Nokea
A clinic nurse is planning a teaching session about childhood obesity prevention for parents of school-age children. The nurse should include which associated risk of obesity in the teaching plan?
- A. Type I diabetes
- B. Respiratory disease
- C. Celiac disease
- D. Type II diabetes
Correct Answer: D
Rationale: Childhood obesity is strongly associated with an increased risk of developing Type II diabetes. When children are obese, their body's ability to utilize insulin properly can become compromised, leading to insulin resistance and eventually the development of Type II diabetes. This chronic condition can have serious long-term health consequences if not properly managed, making it crucial for parents to understand the link between childhood obesity and Type II diabetes in order to prevent or address it early on.
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A 2-year-old male child has an asymptomatic right flank mass discovered incidentally by the mother while bathing. Suspicion of Wilms tumor is raised. Of the following, the LEAST likely investigation to be performed in this child is
- A. plain abdominal radiography
- B. computerized tomography (CT) scan of the abdomen
- C. CT scan of the chest
- D. biopsy of the mass
Correct Answer: D
Rationale: Biopsy is generally avoided in suspected Wilms tumor to prevent upstaging the disease.
Cow's milk allergy (CMA) is diagnosed in a 6-month-old infant. Which should the nurse recommend as a substitute formula?
- A. Nutramigen
- B. Goat's milk
- C. Similac
- D. Enfamil
Correct Answer: A
Rationale: Nutramigen is a hypoallergenic formula specifically designed for infants with cow's milk allergy (CMA). It is extensively hydrolyzed, which means the cow's milk proteins are broken down into smaller pieces, making it easier for babies with CMA to digest without triggering an allergic reaction. Other options such as goat's milk, Similac, and Enfamil are not suitable substitutes for an infant with CMA as they may still contain proteins that can cause an allergic response in these infants. Therefore, Nutramigen is the most appropriate recommendation for a 6-month-old infant diagnosed with cow's milk allergy.
Mr. Garcia, a 41-year old chronic alcohol drinker is admitted to the hospital after vomiting bright red blood. He was diagnosed to have a bleeding gastric ulcer and suddenly develops sudden sharp pain in the midepigastric region with a rigid boardlike abdomen. This likely indicates:
- A. development of intestinal
- B. inflammation of the esophagus
- C. perforation of the ulcer
- D. development of additional ulcers
Correct Answer: C
Rationale: The sudden sharp pain in the midepigastric region with a rigid boardlike abdomen in a patient with a bleeding gastric ulcer, especially in the setting of chronic alcohol use, is indicative of a perforation of the ulcer. Perforation occurs when the ulcer penetrates through the wall of the stomach or duodenum, leading to the leakage of gastric contents into the peritoneal cavity. This results in peritonitis, causing severe abdominal pain and rigidity. Perforation of the ulcer is a surgical emergency requiring immediate intervention to repair the perforation, control the infection, and prevent further complications like sepsis. It is a life-threatening condition that necessitates prompt diagnosis and management.
Morphine is given in acute pulmonary edema to redistribute the pulmonary circulation to the periphery by decreasing:
- A. Periphery resistance
- B. Pulmonary capillary pressure
- C. Transudation of fluid
- D. All of the above CARING FOR CLIENTS WITH HEART FAILURE
Correct Answer: B
Rationale: Morphine is given in acute pulmonary edema to decrease pulmonary capillary pressure. By reducing pulmonary capillary pressure, morphine helps to redistribute the pulmonary circulation to the periphery, leading to improved oxygenation and decreased symptoms of pulmonary edema. Morphine works to vasodilate the blood vessels, which ultimately helps decrease the pressure in the pulmonary capillaries, allowing for improved blood flow to the periphery of the lungs. This redistribution of pulmonary circulation helps to alleviate the congestion and fluid buildup in the lungs that occurs in acute pulmonary edema.
A client with stage II ovarian cancer undergoes a total abdominal hysterectomy and bilateral salpingo- oopherectomy with tumor secretion, omentectomy, appendectomy, and lymphadenopathy. During the second postoperative day, which of the following assessment findings would raise concern in the nurse?
- A. Abdominal pain
- B. Serous drainage from the incision
- C. Hypoactive bowel sounds
- D. Shallow breathing and increasing lethargy
Correct Answer: D
Rationale: Shallow breathing and increasing lethargy are concerning assessment findings postoperatively as they can be indicative of respiratory complications such as atelectasis, pneumonia, or pulmonary embolism. These conditions can be life-threatening and require prompt medical attention. It is essential for the nurse to monitor the client closely for any signs of respiratory distress and intervene immediately if these symptoms are present. Abdominal pain, serous drainage from the incision, and hypoactive bowel sounds are common findings after abdominal surgery and are expected in the early postoperative period.