Nokea
Bryce is a child diagnosed with coarctation of aorta. While assessing him, Nurse Zach would expect to find which of the following?
- A. Squatting posture
- B. Absent or diminished femoral pulses
- C. Severe cyanosis at birth
- D. Cyanotic ("tet") episodes 46
Correct Answer: B
Rationale: Coarctation of the aorta is a congenital heart defect where there is a narrowing of the aorta, usually near the insertion of the ductus arteriosus. This narrowing can lead to decreased blood flow to the lower body. A common finding in a child with coarctation of the aorta is absent or diminished femoral pulses due to the obstruction of blood flow through the narrowed aorta. Other symptoms may include high blood pressure in the arms, weak lower body pulses, and heart murmur. Squatting posture, severe cyanosis at birth, and cyanotic ("tet") episodes are not typically associated with coarctation of the aorta.
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Justine is admitted to the pediatric unit due to the occurrence of diabetic ketoacidosis signaling a new diagnosis of diabetes. The diabetes team explores the cause of the episode and take steps to prevent a recurrence. Diabetic ketoacidosis (DKA) results from an excessive accumulation of which of the following?
- A. Sodium bicarbonate from renal compensation
- B. Potassium from cell death
- C. Glucose from carbohydrate metabolism
- D. Ketone bodies from fat metabolism
Correct Answer: D
Rationale: Diabetic ketoacidosis (DKA) is a serious complication of diabetes that occurs when there is not enough insulin in the body. In the absence of sufficient insulin, the body is unable to use glucose for energy, leading to the breakdown of fats for fuel. This results in the excessive production of ketone bodies, specifically acetoacetate and beta-hydroxybutyrate. As the ketone bodies accumulate in the blood, they lower the blood pH, leading to acidosis. This is what causes the characteristic symptoms of DKA, such as fruity breath, deep rapid breathing, and abdominal pain. Therefore, the excessive accumulation of ketone bodies from fat metabolism is the primary cause of diabetic ketoacidosis.
The nurse is caring for a 5-year-old child with impetigo contagiosa. The parents ask the nurse what will happen to their child's skin after the infection has subsided and healed. Which answer should the nurse give?
- A. There will be no scarring.
- B. There may be some pigmented spots.
- C. It is likely there will be some slightly depressed scars.
- D. There will be some atrophic white scars.
Correct Answer: A
Rationale: Impetigo contagiosa typically does not leave scarring once it has subsided and healed. This skin infection primarily affects the superficial layers of the skin and does not cause damage deep enough to result in scarring. While there may be some temporary pigmented spots or mild changes in skin color after the infection resolves, scarring is not a common outcome of impetigo contagiosa in most cases. Thus, the nurse should reassure the parents that their child's skin is not likely to have any scarring after the infection has healed.
The MOST appropriate age of a child who helps to undress; puts 3 words together (subject, verb, object); and handles spoon well is
- A. 15 months
- B. 18 months
- C. 24 months
- D. 30 months
Correct Answer: C
Rationale: These milestones are typically achieved around 24 months.
The nurse would monitor the client for which of the following?
- A. Trousseau's sign
- B. Hypoglycemia
- C. Hypokalamia
- D. Respiratory changes
Correct Answer: A
Rationale: Trousseau's sign is a clinical sign characterized by carpal spasm induced by inflating a blood pressure cuff above the systolic pressure for a few minutes. It is indicative of hypocalcemia, specifically low calcium levels in the blood. Therefore, the nurse would monitor the client for Trousseau's sign to assess for potential hypocalcemia. This could prompt the healthcare provider to order further diagnostic tests or interventions to address the underlying calcium imbalance. Options B, C, and D do not directly relate to monitoring for Trousseau's sign.
One of the clinical manifestations of chronic renal failure is uremic frost. Which best describes this term?
- A. Deposits of urea crystals in urine
- B. Deposits of urea crystals on skin
- C. Overexcretion of blood urea nitrogen
- D. Inability of body to tolerate cold temperatures
Correct Answer: B
Rationale: Uremic frost is a term used to describe the presence of urea crystals on the skin of individuals with chronic renal failure. As kidney function declines in chronic renal failure, the body is unable to effectively excrete waste products such as urea. Urea can then be deposited on the skin when sweating, leading to the formation of white or frost-like crystals, giving the appearance of "uremic frost." This condition is a visible indicator of severe kidney dysfunction and the buildup of waste products in the body.