Nokea
Hindbrain herniation or the Chiari type II malformation is seen in which percent of individuals with myelomeningocele
- A. 10-20%
- B. 20-30%
- C. 40-50%
- D. 80-90%
Correct Answer: D
Rationale: Chiari type II malformation is strongly associated with myelomeningocele, occurring in approximately 80-90% of cases due to abnormal cerebellar development and cranial settling.
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An agitated, confused client arrives in the emergency department. The client's history includes type 1 diabetes mellitus, hypertension, and angina pectoris. Assessment reveals pallor, diaphoresis, headache, and intense hunger. A stat blood glucose sample measures 42mg/dl, and the client is treated for an acute hypoglycemic reaction. After recovery, the nurse teaches the client to treat hypoglycemia by ingesting:
- A. 2 to 5 of a simple carbohydrate.
- B. 18 to 20 g of a simple carbohydrat
- C. 10 to 15 g of a simple carbohydrate.
- D. 25 to 30 g of a simple carbohydrate.
Correct Answer: C
Rationale: When treating hypoglycemia, it is important to provide a quick source of sugar to raise blood glucose levels rapidly. Consuming 10 to 15 grams of a simple carbohydrate is appropriate for treating mild to moderate hypoglycemia. Examples of foods that contain approximately 10 to 15 grams of simple carbohydrates include four glucose tabs, 4 ounces of fruit juice, 5 to 6 pieces of hard candy, or 1 tablespoon of honey. It is also recommended to recheck blood glucose levels after 15 minutes and have a snack or meal to prevent glucose levels from dropping again.
Although the etiology of hepatoblastoma is unknown, there are many associated risk factors for development of hepatoblastoma EXCEPT
- A. Beckwith-Wiedemann syndrome
- B. familial adenomatous polyposis syndrome
- C. prematurity
- D. low birth weight
Correct Answer: E
Rationale: Hepatitis C infection is not a recognized risk factor for hepatoblastoma.
The nurse is taking care of a 7-year-old child with a skin rash called a papule. Which clinical finding should the nurse expect to assess with this type of skin rash?
- A. A lesion that is elevated, palpable, firm, and circumscribed; less than 1 cm in diameter
- B. A lesion that is elevated, flat-topped, firm, rough, and superficial; greater than 1 cm in diameter
- C. An elevated lesion, firm, circumscribed, palpable; 1 to 2 cm in diameter
- D. An elevated lesion, circumscribed, filled with serous fluid; less than 1 cm in diameter
Correct Answer: A
Rationale: A papule is a small, solid, elevated skin lesion that is less than 1 cm in diameter. It is usually palpable, firm, circumscribed, and can be various colors. Papules do not contain any fluid or pus. In this case, the nurse should expect to assess an elevated lesion that is firm and circumscribed, measuring less than 1 cm in diameter. This description matches option A, making it the correct choice for a papule.
Early this morning a client had a subtotal thyroidectomy. During evening rounds, the nurse assesses the client, who has now nausea, a temperature of 105F (40.5C), tachycardia, and extreme restlessness. What is the most likely cause of these signs?
- A. Diabetic ketoacidosis
- B. Hypoglycemia
- C. Thyroid crisis
- D. Tetany
Correct Answer: C
Rationale: The signs and symptoms described - nausea, elevated temperature, tachycardia, and extreme restlessness - are indicative of a thyroid crisis, also known as thyroid storm. A thyroid storm is a life-threatening condition that can occur after thyroid surgery such as a subtotal thyroidectomy. It is characterized by an exaggerated state of hyperthyroidism, leading to a surge of thyroid hormones in the bloodstream. This can result in severe symptoms such as high fever, tachycardia, nausea, agitation, and even confusion or delirium.
A 5-year-old girl Hannah is recently diagnosed with Kawasaki disease. Apart from the identified symptoms of the disease, she may also likely develop which of the following?
- A. Sepsis
- B. Meningitis
- C. Mitral valve disease
- D. Aneurysm formation 45
Correct Answer: D
Rationale: Kawasaki disease is an inflammatory condition that primarily affects medium-sized blood vessels, including the coronary arteries. If not promptly and effectively treated, about 25% of untreated cases can lead to the development of coronary artery aneurysms. These aneurysms can increase the risk of serious complications such as myocardial infarction and sudden death. Therefore, it is crucial to closely monitor and manage the cardiovascular complications in patients with Kawasaki disease, particularly the risk of aneurysm formation.