Nokea
Biopsy is not usually performed for a child with suspicion of Wilms tumor EXCEPT
- A. age of 2-3 year
- B. signs of inflammation or infection
- C. significant lymph node enlargement radiologically
- D. intratumoral calcification radiologically
Correct Answer: D
Rationale: Presence of intratumoral calcifications may warrant biopsy to rule out other diagnoses.
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The parents of a young child with heart failure tell the nurse that they are "nervous" about giving digoxin (Lanoxin). The nurse's response should be based on which statement?
- A. It is a safe, frequently used drug.
- B. It is difficult to either overmedicate or undermedicate with digoxin.
- C. Parents lack the expertise necessary to administer digoxin.
- D. Parents must learn specific, important guidelines for administration of digoxin.
Correct Answer: A
Rationale: The correct response is option A. By reassuring the parents that digoxin is a safe and frequently used drug, the nurse can help alleviate their concerns about administering the medication to their child. This approach fosters trust and confidence in the treatment plan. It is essential for the nurse to provide accurate information to help the parents feel more comfortable and confident in caring for their child.
Which of the ff finding would confirm that a female client has mastitis? Choose all that apply
- A. A crack in the nipple or the areola
- B. Multiple lumps within the breast tissue
- C. Swollen, firm, and hard breasts
- D. Enlargement of the axillary lymph nodes
Correct Answer: C
Rationale: Mastitis is an inflammatory condition of the breast tissue, often caused by an infection. Common symptoms of mastitis in a female client include swollen, firm, and hard breasts. These changes in breast tissue texture are indicative of inflammation and infection. Other possible signs of mastitis may include redness, warmth, and tenderness in the affected breast. The presence of swollen, firm, and hard breasts would confirm the diagnosis of mastitis in a female client.
When teaching a client about insulin administration, the nurse should include which instruction?
- A. "Administer insulin after the first meal of the day."
- B. "Inject insulin at a 45-degree angle into the deltoid muscle."
- C. "Shake the insulin vial vigorously before withdrawing the medication."
- D. "Draw up clear insulin first when mixing two types of insulin in one syringe."
Correct Answer: D
Rationale: When mixing two types of insulin in one syringe, it is essential to draw up the clear insulin first before drawing up the cloudy insulin. This sequence prevents the clear insulin from becoming contaminated with the cloudy insulin and ensures accurate dosing. Drawing up the clear insulin first helps to minimize the risk of inaccurate dosing and maintains the effectiveness of the insulin being administered.
Which of the ff points should a nurse include in the teaching plan for clients who have potential for hypovolemia?
- A. Avoid alcohol and caffeine
- B. Increase intake of milk and dairy products
- C. Increase intake of dried peas and beans
- D. Avoid table salt or food containing sodium
Correct Answer: A
Rationale: Clients at risk for hypovolemia, which is a condition characterized by low blood volume, should be advised to avoid alcohol and caffeine. Alcohol and caffeine are known to have diuretic effects, which can further deplete the body's fluid volume and worsen the condition. By avoiding alcohol and caffeine, clients can help maintain adequate fluid levels in the body and reduce the risk of exacerbating hypovolemia. Additionally, it is important for clients at risk for hypovolemia to stay hydrated by consuming adequate amounts of water or other hydrating fluids.
Pneumocystic pneumonia. Which anemias are described as microcytic, hypochromic anemia?
- A. Vitamin B12 and iron deficiency anemia
- B. Folic acid and iron deficiency anemia
- C. Iron deficiency anemia and thalassemia
- D. Sickle cell anemia and anemia if chronic disease
Correct Answer: C
Rationale: Microcytic, hypochromic anemia is characterized by small red blood cells with decreased hemoglobin content. Iron deficiency anemia and thalassemia are the two main types of anemia that present with these characteristics. Iron deficiency anemia is caused by a lack of iron in the body, which is essential for the production of hemoglobin. Thalassemia is a genetic disorder that results in decreased production of normal hemoglobin. Both conditions lead to small, pale red blood cells, fitting the description of microcytic, hypochromic anemia. Other choices such as Vitamin B12 deficiency anemia (choice A), folic acid deficiency anemia (choice B), sickle cell anemia (choice D), and anemia of chronic disease (choice D) typically present as normocytic or macrocytic anemias.