Burns Pediatric Primary Care 7th Edition Test Bank

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A patient returns from surgery ff. a TURP with a three-way Foley catheter and continuous bladder irrigation. Postoperative orders include Meperidine (Demerol) 75 mg IM q3h as needed for pain, belladonna and opium (B&O) suppository q4h as needed, and strict I&O. the patient complains of painful bladder spasms, and the nurse observes blood-tinged urine on the sheets. Which action should the nurse take?

  • A. Give Demerol
  • B. Give B&O suppository
  • C. Warm the irrigation solution to body temperature
  • D. Notify the physician stat
Correct Answer: D

Rationale: The nurse should notify the physician stat in this situation. The presence of blood-tinged urine and painful bladder spasms in a patient with a three-way Foley catheter and continuous bladder irrigation post TURP could indicate a potential complication such as hemorrhage or clot retention. It is crucial to ensure prompt medical evaluation and intervention to address these issues effectively. Waiting or administering pain medication without further assessment could delay necessary treatment and lead to worsening of the patient's condition. Therefore, notifying the physician immediately is the most appropriate action in this scenario.

You may also like to solve these questions

Which of the following is the most common cause of hyperaldosteronism?

  • A. Excessive sodium intake
  • B. Deficient potassium intake
  • C. A pituitary adenoma
  • D. An adrenal adenoma
Correct Answer: D

Rationale: The most common cause of hyperaldosteronism is an adrenal adenoma, which is a benign tumor of the adrenal gland. Adrenal adenomas produce excessive amounts of aldosterone, a hormone that regulates sodium and potassium balance in the body. This overproduction of aldosterone can lead to increased sodium retention and potassium excretion, resulting in hypertension and low potassium levels in the blood. Excessive sodium intake and deficient potassium intake are not common causes of hyperaldosteronism. Pituitary adenomas are associated with conditions such as Cushing's syndrome or acromegaly, but not hyperaldosteronism.

Of the following, the WORST prognostic factor in pediatric osteosarcoma is

  • A. primary pelvic bone tumor
  • B. poor histologic response to treatment
  • C. bony metastases at the time of diagnosis
  • D. lung metastases at the time of diagnosis
Correct Answer: B

Rationale: Poor histologic response to neoadjuvant chemotherapy is a strong predictor of poor prognosis.

When a child has chronic renal failure, the progressive deterioration produces a variety of clinical and biochemical disturbances that eventually are manifested in the clinical syndrome known as:

  • A. uremia.
  • B. oliguria.
  • C. proteinuria.
  • D. pyelonephritis.
Correct Answer: A

Rationale: Chronic renal failure leads to the build-up of waste products and toxins in the blood, known as uremia. This condition results from the kidneys' inability to effectively filter waste from the blood and maintain proper fluid and electrolyte balance. As renal function declines, uremia can lead to a variety of clinical manifestations such as fatigue, nausea, itching, and electrolyte imbalances, ultimately resulting in the clinical syndrome known as uremia. Oliguria refers to reduced urine output, proteinuria is the presence of excessive protein in the urine, and pyelonephritis is a bacterial infection of the kidneys - these conditions may be present in chronic renal failure but are not the defining clinical syndrome.

A client has a routine Papanicolaou (Pap) test during a yearly gynecologic examination. The result reveals a class V finding. What should the nurse tell the client about this finding?

  • A. It's normal and requires no action
  • B. It calls for a repeat Pap test in 6 weeks
  • C. It calls for a repeat Pap test in 3 months
  • D. It calls for a biopsy as soon as possible
Correct Answer: D

Rationale: Class V findings on a Pap test indicate the presence of severely abnormal cells, suggesting a high likelihood of precancerous or cancerous changes. Therefore, it calls for a biopsy as soon as possible to further investigate and determine the appropriate course of action. Immediate follow-up and intervention are crucial in cases of Class V Pap test results to address any potential serious health concerns.

The physical manifestations of fetal alcohol syndrome include:

  • A. abnormal facial tissue, cleft lip, and cleft palate.
  • B. hepatomegaly, hypotonia, and microphthalmia.
  • C. microcephaly, short philtrum, and intrauterine growth restriction.
  • D. hyperbilirubinemia, jaundice, and failure to thrive.
Correct Answer: C

Rationale: Fetal alcohol syndrome is characterized by microcephaly, a short philtrum, and intrauterine growth restriction, among other features.

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