Nokea
Family discharge teaching has been effective when the parent of a toddler diagnosed with Kawasaki disease (KD) states:
- A. The arthritis in her knees is permanent. She will need knee replacements.
- B. I will give her diphenhydramine (Benadryl) for her peeling palms and soles of her feet.
- C. I know she will be irritable for 2 months after her symptoms start.
- D. I will continue with high doses of Tylenol for her inflammation.
Correct Answer: C
Rationale: This statement indicates the parent understands that irritability may persist for about 2 months after symptom onset in KD.
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The nurse explained how to position an infant with tetralogy of Fallot if the infant suddenly becomes cyanotic. Which statement by the father leads the nurse to determine he understood the instructions?
- A. If the baby turns blue, I will hold him against my shoulder with his knees bent up toward his chest.
- B. If the baby turns blue, I will lay him down on a firm surface with his head lower than the rest of his body.
- C. If the baby turns blue, I will immediately put the baby upright in an infant seat.
- D. If the baby turns blue, I will put the baby in supine position with his head elevated.
Correct Answer: A
Rationale: In the event of a paroxysmal hypercyanotic or tet spell, the infant should be placed in a knee-chest position.
The MOST common cyanotic congenital cardiac lesion to present in the newborn period is
- A. dextroposed heart
- B. transposition of great arteries
- C. tetralogy of Fallot
- D. truncus arteriosus
Correct Answer: B
Rationale: Transposition of the great arteries is the most common cyanotic congenital heart defect presenting in the neonatal period.
Routine hearing tests in the community are usually based on:
- A. Distraction testing
- B. Auditory brainstem responses
- C. Evoked potentials
- D. Object discrimination
Correct Answer: A
Rationale: Distraction testing is a common method used in community settings to assess hearing in young children.
All of the following are true regarding intussusception in children, except
- A. It is more common in boys than girls
- B. Adeno virus C has been implicated
- C. Urgent barium meal follow-through is the investigation of choice
- D. Postoperative intussusception is commonly ileoileal
Correct Answer: C
Rationale: Urgent barium meal follow-through is not the investigation of choice for intussusception; ultrasound is preferred for diagnosis.
An older adult man recently diagnosed with chronic obstructive pulmonary disease (COPD) is admitted with shortness of breath. The nurse observes the client sitting upright and leaning over the bedside table, using accessory muscles to assist in breathing. What action should the nurse take?
- A. Assist the client to a high Fowler's position in bed
- B. Observe the client for the presence of a barrel chest
- C. Prepare to transfer the client to a critical care unit
- D. Instruct the client in pursed lip breathing techniques
Correct Answer: D
Rationale: Pursed lip breathing helps reduce dyspnea and improves oxygenation in clients with COPD.