Nokea
A newborn begins to cough, choke, and becomes cyanotic while feeding. What is the nurse's immediate action?
- A. Inform the physician.
- B. Have the mother stop feeding and observe.
- C. Remove the infant from the mother, place the infant in the crib for assessment, obtain oxygen saturation, and administer blow-by oxygen immediately.
- D. Continue feeding while monitoring.
Correct Answer: C
Rationale: Immediate removal from the feeding situation and rapid assessment with oxygen support is critical for airway safety.
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When can a donor and recipient of blood be considered compatible?
- A. If there is no change in the blood color when both samples are mixed in the laboratory
- B. If there are blood clots when both samples are mixed in the laboratory
- C. If there is no clumping or hemolysis when both samples are mixed in the laboratory
- D. If a blood drop does not sink when dropped in water after both samples are mixed in the laboratory
Correct Answer: C
Rationale: Compatibility between a donor and recipient of blood is determined by testing for compatibility of blood types. The most common blood typing systems are ABO and Rh. In compatibility testing, both the donor and recipient blood samples are mixed in the laboratory. If there is no clumping (agglutination) or hemolysis (rupture of red blood cells) observed when the samples are mixed, then the donor and recipient are considered compatible. Clumping or hemolysis indicates an incompatible blood transfusion, which can lead to serious complications like agglutination, blood clotting, or immune responses. Therefore, the absence of clumping or hemolysis is a key indicator of blood compatibility in transfusion medicine.
A nurse is reviewing acid-base laboratory data on a newborn admitted to the NICU for meconium aspiration. Which laboratory values should the nurse report to the physician? (Select all that apply.)
- A. pH: 7.35
- B. PCO : 49
- C. HCO -: 30
- D. PaO : 96
Correct Answer: B
Rationale: pH: 7.35 - This pH value is within the normal range for a newborn and does not indicate acidosis or alkalosis.
Biopsy is not usually performed for a child with suspicion of Wilms tumor EXCEPT
- A. age of 2-3 year
- B. signs of inflammation or infection
- C. significant lymph node enlargement radiologically
- D. intratumoral calcification radiologically
Correct Answer: D
Rationale: Presence of intratumoral calcifications may warrant biopsy to rule out other diagnoses.
The adolescent patient has symptoms of meningitis: nuchal rigidity, fever, vomiting, and lethargy. The nurse knows to prepare for the following test:
- A. blood culture.
- B. throat and ear culture.
- C. CAT scan.
- D. lumbar puncture.
Correct Answer: D
Rationale: The symptoms described (nuchal rigidity, fever, vomiting, and lethargy) suggest possible meningitis, which is an inflammation of the meninges, the membranes surrounding the brain and spinal cord. One of the key diagnostic tests for meningitis is a lumbar puncture, also known as a spinal tap. During a lumbar puncture, cerebrospinal fluid (CSF) is collected from the space around the spinal cord and analyzed for signs of infection, inflammation, or other abnormalities. This test helps confirm or rule out a diagnosis of meningitis and identify the specific infectious agent causing the illness. Other tests, such as blood cultures, may also be done to further evaluate the infection, but a lumbar puncture is essential for diagnosing meningitis in this case.
A 3-day-old neonate has a large, soft, painless mass involving the head and neck region that mostly transilluminate; CT scan reveals a cystic mass involving the neck and intrathoracic mediastinum. The BEST modality for treatment of this neonate is
- A. surgical resection
- B. injection sclerosing agent
- C. laser therapy
- D. systemic interferon therapy
Correct Answer: A
Rationale: Surgical resection is the definitive treatment for cystic hygroma.