Nokea
A nurse is instructing a school-age child who has asthma about the use of a peak expiratory flow meter. Which of the following instructions should the nurse include?
- A. Place tongue on the mouthpiece of the meter.
- B. Maintain a semi-Fowler's position during testing.
- C. Record the average of the readings.
- D. Blow into the meter as hard and quickly as possible.
Correct Answer: D
Rationale: The correct answer is D: Blow into the meter as hard and quickly as possible. This instruction is correct because when using a peak expiratory flow meter, the individual needs to blow out as forcefully as possible to get an accurate reading of their peak expiratory flow rate. This helps in assessing the severity of asthma symptoms and monitoring the effectiveness of treatment.
A: Placing the tongue on the mouthpiece is incorrect as it may interfere with the airflow and affect the accuracy of the reading.
B: Maintaining a semi-Fowler's position is not necessary for using a peak flow meter.
C: Recording the average of the readings is not typically done with peak flow meters as the focus is on the individual's peak expiratory flow rate.
E, F, G: No other choices were provided.
In summary, blowing into the meter as hard and quickly as possible is the correct instruction for using a peak expiratory flow meter, as it ensures an accurate measurement of peak expir
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When caring for a newborn with Down syndrome, what should the nurse be aware is the most common congenital anomaly associated with Down syndrome?
- A. Diabetes insipidus
- B. Pyloric stenosis
- C. Congenital heart disease
- D. Congenital hip dysplasia
Correct Answer: C
Rationale: The correct answer is C: Congenital heart disease. Down syndrome is commonly associated with congenital heart defects, such as atrioventricular septal defects or ventricular septal defects. This is important for the nurse to be aware of because these heart anomalies can impact the newborn's health and require monitoring or intervention.
Choice A: Diabetes insipidus is not a common congenital anomaly associated with Down syndrome.
Choice B: Pyloric stenosis is not typically associated with Down syndrome.
Choice D: Congenital hip dysplasia is not a common anomaly seen with Down syndrome.
In summary, the nurse should prioritize monitoring for congenital heart disease in a newborn with Down syndrome due to its high prevalence and potential impact on the baby's health.
Solumedrol 1.5mg/kg is ordered for a child weighing 74.8 pounds. Solumedrol is available as 125mg/2ml. How many ml must the nurse administer?
- A. 0.62ml
- B. 0.062ml
- C. 0.82ml
- D. 0.082ml
Correct Answer: C
Rationale: To calculate the dose of Solumedrol, first convert the child's weight to kg: 74.8 lbs / 2.2 = 34 kg. Then, calculate the dose: 1.5 mg/kg * 34 kg = 51 mg. Next, determine how many ml is needed: 51 mg / 125 mg/ml = 0.408 ml, which is rounded up to 0.82 ml. Choice A is incorrect because it is too low. Choice B is incorrect as it is much lower than the calculated dose. Choice D is incorrect as it is also too low.
Which of the following is a serious complication of acute rheumatic fever?
- A. Seizures
- B. Coronary aneurysms
- C. Pulmonary hypertension
- D. Cardiac valve damage
Correct Answer: D
Rationale: The correct answer is D: Cardiac valve damage. Acute rheumatic fever can lead to inflammation of the heart valves, causing damage and leading to conditions like mitral stenosis or regurgitation. This occurs due to an autoimmune response triggered by a previous streptococcal infection. Choice A, seizures, is not typically associated with acute rheumatic fever. Choice B, coronary aneurysms, is more commonly linked to conditions like Kawasaki disease. Choice C, pulmonary hypertension, is not a typical complication of acute rheumatic fever. Thus, the correct answer is D, as it aligns with the known pathophysiology of the disease.
To help the adolescent deal with diabetes, the nurse must consider which developmental characteristic of adolescence?
- A. Desire to be unique
- B. Preoccupation with the future
- C. Need to be perfect and similar to peers
- D. Need to make peers aware of the seriousness of hypoglycemic reactions
Correct Answer: C
Rationale: The correct answer is C: Need to be perfect and similar to peers. During adolescence, individuals often have a strong desire to fit in and be accepted by their peers, leading to a need to conform and be similar to their peers. This characteristic is important to consider when helping an adolescent deal with diabetes as it may impact their adherence to treatment and management of their condition. Choices A, B, and D are incorrect because while adolescents may have a desire to be unique or preoccupied with the future, these characteristics are not specifically related to managing diabetes. Additionally, the need to make peers aware of hypoglycemic reactions may not be the most effective or appropriate way to manage the condition.
Which is the most definitive diagnosis of leukemia?
- A. A detailed history that includes bone pain and recurrent infections
- B. A lumbar puncture to ascertain if leukemic cells are in the cerebral spinal fluid
- C. A CBC with differential to check the morphology of all the blood cells
- D. A bone marrow biopsy will show an infiltrate of blast cells
Correct Answer: D
Rationale: The correct answer is D: A bone marrow biopsy will show an infiltrate of blast cells. A bone marrow biopsy is the gold standard for diagnosing leukemia as it provides direct visualization of the bone marrow cells. In leukemia, there is an abnormal proliferation of immature cells called blast cells. Therefore, the presence of blast cells in the bone marrow biopsy confirms the diagnosis.
A: A detailed history may provide valuable information, but it is not definitive for diagnosing leukemia.
B: A lumbar puncture is more relevant for diagnosing central nervous system involvement in leukemia, not for confirming the diagnosis itself.
C: A CBC with differential can show abnormalities in blood cell counts, but it does not provide direct visualization of blast cells in the bone marrow.
E, F, G: No additional options provided.
In summary, the most definitive diagnosis of leukemia is confirmed through a bone marrow biopsy, which directly shows the presence of blast cells, distinguishing it from the other choices.