Nokea
An adult has a Hickman type central venous catheter and needs to have blood drawn from it. Which of the following should the nurse do first?
- A. Use sterile technique to assemble supplies needed
- B. Aspirate and discard the first 10 ml of the blood
- C. First flush the catheter with heparinized solution, then withdraw the blood
- D. Remove the cap of the catheter and replace it with a new one
Correct Answer: C
Rationale: Before drawing blood from a central venous catheter like a Hickman type, it is essential to ensure that the catheter is patent and free of any clots. Flushing the catheter with a heparinized solution (to prevent clot formation) before withdrawing blood helps clear the catheter and ensures accurate blood sample collection. Removing clots or obstructions from the catheter is crucial to prevent complications and maintain the catheter's function. Therefore, it is important to first flush the catheter with a heparinized solution before drawing blood from it.
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Which immunoglobulin is specific to an allergic response?
- A. IgA
- B. IgE
- C. IgB
- D. IgG
Correct Answer: B
Rationale: IgE is the immunoglobulin specific to an allergic response. When an individual is exposed to an allergen, the immune system produces IgE antibodies that bind to mast cells and basophils. Upon re-exposure to the same allergen, these IgE antibodies trigger the release of histamine and other chemicals that cause allergic symptoms such as itching, swelling, and inflammation. IgE is not normally found in high concentrations in the bloodstream unless there is an allergic reaction occurring. Other immunoglobulins like IgA, IgG, and IgM are not specifically associated with allergic responses.
During starvation, the body slows metabolic processes and growth to minimize the need for nutrients. With the rapid reinstitution of feeding after starvation refeeding syndrome may occur. Of the following, the major changes that may occur with refeeding syndrome typically affect
- A. electrolytes
- B. serum proteins
- C. hormones
- D. liver enzymes
Correct Answer: A
Rationale: Refeeding syndrome primarily affects electrolytes, particularly phosphorus, potassium, and magnesium, which can become dangerously depleted due to rapid shifts in metabolism.
which of the following is true concerning rheumatic fever?
- A. it is usually associated with glomerulonephritis
- B. symptoms disappear shortly after the fever abate and the temperature returns to normal
- C. the child should resume normal activities as soon as she feels well
- D. it usually follows a streptococcal infection
Correct Answer: D
Rationale: Rheumatic fever is an inflammatory disease that can develop as a complication of inadequately treated streptococcal infections, especially streptococcal throat infections caused by group A streptococcus bacteria. The bacteria trigger an abnormal immune response in susceptible individuals, leading to the development of rheumatic fever. The other choices are not accurate. Glomerulonephritis is a separate condition associated with certain types of streptococcal infections but not with rheumatic fever. Symptoms of rheumatic fever can persist even after the fever has subsided, and it is important for children with rheumatic fever to follow proper treatment and rest guidelines as advised by healthcare providers. It is crucial for individuals with rheumatic fever to avoid activities that could strain the heart until the condition has been properly managed.
12-year-old Caroline has recurring nephrotic syndrome; which of the following areas of potential disturbances should be a prime consideration when planning ongoing nursing care?
- A. Body image
- B. Sexual maturation
- C. Muscle coordination
- D. Intellectual development
Correct Answer: A
Rationale: For 12-year-old Caroline with recurring nephrotic syndrome, body image should be a prime consideration when planning ongoing nursing care. Nephrotic syndrome can cause physical changes such as weight gain, swelling, and changes in appearance due to the disease process and treatment side effects like corticosteroids. These physical changes can impact a child's self-esteem and body image, especially during the sensitive pre-adolescent period. As a result, addressing Caroline's body image concerns through open communication, providing support, promoting self-acceptance, and involving her in decision-making regarding her care can significantly impact her emotional well-being and overall quality of life.
A sexually active female adolescent asks the nurse about the contraceptive Depo-Provera. What should the nurse explain regarding the contraceptive?
- A. Requires injections every 3 months
- B. Requires daily administration of medication by mouth
- C. Provides long-term continuous protection, up to 5 years
- D. Prevents pregnancy if given within 72 hours of unprotected sex
Correct Answer: A
Rationale: Depo-Provera is a contraceptive method that consists of receiving an injection every 3 months to prevent pregnancy. It contains a progestin hormone called medroxyprogesterone acetate, which works by suppressing ovulation, thickening cervical mucus, and thinning the uterine lining. This method of contraception is highly effective when used correctly and is convenient for individuals who prefer not to take a daily pill.