Nokea
A client with Addison's disease started taking hydrocortisone in a divided daily dose last week. It is most important for the nurse to monitor which serum laboratory value?
- A. Osmolarity
- B. Glucose
- C. Albumin
- D. Platelets
Correct Answer: B
Rationale: Hydrocortisone can affect blood glucose levels, making it important to monitor for hyperglycemia.
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Which information should the nurse know when caring for a child with Kawasaki disease?
- A. A child’s fever is usually responsive to antibiotics within 48 hours.
- B. The principal area of involvement is the joints.
- C. Aspirin is contraindicated.
- D. Therapeutic management includes administration of gamma globulin and aspirin.
Correct Answer: D
Rationale: High-dose IV gamma globulin and aspirin therapy is indicated to reduce the incidence of coronary artery abnormalities when given within the first 10 days of the illness. The fever of Kawasaki disease is unresponsive to antibiotics and antipyretics. Mucous membranes, conjunctiva, changes in the extremities, and cardiac involvement are seen. Aspirin is part of the therapy.
The following foramina are found in the brain:
- A. Foramen of Monro
- B. Foramen ovale
- C. Foramen of Magendie
- D. Foramen transversalis
Correct Answer: A
Rationale: Foramen of Monro: The foramen of Monro connects the lateral ventricles to the third ventricle and plays a key role in the circulation of cerebrospinal fluid (CSF).
A male client who had colon surgery 3 days ago is anxious and requesting assistance to reposition. While the nurse is turning him, the wound dehiscences and eviscerates. The nurse moistens an available sterile dressing and places it over the wound. What intervention should the nurse implement next?
- A. Bring additional sterile dressing supplies to the room
- B. Prepare the client to return to the operating room
- C. Obtain a sample of the drainage to send to the lab
- D. Auscultate the abdomen for bowel sound activity
Correct Answer: B
Rationale: Evisceration is a surgical emergency and requires immediate return to the operating room for repair.
The tricuspid valve is in closed position corresponding to which of the following curves of central venous pressure:
- A. a' wave
- B. x descent
- C. x' descent
- D. y descent
Correct Answer: B
Rationale: The tricuspid valve is closed during the x descent of the central venous pressure curve.
Parents of a 3-year-old child with congenital heart disease are afraid to let their child play with other children because of possible overexertion. The nurse’s reply should be based on which statement?
- A. The child needs opportunities to play with peers.
- B. The child needs to understand that peers’ activities are too strenuous.
- C. Parents can meet all of the child’s needs.
- D. Constant parental supervision is needed to avoid overexertion.
Correct Answer: A
Rationale: The child needs opportunities for social development. Children usually limit their activities if allowed to set their own pace. The child will limit activities as necessary. Parents must be encouraged to seek appropriate social activities for the child, especially before kindergarten. The child needs to have activities that foster independence. The child will be able to regulate activities.