Nokea
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.
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Mrs. Tan is scheduled to undergo percutaneous transluminal coronary angioplasty (PTCA). Which of the following is the priority goal for her immediately after the procedure?
- A. prevent fluid volume deficit
- B. maintain blood pressure control
- C. decrease myocardial contractility
- D. minimize dyspnea
Correct Answer: B
Rationale: Maintaining blood pressure control is the priority goal for Mrs. Tan immediately after percutaneous transluminal coronary angioplasty (PTCA). PTCA is a procedure used to open narrowed or blocked arteries in the heart. After the procedure, there is a risk of abrupt changes in blood pressure due to various factors, such as contrast dye used during the procedure, stress on the heart, and potential complications. Maintaining stable blood pressure is crucial to ensure adequate perfusion to the heart and other organs. Monitoring and controlling blood pressure help prevent further complications and promote a smooth recovery process for the patient. It is important to address this priority goal to optimize Mrs. Tan's post-procedure outcomes.
A 72-year-old chemist has left lower lobe pneumonia. His nurse checks his oxygen saturation and the result is 86%. Which of the ff. actions by the nurse is best?
- A. Call the physician for an order for oxygen.
- B. No action necessary; this is a normal SaO
Correct Answer: A
Rationale: An oxygen saturation (SaO2) level of 86% is significantly below the normal range of 95-100%. This indicates hypoxemia, which means the body is not getting enough oxygen. In a patient with pneumonia, low oxygen saturation can lead to further respiratory compromise and potential organ damage. Therefore, it is essential for the nurse to notify the physician promptly to obtain an order for supplemental oxygen to correct the hypoxemia and improve the patient's oxygen saturation levels. Delay in addressing low oxygen levels can have serious consequences for the patient's health and recovery.
A 10-month-old child can do all the following EXCEPT
- A. says mama or dada
- B. follows one-step command without gesture
- C. points to objects or real first word
- D. speaks inhibition word 'no'
Correct Answer: D
Rationale: Speaking inhibition words like 'no' typically occurs later.
A client is diagnosed with diabetes mellitus. Which assessment finding best supports a nursing diagnosis of Ineffective individual coping related to diabetes mellitus?
- A. Recent weight gain of 20 lb
- B. Skipping insulin doses during illness
- C. Failure to monitor blood glucose
- D. Crying whenever diabetes is levels mentioned
Correct Answer: D
Rationale: Crying whenever diabetes is mentioned indicates a maladaptive coping mechanism, which can be a sign of ineffective individual coping related to diabetes mellitus. Coping with a chronic condition like diabetes can be overwhelming, and excessive emotional distress may hinder the client's ability to effectively manage their disease. It is important for the nurse to identify maladaptive coping strategies in order to provide appropriate interventions and support for the client.
When educating parents regarding known antecedent infections in acute glomerulonephritis, which of the following should the nurse cover?
- A. Scabies
- B. Impetigo
- C. Herpes simplex
- D. Varicella
Correct Answer: B
Rationale: When educating parents regarding known antecedent infections in acute glomerulonephritis, the nurse should cover impetigo. Acute poststreptococcal glomerulonephritis (APSGN) is commonly triggered by a streptococcal infection, such as impetigo or strep throat. Impetigo, a superficial skin infection caused by Staphylococcus aureus or Streptococcus pyogenes, is a common precursor to APSGN in children. Therefore, educating parents about impetigo and its potential link to acute glomerulonephritis is crucial in helping them recognize and manage their child's health effectively.