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Cow's milk allergy (CMA) is diagnosed in a 6-month-old infant. Which should the nurse recommend as a substitute formula?
- A. Nutramigen
- B. Goat's milk
- C. Similac
- D. Enfamil
Correct Answer: A
Rationale: Nutramigen is a hypoallergenic formula specifically designed for infants with cow's milk allergy (CMA). It is extensively hydrolyzed, which means the cow's milk proteins are broken down into smaller pieces, making it easier for babies with CMA to digest without triggering an allergic reaction. Other options such as goat's milk, Similac, and Enfamil are not suitable substitutes for an infant with CMA as they may still contain proteins that can cause an allergic response in these infants. Therefore, Nutramigen is the most appropriate recommendation for a 6-month-old infant diagnosed with cow's milk allergy.
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Which of the ff. actions would the nurse include in the plan of care to reduce the symptoms of the patient who has vertigo?
- A. Avoid noises
- B. Encourage fluid intake
- C. Avoid sudden movements
- D. Administer analgesics
Correct Answer: C
Rationale: Vertigo is a sensation of spinning or dizziness that can be caused by issues in the inner ear. One of the key strategies in managing vertigo is to avoid sudden movements that can trigger or worsen the symptoms. Sudden movements can disrupt the balance mechanisms in the inner ear and further exacerbate the feeling of dizziness and spinning. By advising the patient to avoid sudden movements, the nurse can help reduce the intensity and frequency of vertigo episodes, promoting greater comfort and quality of life for the patient.
Charles is started on chemotherapy, which is aimed at restoring dopaminergic activities. An example of such a drug is:
- A. Artane
- B. Elavil
- C. Benadryl
- D. Dopar
Correct Answer: D
Rationale: Dopar is a drug that contains L-DOPA (levodopa), which is a precursor to dopamine. L-DOPA is used in the treatment of Parkinson's disease to restore dopaminergic activity in the brain. By converting into dopamine in the brain, L-DOPA helps to alleviate the symptoms of Parkinson's disease, such as muscle rigidity, tremors, and slowed movement. Therefore, Dopar is an example of a drug aimed at restoring dopaminergic activities, making it the correct choice in this scenario.
When caring for a 3 year old with tetralogy of Fallot, he nurse expects to see fatigue and poor activity tolerance. This is caused by:
- A. Poor muscle tone
- B. Inadequate oxygenation of tissues.
- C. Restricted blood flow leaving the heart
- D. Inadequate intake of food.
Correct Answer: B
Rationale: Tetralogy of Fallot is a heart defect that involves four specific abnormalities in the heart's structure. One of these abnormalities is a ventricular septal defect, which results in a mixing of oxygenated and deoxygenated blood. This leads to inadequate oxygenation of tissues because some of the blood that is pumped out to the body is not fully oxygenated. As a result, the child may experience fatigue and poor activity tolerance due to the reduced oxygen supply to the tissues and organs. This is why the nurse would expect to see these symptoms in a 3-year-old with tetralogy of Fallot.
An 11-month-old girl infant is found to have low weight and height consistent with FTT. She was exclusively breast feeding till the age of 4 month, and then artificial milk-formula was added. She has had a normal growth pattern till the age of 6 month when the mother introduced juices and cereals. Examination is unremarkable apart from significant decline of normal growth pattern. Of the following, the MOST likely cause is
- A. failed breast feeding
- B. improper formula preparation
- C. congenital syndromes
- D. congenital infections
Correct Answer: B
Rationale: Improper formula preparation can lead to inadequate nutrition, causing FTT. This scenario suggests a dietary issue rather than congenital or infectious causes.
A client with diabetes mellitus must learn how to self-administer insulin. The physician has prescribed 10 U of U- 100 regular insulin and 35 U of 100-U isophane insulin suspension (NPH) to be taken before breakfast. When teaching the client how to select and rotate insulin injection sites, the nurse should provide which instruction?
- A. "Inject insulin into healthy tissue with large blood vessels and nerves."
- B. "Rotate injection sites within the same anatomic region, not among different regions."
- C. "Administer insulin into areas of scar tissue or hypotrophy whenever possible."
- D. "Administer insulin into sites above muscles that you plan to exercise heavily later that day."
Correct Answer: B
Rationale: The nurse should instruct the client to rotate injection sites within the same anatomic region, not among different regions. Proper rotation of injection sites helps prevent lipodystrophy (changes in fat tissue) and ensures consistent absorption of insulin. By rotating sites within the same region, the client can minimize the risk of developing localized skin complications. Additionally, rotating sites helps to ensure that the insulin is absorbed consistently, leading to more predictable blood glucose control. It is important to avoid injecting into areas of scar tissue, hypotrophy, large blood vessels, or nerves, as these can affect the absorption of insulin and may lead to inconsistent blood glucose levels.