Nokea
If Baby Sharon develops dehydration, what is the FIRST sign to look for by Nurse Juvy?
- A. Oliguria
- B. Sunken fontanels
- C. Soft and depressed eyeballs
- D. Non-elastic skin/poor skin turgor on thighs and abdomen Situation 3 -
Correct Answer: B
Rationale: Sunken fontanels are one of the earliest signs of dehydration in infants. Fontanels are soft spots on an infant's head where the skull bones have not yet fused together. If a baby's fontanel appears sunken, it indicates that the baby is likely dehydrated. This occurs because when there is a lack of fluid in the body, the soft spots on the head will appear depressed or sunken. It is crucial for Nurse Juvy to closely monitor the fontanels of Baby Sharon, as identifying dehydration early is essential for prompt intervention and preventing complications.
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Which of the following imaging test that uses transducer will be likely be ordered by the physician to detect gallstones?
- A. Computed Tomography
- B. Abdominal Ultrasound
- C. Abdominal X-ray
- D. Doppler sonography
Correct Answer: B
Rationale: An abdominal ultrasound is the imaging test that uses a transducer and is most commonly ordered by physicians to detect gallstones. This non-invasive procedure allows the physician to visualize the gallbladder and detect any presence of gallstones. The transducer emits sound waves that bounce off the gallstones, creating images that can be seen on a screen. This imaging test is safe, reliable, and effective in diagnosing gallstones without the use of radiation or contrast dye.
A patient presents with chest pain that worsens with exertion and improves with rest. An electrocardiogram (ECG) shows ST-segment depression. Which cardiovascular disorder is most likely responsible for these symptoms?
- A. Stable angina
- B. Unstable angina
- C. Acute myocardial infarction
- D. Prinzmetal's angina
Correct Answer: A
Rationale: The patient is presenting with chest pain that worsens with exertion and improves with rest, which is characteristic of stable angina. Additionally, ST-segment depression on ECG is a common finding in patients with stable angina. Stable angina is typically caused by coronary artery disease, which leads to partial obstruction of the coronary arteries resulting in inadequate blood flow to the heart muscle during periods of increased demand (such as exertion). The chest pain is usually predictable and reproducible, occurring with similar intensity and duration during episodes of exertion. Rest or nitroglycerin can help relieve the symptoms by increasing coronary blood flow. It is important to differentiate stable angina from unstable angina and acute myocardial infarction, which have different management and prognostic implications.
A patient presents with a palpable, non-tender mass in the right neck, just below the angle of the mandible. Ultrasound imaging demonstrates a well-defined, hypoechoic lesion with cystic components. Which of the following conditions is most likely responsible for this presentation?
- A. Branchial cleft cyst
- B. Thyroglossal duct cyst
- C. Lymphadenopathy
- D. Parotid gland tumor
Correct Answer: A
Rationale: The presentation of a palpable, non-tender mass in the right neck, just below the angle of the mandible, along with ultrasound imaging findings of a well-defined, hypoechoic lesion with cystic components, is classic for a branchial cleft cyst. Branchial cleft cysts are congenital anomalies that arise from remnants of the branchial clefts or pouches during embryonic development. They are typically located along the anterior border of the sternocleidomastoid muscle, just below the mandible. Ultrasound imaging often shows a cystic lesion with well-defined borders and hypoechoic content, which is consistent with the described findings. Thyroglossal duct cysts usually present as midline neck masses that move with swallowing or tongue protrusion, not in the location described in the scenario. Lymphadenopathy would present as enlarged lymph nodes that may be tender and associated with systemic symptoms.
Which of the following actions is indicated in the management of a patient with an open chest wound (sucking chest wound)?
- A. Applying a sterile dressing and occlusive dressing.
- B. Administering supplemental oxygen.
- C. Providing reassurance and emotional support.
- D. Elevating the patient's legs to improve venous return.
Correct Answer: A
Rationale: An open chest wound, also known as a sucking chest wound, can lead to a collapsed lung and respiratory distress. Immediate management involves sealing the wound to prevent air from entering the pleural space and further compromising the patient's respiratory function. Applying a sterile dressing over the wound helps to prevent contamination and occluding the wound with an airtight covering, such as an occlusive dressing, can effectively reduce the risk of a tension pneumothorax, a serious complication that can arise from a sucking chest wound. These interventions help to stabilize the patient's condition and improve the chances of a successful recovery. Administering supplemental oxygen, though beneficial, would be secondary to the primary management of sealing the chest wound. Providing emotional support is important but addressing the physical emergency takes precedence. Elevating the patient's legs would not be appropriate in managing an open chest wound.
You encounter a conscious adult choking on a piece of food. The person is coughing forcefully but unable to speak or breathe effectively. What is the most appropriate action?
- A. Encourage continued coughing.
- B. Perform abdominal thrusts (Heimlich maneuver).
- C. Deliver back blows.
- D. Administer rescue breaths.
Correct Answer: B
Rationale: The most appropriate action in this situation is to perform abdominal thrusts, also known as the Heimlich maneuver. This technique is used to clear a blocked airway caused by a choking obstruction. Encouraging continued coughing may not be effective if the person is unable to dislodge the obstruction on their own. Delivering back blows can sometimes be effective, but abdominal thrusts are more commonly recommended in cases of choking in adults. Administering rescue breaths is not recommended if the person is conscious and able to cough, as it may worsen the situation by pushing the obstruction further down. By quickly performing abdominal thrusts, you can help dislodge the obstruction and potentially save the person's life.