Nokea
Children with anterior mediastinal masses are at serious risk for airway compromise and vascular obstruction. Which of the following is NOT an indication for CT scan in these cases?
- A. Cardiac tamponade
- B. Airway compromise
- C. Carina compression
- D. Temporo-mandibular subluxation
Correct Answer: D
Rationale: Temporo-mandibular subluxation is unrelated to the assessment of mediastinal masses.
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A 5 years old boy presents with joint swelling after minor trauma, mother gives history of prolonged bleeding from circumcision site. His platelets count is 170000, PT is 10 seconds and APTT is 60 seconds. What is most likely the diagnosis?
- A. Idiopathic thrombocytopenic purpura
- B. Platelets function defect
- C. Von Willebrand disease
- D. Hemophilia
Correct Answer: D
Rationale: Hemophilia is characterized by prolonged APTT with normal platelet count and PT, indicating a coagulation factor deficiency.
Clay is an 8-year-old boy diagnosed with heart failure. Which of the following shows that he is strictly following the directed therapeutic regimen?
- A. Daily use of an antibiotic
- B. Pulse rate less than 50 beats/minute
- C. Normal weight for age
- D. Elevation in red blood cell (RBC) count
Correct Answer: C
Rationale: In a young child like Clay who is diagnosed with heart failure, following the directed therapeutic regimen would involve maintaining a normal weight for his age. Weight monitoring is crucial in managing heart failure as excessive weight gain could lead to worsening of symptoms and complications. Ensuring that Clay stays within a normal weight range for his age shows his adherence to dietary recommendations, fluid restrictions, and overall treatment plan aimed at managing his heart failure effectively. Monitoring his weight would also help healthcare providers assess if the treatment plan is working and make necessary adjustments as needed. Therefore, Clay maintaining a normal weight for his age indicates that he is strictly following the directed therapeutic regimen for his heart failure.
Which of the following BP changes alerts the nurse to increasing ICP, and should be reported immediately?
- A. Gradual increase
- B. Widening pulse pressure
- C. Rapid drop followed by gradual increase
- D. Rapid fluctuations
Correct Answer: B
Rationale: Widening pulse pressure is indicative of increasing intracranial pressure (ICP) and must be reported immediately. Pulse pressure is calculated by subtracting the diastolic blood pressure from the systolic blood pressure. An increasing pulse pressure can suggest a rise in ICP due to factors like cerebral edema or hemorrhage. This change indicates increased pressure exerted on blood vessels within the brain, potentially leading to serious consequences like brain herniation. Thus, recognizing and promptly reporting a widening pulse pressure is crucial to prevent further complications and enable appropriate interventions for the patient.
The physician writes a "now" order for codeine 45 mg IM for a patient with thrombophlebitis. The nurse has on hand 60 mg/2 mL. Which of the ff. doses should be given?
- A. 1.45 mL c.1.75 mL
- B. 1.50 mL
- C. 2.15 mL
Correct Answer: B
Rationale: To determine how many milliliters of the medication should be given, it is important to first calculate the total amount of codeine required based on the physician's order. The physician ordered codeine 45 mg IM, and the available concentration is 60 mg/2 mL. To find out the appropriate dose to administer, you can set up a proportion:
A 5 years old boy presents with joint swelling after minor trauma, mother gives history of prolonged bleeding from circumcision site. His platelets count is 170000, PT is 10 seconds and APTT is 60 seconds. What is most likely the diagnosis?
- A. Idiopathic thrombocytopenic purpura
- B. Platelets function defect
- C. Von Willebrand disease
- D. Hemophilia
Correct Answer: D
Rationale: Hemophilia is characterized by prolonged APTT with normal platelet count and PT, indicating a coagulation factor deficiency.