Nokea
An infant with bladder exstrophy has had a continent urinary reservoir placed. Which discharge instruction should be included?
- A. Allow your child to sleep on the abdomen for comfort.
- B. Avoid contact with latex-containing surfaces (e.g., playgrounds with rubber) to prevent allergic reactions.
- C. Encourage a varied diet to prevent allergies.
- D. Provide brightly colored objects to stimulate development.
Correct Answer: B
Rationale: Children with urologic malformations are prone to latex allergies; parents should be advised to avoid latex exposure.
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Marichu is admitted to the hospital because of hepatic failure and was prescribed with lactulose (Duphalac). The primary action of this drug is:
- A. prevent constipation
- B. decrease resident intestinal flora
- C. increase intestinal peristalsis
- D. prevent portal hypertension
Correct Answer: B
Rationale: Lactulose (Duphalac) is a synthetic sugar that is not absorbed in the small intestine but is broken down by bacteria in the colon into short-chain fatty acids and low molecular weight organic acids. The primary action of lactulose is to decrease resident intestinal flora. This reduces the production of ammonia in the colon and leads to acidification of the colonic contents. By doing so, lactulose helps in treating hepatic encephalopathy, a condition associated with hepatic failure where ammonia levels are elevated in the body. It works by promoting the excretion of ammonia through the stool, thereby reducing the toxic effects of ammonia on the brain.
Which of the ff. does the nurse understand usually precedes rheumatic fever?
- A. A viral infection
- B. A beta-hemolytic streptococcal
- C. A fungal infection infection c.A staphylococcal infection
Correct Answer: B
Rationale: Rheumatic fever is an inflammatory disease that can develop as a complication of untreated or inadequately treated infections caused by group A beta-hemolytic streptococci. These bacterial infections are usually in the form of strep throat or scarlet fever. Rheumatic fever typically occurs 2-4 weeks after a streptococcal infection. The body's immune response to the streptococcal infection can lead to an autoimmune reaction, resulting in rheumatic fever. It is important to promptly diagnose and treat streptococcal infections to prevent the development of rheumatic fever.
A 13-year-old is worried because his breasts are growing and are tender. What should the nurse tell him?
- A. We will draw blood to determine the cause.
- B. It is a slight hormonal imbalance that can be corrected with medication.
- C. It is a normal condition of puberty (gynecomastia) that usually resolves within a year or two.
- D. It is a rare finding in boys during puberty.
Correct Answer: C
Rationale: Gynecomastia and breast tenderness occur in about one-third of boys during mid-puberty and usually resolve within 2 years.
Which is an important nursing consideration when caring for a child with herpetic gingivostomatitis (HGS)?
- A. Apply topical anesthetics before eating.
- B. Drink from a cup, not a straw.
- C. Wait to brush teeth until lesions are sufficiently healed.
- D. Explain to parents how this is sexually transmitted.
Correct Answer: C
Rationale: An important nursing consideration when caring for a child with herpetic gingivostomatitis (HGS) is to wait to brush teeth until lesions are sufficiently healed. This is because brushing teeth while the lesions are present can be painful and potentially disruptive to the healing process. It is important to ensure that the child is comfortable and that the healing of the lesions is not impeded by brushing too early. This consideration helps promote optimal healing and comfort for the child with this condition.
Which information could be given to the parents of a 12-month-old child regarding appropriate play activities?
- A. Give large push-pull toys for kinetic stimulation.
- B. Place cradle gym across crib to facilitate fine motor skills.
- C. Provide child with finger paints to enhance fine motor skills.
- D. Provide stick horse to develop gross motor coordination.
Correct Answer: A
Rationale: At 12 months of age, children are generally starting to become more mobile and interested in exploring their surroundings. Large push-pull toys are a great option for encouraging physical activity and helping with gross motor skills development. These toys can help the child practice walking, crawling, and hand-eye coordination. Push-pull toys also provide kinetic stimulation which is important for the child's overall physical development at this age. Other play activities mentioned in the options, such as finger paints or cradle gym, may be suitable for older children as they require more fine motor skills and coordination. Stick horse, on the other hand, is more appropriate for older children who have better developed gross motor coordination.