Nokea
A five-year-old child is hospitalized for correction of congenital hip dysplasia. During the assessment of the child, the nurse can expect to find the presence of:
- A. Scarf sign
- B. Harlequin sign
- C. Cullen's sign
- D. Trendelenburg sign
Correct Answer: D
Rationale: Trendelenburg sign, where the pelvis tilts downward on the unaffected side when standing on the affected leg, is associated with congenital hip dysplasia due to weak hip abductors. The other signs are unrelated.
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A female client was recently diagnosed with gastric cancer. She entered the hospital and had a total gastrectomy with esophagojejunostomy. Her postoperative recovery was uneventful. On conducting discharge teaching, the nurse discusses changes in bodily function and lifestyle changes with the client. In order to prevent pernicious anemia, the nurse stresses that the client must:
- A. Receive monthly blood transfusions
- B. Increase the amount of iron in her diet
- C. Eat small quantities several times daily until she is able to tolerate food in moderate portions
- D. Understand the need for Vitamin B12 replacement therapy
Correct Answer: D
Rationale: Monthly blood transfusions are not indicated postgastrectomy. Increasing iron in the client's diet may cause irritation and will not alleviate pernicious anemia. It may be necessary that the client eat small meals several times per day, but this measure has no relevance to prevention of pernicious anemia. Pernicious anemia is caused by lack of Vitamin B12, and replacement therapy will be necessary because the client's stomach has been removed.
A client with a diagnosis of HPV is at increased risk for which of the following?
- A. Hodgkin's lymphoma
- B. Cervical cancer
- C. Multiple myeloma
- D. Ovarian cancer
Correct Answer: B
Rationale: Human papillomavirus (HPV) is a major risk factor for cervical cancer particularly high-risk strains like HPV-16 and HPV-18. It is not strongly associated with Hodgkin’s lymphoma multiple myeloma or ovarian cancer.
When discussing the relationship between exercise and insulin requirements, a 26-year-old client with IDDM should be instructed that:
- A. When exercise is increased, insulin needs are increased
- B. When exercise is increased, insulin needs are decreased
- C. When exercise is increased, there is no change in insulin needs
- D. When exercise is decreased, insulin needs are decreased
Correct Answer: B
Rationale: Exercise decreased the blood sugar by promoting uptake of glucose by the muscles. Consequently, less insulin is needed to metabolize ingested carbohydrates. Extra food may be required for extra activity.
The client is prescribed levothyroxine (Synthroid) for hypothyroidism. Which instruction should the nurse include?
- A. Take the medication at bedtime.'
- B. Report palpitations or chest pain.'
- C. Increase dietary fiber to prevent constipation.'
- D. Take the medication with meals.'
Correct Answer: B
Rationale: Levothyroxine can cause cardiac side effects like palpitations or chest pain, which should be reported. It is taken in the morning, fiber is not directly related, and food reduces absorption.
A client with a history of prostate cancer is admitted with complaints of bone pain. The nurse should give priority to:
- A. Monitoring for metastasis
- B. Administering pain medication
- C. Monitoring blood pressure
- D. Administering chemotherapy
Correct Answer: A
Rationale: Bone pain in prostate cancer often indicates bone metastasis, so monitoring for metastasis is the priority.