Nokea
An infant with hydrocele is seen in the clinic for a follow-up visit at 1 month of age. The scrotum is smaller than it was at birth, but fluid is still visible on illumination. Which of the following actions is the physician likely to recommend?
- A. Massaging the groin area twice a day until the fluid is gone.
- B. Referral to a surgeon for repair.
- C. No treatment is necessary; the fluid is reabsorbing normally.
- D. Keeping the infant in a flat, supine position until the fluid is gone.
Correct Answer: C
Rationale: A hydrocele is a collection of fluid in the scrotum that results from a patent tunica vaginalis. Illumination of the scrotum with a pocket light demonstrates the clear fluid. In most cases, the fluid reabsorbs within the first few months of life and no treatment is necessary. Massaging the groin area (Choice A) is not recommended as it will not help in the resolution of the hydrocele. Referral to a surgeon (Choice B) is not necessary at this stage since hydroceles often resolve on their own in infants. Keeping the infant in a flat, supine position (Choice D) does not aid in the reabsorption of fluid and is not a recommended intervention for hydrocele management.
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The nursing care plan for a toddler diagnosed with Kawasaki Disease (mucocutaneous lymph node syndrome) should be based on the high risk for development of which problem?
- A. Chronic vessel plaque formation
- B. Pulmonary embolism
- C. Occlusions at the vessel bifurcations
- D. Coronary artery aneurysms
Correct Answer: A
Rationale: The correct answer is chronic vessel plaque formation. Kawasaki Disease affects small and medium-sized blood vessels, leading to progressive inflammation and potential damage to the walls of medium-sized muscular arteries, which can result in coronary artery aneurysms. While other complications such as pulmonary embolism and occlusions at vessel bifurcations can occur in different conditions, for Kawasaki Disease, the primary concern is the development of chronic vessel plaque formation.
The nurse is caring for a 2-year-old who is being treated with chelation therapy, calcium disodium edetate, for lead poisoning. The nurse should be alert for which of the following side effects?
- A. Neurotoxicity
- B. Hepatomegaly
- C. Nephrotoxicity
- D. Ototoxicity
Correct Answer: C
Rationale: The correct answer is nephrotoxicity. Calcium disodium edetate, used in chelation therapy for lead poisoning, can lead to kidney toxicity. This is an important side effect to monitor in patients undergoing this treatment. Choices A, B, and D are incorrect. Neurotoxicity, hepatomegaly, and ototoxicity are not typically associated with calcium disodium edetate therapy for lead poisoning.
Which patient is at risk for developing oral candidiasis, a type of stomatitis?
- A. A 77-year-old woman in a long-term care facility taking an antibiotic
- B. A 35-year-old man who has had HIV for 6 years
- C. A 40-year-old man who is undergoing chemotherapy
- D. An 80-year-old woman with dentures
Correct Answer: A
Rationale: The correct answer is a 77-year-old woman in a long-term care facility taking an antibiotic. This patient has multiple risk factors for developing oral candidiasis, including older age, being in a long-term care facility, and taking antibiotics. Candidiasis can be caused by long-term antibiotic therapy, immunosuppressive therapy (such as chemotherapy), older age, living in a long-term care facility, diabetes, having dentures, and poor oral hygiene. Choices B, C, and D are less likely to be at high risk for oral candidiasis compared to the correct answer.
A nurse and client are discussing the client's progress toward understanding his behavior under stress. This is typical of which phase in the therapeutic relationship?
- A. Pre-interaction
- B. Orientation
- C. Working
- D. Termination
Correct Answer: C
Rationale: The correct answer is the working phase. During this phase, the nurse and client actively work together to explore alternative behaviors and techniques. Discussions in this phase focus on understanding the underlying meaning behind the behavior and implementing strategies for change. Pre-interaction (choice A) refers to the phase before the nurse and client first meet and establish a relationship. The orientation phase (choice B) involves introductions, setting goals, and establishing boundaries. Termination (choice D) is the phase where the therapeutic relationship concludes, and closure is achieved.
What is the most common complication of chest wall injury?
- A. Hemothorax
- B. Atelectasis
- C. Pneumonia
- D. Pneumothorax
Correct Answer: C
Rationale: Pneumonia is the most common complication of chest wall injury. Chest wall trauma can lead to impaired lung function, making patients more susceptible to pneumonia due to reduced ability to clear secretions and impaired breathing. While hemothorax and pneumothorax are potential complications of chest wall injury, pneumonia is more commonly encountered. Atelectasis, although a common pulmonary complication, is not typically the most common complication seen in chest wall injuries.