Nokea
About 500 children have just been exposed to radiation from a nuclear power plant accident. The most appropriate first step in your treatment of these children should be to
- A. prescribe potassium iodide to protect the thyroid
- B. order thyroid function tests
- C. order complete blood counts (CBCs)
- D. do nothing acutely; evaluate in 4-6 weeks
Correct Answer: A
Rationale: Potassium iodide can protect the thyroid from radioactive iodine exposure, which is a critical first step in radiation exposure.
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Nurse Nancy is assessing a child with pyloric stenosis; she is likely to note which of the following?
- A. "Currant jelly" stools
- B. Regurgitation
- C. Steatorrhea
- D. Projectile vomiting
Correct Answer: D
Rationale: Pyloric stenosis is a condition in infants where there is a tightening of the muscle at the outlet of the stomach, causing obstruction of food passage into the small intestine. One of the hallmark symptoms of pyloric stenosis is projectile vomiting, in which the vomit is forceful and shoots out a significant distance. This distinguishes it from regular regurgitation or spitting up, which are more common in infants for other reasons. Nurse Nancy would likely note this symptom while assessing a child with pyloric stenosis.
A client with human immunodeficiency virus (HIV) undergoes intradermal anergy testing using Candida and mumps antigen. During the 3 days following the tests, there is no induration or evidence of reaction at the intradermal injection sites. The most accurate conclusion the nurse can make is:
- A. The client has no previous exposure to the antigens injected
- B. The results demonstrate the client has antibodies to the antigens
- C. The client is immunodeficient and won't have a skin response
- D. The client isn't allergic to the antigens and therefore doesn't react
Correct Answer: C
Rationale: A client with HIV undergoing intradermal anergy testing with Candida and mumps antigens is suspected to be immunodeficient, making them unable to mount a normal skin response to these antigens. In an immunodeficient individual, the immune system is weakened, leading to a lack of response when exposed to these antigens. A lack of induration or reaction in the 3 days following the test suggests that the client's immune system is not able to mount a normal response, indicating immunodeficiency. The absence of a reaction does not necessarily indicate lack of exposure (Option A), presence of antibodies (Option B), or the absence of allergies (Option D), but rather points to a compromised immune system in an individual with HIV.
A female child, age 2, is brought to the emergency department after ingesting an unknown number of aspirin tablets about 30 minutes earlier. On entering the examination room, the child is crying and clinging to the mother. Which data should the nurse obtain first?
- A. Heart rate, respiratory rate, and bloodpressure
- B. Recent exposure to communicable diseases
- C. Number of immunizations received
- D. Height and weight
Correct Answer: A
Rationale: In this situation, the priority data the nurse should obtain first is the vital signs including heart rate, respiratory rate, and blood pressure of the child. This information will help assess the child's current physiological status and potential effects of ingesting the aspirin. Aspirin overdose in children can lead to serious complications such as metabolic acidosis, respiratory distress, and cardiovascular instability. Monitoring the vital signs will provide crucial information to guide appropriate interventions and determine the severity of the child's condition. Height and weight (option D) are important for routine assessments but not the priority in this urgent situation. Recent exposure to communicable diseases (option B) and number of immunizations received (option C) are not relevant to the immediate management of the child's aspirin ingestion.
To supplement a diet with foods high in potassium, the nurse should recommend the addition of:
- A. Fruits such as bananas
- B. Milk and yogurt
- C. Green leafy vegetables
- D. Nuts and legumes
Correct Answer: A
Rationale: Fruits such as bananas are a good source of potassium. Potassium is an essential mineral that plays a vital role in various bodily functions, including maintaining proper muscle function, nerve transmission, and fluid balance. Bananas are easy to incorporate into the diet and provide a significant amount of potassium per serving. Other fruits high in potassium include oranges, melons, and avocados. Therefore, recommending the addition of fruits such as bananas is a suitable way to supplement a diet with foods high in potassium.
Nurse Kara is giving instructions to an elderly client on diabetic foot care. Which teaching is not part of foot care?
- A. wear comfortable shoes that fit well and protect your feet
- B. trim your toenails straight across and file edges with emery board
- C. wash your feet in hot water to keep feet soft
- D. wear shoes at the beach or on hot pavement
Correct Answer: C
Rationale: Washing your feet in hot water is not recommended as it can actually worsen diabetic foot conditions. Hot water can lead to burns and damage the skin, especially for individuals with reduced sensation in their feet due to diabetes. It is advised to wash feet in warm water instead, avoiding hot temperatures to prevent injuries and complications. The other options provide important aspects of diabetic foot care such as wearing appropriate shoes, trimming toenails carefully, and being mindful of footwear choices to protect the feet.