Nokea
Indomethacin is being given to an infant with a patent ductus arteriosus in an attempt to promote closure of the PDA. The nurse caring for this infant becomes concerned about adverse side effects when noticing:
- A. decreased urine output, decreased platelets, and abdominal distention.
- B. increased blood pressure, tachycardia, and decreased oxygen requirements.
- C. increased urine output, increased white blood cell count, and increased reticulocyte count.
- D. Jaundice, pallor, and a petechial rash
Correct Answer: A
Rationale: Indomethacin can cause renal side effects, including decreased urine output, as well as hematologic effects such as decreased platelets, and gastrointestinal effects like abdominal distention, which are concerning adverse effects in an infant.
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Xanthomas within palmar creases are seen characteristically in
- A. Pseudoxanthoma elasticum
- B. Type II hyperlipoproteinemia
- C. Type IIl hyperlipoproteinemia
- D. Hypothyroidism
Correct Answer: C
Rationale: Xanthomas within palmar creases are characteristic of Type III hyperlipoproteinemia.
The following diseases have diagnostic EEG findings:
- A. Petit mal epilepsy
- B. Infantile spasms
- C. Acute measles encephalopathy
- D. Herpes encephalitis
Correct Answer: B
Rationale: Infantile spasms, also known as West syndrome, have a characteristic EEG pattern called hypsarrhythmia, which is diagnostic.
Typical features of Down's syndrome include:
- A. Brachycephaly
- B. Hypotonia
- C. Male infertility
- D. Increased a-fetoprotein in amniotic fluid
Correct Answer: B
Rationale: Hypotonia is a key feature of Down's syndrome, often leading to delayed development and muscle weakness.
In the treatment of asthma, inhaled corticosteroids:
- A. Relieve acute symptoms
- B. Prevent long-term symptoms
- C. Cause airway constriction
- D. Are contraindicated in pregnancy
Correct Answer: B
Rationale: Inhaled corticosteroids are used in asthma management to prevent inflammation and control long-term symptoms, though they do not relieve acute attacks.
Which action by the school nurse is important in the prevention of rheumatic fever?
- A. Encourage routine cholesterol screenings.
- B. Conduct routine blood pressure screenings.
- C. Refer children with sore throats for throat cultures.
- D. Recommend salicylates instead of acetaminophen for minor discomforts.
Correct Answer: C
Rationale: Nurses have a role in prevention—primarily in screening school-age children for sore throats caused by group A β-hemolytic streptococci. They can achieve this by actively participating in throat culture screening or by referring children with possible streptococcal sore throats for testing. Cholesterol and blood pressure screenings do not facilitate the recognition and treatment of group A β-hemolytic streptococci. Salicylates should be avoided routinely because of the risk of Reye syndrome after viral illnesses.