Nokea
Following treatment for Addison's disease in a seven-year-old patient, the nurse plans for the client's discharge. The mother asks how long her daughter must continue receiving replacement therapy. The nurse's response should be
- A. For approximately six months.
- B. For approximately one year.
- C. Until she reaches puberty.
- D. For the rest of her life.
Correct Answer: D
Rationale: disease is caused by deficiency in glucocorticoids, will always need corticosteroids and mineralocorticoids
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An elderly client receiving IV fluids of 0.9% NaCl at 125 cc/h into her left arm. During a routine assessment, the nurse finds that the client has distended neck veins, shortness of breath, and crackles in both lung bases.
The nurse should
- A. decrease the IV rate to 20 cc/h and notify the physician.
- B. decrease the IV rate to 100 cc/h and continue to monitor the client.
- C. discontinue the IV and start oxygen at 6 L/min.
- D. assess for infiltration of the IV solution.
Correct Answer: A
Rationale: Strategy: Answers are a mix of assessments and implementations. Is the assessment appropriate? No. Determine the outcome of each implementation. (1) correct-KVO (20 cc/h) will keep access open (2) need to notify physician, rate still too much since patient is in fluid overload (3) IV line may be necessary, diuretics may be ordered (4) description indicates circulatory overload, not infiltration
The nurse is caring for clients in the pediatric clinic.
- A. Which finding in a six-month-old infant requires follow-up?
- B. The anterior fontanel is open.
- C. The child is not sitting unsupported.
- D. The child is not pulling to a standing position.
- E. The child is not rolling from abdomen to back.
Correct Answer: C
Rationale: By six months, infants typically pull to a standing position with support. Failure to do so may indicate developmental delay, requiring follow-up. An open anterior fontanel is normal until 18 months, sitting unsupported begins around 7-8 months, and rolling over is expected by 5-6 months.
A 12-year-old boy injured his right knee yesterday during a soccer game.
- A. Which medication is best for a 12-year-old boy with a painful, swollen knee and hemophilia A?
- B. Oxycodone terephthalate (Percodan).
- C. Ibuprofen (Motrin).
- D. Enteric-coated aspirin.
- E. Codeine phosphate (Paveral).
Correct Answer: D
Rationale: Codeine is an appropriate analgesic for moderate to severe pain in hemophilia A, as it does not increase bleeding risk. Oxycodone (contains aspirin), ibuprofen, and aspirin prolong bleeding time and are contraindicated in bleeding disorders.
The nurse is caring for a client with a history of congestive heart failure.
- A. Which instruction is most important for a client with congestive heart failure?
- B. Weigh yourself daily at the same time.
- C. Take extra diuretics if you feel short of breath.
- D. Eat a high-sodium diet to maintain electrolytes.
- E. Avoid exercise to prevent cardiac strain.
Correct Answer: A
Rationale: Daily weight monitoring detects fluid retention early, a key indicator of worsening heart failure. Extra diuretics require medical orders, high-sodium diets worsen fluid retention, and exercise is encouraged within limits.
During the removal of a radium implant, it is MOST important for the nurse to take which of the following actions?
- A. Clean the radium implant carefully with a disinfectant (alcohol or bleach) using long forceps.
- B. Handle the radium carefully using forceps and rubber latex gloves.
- C. Chart the date and time of removal along with the total time of implant treatment.
- D. Double-bag the radium implant before the person from radiology removes it from the room.
Correct Answer: C
Rationale: important that accurate documentation be maintained on the internal radium implant