Nokea
Pneumocystic pneumonia. Which anemias are described as microcytic, hypochromic anemia?
- A. Vitamin B12 and iron deficiency anemia
- B. Folic acid and iron deficiency anemia
- C. Iron deficiency anemia and thalassemia
- D. Sickle cell anemia and anemia if chronic disease
Correct Answer: C
Rationale: Microcytic, hypochromic anemia is characterized by small red blood cells with decreased hemoglobin content. Iron deficiency anemia and thalassemia are the two main types of anemia that present with these characteristics. Iron deficiency anemia is caused by a lack of iron in the body, which is essential for the production of hemoglobin. Thalassemia is a genetic disorder that results in decreased production of normal hemoglobin. Both conditions lead to small, pale red blood cells, fitting the description of microcytic, hypochromic anemia. Other choices such as Vitamin B12 deficiency anemia (choice A), folic acid deficiency anemia (choice B), sickle cell anemia (choice D), and anemia of chronic disease (choice D) typically present as normocytic or macrocytic anemias.
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Which of the following actions by the practitioner would be important in the prevention of rheumatic fever?
- A. Encourage routine hypertensive screenings.
- B. Conduct routine occult blood screenings.
- C. Refer children with sore throats for throat cultures.
- D. Recommend salicylates instead for minor discomforts.
Correct Answer: C
Rationale: The correct action to prevent rheumatic fever is to refer children with sore throats for throat cultures (Choice C). Rheumatic fever is caused by an abnormal immune response to a bacterial infection with group A Streptococcus. By promptly diagnosing and treating streptococcal infections with antibiotics, the risk of developing rheumatic fever can be minimized. Conducting throat cultures for children with sore throats helps identify streptococcal infections and allows for appropriate antibiotic treatment, thereby preventing the progression to rheumatic fever. Encouraging routine hypertensive screenings (Choice A) and conducting routine occult blood screenings (Choice B) are not directly related to the prevention of rheumatic fever. Recommending salicylates instead for minor discomforts (Choice D) is contraindicated in cases of suspected or confirmed streptococcal infections due to the risk of worsening symptoms and potentially triggering rheumatic fever.
The basic principle of healthy sleep hygiene which is NOT included is
- A. set routine
- B. avoid stimulating activities as playing computer games
- C. makes sure child spends time outside every day
- D. gives a heavy meal within an hour of bedtime
Correct Answer: D
Rationale: Heavy meals close to bedtime disrupt sleep.
The major pharmacologic action of albuterol sulfate (Proventil HFA) is:
- A. decreasing airway reactivity.
- B. decreasing inflammation and airway obstruction.
- C. improving the action of cilia to sweep trapped mucous upward.
- D. relaxing constricted bronchial smooth muscle.
Correct Answer: D
Rationale: Albuterol acts as a beta-2 agonist, relaxing bronchial smooth muscle to relieve airway constriction.
Which is most suggestive that a nurse has a nontherapeutic relationship with a patient and family?
- A. Staff is concerned about the nurse's actions with the patient and family.
- B. Staff assignments allow the nurse to care for same patient and family over an extended time.
- C. Nurse is able to withdraw emotionally when emotional overload occurs but still remains committed.
- D. Nurse uses teaching skills to instruct patient and family rather than doing everything for them.
Correct Answer: A
Rationale: Option A is the most suggestive that a nurse has a nontherapeutic relationship with a patient and family because when the staff is concerned about the nurse's actions with the patient and family, it indicates that there may be issues or red flags in the nurse's interactions. This could imply that the nurse's behavior is not promoting a positive, therapeutic relationship with the patient and family, which is crucial for effective care delivery. Staff concerns may arise due to behaviors that are inappropriate, unprofessional, or lacking empathy, which can hinder the development of a therapeutic relationship and affect the quality of care provided.
A client with idiopathic thrombocytopenic purpura (ITP), an autoimmune disorder, is admitted to an acute care facility. Concerned about hemorrhage, the nurse monitors the client's platelet count and observes closely for signs and symptoms of bleeding. The client is at greatest risk for cerebral hemorrhage when the platelet count falls below:
- A. 135,000/ul
- B. 20,000/ul
- C. 75,000/ul
- D. 500/ul
Correct Answer: B
Rationale: In a client with idiopathic thrombocytopenic purpura (ITP), a platelet count falling below 20,000/ul puts them at the greatest risk for cerebral hemorrhage. This is because the risk of spontaneous bleeding, especially in critical areas like the brain, significantly increases as platelet counts drop below this level. The brain is a sensitive organ, and even minor bleeds can have serious consequences. Therefore, it is crucial for healthcare providers to closely monitor platelet counts and promptly intervene to prevent life-threatening hemorrhage in clients with ITP.