Nokea
A client with hypothyroidism reports difficulty falling asleep because of feelings of depression. Which action should the nurse implement?
- A. Review most recent thyroid function test results
- B. Encourage the client to take an afternoon nap.
- C. Refer the client for a psychiatric evaluation.
- D. Suggest reducing fluid intake before bedtime.
Correct Answer: A
Rationale: Hypothyroidism can cause depression and sleep disturbances. Reviewing thyroid function tests helps determine if the symptoms are related to inadequate thyroid hormone levels.
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A child with a known history of asthma is admitted to the hospital with a respiratory infection. Which action is the nurse's priority?
- A. Administer a nebulizer treatment as ordered.
- B. Perform chest physiotherapy.
- C. Monitor oxygen saturation levels closely.
- D. Educate the parents about infection prevention.
Correct Answer: A
Rationale: The priority in asthma management is ensuring the airways are open, which is best achieved by administering a nebulizer treatment as ordered.
A 7-year-old child who has a history of a repaired congenital heart defect (CHD)has many dental caries along with gingival erythema and irritation and a temperature of 102.5°F. What will the primary care pediatric nurse practitioner do next?
- A. Admit to the hospital with a pediatric cardiology consult.
- B. Obtain blood cultures and a CBC and consult a pediatric cardiologist.
- C. Refer the child to a pediatric dental surgeon immediately.
- D. Start prophylactic antibiotics such as penicillin twice daily for 2 weeks.
Correct Answer: A
Rationale: Children who are suspected of having SBE should be admitted to the hospital and referred to pediatric cardiology.
Regarding puberty:
- A. The beginning of puberty is closely related to bony changes rather than to age
- B. The first sign of puberty in a boy is the development of axillary hair
- C. Constitutional precocious puberty is commoner in girls than boys
- D. Delayed puberty is defined as lack of pubertal changes in a boy after 14 years of age
Correct Answer: C
Rationale: Constitutional precocious puberty is more common in girls than boys, often due to earlier activation of the hypothalamic-pituitary-gonadal axis.
A client with type 2 diabetes mellitus (DM) is admitted to the hospital for uncontrolled DM. Insulin therapy is initiated with an initial dose of Humulin N insulin at 0800. At 1600, the client complains of diaphoresis, rapid heartbeat, and feeling shaky. What should the nurse do first?
- A. Determine the client's current glucose level
- B. Administer 10 units of fast-acting insulin.
- C. Offer the client a snack with high protein.
- D. Increase the IV infusion rate of normal saline.
Correct Answer: A
Rationale: The symptoms suggest hypoglycemia. Checking the glucose level confirms the diagnosis and guides appropriate treatment.
The nurse is caring for a child with persistent hypoxia secondary to a cardiac defect. The nurse recognizes that a risk exists of cerebrovascular accidents (strokes). Which is an important objective to decrease this risk?
- A. Minimize seizures
- B. Prevent dehydration
- C. Promote cardiac output
- D. Reduce energy expenditure
Correct Answer: B
Rationale: In children with persistent hypoxia, polycythemia develops. Dehydration must be prevented in hypoxemic children because it potentiates the risk of strokes. Minimizing seizures, promoting cardiac output, and reducing energy expenditure will not reduce the risk of cerebrovascular accidents.