Nokea
Mr. Umali, 52-year-old male is being evaluated for acute ulcerative colitis. im preparing Mr. Umali for a barium enema, the nurse can expect that he will be:
- A. contraindicated with cathartics
- B. given an oil retention enema the morning of the study
- C. instructed to swallow six radiopaque tablets the evening before the study
- D. positioned in ahigh fowler's position immediately following the procedure
Correct Answer: A
Rationale: In preparing a 52-year-old male patient like Mr. Umali for a barium enema to evaluate acute ulcerative colitis, the nurse can expect that he will be contraindicated with cathartics. Cathartics, which are substances that induce bowel movements, are generally contraindicated in patients being evaluated for acute colitis as they can exacerbate the condition and cause additional discomfort. In contrast, using oil retention enemas or radiopaque tablets may not be suitable for a patient with acute ulcerative colitis. Positioning in a high Fowler's position following the procedure is not related to the preparation for a barium enema in this case.
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The nurse is caring for a newborn who was born 24 hours ago to a mother who received no prenatal care. The newborn is a poor feeder but sucks avidly on his hands. Clinical manifestations also include loose stools, tachycardia, fever, projectile vomiting, sneezing, and generalized sweating. Which should the nurse suspect?
- A. Seizure disorder
- B. Narcotic withdrawal
- C. Placental insufficiency
- D. Meconium aspiration syndrome
Correct Answer: B
Rationale: The clinical manifestations described in the scenario are classic signs of neonatal abstinence syndrome (NAS), which occurs in newborns who were exposed to drugs, particularly narcotics, in utero. The newborn's symptoms of poor feeding, sucking on his hands, tachycardia, fever, projectile vomiting, loose stools, sneezing, and generalized sweating are consistent with NAS. These symptoms occur as the newborn experiences withdrawal from the drugs to which they were exposed during pregnancy. In this case, the lack of prenatal care suggests that the mother may have used narcotics during pregnancy, leading to NAS in the newborn. It is essential for healthcare providers to recognize these signs and provide appropriate care and support for infants experiencing NAS.
The nurse understands that which of the ff. best describes the action of enalapril maleate (Vasotec)?
- A. It decreases levels of angiotensin II
- B. It dilates the arterioles and veins
- C. It adjusts the extracellular volume
- D. It decreases cardiac output
Correct Answer: A
Rationale: Enalapril maleate (Vasotec) is an angiotensin-converting enzyme (ACE) inhibitor. The main action of ACE inhibitors like enalapril is to decrease the levels of angiotensin II in the body. Angiotensin II is a potent vasoconstrictor that plays a role in regulating blood pressure, stimulating aldosterone secretion, and promoting sodium and water retention. By inhibiting the conversion of angiotensin I to angiotensin II, enalapril reduces vasoconstriction and aldosterone secretion, leading to vasodilation, decreased blood pressure, and ultimately decreased levels of angiotensin II. This mechanism allows for the dilation of arterioles and veins, reduction in cardiac afterload, and ultimately decreases the workload of the heart.
The nurse is caring for a newborn with hyperbilirubinemia who is receiving phototherapy. Which is an appropriate nursing intervention for this newborn?
- A. Apply lotion as prescribed to moisturize skin.
- B. Maintain nothing-by-mouth (NPO) status to prevent nausea and vomiting.
- C. Monitor temperature to prevent hypothermia or hyperthermia.
- D. Keep eye patches on for at least 8 to 12 of every 24 hours.
Correct Answer: C
Rationale: Monitoring temperature to prevent hypothermia or hyperthermia is an appropriate nursing intervention for a newborn with hyperbilirubinemia receiving phototherapy. Phototherapy can increase the risk of hypothermia in newborns due to increased heat loss from evaporation, convection, and conduction. On the other hand, hyperthermia can occur if the newborn is over-wrapped or placed too closely to the light source. Therefore, frequent temperature monitoring is essential to maintain a stable body temperature within a normal range and prevent adverse effects related to temperature dysregulation.
Early this morning a client had a subtotal thyroidectomy. During evening rounds, the nurse assesses the client, who has now nausea, a temperature of 105F (40.5C), tachycardia, and extreme restlessness. What is the most likely cause of these signs?
- A. Diabetic ketoacidosis
- B. Hypoglycemia
- C. Thyroid crisis
- D. Tetany
Correct Answer: C
Rationale: The signs and symptoms described - nausea, elevated temperature, tachycardia, and extreme restlessness - are indicative of a thyroid crisis, also known as thyroid storm. A thyroid storm is a life-threatening condition that can occur after thyroid surgery such as a subtotal thyroidectomy. It is characterized by an exaggerated state of hyperthyroidism, leading to a surge of thyroid hormones in the bloodstream. This can result in severe symptoms such as high fever, tachycardia, nausea, agitation, and even confusion or delirium.
Older school-age children who begin to participate in competitive sports should have a careful evaluation of the
- A. vision
- B. hearing
- C. sexual maturity
- D. cardiovascular system
Correct Answer: D
Rationale: Cardiovascular evaluation is important for children participating in competitive sports.