A. Mental retardation
- B. Inherited genetic factors
- C. Delayed physical growth
- D. Clubbing of the fingertips
Correct Answer: C
Rationale: Delayed physical growth is a common finding in children with symptomatic cardiac malformations. This occurs due to insufficient oxygenation and nutrient supply, which can affect overall growth and development. Mental retardation (Choice A) is not typically associated with symptomatic cardiac malformations. Inherited genetic factors (Choice B) may contribute to the development of cardiac malformations but are not a common finding in affected children. Clubbing of the fingertips (Choice D) is more commonly associated with chronic respiratory or cardiovascular conditions, rather than symptomatic cardiac malformations.
Congenital heart defects have traditionally been divided into acyanotic or cyanotic defects. Based on the nurse's knowledge of congenital heart defects, this system in clinical practice is
- A. helpful because it explains the hemodynamics involved
- B. helpful because children with cyanotic defects are easily identified
- C. problematic because cyanosis is rarely present in children
- D. problematic because children with acyanotic heart defects may develop cyanosis
Correct Answer: D
Rationale: The classification system of congenital heart defects into acyanotic or cyanotic defects is problematic because children with acyanotic heart defects may develop cyanosis, complicating the differentiation. Cyanosis can occur in some acyanotic defects due to various reasons such as right-to-left shunting or decreased pulmonary blood flow, making the classification based solely on cyanosis misleading. Choice A is incorrect because while the classification may involve hemodynamics, the main issue lies in the potential for acyanotic defects to develop cyanosis. Choice B is incorrect as the ease of identifying children with cyanotic defects does not address the main problem with the classification system. Choice C is also incorrect as the presence of cyanosis is not the only factor determining the classification's validity.
A group of students is reviewing information about the various types of insulin used to treat type 1 diabetes. The students demonstrate understanding of the information when they identify which of these insulins as having the longest duration?
- A. Lispro
- B. Regular
- C. NPH
- D. Glargine
Correct Answer: D
Rationale: The correct answer is Glargine (Lantus) as it has the longest duration of action among the insulins listed, lasting 12 to 24 hours. Lispro (A) and Regular (B) are rapid-acting insulins with shorter durations of action. NPH (C) is an intermediate-acting insulin with a duration of action of about 12-16 hours. Therefore, Glargine is the correct choice for the insulin with the longest duration.