Nokea
During the routine exam of an infant the parents state a 5th degree family history of adenomatous polyposis. The statement that should be included during the discussion is the infant is at increased risk of colonic adenocarcinoma
- A. the infant is at increased risk of acute lymphocytic leukemia
- B. the infant is at increased risk of intestinal Burkitt lymphoma
- C. the infant is at increased risk of hepatoblastoma
- D. the infant is at increased risk of germ cell tumor
Correct Answer: C
Rationale: Familial adenomatous polyposis significantly increases the risk of developing colorectal cancer.
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When the LPN is assisting the patient to use an incentive spirometer, which of the following actions by the patient indicates that the patient needs further teaching on how to use the spirometer?
- A. Taking two normal breaths before use.
- B. Sitting upright before use.
- C. Inhaling deeply to reach target.
- D. Exhaling deeply to reach target.
Correct Answer: D
Rationale: When using an incentive spirometer, the patient should inhale deeply to reach the target volume indicated by the marker. Exhaling deeply does not achieve the objective of the incentive spirometer, which is to encourage deep inhalation. If the patient exhales deeply to reach the target, further teaching and clarification about the proper technique of using the spirometer are needed. The correct technique involves inhaling deeply to expand the lungs and help improve lung function.
A 5-year old boy presents with afebrile generalized tonic-clonic seizure lasting for 5 minutes. Previously he was healthy and had no such problem. On examination there is no abnormality. Your plan of management should be:
- A. Start anticonvulsant therapy
- B. Request for an EEG and wait for its report
- C. Request for an EEG and start anticonvulsant therapy immediately
- D. Request for EEG and MRI brain
Correct Answer: C
Rationale: In a first-time generalized seizure, an immediate EEG and starting anticonvulsant therapy is prudent to prevent recurrence, especially if the EEG shows epileptiform activity.
The nurse is caring for a newborn with respiratory distress syndrome. The newborn has an endotracheal tube. Which statement describes nursing considerations related to suctioning?
- A. Suctioning should not be carried out routinely.
- B. Newborn should be in Trendelenburg position for suctioning.
- C. Routine suctioning, usually every 15 minutes, is necessary.
- D. Frequent suctioning is necessary to maintain patency of bronchi.
Correct Answer: A
Rationale: Suctioning should not be carried out routinely in a newborn with respiratory distress syndrome and an endotracheal tube. Routine, frequent suctioning can lead to airway trauma, damage to mucous membranes, and increased risk of infection. Suctioning should only be performed when there are clinical indications such as visible secretions or signs of respiratory distress. Each suctioning event should be carefully assessed and performed with gentle technique to minimize potential harm to the newborn's delicate airway.
The nurse is discussing development and play activities with the parent of a 2-month-old. Recommendations should include giving a first rattle at about which age?
- A. 2 months
- B. 4 months
- C. 7 months
- D. 9 months
Correct Answer: A
Rationale: At 2 months old, infants start to demonstrate more control over their arm movements and are becoming more aware of objects around them. They may also start to grasp objects intentionally. Giving a first rattle at this age can help stimulate their senses, promote sensory exploration, and encourage their fine motor skills development. This early exposure to different textures, shapes, and sounds can also aid in their cognitive and sensory development, making it an appropriate choice for a parent looking to support their baby's early growth and learning.
Nurse Kara is giving instructions to an elderly client on diabetic foot care. Which teaching is not part of foot care?
- A. wear comfortable shoes that fit well and protect your feet
- B. trim your toenails straight across and file edges with emery board
- C. wash your feet in hot water to keep feet soft
- D. wear shoes at the beach or on hot pavement
Correct Answer: C
Rationale: Washing your feet in hot water is not recommended as it can actually worsen diabetic foot conditions. Hot water can lead to burns and damage the skin, especially for individuals with reduced sensation in their feet due to diabetes. It is advised to wash feet in warm water instead, avoiding hot temperatures to prevent injuries and complications. The other options provide important aspects of diabetic foot care such as wearing appropriate shoes, trimming toenails carefully, and being mindful of footwear choices to protect the feet.