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Amy, age 6 years, needs to be hospitalized again because of a chronic illness. The clinic nurse overhears her school-age siblings tell her, "We are sick of Mom always sitting with you in the hospital and playing with you. It isn't fair that you get everything and we have to stay with the neighbors." Which is the nurse's best assessment of this situation?
- A. The siblings are immature and probably spoiled.
- B. Jealousy and resentment are common reactions to the illness or hospitalization of a sibling.
- C. Family has ineffective coping mechanisms to deal with chronic illness.
- D. The siblings need to better understand their sister's illness and needs.
Correct Answer: B
Rationale: Jealousy and resentment are common reactions among siblings when one child requires more attention due to illness or hospitalization. It is natural for siblings to feel left out, overlooked, or envious of the extra attention the sick child is receiving. These feelings do not necessarily indicate immaturity or being spoiled but rather a normal emotional response to a challenging family situation. It is important for healthcare providers to recognize and address these feelings to support the entire family in coping with the chronic illness of one of their members.
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Primary amenorrhea should be considered for any female adolescent who has not reached menarche by
- A. 13 years or has not done so within 3 years of thelarche
- B. 14 years or has not done so within 2 years of thelarche
- C. 14 years or has not done so within 3 years of thelarche
- D. 15 years or has not done so within 3 years of thelarche
Correct Answer: D
Rationale: Primary amenorrhea is suspected if menarche has not occurred by age 15 or within 3 years of thelarche.
Clients will go through operations and who have undergone surgery need the proper observation, treatment, and care. Implementing the nursing process to these patients will help reduce complications. Nurse Maria is preparing Mr. Sy for surgery. Which of the following statements by the client would indicate he is well-informed about his imminent surgery?
- A. " Right after the operation, I will wear the pneumatic compression device while sitting on the chair."
- B. "I will not eat anything after 12 pm the night befire my operation, but I sure can drink."
- C. "The skin preparation site is longer and wider than the actual incision site."
- D. "I will need to sign the consent from after I get to the operating table."
Correct Answer: B
Rationale: Option B, "I will not eat anything after 12 pm the night before my operation, but I sure can drink," indicates that the client understands and is knowledgeable about the pre-operative fasting guidelines. It is crucial for patients to have an empty stomach before surgery to prevent complications related to anesthesia, such as aspiration pneumonia. This statement shows that Mr. Sy is well-informed and compliant with this important pre-operative instruction. Options A, C, and D do not directly demonstrate specific knowledge regarding the surgery preparations.
What should the nurse suggest to the parents of an infant who has a prolonged need for middle-of-the-night feedings?
- A. Decrease daytime feedings.
- B. Allow child to go to sleep with a bottle.
- C. Offer last feeding as late as possible at night.
- D. Put infant to bed after asleep from rocking.
Correct Answer: C
Rationale: The nurse should suggest to the parents to offer the last feeding as late as possible at night for an infant who has a prolonged need for middle-of-the-night feedings. By ensuring that the infant gets a full feeding closer to bedtime, it can potentially help the baby stay fuller for a longer period during the night, reducing the need for frequent nighttime feedings. This approach can help the parents establish a bedtime routine that supports longer stretches of sleep for both the infant and themselves. It is important to note that decreasing daytime feedings, allowing the child to go to sleep with a bottle, and putting the infant to bed after they are already asleep from rocking are not recommended strategies for addressing prolonged middle-of-the-night feedings.
If a patient has elevated pulmonary vascular pressures, the nurse understands that the patient is most likely to develop which of the ff. physiological cardiac changes?
- A. Left atrial atrophy
- B. Left ventricular hypertrophy
- C. Right atrial atrophy
- D. Right ventricular hypertrophy
Correct Answer: D
Rationale: Elevated pulmonary vascular pressures can lead to pulmonary hypertension, which causes increased pressure in the right side of the heart. The right ventricle has to work harder to pump blood against the increased resistance in the pulmonary circulation. Over time, this can result in the development of right ventricular hypertrophy as the muscle of the right ventricle thickens in response to the increased workload. This is a compensatory mechanism to try to maintain cardiac output despite the increased pressure in the pulmonary circulation. Left atrial atrophy, left ventricular hypertrophy, and right atrial atrophy are not typically associated with elevated pulmonary vascular pressures.
Which of the following blood products is most likely to be given to Joel?
- A. Factor VIII concentrate
- B. Fresh frozen plasma
- C. Factor II, Vll, IX, X complex
Correct Answer: A
Rationale: Joel most likely requires Factor VIII concentrate. Factor VIII deficiency is characteristic of hemophilia A, which is a condition where there is a deficiency in clotting factor VIII. Treatment for hemophilia A involves replacing the missing Factor VIII through Factor VIII concentrate infusions to assist in blood clotting. Fresh frozen plasma and Factor II, VII, IX, X complex are not specific treatments for Factor VIII deficiency.