Nokea
The following investigations are not needed in a 3-year old on TPN for the past 3 weeks:
- A. Serum selenium
- B. Serum manganese
- C. Serum iron
- D. Serum calcium
Correct Answer: C
Rationale: The correct answer is C because serum iron is not typically monitored in children on total parenteral nutrition (TPN). The other options (a, b, d, e) are commonly monitored to prevent deficiencies or toxicities.
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In utero heart failure, often with fetal pleural and pericardial effusions and generalized ascites (nonimmune hydrops fetalis) may occur in
- A. ventricular septal defect
- B. coarctation of aorta
- C. d-Transposition of great arteries
- D. single ventricle
Correct Answer: D
Rationale: Single ventricle anatomy can lead to in utero heart failure and hydrops fetalis.
The nurse is caring for a child with persistent hypoxia secondary to a cardiac defect. The nurse recognizes that a risk exists of cerebrovascular accidents (strokes). Which is an important objective to decrease this risk?
- A. Minimize seizures
- B. Prevent dehydration
- C. Promote cardiac output
- D. Reduce energy expenditure
Correct Answer: B
Rationale: In children with persistent hypoxia, polycythemia develops. Dehydration must be prevented in hypoxemic children because it potentiates the risk of strokes. Minimizing seizures, promoting cardiac output, and reducing energy expenditure will not reduce the risk of cerebrovascular accidents.
Which of the following conditions results primarily from mutation in the gene encoding Vitamin D receptor?
- A. Vitamin D dependent rickets type 1
- B. Vitamin D dependent rickets type 2
- C. X-linked hypophosphatemic rickets
- D. Autosomal dominant hypophosphatemic rickets
Correct Answer: B
Rationale: Vitamin D dependent rickets type 2 is caused by mutations in the vitamin D receptor gene, leading to resistance to vitamin D.
While assisting a female client to the toilet, the client begins to have a seizure and the nurse eases her to the floor. The nurse calls for help and monitors the client until the seizing stops. Which intervention should the nurse implement first?
- A. Document details of the seizure activity
- B. Observe for lacerations to the tongue
- C. Observe for prolonged periods of apnea
- D. Evaluate for evidence of incontinence
Correct Answer: C
Rationale: Observing for prolonged periods of apnea is critical to ensure the client's airway remains patent and to prevent hypoxia.
A male client with pernicious anemia takes supplemental folate and self-administers monthly Vitamin B12 injections. He reports feeling increasingly fatigued. Which laboratory value should the nurse review?
- A. Complete blood count
- B. Serum ferritin level
- C. Serum potassium level
- D. Liver function tests
Correct Answer: A
Rationale: Fatigue in pernicious anemia may indicate inadequate treatment. A complete blood count helps assess hemoglobin and red blood cell levels.