Nokea
Mrs. Zeno asks the nurse why the disease has occurred. The nurse bases the reply on the knowledge that there is:
- A. A genetic defect in the production of acetylcholine
- B. A reduced amount of neurotransmitter acetylcholine
- C. A decreased number of functioning acetyl-choline receptor sites
- D. An inhibition of the enzyme Ache leaving the end plates folded.
Correct Answer: C
Rationale: The disease mentioned in the question is likely myasthenia gravis. Myasthenia gravis is an autoimmune disorder where the body's immune system attacks acetylcholine receptors at the neuromuscular junction. Acetylcholine is a neurotransmitter responsible for transmitting nerve impulses to muscles. In myasthenia gravis, the immune system destroys or blocks the acetylcholine receptor sites on muscle cells, leading to a decrease in the number of functioning receptor sites. This results in muscle weakness and fatigue because the communication between nerves and muscles is impaired. This is why the nurse would base the reply on the knowledge that there is a decreased number of functioning acetyl-choline receptor sites as the underlying cause of the disease.
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You have learned that in babies and children with developmental dysplasia (dislocation) of the hip (DDH), the hip joint has not formed normally. Which of the following is the most common form of DDH?
- A. Acetabular dysplasia
- B. Dislocation
- C. Preluxation
- D. Subluxation
Correct Answer: A
Rationale: Acetabular dysplasia is the most common form of developmental dysplasia of the hip (DDH). It is characterized by an underdeveloped or shallow socket (acetabulum) in the hip joint, which can lead to instability and predispose the hip to dislocation. In DDH, the abnormal development of the hip joint can range from mild acetabular dysplasia to complete dislocation. Acetabular dysplasia is often present from birth or develops during infancy and can lead to long-term consequences if not properly managed. Early detection and treatment of acetabular dysplasia are crucial to prevent complications such as hip dislocation and osteoarthritis later in life.
What is an early clinical manifestation of bilirubin encephalopathy in the newborn?
- A. Cognitive impairment
- B. Absence of stooling
- C. Lethargy or irritability
- D. Increased or decreased temperature
Correct Answer: C
Rationale: An early clinical manifestation of bilirubin encephalopathy in a newborn is lethargy or irritability. Bilirubin encephalopathy, also known as kernicterus, is a serious condition that occurs when high levels of unconjugated bilirubin build up in the brain tissues. Initially, the baby may become lethargic or irritable due to the toxic effects of bilirubin on the central nervous system. As the condition progresses, symptoms may include poor feeding, high-pitched crying, muscle tone abnormalities, and eventually may lead to more severe consequences such as seizures and irreversible neurological damage. Prompt recognition and treatment of bilirubin encephalopathy are crucial to prevent long-term complications.
A parent asks the nurse "when will my infant start to teethe?" The nurse responds that the earliest age at which an infant begins teething with eruption of lower central incisors is _____ months.
- A. 4
- B. 6
- C. 8
- D. 12
Correct Answer: B
Rationale: The earliest age at which an infant typically begins teething with the eruption of their lower central incisors is around 6 months old. Teething typically starts around this age, but it can vary from one infant to another. It is important to note that while 6 months is a common age for teething to begin, some infants may start teething a little earlier or later. It's essential for parents to monitor their baby's development and seek guidance from healthcare professionals if needed.
A client metastatic ovarian cancer is prescribed cisplatin (Platinol). Before administering the first dose, the nurse reviews the client's medication history for drugs that may interact with cisplatin. Which drug may cause significant interactions when given concomitantly with cisplatin?
- A. Erythromycin
- B. A cephalosporin
- C. A tetracycline
- D. An amino glycoside Situation: A client with ovarian cancer is prescribed hydroxyurea (Hydrea), an antimetabolite drug.
Correct Answer: D
Rationale: Amino glycosides, such as gentamicin or amikacin, can interact significantly with cisplatin, leading to increased risk of kidney damage or hearing loss. Both amino glycosides and cisplatin are known to have nephrotoxic and ototoxic effects independently. When combined, the risk of these side effects is potentiated, making it important to monitor renal function and hearing closely when these drugs are co-administered. Therefore, it is crucial to avoid the concomitant use of amino glycosides with cisplatin in order to prevent harmful drug interactions and reduce the risk of adverse effects in the client with metastatic ovarian cancer.
Fentanyl is used as analgesia during operative and postoperative procedures. Which of the following conditions is NOT associated with fentanyl use?
- A. Tachycardia
- B. Hypotension
- C. Nausea and vomiting
- D. Acidosis
Correct Answer: D
Rationale: Fentanyl typically causes hypotension, nausea, and vomiting, but it does not cause acidosis.