Nokea
An 8-year-old child is receiving digoxin (Lanoxin). The nurse should notify the practitioner and withhold the medication if the apical pulse is less than _____ beats/min.
- A. 60
- B. 70
- C. 90
- D. 100
Correct Answer: B
Rationale: If a 1-minute apical pulse is less than 70 beats/min for an older child, the digoxin is withheld; 60 beats/min is the cut-off for holding the digoxin dose in an adult. A pulse below 90 to 110 beats/min is the determination for not giving a digoxin dose to infants and young children.
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Specific receptor defects occur in:
- A. Guillain-Barre syndrome
- B. Myasthenia gravis
- C. Graves' disease
- D. Ulcerative colitis
Correct Answer: B
Rationale: Myasthenia gravis is characterized by antibodies against acetylcholine receptors at the neuromuscular junction, leading to muscle weakness.
Family discharge teaching has been effective when the parent of a toddler diagnosed with Kawasaki disease (KD) states:
- A. The arthritis in her knees is permanent. She will need knee replacements.
- B. I will give her diphenhydramine (Benadryl) for her peeling palms and soles of her feet.
- C. I know she will be irritable for 2 months after her symptoms start.
- D. I will continue with high doses of Tylenol for her inflammation.
Correct Answer: C
Rationale: This statement indicates the parent understands that irritability may persist for about 2 months after symptom onset in KD.
Hypoglycemia in an infant is defined as whole blood glucose level less than
- A. 40 mg/dl
- B. 50 mg/dl
- C. 60 mg/dl
- D. 80 mg/dl
Correct Answer: A
Rationale: Hypoglycemia in infants is defined as a whole blood glucose level less than 40 mg/dl, as this threshold is critical for brain function.
All of the following are features of Behcet disease except
- A. Reduced T helper cell 1 activity
- B. Increased expression of HSP60
- C. Association with HLA-B51
- D. Vasculitis with fibrinoid necrosis
Correct Answer: A
Rationale: Behcet disease is associated with increased T helper cell 1 activity
Which type of shock is characterized by a hypersensitivity reaction causing massive vasodilation and capillary leaks, which may occur with drug or latex allergy?
- A. Neurogenic
- B. Cardiogenic
- C. Hypovolemic
- D. Anaphylactic
Correct Answer: D
Rationale: Anaphylactic shock results from extreme allergy or hypersensitivity to a foreign substance. Neurogenic shock results from loss of neuronal control, such as the interruption of neuronal transmission that occurs from a spinal cord injury. Cardiogenic shock is decreased cardiac output. Hypovolemic shock is a reduction in the size of the vascular compartment, decreasing blood pressure, and low central venous pressure.