Nokea
A child with which of the following diseases may suffer a severe acute reaction to radiotherapy?
- A. Chédiak-Higashi syndrome
- B. Neurofibromatosis
- C. Chronic mucocutaneous candidiasis
- D. Ataxia-telangiectasia
Correct Answer: D
Rationale: Children with ataxia-telangiectasia are highly sensitive to radiation and can suffer severe reactions to radiotherapy.
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Which points should a nurse includes in the discharge teaching plan for a client after cardiac surgery?
- A. Avoid showers and take tub bath until all incisions are healed
- B. Notify the physician if a painless lump is felt at the top of the chest incision
- C. Continue to wear support hose or elastic stockings during the night and remove them during the day
- D. Sexual relations typically can be resumed in 2-4 weeks depending on tolerance for activity
Correct Answer: B
Rationale: The correct answer is B. In the discharge teaching plan for a client after cardiac surgery, it is important for the nurse to include education on monitoring for signs of complications, such as notifying the physician if a painless lump is felt at the top of the chest incision. This could potentially indicate a seroma or hematoma, which may require medical attention. By educating the client on this specific point, the nurse helps to promote early detection and prompt management of any post-operative issues, which contributes to better outcomes for the client. The other options mentioned are important aspects of post-cardiac surgery care but do not address the specific concern of a painless lump at the chest incision site.
Which is the best position for an 8-year-old who has returned after an appendectomy for a ruptured appendix?
- A. Right side-lying.
- B. Semi-Fowler.
- C. Prone.
- D. Left side-lying.
Correct Answer: A
Rationale: Right side-lying promotes drainage of the peritoneal cavity and enhances comfort after surgery.
A 5-year old girl presents to ER with fever, convulsions and unconsciousness of one day duration. On examination she is pale, Glasgow coma scale is 8 and there are no signs of meningial irritation and no focal neurological signs. The most likely diagnosis is:
- A. Viral encephalitis
- B. Pyomeningitis
- C. Tuberculous meningitis
- D. Cerebral malaria
Correct Answer: D
Rationale: Cerebral malaria can cause fever, seizures, altered consciousness, and normal cerebrospinal fluid findings without focal neurological signs.
Postural Hypotension is A drop in systolic pressure less than 10 mmHg when patient changes position from lying to sitting.
- A. A drop in systolic pressure greater than 10 mmHg when patient changes position from lying to sitting
- B. A drop in diastolic pressure less than 10 mmHg when patient changes position from lying to sitting
- C. A drop in diastolic pressure greater than 10 mmHg when patient changes position from lying to sitting
Correct Answer: A
Rationale: Postural hypotension, also known as orthostatic hypotension, refers to a drop in blood pressure when a person stands up from a sitting or lying position. The usual criteria for diagnosing postural hypotension is a drop in systolic blood pressure of 20 mmHg or more or a drop in diastolic blood pressure of 10 mmHg or more within 3 minutes of standing up.
A patient is hospitalized following a stroke. Three days after admission, the patient is able to converse clearly with the nurse during the morning assessment. Early in the afternoon, the patient's daughter runs out of the room and says, "My mother can't talk. Somebody help!" Which response by the nurse is best?
- A. Explain to the daughter that this is not uncommon, esp. in the afternoon when the patient is tired from the morning care activities.
- B. Do a quick assessment to confirm the change in the patient's status, then notify the RN or physician.
- C. Call the speech therapist to come and to do a comprehensive speech assessment.
- D. Show the daughter how to do the speech exercises with her mother that were provided by the therapist
Correct Answer: B
Rationale: The best response by the nurse in this situation would be to do a quick assessment to confirm the change in the patient's status and then notify the registered nurse (RN) or physician. It is essential for the healthcare team to promptly assess and address any sudden changes in a stroke patient's condition, such as the sudden inability to speak. This could indicate a serious issue that requires immediate attention and intervention. By quickly assessing the patient's status and notifying the appropriate healthcare provider, the nurse can ensure that the patient receives the necessary care and interventions in a timely manner.