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An adult woman with primary Raynaud phenomenon develops pallor and then cyanosis of her fingers. After warming her hands, the fingers turn red and the client reports a burning sensation. What action should the nurse take?
- A. Apply a cool compress to the affected fingers for 20 minutes
- B. Secure a pulse oximeter to monitor the client's oxygen saturation
- C. Report the finding to the healthcare provider as soon as possible
- D. Continue to monitor the fingers until color returns to normal
Correct Answer: D
Rationale: Monitoring is appropriate as the symptoms are consistent with Raynaud's phenomenon and should resolve with warming.
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Which therapeutic management should the nurse expect to implement for a child with rheumatic fever?
- A. Administering penicillin
- B. Avoiding salicylates (aspirin)
- C. Imposing strict bed rest for 4 to 6 weeks
- D. Administering corticosteroids if chorea develops
Correct Answer: A
Rationale: The goal of medical management is the eradication of the hemolytic streptococci. Penicillin is the drug of choice. Salicylates can be used to control the inflammatory process, especially in the joints, and reduce the fever and discomfort. Bed rest is recommended for the acute febrile stage, but it does not need to be strict. The chorea is transient and will resolve without treatment.
A client tells the nurse that her biopsy results indicate that the cancer cells are well-differentiated. How should the nurse respond?
- A. Ask the client if the healthcare provider has given her any information about the classification of her cancer
- B. Tell the client that well-differentiated cancer cells usually have a poor prognosis.
- C. Reassure the client that the cancer is not serious.
- D. Encourage the client to seek a second opinion for confirmation of the diagnosis.
Correct Answer: A
Rationale: Well-differentiated cancer cells typically indicate a slower-growing tumor. Clarifying the client's understanding ensures accurate communication and emotional support.
Diamond Blackfan anemia is different from Transient Erythroblastopenia of Childhood as the former has
- A. Increased adenosine deaminase
- B. Mean corpuscular volume is decreased
- C. Female predominance
- D. Antecedent history of viral illness
Correct Answer: A
Rationale: Diamond Blackfan anemia is characterized by increased adenosine deaminase activity, unlike Transient Erythroblastopenia of Childhood.
Diagnostic signs of child abuse are:
- A. Sub-hyaloid bleeding
- B. Spiral fracture of a long bone
- C. Lacerated tongue
- D. Posterior rib fractures
Correct Answer: D
Rationale: Posterior rib fractures are highly suggestive of child abuse, as they are often caused by forceful squeezing or shaking.
What are FOUR possible causes of left axis deviation in a newborn with features of Trisomy 21?
- A. AVSD
- B. Tricuspid atresia
- C. Pulmonary atresia with intact ventricular septum
- D. Mechanical shift
Correct Answer: A
Rationale: AVSD is a common congenital heart defect associated with Trisomy 21 and can lead to left axis deviation seen on ECG.