Nursing interventions for the child after a cardiac catheterization should include which actions? (Select all that apply.)
- A. Allow ambulation as tolerated.
- B. Monitor vital signs every 2 hours.
- C. Assess the affected extremity for temperature and color.
- D. Check pulses above the catheterization site for equality and symmetry.
Correct Answer: A
Rationale: Allowing ambulation as tolerated helps promote circulation and prevent complications such as blood clots.
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Which is true of a Wilms tumor? (Select all that apply.)
- A. It is also referred to as neuroblastoma.
- B. It is most commonly seen between the ages of 2 and 5 years.
- C. It can occur on its own or be associated with congenital anomalies.
- D. It is a slow-growing tumor.
Correct Answer: C
Rationale: Wilms tumor typically occurs in children aged 2-5 years and may be associated with congenital anomalies. It is not the same as neuroblastoma, and its prognosis is generally good with treatment.
What is the last step when inserting an IV cannula?
- A. Secure the cannula with tape.
- B. Document the insertion site, date, and type of cannula used.
- C. Assess the site
- D. Place a sterile dressing over the insertion site. INFLAMMATORY AND INFECTIOUS DISTURBANCES Caring for clients with upper respiratory infections
Correct Answer: D
Rationale: The last step when inserting an IV cannula is to place a sterile dressing over the insertion site. This helps to protect the site from contamination and reduce the risk of infection. A sterile dressing also helps to maintain the integrity of the insertion site and prevent any foreign materials from entering the wound. Additionally, the dressing provides a barrier between the cannula site and the external environment, promoting healing and reducing the chance of complications.
A 36-year-old man is scheduled for a unilateral orchiectomy for treatment of testicular cancer. He is withdrawn and does not interact with the nurse. Which action is most appropriate?
- A. Identify the problem with a nursing diagnosis of impaired communication related to the diagnosis of cancer
- B. Set a patient outcome that the patient will verbalize his concerns about his diagnosis
- C. Ask the patient whether he is worried about future sexual functioning
- D. Say, "You seem quiet. Are you feeling concerned about your diagnosis or treatment?"
Correct Answer: D
Rationale: Option D is the most appropriate action in this scenario because it demonstrates empathy and opens the door for the patient to express his concerns. By acknowledging the patient's withdrawn behavior and directly inquiring about his feelings regarding the diagnosis or treatment, the nurse creates an opportunity for the patient to share his thoughts and concerns. This open-ended question allows the patient to express himself without any assumptions or judgments. It shows that the nurse is attentive, supportive, and willing to listen to the patient's emotional needs during this challenging time.
The following. items are transported in blood plasma, EXCEPT:
- A. Oxygen
- B. Carbon dioxide
- C. Nutrients
- D. Hormones
Correct Answer: A
Rationale: Oxygen is not transported in blood plasma. Instead, it is transported bound to hemoglobin within red blood cells. Carbon dioxide, nutrients, and hormones are examples of substances that are transported in blood plasma. Oxygen binds to hemoglobin in the red blood cells as they pass through the lungs, while carbon dioxide is carried back to the lungs and expelled from the body through the respiratory system. Nutrients like glucose and amino acids are carried in the blood plasma to be delivered to various tissues for energy production and cellular processes. Hormones are chemical messengers that are released into the bloodstream by endocrine glands to regulate numerous physiological functions throughout the body.
Where do the lesions of atopic dermatitis (eczema) most commonly occur in the infant? (Select all that apply.)
- A. Cheeks
- B. Buttocks
- C. Extensor surfaces of arms and legs
- D. Back
Correct Answer: A
Rationale: In infants with atopic dermatitis (eczema), the lesions most commonly occur on the cheeks (option A) and the extensor surfaces of the arms and legs (option C). The cheeks are a common site of involvement due to increased exposure to irritants and saliva from drooling. The extensor surfaces of the arms and legs are also frequently affected due to scratching and rubbing against clothing. While atopic dermatitis can occur in other areas such as the buttocks, back, and trunk, the cheeks and extensor surfaces are the most common locations in infants.