An eleven-month-old infant is brought to the pediatric clinic. The nurse suspects that the child has iron deficiency anemia. Because iron deficiency anemia is suspected, which of the following is the most important information to obtain from the infant's parents?
- A. Normal dietary intake
- B. Relevant socio cultural, economic, and educational background of the family
- C. Any evidence of blood in the stools
- D. A history of maternal anemia during pregnancy
Correct Answer: A
Rationale: Dietary intake reveals iron sources, critical for diagnosing deficiency.
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The nurse is aware that this is considered as the master gland of the body
- A. Hypothalamus
- B. Pituitary gland
- C. Thyroid gland
- D. Pineal gland
Correct Answer: B
Rationale: The pituitary gland master gland e.g., regulates thyroid, adrenals via hormones. Hypothalamus controls it, thyroid/pineal have specific roles. Nurses know e.g., endocrine for systemic effects, per physiology.
The coronary vessels, unlike any other blood vessels in the body, respond to sympathetic stimulation by
- A. Vasoconstriction
- B. Vasodilatation
- C. Decreases force of contractility
- D. Decreases cardiac output
Correct Answer: B
Rationale: The coronary vessels are unique because they respond to sympathetic stimulation with vasodilatation, unlike most other blood vessels which constrict. Sympathetic stimulation activates the fight-or-flight response, increasing heart rate and oxygen demand. To meet this demand, the coronary arteries dilate to supply more blood to the heart muscle. Vasoconstriction (A) is incorrect as it would reduce blood flow, countering the heart's needs during stress. Decreases in force of contractility (C) or cardiac output (D) are unrelated to the vascular response and pertain more to myocardial function, not the coronary vessels' behavior. This vasodilatation is mediated by beta-adrenergic receptors, ensuring adequate perfusion during heightened activity, making B the correct choice.
An 8-year-old admitted with an upper-respiratory infection has an order for O2 saturation via pulse oximeter. To ensure an accurate reading, the nurse should:
- A. Place the probe on the child's abdomen
- B. Recalibrate the oximeter at the beginning of each shift
- C. Apply the probe and wait 15 minutes before obtaining a reading
- D. Place the probe on the child's finger
Correct Answer: D
Rationale: Placing the pulse oximeter probe on the finger ensures an accurate oxygen saturation reading in an 8-year-old, as peripheral sites like fingers provide reliable arterial pulsation data. The abdomen isn't suitable, recalibration isn't routine, and waiting 15 minutes delays care unnecessarily. Nurses use this technique for quick, precise monitoring, critical in respiratory infections to guide oxygen therapy.
Which of the following statement best describe battery in nursing?
- A. A verbal threat
- B. Unconsented physical contact
- C. A legal fine
- D. A care plan
Correct Answer: B
Rationale: Battery is unconsented physical contact (B), per law e.g., touching without permission. Not threat (A, assault), not fine (C), not plan (D) contact-based. B best defines battery's violation, like touching Mr. Gary against will, making it correct.
The nurse is caring for an elderly woman who has had a fractured hip repaired. In the first few days following the surgical repair, which of the following nursing measures will best facilitate the resumption of activities for this client?
- A. Arranging for the wheelchair
- B. Asking her family to visit
- C. Assisting her to sit out of bed in a chair qid
- D. Encouraging the use of an overhead trapeze
Correct Answer: D
Rationale: The trapeze promotes upper body strength and mobility, aiding recovery.