Nokea
Liver failure in children:
- A. Is always chronic in nature
- B. Wilson's disease is a common cause
- C. Leads to failure to thrive
- D. One of the causes is Reye syndrome
Correct Answer: D
Rationale: Reye syndrome is a known cause of acute liver failure in children, often associated with viral infections and aspirin use.
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A harsh, blowing grade IV/VI murmur is auscultated in a 6-month-old infant. What will the nurse practitioner do next?
- A. Get a complete blood count to rule out severe anemia.
- B. Obtain an electrocardiogram to assess for arrhythmia.
- C. Order a chest radiograph to evaluate for cardiomegaly.
- D. Refer to a pediatric cardiologist for further evaluation.
Correct Answer: D
Rationale: A harsh, blowing murmur is suspicious for pathology, so a cardiology referral is warranted.
Increased anion gap is seen in:
- A. Uraemia
- B. Starvation
- C. Renal tubular acidosis
- D. Acetazolamide therapy
Correct Answer: A
Rationale: Uraemia, a condition of high levels of urea in the blood, is associated with an increased anion gap due to the accumulation of acids.
The most common indication of heart transplantation in the neonate is
- A. Hypoplastic left heart syndrome
- B. Hypoplastic right heart syndrome
- C. Severe Ebstein's anomaly
- D. Dilated cardiomyopathy
Correct Answer: A
Rationale: Hypoplastic left heart syndrome is the most common indication for heart transplantation in neonates.
Seventy-two hours after cardiac surgery, a young child has a temperature of 101° F. Which action should the nurse take?
- A. Keep child warm with blankets.
- B. Apply a hypothermia blanket.
- C. Record temperature on nurses’ notes.
- D. Report findings to physician.
Correct Answer: D
Rationale: In the first 24 to 48 hours after surgery, the body temperature may increase to 37.7° C (100° F) as part of the inflammatory response to tissue trauma. If the temperature is higher or continues after this period, it is most likely a sign of an infection and immediate investigation is indicated. Blankets should be removed from the child to keep the temperature from increasing. Hypothermia blanket is not indicated for this level of temperature. The temperature should be recorded, but the physician must be notified for evaluation. Suctioning should be done only as indicated, not on a routine basis. The child should be suctioned for no more than 5 seconds at one time. Symptoms of respiratory distress are avoided by using appropriate technique.
When caring for a client with nephrotic syndrome, which assessment is most important for the nurse to obtain?
- A. Daily weight
- B. Vital signs
- C. Level of consciousness
- D. Bowel sounds
Correct Answer: A
Rationale: Daily weight is crucial in monitoring fluid balance in clients with nephrotic syndrome, as they are prone to edema.