Nokea
A nurse is assessing a child and notes Koplik spots. In which of these communicable diseases are Koplik spots present?
- A. Rubella
- B. Measles (rubeola)
- C. Chickenpox (varicella)
- D. Exanthema subitum (roseola)
Correct Answer: B
Rationale: Koplik spots are small white spots with a bluish-white center on the buccal mucosa (inside the cheeks). They are a characteristic finding in measles (rubeola) and are considered an early sign of the disease. Measles is a highly contagious viral infection that primarily affects children. In addition to Koplik spots, other symptoms of measles include fever, cough, runny nose, and a characteristic rash that typically starts on the face and spreads to the rest of the body. Vaccination is an effective way to prevent measles and its complications.
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A 1-year-old with acute renal failure (ARF) is edematous with minimal urine output. Vital signs: HR 146, BP 176/92, RR 42; the child has nasal flaring and retractions. Despite oral Kayexalate, serum potassium continues to rise. Which treatment will most benefit the child?
- A. Additional rectal Kayexalate.
- B. Intravenous furosemide.
- C. Endotracheal intubation and ventilatory assistance.
- D. Placement of a Tenckhoff catheter for peritoneal dialysis.
Correct Answer: D
Rationale: When ARF deteriorates and electrolyte imbalances worsen, peritoneal dialysis (via a Tenckhoff catheter) is indicated.
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.
Hypernatremia is associated with a:
- A. Serum osmolality of 245mOsm/kg
- B. Urine specific gravity below 1.003
- C. Serum sodium of 150mEq/L
- D. Combination of all of the above
Correct Answer: C
Rationale: Hypernatremia is defined as an elevated serum sodium level above 145mEq/L. In this case, a serum sodium level of 150mEq/L indicates hypernatremia. The other options, serum osmolality of 245mOsm/kg and urine specific gravity below 1.003, are not specific criteria for the diagnosis of hypernatremia. The primary marker used for diagnosing hypernatremia is an elevated serum sodium level.
Which is an objective of care for a 10-year-old child with minimal change nephrotic syndrome?
- A. Reduce blood pressure.
- B. Reduce excretion of urinary protein.
- C. Increase excretion of urinary protein.
- D. Increase ability of tissues to retain fluid.
Correct Answer: B
Rationale: The management goal for a child with minimal change nephrotic syndrome is to reduce the excretion of urinary protein. In this condition, there is an abnormal loss of protein in the urine due to damage in the glomeruli of the kidneys. Reducing the excretion of urinary protein helps prevent complications associated with protein loss, such as edema and hypoalbuminemia. While reducing blood pressure may be important in some cases, the primary focus for this specific condition is to address the protein leak in the urine. Increasing the excretion of urinary protein would worsen the condition, and increasing the ability of tissues to retain fluid is not the desired outcome in this context.
To prevent infection in a patient with a subdural intracranial pressure monitoring system in place, the nurse should;
- A. Use aseptic technique for the insertion site.
- B. Use clean technique for cleansing connections and aseptic technique for the insertion site.
- C. Use sterile technique when cleansing the insertion site
- D. Close any leaks in the tubing with tape. SITUATION: Mr. Dela Isla, a client with early Dementia exhibits thought process disturbances.
Correct Answer: A
Rationale: To prevent infection in a patient with a subdural intracranial pressure monitoring system in place, the nurse should use aseptic technique for the insertion site. Aseptic technique involves maintaining a sterile field to prevent the introduction of microorganisms that could lead to infection. Using aseptic technique specifically for the insertion site helps reduce the risk of introducing pathogens into the patient's intracranial system, reducing the chances of infection. Additionally, maintaining a strict aseptic technique is crucial for preventing complications and ensuring patient safety when managing intracranial pressure monitoring systems.