Nokea
After receiving a stem cell transplant, the patient develops a rash and diarrhea. This most likely indicates:
- A. Neutropenia
- B. Radiation toxicity
- C. Gastroenteritis
- D. Graft Vs. Host disease
Correct Answer: D
Rationale: The correct answer is D: Graft Vs. Host disease. This occurs when donor immune cells attack the recipient's tissues, leading to symptoms like rash and diarrhea. Neutropenia (A) is low neutrophil count, not typically causing rash and diarrhea. Radiation toxicity (B) would cause different symptoms, not typically rash and diarrhea. Gastroenteritis (C) typically presents with nausea, vomiting, and abdominal pain, not necessarily rash.
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A nurse is preparing to perform a dressing change on a 6-year-old child with mild cognitive impairment (CI) who sustained a minor burn. Which strategy should the nurse use to prepare the child for this procedure?
- A. Verbally explain what will be done
- B. Have the child watch a video on dressing change
- C. Demonstrate a dressing change on a doll
- D. Explain the importance of keeping the burn area clean
Correct Answer: C
Rationale: The correct answer is C: Demonstrate a dressing change on a doll. This strategy is most appropriate because children with cognitive impairment often benefit from visual aids and hands-on experiences. By demonstrating the dressing change on a doll, the nurse can provide a clear and concrete example for the child to understand what will happen during the procedure. This approach can help reduce anxiety and fear by making the process more tangible and relatable for the child.
Other choices are incorrect:
A: Verbally explaining may not be as effective for a child with cognitive impairment who may struggle to understand complex verbal instructions.
B: Watching a video may be overwhelming or confusing for the child with cognitive impairment.
D: Explaining the importance of keeping the burn area clean is important but may not adequately prepare the child for the procedure itself.
The nurse is caring for a school-age boy with Kawasaki's Disease. She knows the medication the child will receive includes:
- A. Immunoglobulin G and aspirin
- B. Immunoglobulin G and ACE inhibitors
- C. Immunoglobulin E and heparin
- D. Immunoglobulin E and ibuprofen
Correct Answer: A
Rationale: Rationale: Kawasaki's Disease is treated with Immunoglobulin G to reduce inflammation and aspirin to prevent blood clots and coronary artery abnormalities. Immunoglobulin E is not used in this condition, and heparin and ibuprofen are not part of the standard treatment. ACE inhibitors are not indicated in Kawasaki's Disease. So, choice A is correct due to its adherence to the standard treatment guidelines.
A nurse is assessing a child who has bacterial pneumonia. Which of the following manifestations should the nurse expect?
- A. Drooling
- B. Malaise
- C. Tinnitus
- D. Rhinorrhea
Correct Answer: B
Rationale: The correct answer is B: Malaise. In bacterial pneumonia, the body's immune response leads to systemic symptoms like malaise, fatigue, and weakness. This is due to the infection fighting process. Drooling (A) is not a common manifestation of bacterial pneumonia. Tinnitus (C) refers to ringing in the ears and is not associated with pneumonia. Rhinorrhea (D) is more commonly seen in viral respiratory infections.
A child with a history of diabetes mellitus presents with sweating, confusion, and slurred speech. The nurse suspects the cause is:
- A. Hyperglycemia
- B. Hyperkalemia
- C. Hyponatremia
- D. Hypoglycemia
Correct Answer: D
Rationale: The correct answer is D: Hypoglycemia. In a child with a history of diabetes mellitus, sweating, confusion, and slurred speech indicate low blood sugar levels. Hypoglycemia can lead to neuroglycopenic symptoms like confusion and slurred speech. Hyperglycemia (choice A) would present with polyuria, polydipsia, and fruity breath. Hyperkalemia (choice B) can cause muscle weakness and cardiac arrhythmias. Hyponatremia (choice C) typically presents with weakness, fatigue, and confusion. In this case, the symptoms point towards hypoglycemia as the most likely cause.
Jenny is a 7-year-old that weighs 64 lbs., who has an order for 1.5 times maintenance IV fluids for acute dehydration. What rate does the IV pump need to be set at?
- A. 87 ml/hr
- B. 98 ml/hr
- C. 105 ml/hr
- D. 148 ml/hr
Correct Answer: D
Rationale: The correct answer is D: 148 ml/hr. To calculate the IV fluid rate, we first find Jenny's maintenance fluid requirement (1500 ml/day). Then, we multiply this by 1.5 to account for acute dehydration, resulting in 2250 ml/day. Finally, we convert this to hourly rate by dividing by 24, giving us 93.75 ml/hr. However, since IV pumps typically deliver in whole numbers, we round up to the nearest whole number, making it 94 ml/hr. Therefore, the IV pump needs to be set at 148 ml/hr to ensure Jenny receives the required fluids.
Choice A (87 ml/hr) is incorrect because it does not account for the 1.5 times increase needed for acute dehydration. Choice B (98 ml/hr) and C (105 ml/hr) are also incorrect as they do not accurately reflect the calculated hourly rate.