Nokea
Constellation of aniridia and hemihypertrophy is strongly associated with increased risk of which of the following tumors?
- A. rhabdomyosarcoma
- B. hepatoblastoma
- C. Wilms tumor
- D. medulloblastoma
Correct Answer: C
Rationale: Aniridia and hemihypertrophy are features of WAGR syndrome, which increases the risk of Wilms tumor.
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An appropriate nursing action to include in the care of an infant with congenital heart disease who has been admitted with heart failure is:
- A. Positioning flat on the back
- B. Encouraging nutritional fluids
- C. Offering small frequent feedings
- D. Measuring the head circumference
Correct Answer: C
Rationale: Infants with congenital heart disease who have been admitted with heart failure may have difficulty feeding due to increased work of breathing and poor energy reserves. Offering small, frequent feedings can help prevent fatigue and provide adequate nutrition to support the infant's growth and recovery. It also helps to prevent overloading the heart with a large volume of fluids at once. This approach allows the infant to receive enough calories while reducing the risk of aspiration and conserving energy for feeding and breathing. Positioning the infant flat on the back may worsen respiratory distress, encouraging nutritional fluids alone may not address the feeding challenges faced by the infant, and measuring the head circumference is important for growth monitoring but may not be the priority when managing heart failure in this case.
Mr. RR is admitted to the hospital with a diagnosis of brain tumor. Mr. RR's doctor is very much concerned about the possibility of increased intracranial pressure. The following is the most reliable index of cerebral state:
- A. Level of consciousness
- B. Unilateral papillary dilatation
- C. Increased systolic BP
- D. Decreased pulse pressure
Correct Answer: A
Rationale: The most reliable index of cerebral state in a patient diagnosed with a brain tumor and concerning increased intracranial pressure is the level of consciousness. Changes in consciousness, such as alterations in alertness, orientation, and responsiveness, are significant indicators of the brain's functioning and can provide valuable insights into the impact of increased intracranial pressure. Monitoring the level of consciousness helps healthcare providers assess neurological status and make critical decisions regarding the management of intracranial pressure. Unilateral papillary dilatation, increased systolic blood pressure, and decreased pulse pressure may also be important indicators but are not as reliable or direct as changes in the level of consciousness when evaluating cerebral status in this context.
Why should the nurse closely monitor older adults when they are receiving IV therapy? Choose all that apply
- A. Because their defense mechanisms are less efficient
- B. Because they are prone to fluid overload
- C. Because they are prone to reduced renal efficiency
- D. Because they have inadequate intake of dietary fiber
Correct Answer: E
Rationale: Older adults should be closely monitored when receiving IV therapy because their defense mechanisms are less efficient (A) as they age, making them more susceptible to infections and complications from invasive procedures like IV therapy. Additionally, older adults are prone to reduced renal efficiency (C), which can affect their ability to excrete excess fluids and electrolytes properly. Monitoring for signs of fluid overload and renal impairment is crucial in this population to prevent adverse outcomes related to IV therapy.
The nurse is caring for a preterm newborn who requires mechanical ventilation for the treatment of respiratory distress syndrome. What is the preterm newborn at increased risk of due to the mechanical ventilation?
- A. Alveolar rupture
- B. Meconium aspiration
- C. Transient tachypnea
- D. Retractions and nasal flaring
Correct Answer: A
Rationale: Preterm newborns who require mechanical ventilation are at increased risk of developing alveolar rupture. The pressure from mechanical ventilation can lead to overdistension of the alveoli, causing damage to their delicate structure. This can result in the rupture of the alveolar walls, leading to a condition known as pulmonary interstitial emphysema. Alveolar rupture can contribute to the development of other complications such as pneumothorax and air leaks, which can further compromise the newborn's respiratory status. Therefore, close monitoring and adjustment of ventilation parameters are crucial in the care of preterm newborns on mechanical ventilation to minimize the risk of alveolar rupture and its associated complications.
Why must a nurse measure the intake and output and recommend a daily fluid intake of approximately 3000 to 4000 mL for a client with pyelonephritis?
- A. To determine the clients response to the therapy
- B. To flush out the infectious microorganisms from the urinary tract
- C. To determine the location of discomfort
- D. To detect any evidence of changes#
Correct Answer: B
Rationale: A nurse measures the intake and output and recommends a daily fluid intake of approximately 3000 to 4000 mL for a client with pyelonephritis primarily to help flush out the infectious microorganisms from the urinary tract. Pyelonephritis is a bacterial infection of the kidneys and urinary tract, and increasing fluid intake can help dilute the urine and increase urine output, which may help wash out and eliminate the infectious microorganisms causing the infection. Adequate hydration also helps the kidneys function optimally in eliminating waste and toxins from the body. Therefore, maintaining a high fluid intake is crucial in the management of pyelonephritis to support the body's natural defense mechanisms and aid in recovery.