Nokea
A patient asks how to avoid lung cancer. The following are risk factors, except:
- A. Exposure to passive smoke
- B. Crowded living conditions
- C. Air pollution
- D. Diet low in fruits and vegetables
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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How does the nurse assess a child's capillary refill time?
- A. Inspecting the chest
- B. Auscultating the heart
- C. Palpating the apical pulse
- D. Palpating the skin to produce a slight blanching
Correct Answer: D
Rationale: Capillary refill time is a clinical assessment used to evaluate peripheral perfusion. To perform this assessment on a child, the nurse would gently press on the child's nail bed or skin, causing the area to momentarily blanch (turn white) as blood is temporarily forced out of the capillaries. Once pressure is released, the nurse observes and times how quickly the color returns to normal. A normal capillary refill time in a child is less than 2 seconds. This method helps the nurse determine if the child's peripheral circulation is adequate. Inspecting the chest (choice A), auscultating the heart (choice B), and palpating the apical pulse (choice C) are not appropriate methods for assessing capillary refill time.
Which of the following respiratory conditions is always considered a medical emergency?
- A. Asthma
- B. Cystic fibrosis (CF)
- C. Epiglottiditis
- D. Laryngotracheobronchitis (LTB)
Correct Answer: C
Rationale: Epiglottiditis is always considered a medical emergency due to the potential risk of airway obstruction. The epiglottis is a flap of tissue that prevents food and liquids from entering the airway during swallowing. If the epiglottis becomes inflamed or infected, it can swell and block the airway, making it difficult or impossible for the person to breathe. This obstruction can rapidly progress to a life-threatening situation if not treated promptly. Therefore, epiglottiditis requires immediate medical attention to ensure the airway remains open and the individual can breathe properly.
A nurse is teaching a parent about introduction of solid foods into an infant's diet. Which should the nurse include in the teaching session? (Select all that apply.)
- A. Solid food introduction can be started at 2 months of age.
- B. Rice cereal is introduced first.
- C. Begin the introduction of solid foods by mixing with formula in the bottle.
- D. Introduce egg white in small quantities (1 tsp) toward the end of the first year.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client was brought to the emergency room with complains of difficulty of breathing. What can lead the nurse to suspect that the client is experiencing acute respiratory distress syndrome (ARDS)?
- A. paO2 of 95, pCO2 of 43, x-ray showing enlarged heart, bradycardia
- B. Thick green sputum production, paO2 of 74, pH of 7.41
- C. restlessness, suprasternal retractions, paO2 of 62
- D. wheezes, slow, deep respirations, pCO2 of 52, pH of 7.35
Correct Answer: C
Rationale: Acute respiratory distress syndrome (ARDS) is a severe form of acute respiratory failure characterized by rapidly progressive dyspnea, hypoxemia, and noncardiogenic pulmonary edema. The key signs of ARDS include severe respiratory distress, low partial pressure of oxygen (paO2), and bilateral infiltrates on chest x-ray. In the given scenario, the client presenting with restlessness and suprasternal retractions along with a paO2 level of 62 indicates severe respiratory distress and hypoxemia, which are consistent with ARDS. Therefore, option C is the most indicative of ARDS among the choices provided.
Which clinical manifestation would be seen in a child with chronic renal failure?
- A. Hypotension
- B. Massive hematuria
- C. Hypokalemia
- D. Unpleasant "uremic" breath odor
Correct Answer: D
Rationale: Chronic renal failure is characterized by the buildup of waste products and toxins in the blood due to kidney dysfunction. One common clinical manifestation in children with chronic renal failure is the development of an unpleasant "uremic" breath odor. This odor is often described as a fishy or ammonia-like smell and is a result of the accumulation of urea in the blood, which is normally filtered out by the kidneys. Other common clinical manifestations of chronic renal failure in children may include hypertension, fluid retention, electrolyte abnormalities (such as hyperkalemia rather than hypokalemia), anemia, growth failure, and bone abnormalities.