Nokea
Parents of a 3-year-old child with congenital heart disease are afraid to let their child play with other children because of possible overexertion. The nurse’s reply should be based on which statement?
- A. The child needs opportunities to play with peers.
- B. The child needs to understand that peers’ activities are too strenuous.
- C. Parents can meet all of the child’s needs.
- D. Constant parental supervision is needed to avoid overexertion.
Correct Answer: A
Rationale: The child needs opportunities for social development. Children usually limit their activities if allowed to set their own pace. The child will limit activities as necessary. Parents must be encouraged to seek appropriate social activities for the child, especially before kindergarten. The child needs to have activities that foster independence. The child will be able to regulate activities.
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A client with acute renal injury (AKI) who weighs 50 kg and has a potassium level of 6.7 mEq/L (6.7 mmol/l) is admitted to the hospital. Which prescribed medication should the nurse administer first?
- A. Sevelamer (RenaGel) one tablet PO.
- B. Epoetin alfa, recombinant (Epogen) 2,500 units SUBQ
- C. Sodium polystyrene (Kayexalate) 15 grams PO
- D. Calcium acetate (Phos-Lo) one tablet PO
Correct Answer: C
Rationale: Sodium polystyrene (Kayexalate) helps remove excess potassium, which is the priority concern in AKI with elevated potassium.
Complement system:
- A. Is activated by bacterial endotoxins by the classical pathway
- B. Reduced C3 and C4 are usual findings in acute glomerulonephritis
- C. Hereditary angioneurotic oedema is caused by deficiency of one of the components of the classical pathway of the system
- D. Is part of humoral immunity
Correct Answer: D
Rationale: The complement system is a key component of humoral immunity, playing a role in the immune response to pathogens.
A child with rheumatic fever is being admitted to the pediatric floor. On admission assessment, the nurse should ask the parents which question to elicit assessment information specific to the development of rheumatic fever?
- A. “Has your child complained of back pain?â€
- B. “Has your child complained of headaches?â€
- C. “Has your child had any nausea or vomiting?â€
- D. “Did your child have a sore throat or fever within the last 2 months?â€
Correct Answer: D
Rationale: A history of sore throat or fever within the last 2 months is significant as rheumatic fever often follows a streptococcal infection such as strep throat.
Pulmonary hypertension is a complication of:
- A. ASD
- B. Eisenmenger syndrome
- C. Tricuspid atresia
- D. Tricuspid regurgitation
Correct Answer: B
Rationale: Eisenmenger syndrome is a well-known cause of pulmonary hypertension. The other options (a-d) can also lead to pulmonary hypertension but are less specific.
A client uses triamcinolone (Kenalog), a corticosteroid ointment, to manage pruritus caused by a chronic skin rash. The client calls the clinic nurse to report increased erythema with purulent exudate at the site. Which action should the nurse implement?
- A. Schedule an appointment for the client to see the healthcare provider
- B. Advise the client to apply more corticosteroid cream
- C. Recommend using an antibiotic ointment.
- D. Instruct the client to stop using the medication for 24 hours.
Correct Answer: A
Rationale: Increased erythema and purulent exudate suggest infection. The client needs evaluation and possible treatment with antibiotics.