Nokea
How many drops per minute should be delivered?
- A. 6
- B. 17
- C. 50
- D. 100
Correct Answer: B
Rationale: The standard drip factor for an IV infusion set is typically 15 drops per milliliter. To calculate drops per minute, you would multiply the flow rate in milliliters per hour by the drip factor and divide by 60 minutes per hour.
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The knows that a positive diagnosis for HIV infection is made based on; a.A history of high-risk sexual behaviors
- A. Positive ELISA and Western blot tests
- B. Evidence of extreme weight loss and high fever
- C. Identification of an associated opportunistic infection
Correct Answer: A
Rationale: The definitive diagnosis of HIV infection is made based on the detection of specific antibodies in the blood. The most commonly used tests for this purpose are ELISA (Enzyme-Linked Immunosorbent Assay) and Western blot. A positive result on both tests confirms the presence of HIV antibodies in the blood, indicating an active HIV infection. High-risk sexual behaviors, extreme weight loss, and opportunistic infections may raise suspicion for HIV infection, but a positive diagnosis is confirmed through specific laboratory tests like ELISA and Western blot.
With pulmonary edema, there is usually an alteration in:
- A. Afterload
- B. Preload
- C. Contractility
- D. All of the above
Correct Answer: D
Rationale: Pulmonary edema is characterized by the accumulation of excess fluid in the lungs, which can lead to impaired gas exchange and respiratory distress. In the presence of pulmonary edema, there is usually an alteration in all three factors mentioned: afterload, preload, and contractility.
Nurse Angelo is attending for a child with Cushing's syndrome; which of the following nursing interventions would be most necessary?
- A. Observing the child for signs and symptoms of metabolic acidosis
- B. Handling the child carefully to prevent bruising
- C. Monitoring vital signs for hypertensionand tachycardia
- D. Monitoring the child for signs and symptoms of hypoglycemia
Correct Answer: C
Rationale: In a child with Cushing's syndrome, excessive levels of cortisol are present in the body. Cortisol can lead to hypertension (high blood pressure) and tachycardia (elevated heart rate). Therefore, closely monitoring vital signs for signs of hypertension and tachycardia is essential for early detection and management of these potential complications. Prompt identification and treatment of these cardiovascular issues can help prevent further complications and ensure the child's well-being.
A nurse is teaching a parent about administration of iron supplements to a 7-month-old infant. Which should the nurse include in the teaching session? (Select all that apply.)
- A. Administer the iron supplement with a dropper toward the side and to the back of the mouth
- B. Administer the iron supplement with feedings.
- C. Your infant's stools may look tarry green.
- D. Your infant may have some diarrhea initially.
Correct Answer: A
Rationale: Administer the iron supplement with a dropper toward the side and to the back of the mouth: This instruction helps ensure that the iron supplement bypasses the taste buds on the front of the tongue, which may reduce the likelihood of a strong taste causing rejection or spitting out by the infant.
The nurse should plan to teach the client with pancytopenia caused by a chemotherapy to;
- A. Begin a program of aggressive, strict mouth care
- B. Avoid traumatic injuries and exposure to any infection
- C. increase oral fluid intake to a minimum of 3000 ml daily
- D. Report any unusual muscle cramps or tingling sensations in the extremities
Correct Answer: B
Rationale: The correct action for the nurse to teach a client with pancytopenia caused by chemotherapy is to avoid traumatic injuries and exposure to any infection. Pancytopenia is a condition characterized by low levels of all blood cell types - red blood cells, white blood cells, and platelets. This leaves the individual vulnerable to infections, easy bruising, and bleeding. By advising the client to avoid traumatic injuries and exposure to infection, the nurse is helping to reduce the risk of further complications that can arise from low blood cell counts. This includes advising the client on taking precautions such as gentle handling to prevent skin injury, using a soft toothbrush for oral care, and avoiding contact with individuals who are sick to minimize the risk of infection.