Nokea
Kasabach-Merritt syndrome is characterized by all the following EXCEPT
- A. thrombocytopenia
- B. microangiopathic hemolytic anemia
- C. coagulopathy
- D. association with infantile hemangiomas
Correct Answer: D
Rationale: Kasabach-Merritt syndrome is not typically associated with hemangiomas.
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After receiving an immunization for pediatric diphtheria, tetanus, and acellular pertussis (DTaP), a patient develops swelling and tenderness at the injection site, a low-grade fever, and malaise. The pediatric nurse informs the patient's parents that:
- A. they should delay future immunizations until the patient sees an allergist.
- B. this is a mild reaction, and teaches them how to manage it.
- C. this is an appropriate reaction, and instructs them to do nothing.
- D. none of the above.
Correct Answer: B
Rationale: Mild reactions like swelling, tenderness, low-grade fever, and malaise are common after DTaP vaccination and can be managed with supportive care.
The nurse is conducting a staff in-service on congenital heart defects. Which structural defect constitutes tetralogy of Fallot?
- A. Pulmonic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy
- B. Aortic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy
- C. Aortic stenosis, atrial septal defect, overriding aorta, left ventricular hypertrophy
- D. Pulmonic stenosis, ventricular septal defect, aortic hypertrophy, left ventricular hypertrophy
Correct Answer: A
Rationale: Tetralogy of Fallot is a combination of four structural defects in the heart. These include pulmonic stenosis (narrowing of the pulmonary valve or artery), ventricular septal defect (hole in the wall that separates the two lower chambers of the heart), overriding aorta (aorta positioned directly over the ventricular septal defect), and right ventricular hypertrophy (enlargement of the right ventricle due to increased workload). Therefore, the correct combination of defects that constitute tetralogy of Fallot is pulmonic stenosis, ventricular septal defect, overriding aorta, and right ventricular hypertrophy, which is option A.
In assessing a post mastectomy client, the nurse determines that the client is in denial. The nurse can best respond by:
- A. Accepting the denial.
- B. Supporting the denial.
- C. Confronting the denial.
- D. Interpreting the denial.
Correct Answer: C
Rationale: Confronting the denial is the best response in this situation. Denial is a common defense mechanism that individuals may use when faced with overwhelming emotions or situations, such as in the case of a post-mastectomy client. By confronting the denial in a supportive and empathetic manner, the nurse can help the client acknowledge and accept their feelings, which is an important step in the healing and coping process. Ignoring or supporting the denial may hinder the client's ability to address their emotions and work through them effectively. Confronting the denial allows for open communication and helps the client move towards acceptance and adjustment.
A client with diabetes mellitus must learn how to self-administer insulin. The physician has prescribed 10 U of U- 100 regular insulin and 35 U of 100-U isophane insulin suspension (NPH) to be taken before breakfast. When teaching the client how to select and rotate insulin injection sites, the nurse should provide which instruction?
- A. "Inject insulin into healthy tissue with large blood vessels and nerves."
- B. "Rotate injection sites within the same anatomic region, not among different regions."
- C. "Administer insulin into areas of scar tissue or hypotrophy whenever possible."
- D. "Administer insulin into sites above muscles that you plan to exercise heavily later that day."
Correct Answer: B
Rationale: The nurse should instruct the client to rotate injection sites within the same anatomic region, not among different regions. Proper rotation of injection sites helps prevent lipodystrophy (changes in fat tissue) and ensures consistent absorption of insulin. By rotating sites within the same region, the client can minimize the risk of developing localized skin complications. Additionally, rotating sites helps to ensure that the insulin is absorbed consistently, leading to more predictable blood glucose control. It is important to avoid injecting into areas of scar tissue, hypotrophy, large blood vessels, or nerves, as these can affect the absorption of insulin and may lead to inconsistent blood glucose levels.
Before a cancer receiving total parenteral nutrition (TPN) resumes a normal diet, the nurse teaches him about dietary sources of minerals. Which foods are good sources of zinc?
- A. Fruits and yellow vegetables
- B. Fruits and green vegetables
- C. Yeast and legumes
- D. Whole grains and meats
Correct Answer: D
Rationale: Zinc is an essential mineral that plays a crucial role in immune function, wound healing, and overall growth and development. Good dietary sources of zinc include whole grains and meats. Whole grains such as wheat and rice contain moderate amounts of zinc, while meats such as beef, pork, and chicken are rich sources of this mineral. Including these foods in the diet can help ensure an adequate intake of zinc, especially for individuals who have increased nutritional needs like cancer patients receiving TPN.