Nokea
For most children with enuresis, the only test recommended is
- A. blood sugar
- B. serum electrolytes
- C. urinalysis
- D. abdominal sonography
Correct Answer: C
Rationale: Urinalysis is the standard initial test for evaluating enuresis to rule out urinary tract infections or other conditions.
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Samantha, age 5 years, tells the nurse that she "needs a Band-Aid" where she had an injection. Which is the best nursing action?
- A. Apply a Band-Aid.
- B. Ask her why she wants a Band-Aid.
- C. Explain why a Band-Aid is not needed.
- D. Show her that the bleeding has already stopped.
Correct Answer: C
Rationale: The best nursing action in this scenario is to explain why a Band-Aid is not needed. At 5 years old, Samantha is at an age where she can begin to understand explanations. By providing her with a simple and clear explanation, the nurse can help Samantha understand that a Band-Aid is not necessary in this situation. This also promotes education and helps Samantha learn about wound healing and appropriate care. It is important to involve the child in the decision-making process and provide education to foster their understanding of their own health.
A woman delivers a 3,250 g neonate at 42 weeks' gestation. Which physical finding is expected during an examination if this neonate?
- A. Abundant lanugo
- B. Absence of sole creases
- C. Breast bud of 1-2 mm in diameter
- D. Leathery, cracked, and wrinkled skin
Correct Answer: D
Rationale: A neonate born at 42 weeks' gestation, also known as post-term, is expected to have skin that appears leathery, cracked, and wrinkled due to prolonged exposure to the amniotic fluid in utero. This is a common physical finding in post-term neonates due to the decreased amount of vernix caseosa and amniotic fluid present on the skin at birth. Abundant lanugo (fine hair), absence of sole creases, and breast bud development are more commonly seen in preterm or term newborns, rather than post-term newborns.
Acyclovir (Zovirax) is given to children with chickenpox to:
- A. minimize scarring.
- B. decrease the number of lesions.
- C. prevent aplastic anemia.
- D. prevent spread of the disease.
Correct Answer: B
Rationale: Acyclovir (Zovirax) is an antiviral medication commonly used to treat infections caused by the herpes virus, including chickenpox. When given to children with chickenpox, acyclovir helps decrease the number of lesions present on the skin by slowing down the replication of the virus. This not only helps alleviate the discomfort associated with the rash but also reduces the risk of potential complications and accelerates the healing process. While acyclovir does not completely eliminate the virus from the body, it can help control the symptoms and prevent severe manifestations.
In JRA, the autoimmune reaction primarily occurs in the:
- A. joint tendons.
- B. cartilage.
- C. synovial tissue.
- D. interstitial space.
Correct Answer: C
Rationale: In Juvenile Rheumatoid Arthritis (JRA), which is now referred to as Juvenile Idiopathic Arthritis (JIA), the autoimmune reaction primarily occurs in the synovial tissue of the joints. The synovial tissue lines the inside of the joint capsule and produces synovial fluid, which helps to lubricate and nourish the joint. In JIA, the immune system mistakenly targets the synovial tissue, leading to inflammation, pain, and damage to the joints. This inflammatory process can result in swelling, warmth, stiffness, and eventual joint destruction if left untreated. Therefore, the synovial tissue is the primary site of the autoimmune reaction in JRA/JIA.
A client is receiving a blood transfusion. If this client experiences an acute hemolytic reaction, which nursing intervention is the most important?
- A. Immediately stop the transfusion, infuse dextrose 5% in water (D5W), and call the physician.
- B. Slow the transfusion and monitor the client closely.
- C. Stop the transfusion, notify the blood bank, and administer antihistamines
- D. Immediately stop the transfusion, infuse normal saline solution, notify the blood bank
Correct Answer: D
Rationale: In the case of an acute hemolytic reaction during a blood transfusion, the most important nursing intervention is to immediately stop the transfusion and infuse normal saline solution. This is crucial to prevent further complications associated with the hemolysis of red blood cells. Normal saline helps maintain blood pressure and support kidney function, which may be compromised during a hemolytic reaction. Additionally, notifying the blood bank is important to investigate and prevent future reactions, and to determine if there was an error in blood compatibility. Administering antihistamines or changing the fluid type (such as dextrose 5% in water) will not address the underlying issue of hemolysis and may not be the most appropriate interventions in this scenario.