Nokea
Choose the condition that exhibits blood values with a low pH and a high PCO :
- A. Respiratory acidosis
- B. Metabolic acidosis
- C. Respiratory alkalosis
- D. Metaboliâ‚‚c alkalosis
Correct Answer: A
Rationale: Respiratory acidosis is a condition characterized by elevated levels of carbon dioxide (high PCOâ‚‚) and decreased blood pH (low pH) due to inadequate ventilation leading to the accumulation of carbon dioxide in the body. The excess carbon dioxide reacts with water in the blood to form carbonic acid, resulting in a decrease in pH. This is in contrast to metabolic acidosis, which is characterized by an accumulation of acids other than carbon dioxide, leading to a low blood pH. Respiratory alkalosis would present with a low PCOâ‚‚ and high pH, while metabolic alkalosis features a high pH and elevated bicarbonate levels due to non-respiratory causes.
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Which should the nurse consider when preparing a school-age child and the family for heart surgery?
- A. Unfamiliar equipment should not be shown.
- B. Let the child hear the sounds of an ECG monitor.
- C. Avoid mentioning postoperative discomfort and interventions.
- D. Explain that an endotracheal tube will not be needed if the surgery goes well.
Correct Answer: B
Rationale: When preparing a school-age child and the family for heart surgery, it is essential to provide honest and age-appropriate information to help the child feel more comfortable and reduce anxiety. Letting the child hear the sounds of an ECG monitor is beneficial as it allows them to become familiar with medical equipment and procedures, making them less intimidated by the unfamiliar sounds they may encounter during and after surgery. Familiarizing the child with the sounds can also help alleviate fears and promote understanding of what is happening during the procedure. It is important to maintain open communication, address concerns, and prepare the child and family for what to expect before, during, and after surgery.
The nurse is caring for a client in acute addisonian crisis. Which laboratory data would the nurse expect to find?
- A. Hyperkalemia
- B. Hypernatremia
- C. Reduced blood urea nitrogen (BUN)
- D. Hyperglycemia
Correct Answer: A
Rationale: In acute Addisonian crisis, the adrenal glands do not produce enough cortisol and aldosterone, leading to a decrease in blood volume and blood pressure. This can cause hyperkalemia (high potassium levels) due to the lack of aldosterone, which normally helps regulate potassium excretion from the body. Additionally, clients in Addisonian crisis may experience hyponatremia (low sodium levels) rather than hypernatremia. Reduced blood urea nitrogen (BUN) and hyperglycemia would not be typical findings in acute Addisonian crisis.
Of the following, the WORST prognostic factor in pediatric osteosarcoma is
- A. primary pelvic bone tumor
- B. poor histologic response to treatment
- C. bony metastases at the time of diagnosis
- D. lung metastases at the time of diagnosis
Correct Answer: B
Rationale: Poor histologic response to neoadjuvant chemotherapy is a strong predictor of poor prognosis.
A client diagnosed with hyperosmolar hyperglycemic nonketotic syndrome (HHNS) is stabilized and prepared for discharge. When preparing the client for discharge and home management, which of the following statements indicates that the client understands her condition and how to control it?
- A. “I can avoid getting sick by not becoming dehydrated and by paying attention to my need to urinate, drink, or eat more than usual.â€
- B. "If I experience trembling, weakness, and headache, I should drink a glass of soda that contains sugar."
- C. "I will have to monitor my blood glucose level closely and notify the physician if it's constantly elevated."
- D. "If I begin to feel especially hungry and thirsty, I'll eat a snack high in carbohydrates."
Correct Answer: A
Rationale: Option A demonstrates the client's understanding of her condition and how to control it. Hyperosmolar hyperglycemic nonketotic syndrome (HHNS) is characterized by high blood glucose levels and dehydration. To control the condition, it is crucial to prevent dehydration by staying well-hydrated and paying attention to cues such as increased thirst and urination. By being mindful of these signs and symptoms, the client can take proactive measures to maintain adequate hydration levels and prevent HHNS complications. This statement reflects a clear understanding of the importance of hydration in managing the condition. Options B, C, and D do not address the specific needs of a client with HHNS and may potentially lead to incorrect management of the condition.
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: