Nokea
A school-age child has been admitted to the hospital with an exacerbation of nephrotic syndrome. Which clinical manifestations should the nurse expect to assess? (Select all that apply.)
- A. Weight loss
- B. Facial edema
- C. Cloudy smoky brown-colored urine
- D. Fatigue
Correct Answer: B
Rationale: Facial edema is a common clinical manifestation of nephrotic syndrome due to fluid retention and protein loss in the urine.
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The MOST common cause of obstructive sleep apnea in children is
- A. obesity
- B. allergies
- C. adenotonsillar hypertrophy
- D. pharyngeal reactive edema due to gastroesophageal reflux
Correct Answer: C
Rationale: Adenotonsillar hypertrophy is the leading cause of obstructive sleep apnea in children.
The nurse expects to note an elevated serum glucose level in a client with hyperosmolar hyperglycemic nonketonic syndrome (HHNS). Which other laboratory finding should the nurse anticipate?
- A. Elevated serum acetone level
- B. Serum alkalosis
- C. Serum ketone bodies
- D. Below-normal serum potassium level
Correct Answer: D
Rationale: Hyperosmolar hyperglycemic nonketonic syndrome (HHNS) is characterized by extremely elevated blood glucose levels without significant ketosis. Unlike diabetic ketoacidosis (DKA), patients with HHNS usually do not have high levels of ketone bodies in their blood or urine. Therefore, the nurse should anticipate below-normal serum potassium levels in a client with HHNS, as hyperglycemia can lead to profound potassium losses through osmotic diuresis. Monitoring and treating electrolyte imbalances, including hypokalemia, are crucial in managing HHNS. It is important to correct these imbalances promptly to prevent further complications.
You have learned that in babies and children with developmental dysplasia (dislocation) of the hip (DDH), the hip joint has not formed normally. Which of the following is the most common form of DDH?
- A. Acetabular dysplasia
- B. Dislocation
- C. Preluxation
- D. Subluxation
Correct Answer: A
Rationale: Acetabular dysplasia is the most common form of developmental dysplasia of the hip (DDH). It is characterized by an underdeveloped or shallow socket (acetabulum) in the hip joint, which can lead to instability and predispose the hip to dislocation. In DDH, the abnormal development of the hip joint can range from mild acetabular dysplasia to complete dislocation. Acetabular dysplasia is often present from birth or develops during infancy and can lead to long-term consequences if not properly managed. Early detection and treatment of acetabular dysplasia are crucial to prevent complications such as hip dislocation and osteoarthritis later in life.
A client with lung cancer develops Homer's when the tumor invades the ribs and affects the sympathetic nerve ganglia. When assessing for signs and symptoms of this syndrome, the nurse should note:
- A. Miosis, partial eyelid ptosis, and anhidrosis on the affected side of the face.
- B. Chest pain, dyspnea, cough, weight loss, and fever.
- C. Arm and shoulder pain and atrophy of arm and hand muscles both on the affected side.
- D. Hoarseness and dysphagia.
Correct Answer: A
Rationale: Homer's syndrome, also known as Horner's syndrome, is a rare condition that occurs when the sympathetic nerve supply to the eye and face is disrupted. In the case of lung cancer invading the ribs and affecting the sympathetic nerve ganglia, it can lead to Homer's syndrome. The classic triad of symptoms in Homer's syndrome includes miosis (constriction of the pupil), partial eyelid ptosis (drooping of the upper eyelid), and anhidrosis (lack of sweating) on the affected side of the face. These symptoms result from the disruption of sympathetic nerve pathways affecting the pupillary dilator muscle, the Müller muscle responsible for eyelid elevation, and sweat glands on one side of the face. Therefore, when assessing for signs and symptoms of Homer's syndrome in this client, the nurse should focus on looking for these specific manifestations.
A child is being admitted to the intensive care unit (ICU) and the parents are with the child. Which creates stressors for children and parents in ICUs? (Select all that apply.)
- A. Equipment noise
- B. Privacy
- C. Caring behavior by the nurse
- D. Unfamiliar smells
Correct Answer: A
Rationale: Equipment noise: The noises from medical equipment in the ICU can be loud and continuous, creating a stressful environment for both children and parents. This constant noise can be overwhelming and contribute to feelings of anxiety.