Nokea
Regarding cafe-au-lait spots:
- A. They can be normal findings
- B. They are found in tuberous sclerosis
- C. When present in a child, > 4 spots each > 0.5 cm, is diagnostic of neurofibromatosis type II
- D. Typical appearance in neurofibromatosis is of a smooth border
Correct Answer: A
Rationale: Cafe-au-lait spots can be a normal variant and do not always indicate an underlying pathology.
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A 70-year-old male client with type 2 diabetes mellitus (DM) is hospitalized with an infected ulcer on his great right toe. Which instruction should the nurse emphasize during discharge teaching?
- A. Check the insides and linings of all enclosed shoes before putting the shoes on
- B. Wash the feet with soap and water, then apply a topical antibiotic ointment.
- C. Trim toenails weekly to prevent injury.
- D. Avoid wearing sandals or open-toed shoes.
Correct Answer: A
Rationale: Preventing trauma to the feet is critical for clients with diabetes to avoid complications like infections and ulcers.
Symptoms in patients with aortic stenosis depend on the severity of the obstruction EXCEPT
- A. cardiomegaly
- B. pulmonary congestion
- C. weak pulses
- D. pale skin
Correct Answer: D
Rationale: Pale skin is not a typical symptom of aortic stenosis.
The school nurse has been following a child who frequently complains of dizziness and headache. Today, she is brought in after fainting in the cafeteria following a nosebleed. Her BP is 122/85, and her radial pulses are bounding. The nurse suspects she has:
- A. Transposition of the great vessels
- B. Coarctation of the aorta (COA)
- C. Aortic stenosis (AS)
- D. Pulmonic stenosis (PS)
Correct Answer: B
Rationale: In older children, COA can cause elevated blood pressure, headache, fainting, and bounding radial pulses.
The nurse is assessing a client who has tinea pedis. Which question will allow the nurse to gather further information about this condition?
- A. Do you see any improvement when using tolnaftate?
- B. Have you been avoiding wearing tight-fitting shoes?
- C. Are you experiencing pain or itching in your feet?
- D. How often do you wash your feet and change socks?
Correct Answer: A
Rationale: Tolnaftate is an antifungal medication. Asking about its effectiveness helps assess the client's treatment response and adherence.
A child is undergoing remission induction therapy to treat leukemia. Allopurinol is included in the regimen. The main reason for administering allopurinol as part of the client’s chemotherapy regimen is to:
- A. Prevent metabolic breakdown of xanthine to uric acid
- B. Prevent uric acid from precipitating in the ureters
- C. Enhance the production of uric acid to ensure adequate excretion of urine
- D. Ensure that the chemotherapy doesn’t adversely affect the bone marrow
Correct Answer: A
Rationale: Allopurinol prevents the breakdown of xanthine to uric acid, reducing the risk of uric acid nephropathy during chemotherapy-induced tumor lysis.