Nokea
Initial tests in a 2-year-old child with failure to thrive include:
- A. Thyroid function tests
- B. Sweat test
- C. Urine culture
- D. Colonoscopy
Correct Answer: B
Rationale: a sweat test is crucial for diagnosing cystic fibrosis, a common cause of failure to thrive in children. The other tests (a-d) are less specific and not typically first-line for this presentation.
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Which medication should the nurse prepare for immediate administration to a child experiencing an anaphylactic reaction to a bee sting?
- A. Diphenhydramine (Benadryl)
- B. Dobutamine (Dobutarex)
- C. Epinephrine (Adrenalin)
- D. Calcium chloride (calcium chloride)
Correct Answer: C
Rationale: After the first priority of establishing an airway, administration of epinephrine is the drug of choice. Diphenhydramine, an antihistamine, is usually not used for severe reactions. Dobutamine and calcium chloride are not appropriate drugs for this type of reaction.
Examples of cyanotic heart disease include:
- A. Ebstein's anomaly
- B. Pulmonary stenosis
- C. Coarctation of aorta
- D. Hypoplastic left heart syndrome
Correct Answer: D
Rationale: Hypoplastic left heart syndrome is a form of cyanotic heart disease. Ebstein's anomaly and pulmonary stenosis can also cause cyanosis, but coarctation of the aorta typically does not.
A client with chronic kidney disease (CKD) arrives at the clinic reporting shortness of breath on exertion and extreme weakness. Vital signs are temperature 100.4°F (38°C), heart rate 110 beats/minute, respirations 28 breaths/minute, and blood pressure 175/98 mmHg. The client usually receives dialysis three times a week but missed the last treatment. STAT blood specimens are sent to the laboratory for analysis. Which laboratory results should the nurse report to the healthcare provider immediately?
- A. Potassium 6.5 mEq/L (mmol/L)
- B. Potassium 6 mEq/L (mmol/L)
- C. Potassium 0.5 mEq/L (mmol/L)
- D. Potassium 1.5 mEq/L (mmol/L)
Correct Answer: A
Rationale: Elevated potassium levels in CKD clients can lead to life-threatening arrhythmias, so this result needs immediate intervention.
What should the nurse assess prior to administering digoxin? (Select all that apply.)
- A. Sclera
- B. Apical pulse rate
- C. Cough
- D. Liver function test
Correct Answer: B
Rationale: Because digoxin decreases the heart rate, the apical pulse should be assessed. If the HR is below 60 beats per minute, digoxin should not be administered.
Duchenne muscular dystrophy:
- A. Has an association with malignant hyperpyrexia
- B. Is a reason for never running properly
- C. Is better diagnosed with muscle biopsy than gene probe
- D. Is associated with speech delay
Correct Answer: D
Rationale: Duchenne muscular dystrophy is associated with speech delay due to progressive muscle weakness, including facial muscles affecting speech.