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A nurse is performing an otoscopic exam on a school-age child. Which direction should the nurse pull the pinna for this age of child?
- A. Up and back
- B. Down and back
- C. Straight back
- D. Straight up
Correct Answer: A
Rationale: When performing an otoscopic exam on a school-age child, the nurse should pull the pinna (outer ear) of the child in an upward and backward direction. This technique helps to straighten the ear canal, allowing for better visualization and easier insertion of the otoscope to examine the ear canal and eardrum. Pulling the pinna in the wrong direction could potentially cause discomfort to the child or obstruct the view of the ear canal. Therefore, pulling the pinna up and back is the correct direction for this age group.
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What is the purpose of pursed lip breathing?
- A. Helps exhale less volume of air during expiration
- B. Increases expiration
- C. Promotes effective use of the diaphragm
- D. Relieves compensatory burden on upper thorax
Correct Answer: A
Rationale: Pursed lip breathing is a breathing technique commonly used to help improve breathing efficiency in individuals with respiratory conditions such as chronic obstructive pulmonary disease (COPD). By pursing the lips during exhalation, it creates back pressure that helps to keep the airways open longer. This results in slower and more controlled expiration, allowing the individual to exhale a smaller volume of air while maintaining adequate oxygen exchange. This can reduce the feeling of dyspnea (difficulty breathing) and help improve oxygen saturation levels in the blood.
Which is the most appropriate nursing intervention for the newborn who is jittery and twitching and has a high-pitched cry?
- A. Monitor blood pressure closely.
- B. Obtain urine sample to detect glycosuria.
- C. Obtain serum glucose and serum calcium levels.
- D. Administer oral glucose or, if newborn refuses to suck, IV dextrose.
Correct Answer: C
Rationale: The most appropriate nursing intervention for the jittery and twitching newborn with a high-pitched cry is to obtain serum glucose and serum calcium levels (Option C). These symptoms are indicative of possible hypoglycemia or hypocalcemia, which are common issues for newborns. Monitoring glucose and calcium levels will help identify and address any imbalances that may be causing these symptoms. Administering glucose (Option D) may be necessary if hypoglycemia is confirmed, but it should be based on the results of blood tests. Monitoring blood pressure (Option A) and obtaining a urine sample to detect glycosuria (Option B) are not the priority interventions in this scenario compared to assessing serum glucose and calcium levels.
A 9-mo-old infant is recently diagnosed with bilateral retinoblastoma; examination under anesthesia reveals bilateral multifocal involvement of the retina. An important next step in the management is
- A. radiotherapy of both eyes
- B. retinal examination of 1st degree relatives
- C. orbital ultrasonography
- D. bilateral enucleation
Correct Answer: B
Rationale: Retinal examination of first-degree relatives is crucial to identify hereditary forms of retinoblastoma.
A client suspected of having colorectal cancer will require which diagnostic study to confirm the diagnosis?
- A. Stool hematest
- B. Abdominal computed tomography (CT)
- C. Carcinoembryonic antigen (CEA) scan
- D. Sigmoidoscopy
Correct Answer: D
Rationale: Sigmoidoscopy is a diagnostic study that allows direct visualization of the lower part of the colon and rectum using a flexible tube with a camera at its end, called a sigmoidoscope. This procedure enables the healthcare provider to visually inspect the lining of the colon and rectum, identify any abnormal growths, such as tumors or polyps, and obtain tissue samples for biopsy if necessary. In the case of suspected colorectal cancer, sigmoidoscopy is crucial for confirming the diagnosis by directly visualizing any cancerous lesions or abnormal tissue changes in the colon and rectum. Other diagnostic tests, such as stool hematest, abdominal CT, and CEA scan, may aid in the evaluation and staging of colorectal cancer but are not as effective in confirming the diagnosis as sigmoidoscopy. Thus, sigmoidoscopy is the preferred diagnostic study for definitively diagnosing colorectal cancer in a client suspected of having the disease.
An adolescent girl calls the nurse at the clinic because she had unprotected sex the night before and does not want to be pregnant. What should the nurse explain to the girl?
- A. It is too late to prevent an unwanted pregnancy
- B. An abortion may be the best option if she is pregnant
- C. Norplant can be administered to prevent pregnancy for up to 5 years
- D. Postcoital contraception is available to prevent implantation
Correct Answer: D
Rationale: In this scenario, the most appropriate option for the nurse to explain to the adolescent girl is postcoital contraception, also known as emergency contraception or the morning-after pill. Postcoital contraception is a method used to prevent pregnancy after unprotected sex or contraceptive failure. It works by preventing or delaying ovulation, inhibiting fertilization, or preventing implantation of a fertilized egg in the uterus.