Nokea
During examination of a toddler's extremities, the nurse notes that the child is bowlegged. What should the nurse recognize regarding this finding?
- A. Abnormal and requires further investigation
- B. Abnormal unless it occurs in conjunction with knock-knee
- C. Normal if the condition is unilateral or asymmetric
- D. Normal because the lower back and leg muscles are not yet well developed
Correct Answer: A
Rationale: Bowlegged appearance in a toddler is not considered normal and should prompt further investigation by a healthcare provider. Bowlegs, also known as genu varum, can be caused by various underlying conditions such as vitamin D deficiency, rickets, or genetic factors. It is important to determine the cause of bowleggedness in order to provide appropriate treatment or interventions to promote proper development of the child's legs. Bowleggedness on its own is not considered a normal variation in toddler development and warrants further assessment.
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An inborn error of metabolism that causes a premature destruction of RBC?
- A. G6PD
- B. Homocystinuria
- C. Phenylketonuria
- D. Celiac Disease
Correct Answer: A
Rationale: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an inborn error of metabolism that leads to the premature destruction of red blood cells (hemolysis). G6PD is an enzyme responsible for protecting red blood cells from oxidative damage. In individuals with G6PD deficiency, the red blood cells are more susceptible to oxidative stress, leading to their destruction and resulting in hemolytic anemia. This condition is commonly triggered by certain medications, infections, or dietary factors that cause oxidative stress, leading to hemolysis. Homocystinuria, Phenylketonuria, and Celiac Disease are metabolic disorders that do not typically result in the premature destruction of red blood cells.
Which laboratory test value is elevated in clients who smoke and can't be used as a general indicator of cancer?
- A. Acid phosphatase level
- B. Alkaline phosphatase level
- C. Serum calcitonin level
- D. Carcinoembryonic antigen level
Correct Answer: B
Rationale: Alkaline phosphatase level is elevated in clients who smoke due to various reasons unrelated to cancer. Smoking leads to increased alkaline phosphatase production in the liver, and elevated levels can be attributed to liver damage caused by smoking. However, a high alkaline phosphatase level alone cannot be used as a general indicator of cancer because it is not specific to cancer and can be influenced by several other factors. Therefore, it is not a reliable marker for the presence of cancer in individuals who smoke or in the general population.
Which of the ff must the nurse consider when administering IV fluids to clients with hypertension?
- A. The nurse checks the clients BP every hour
- B. The nurse checks the site and progress of the infusion every hour
- C. The nurse checks the progress of the infusion once a day
- D. The nurse checks the client's pulse rate every hour
Correct Answer: B
Rationale: When administering IV fluids to clients with hypertension, the nurse must closely monitor the site and progress of the infusion every hour to ensure proper hydration and detect any signs of complications such as infiltration or infection. Checking the blood pressure every hour, as in choice A, may not be necessary unless specifically indicated by the healthcare provider. Checking the progress of the infusion once a day, as in choice C, does not provide adequate monitoring for a client with hypertension who may be at higher risk for fluid volume overload. Checking the client's pulse rate every hour, as in choice D, is important but does not directly address the immediate monitoring needs related to the administration of IV fluids.
A patient is having difficulty swallowing following a stroke, and a swallowing evaluation is ordered. The ff. nursing interventions might be recommended to help prevent aspiration during eating except:
- A. Provide clear liquids only until the patient can swallow solid foods.
- B. Have the patient swallow twice after each bite
- C. Place food on the unaffected side of the patient's mouth
- D. Check if the patient's mouth for pocketing of food
Correct Answer: A
Rationale: Providing clear liquids only until the patient can swallow solid foods is not recommended as it restricts the patient's diet unnecessarily. In the case of difficulty swallowing after a stroke, it is important to modify the food consistency and provide appropriate techniques to support safe swallowing. Limiting the patient to clear liquids only could lead to inadequate nutrition and hydration. Instead, it is important to modify the diet consistency and use strategies such as altering the food presentation, having the patient swallow twice after each bite, placing food on the unaffected side of the mouth, and checking for pocketing of food to help prevent aspiration.
A client is hospitalized with oat cell carcinoma of the lung. To manage severe pain, the physician prescribes a continuous I.V. infusion of morphine. Which formula should the nurse use to check that the morphine dose is appropriate for the client?
- A. 1 mg/kg of body weight
- B. 5 mg/70kg of body weight
- C. 5 mg/kg of body weight
- D. 10mg/70kg of body weight
Correct Answer: C
Rationale: When calculating the appropriate dose of morphine for a client, the nurse should consider the client's body weight. The most commonly used formula for calculating the appropriate dose of morphine is 0.1 to 0.2 mg/kg of body weight for hourly dosing or 2.5 to 10 mg/kg/day for continuous infusions.