Nokea
A preterm newborn, after spending 8 weeks in the NICU, is being discharged. The parents of the newborn express apprehension and worry that the newborn may still be in danger. How should the nurse interpret these statements?
- A. Normal
- B. A reason to postpone discharge
- C. Suggestive of maladaptation
- D. Suggestive of inadequate bonding
Correct Answer: A
Rationale: It is normal for parents of preterm newborns who have spent time in the NICU to express apprehension and worry upon discharge. The NICU experience can be stressful and overwhelming for families, and it is common for parents to feel anxious about taking their newborn home. The nurse should provide support and education to help alleviate the parents' concerns and ensure a smooth transition from the hospital to home. It is important to acknowledge the parents' feelings, offer reassurance, and reinforce the importance of follow-up care and monitoring.
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Which medication is most likely included in post-operative care of a child with repair of bladder exstrophy?
- A. Lasix
- B. Mannitol
- C. Meperidine
- D. Oxybutynin
Correct Answer: D
Rationale: Oxybutynin helps control bladder spasms and improves comfort after urinary reconstructive surgery.
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.
When caring for a 3 year old with tetralogy of Fallot, he nurse expects to see fatigue and poor activity tolerance. This is caused by:
- A. Poor muscle tone
- B. Inadequate oxygenation of tissues.
- C. Restricted blood flow leaving the heart
- D. Inadequate intake of food.
Correct Answer: B
Rationale: Tetralogy of Fallot is a heart defect that involves four specific abnormalities in the heart's structure. One of these abnormalities is a ventricular septal defect, which results in a mixing of oxygenated and deoxygenated blood. This leads to inadequate oxygenation of tissues because some of the blood that is pumped out to the body is not fully oxygenated. As a result, the child may experience fatigue and poor activity tolerance due to the reduced oxygen supply to the tissues and organs. This is why the nurse would expect to see these symptoms in a 3-year-old with tetralogy of Fallot.
Nurse Dennis provides health promotion to a group of male adults. He is correct when he states that clients with cirrhosis should include which measure to adhere to a home?
- A. supplemet with daily multivitamins
- B. take sleeping pills at home
- C. limit daily alcohol intake
- D. limit contact at all times
Correct Answer: C
Rationale: Clients with cirrhosis, which is a serious liver condition, should avoid or limit their alcohol intake. Alcohol can worsen liver damage and lead to further complications such as liver failure. Nurse Dennis is correct in advising clients with cirrhosis to adhere to this measure in order to promote their health and reduce the progression of the disease. Taking daily multivitamins can be beneficial for some individuals, but limiting alcohol intake is crucial for those with cirrhosis. Taking sleeping pills at home without medical supervision can also be dangerous, as it may interact with other medications and worsen liver function. Limiting contact at all times is not relevant to managing cirrhosis.
. A client is prescribed prednisone (Deltasone) daily. Which statement best explains why the nurse should instruct the client to take this drug in the morning?
- A. Taking the drug at the same time every day establishes a regular routine, reducing the risk of forgetting a dose.
- B. Prednisone has a longer half-life with morning administration, making it more effective.
- C. Morning administration of prednisone mimics the body's natural corticosteroid secretion pattern.
- D. Prednisone is best absorbed when taken on an empty stomach first thing in the morning.
Correct Answer: C
Rationale: The best statement explaining why the nurse should instruct the client to take prednisone (Deltasone) in the morning is that morning administration mimics the body's natural corticosteroid secretion pattern. Cortisol, a natural corticosteroid, is highest in the morning and decreases throughout the day. By taking prednisone in the morning, the client aligns the medication's peak effects with the body's natural cortisol levels, which can help reduce the risk of disrupting the body's internal rhythm and minimize potential side effects. This timing also helps achieve optimal therapeutic effects while minimizing the risk of adrenal suppression and other adverse effects associated with corticosteroid use.