A sign specific to red blood cell destruction (hemolytic) anemia is:
- A. Jaundice
- B. Pica
- C. Anorexia
- D. Tachycardia
Correct Answer: A
Rationale: Jaundice is the correct answer for red blood cell destruction anemia because it results from the breakdown of red blood cells, causing an increase in bilirubin levels. Jaundice presents as yellowing of the skin and eyes. Pica (eating non-food items), anorexia (loss of appetite), and tachycardia (rapid heart rate) are not specific signs of hemolytic anemia. Jaundice is a key indicator due to the excess bilirubin released from the destruction of red blood cells.
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Which actions by the school nurse is important in the prevention of rheumatic fever?
- A. Encourage routine cholesterol screenings
- B. Conduct routine blood pressure screenings
- C. Refer children with sore throats for throat cultures
- D. Recommend aspirin instead of acetaminophen for minor discomforts
Correct Answer: C
Rationale: The correct answer is C: Refer children with sore throats for throat cultures. This is important in preventing rheumatic fever as it helps identify and treat streptococcal infections promptly, which can lead to rheumatic fever if left untreated. Encouraging routine cholesterol screenings (A) and conducting routine blood pressure screenings (B) are not directly related to preventing rheumatic fever. Recommending aspirin instead of acetaminophen (D) can actually be harmful in children with viral infections, increasing the risk of Reye's syndrome.
Anorexia nervosa may best be described as:
- A. Occurring most frequently in adolescent males
- B. Occurring most frequently in adolescents from lower socioeconomic groups
- C. Resulting from a posterior pituitary disorder
- D. Resulting in severe weight loss in the absence of obvious physical causes
Correct Answer: D
Rationale: Anorexia nervosa is characterized by severe weight loss due to restrictive eating behaviors and distorted body image. Choice D is correct as it accurately describes the hallmark symptom of anorexia. Choices A and B are incorrect because anorexia nervosa is more common in adolescent females and does not discriminate based on socioeconomic status. Choice C is incorrect as anorexia nervosa is primarily a psychological disorder, not a pituitary disorder.
The nurse is caring for a child with frostbite would expect the patient to display:
- A. Redness and swelling of the hands
- B. Blisters that appear 24 to 48 hours after rewarming
- C. Itching and burning that persists after rewarming
- D. Fever
Correct Answer: B
Rationale: The correct answer is B because blisters appearing 24 to 48 hours after rewarming is a common symptom of frostbite. This occurs due to damage to the blood vessels and tissues. A: Redness and swelling are more indicative of mild frostbite. C: Itching and burning are not typical symptoms of frostbite. D: Fever is not a common symptom of frostbite.
A 7-year-old obese child was diagnosed at his 6-year primary care visit with idiopathic hypertension. The family was instructed to modify his diet and begin an exercise program to control the hypertension. At this visit, it was decided the child should begin a low dose of Lisinopril (Zestril) at 0.07 mg/kg/day. The child weighs 99 pounds. What is the correct dose for this child?
- A. 70 mg/day
- B. 30 mg/day
- C. 6 mg/day
- D. 3 mg/day
Correct Answer: D
Rationale: The correct dose for this child is 3 mg/day. To calculate the dose, we first need to convert the child's weight from pounds to kilograms by dividing by 2.2 (99 lbs / 2.2 = 45 kg). Next, we multiply the weight in kg by the prescribed dosage of 0.07 mg/kg/day (45 kg x 0.07 mg/kg/day = 3.15 mg/day). Since the dosing is typically rounded down for safety reasons, the correct dose is 3 mg/day.
Choice A (70 mg/day) is incorrect because it is too high for a child of this weight and could lead to adverse effects. Choice B (30 mg/day) is also too high. Choice C (6 mg/day) is incorrect as it does not reflect the calculated dosage based on the weight of the child. Therefore, the correct answer is D (3 mg/day) based on the calculated dosage per kg for this specific child.
To help the adolescent deal with diabetes, the nurse must consider which developmental characteristic of adolescence?
- A. Desire to be unique
- B. Preoccupation with the future
- C. Need to be perfect and similar to peers
- D. Need to make peers aware of the seriousness of hypoglycemic reactions
Correct Answer: C
Rationale: The correct answer is C: Need to be perfect and similar to peers. During adolescence, individuals often have a strong desire to fit in and be accepted by their peers, leading to a need to conform and be similar to their peers. This characteristic is important to consider when helping an adolescent deal with diabetes as it may impact their adherence to treatment and management of their condition. Choices A, B, and D are incorrect because while adolescents may have a desire to be unique or preoccupied with the future, these characteristics are not specifically related to managing diabetes. Additionally, the need to make peers aware of hypoglycemic reactions may not be the most effective or appropriate way to manage the condition.