Nokea
On assessment of a child admitted with a diagnosis of Kawasaki Disease, the nurse expects to note which clinical manifestation of the acute phase of the disease?
- A. Cracked lips
- B. Normal appearance
- C. Conjuntival hyperemia
- D. Desquamation of the skin
Correct Answer: C
Rationale: Conjunctival hyperemia is a common clinical manifestation during the acute phase of Kawasaki Disease, characterized by redness of the eyes without discharge.
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Regarding intussusception in childhood:
- A. Incidence is most common in children over 3 years of age
- B. Barium enema is the investigation of choice
- C. Patient commonly presents with constant abdominal pain
- D. It is associated with Henoch-Schoenlein purpura
Correct Answer: D
Rationale: Intussusception is associated with Henoch-Schoenlein purpura, a condition that can cause inflammation and bleeding in the small blood vessels.
What should the school nurse recommend when encouraging a heart-healthy diet for a child with high cholesterol?
- A. A fat intake reduction of 5-10% of total calories
- B. A fat intake reduction of 10-15% of total calories
- C. A fat intake reduction of 15-20% of total calories
- D. A fat intake reduction of 25-35% of total calories
Correct Answer: D
Rationale: For a child with increased cholesterol, a fat reduction of 25-35% of total calories with less than 75 saturated fat and less than 200 mg of cholesterol per day is advised.
Afterload reducers are not indicated in children with heart failure secondary to
- A. cardiomyopathy
- B. severe mitral insufficiency
- C. aortic stenosis
- D. ventricular septal defect
Correct Answer: C
Rationale: Afterload reducers are contraindicated in conditions where forward flow is already compromised, such as aortic stenosis.
Which medication should the nurse prepare for immediate administration to a child experiencing an anaphylactic reaction to a bee sting?
- A. Diphenhydramine (Benadryl)
- B. Dobutamine (Dobutarex)
- C. Epinephrine (Adrenalin)
- D. Calcium chloride (calcium chloride)
Correct Answer: C
Rationale: After the first priority of establishing an airway, administration of epinephrine is the drug of choice. Diphenhydramine, an antihistamine, is usually not used for severe reactions. Dobutamine and calcium chloride are not appropriate drugs for this type of reaction.
A male client who had colon surgery 3 days ago is anxious and requesting assistance to reposition. While the nurse is turning him, the wound dehiscences and eviscerates. The nurse moistens an available sterile dressing and places it over the wound. What intervention should the nurse implement next?
- A. Bring additional sterile dressing supplies to the room
- B. Prepare the client to return to the operating room
- C. Obtain a sample of the drainage to send to the lab
- D. Auscultate the abdomen for bowel sound activity
Correct Answer: B
Rationale: Evisceration is a surgical emergency and requires immediate return to the operating room for repair.