Nokea
Regarding fluid and electrolyte homeostasis in a child:
- A. Normal maintenance requirement in a child weighing 20 kg is 1.5 litre/day
- B. A fluid deficit of 50ml/kg produces a body weight loss of 10%
- C. Hypotension is a useful sign ,which indicates moderate dehydration
- D. Normal maintenance needs of sodium are 5-6mmol/kg/day
Correct Answer: B
Rationale: A fluid deficit of 50ml/kg producing a 10% body weight loss is a well-established clinical guideline for assessing dehydration in children. Hypotension is a late sign of severe dehydration, not moderate dehydration.
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All of the following immune-mediated diseases are associated with antineutrophil cytoplasmic antibody, except
- A. Wegener granulomatosis
- B. Churg-Strauss syndrome
- C. Microscopic polyangiitis
- D. Henoch-Schönlein purpura
Correct Answer: D
Rationale: Henoch-Schönlein purpura is not associated with antineutrophil cytoplasmic antibodies (ANCA); it is an IgA-mediated vasculitis.
Pulmonary stenosis
- A. Most common at pulmonary valve level
- B. Valve dilatation done for dysplastic valves
- C. Ejection click occurs in past stenotic dilatation
- D. Surgery done when Rt ventricular pressure exceeds 25 mmHg
Correct Answer: A
Rationale: Pulmonary stenosis is most commonly found at the pulmonary valve level.
An older male client with long-standing lung disease is admitted to the medical unit for treatment of pulmonary infection. In assessing for signs of increasing hypoxia, which action should the nurse include? (select all that apply)
- A. Monitor dryness of mucous membranes
- B. Check for changes in mentation
- C. Observe color of skin and nailbeds
- D. Note appearance of jugular veins
Correct Answer: B
Rationale: Changes in mentation, skin color, and breathing patterns are key indicators of hypoxia in clients with lung disease.
Which explanation regarding cardiac catheterization is appropriate for a preschool child?
- A. Postural drainage will be performed every 4 to 6 hours after the test.
- B. It is necessary to be completely “asleep†during the test.
- C. The test is short, usually taking less than 1 hour.
- D. When the procedure is done, you will have to keep your leg straight for at least 4 hours.
Correct Answer: D
Rationale: The child’s leg will have to be maintained in a straight position for approximately 4 hours. Younger children can be held in the parent’s lap with the leg maintained in the correct position. Postural drainage will not be performed unless the child has corresponding pulmonary problems. The child should be sedated to lie still, but being completely asleep is not necessary. The test will vary in length of time from start to finish.
A health care provider has prescribed oxygen as needed for an infant with heart failure. In which situation should the nurse administer the oxygen?
- A. During sleep
- B. When changing the infant’s diapers
- C. When the mother is holding the infant
- D. When drawing blood for electrolyte level testing
Correct Answer: A
Rationale: Administering oxygen during sleep can help ensure the infant maintains adequate oxygenation, especially since infants with heart failure may have compromised respiratory function.