Nokea
The laboratory results of a patient with disseminated intravascular coagulation are likely to include:
- A. decreased levels of fibrin split products.
- B. increased levels of fibrinogen.
- C. increased platelet counts.
- D. prolonged prothrombin and partial thromboplastin times.
Correct Answer: D
Rationale: DIC leads to prolonged clotting times due to consumption of clotting factors and platelets.
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The nurse is using the FLACC scale to rate the pain level in a 9-month-old. Which is the nurse's best response to the father's question of what the FLACC scale is?
- A. It estimates a child's level of pain utilizing vital sign information.
- B. It estimates a child's level of pain based on parents' perception.
- C. It estimates a child's level of pain utilizing behavioral and physical responses.
- D. It estimates a child's level of pain utilizing a numeric scale from 0 to 5.
Correct Answer: C
Rationale: The FLACC scale uses observable behavioral and physical responses (facial expression, leg movement, activity, cry, and consolability) to estimate pain.
Nursing measures in hemodynamic monitoring include assessing for localized ischemia owing to inadequate arterial flow. The nurse should:
- A. Assess the involved extremity for color and temperature
- B. Check for capillary refill
- C. Evaluate pulse rate
- D. Do all of the above
Correct Answer: D
Rationale: When assessing for localized ischemia owing to inadequate arterial flow, it is important for the nurse to perform all of the mentioned actions:
A teen asks a nurse, "What is physical dependence in substance abuse?" Which is the correct response by the nurse?
- A. Problem that occurs in conjunction with addiction
- B. Involuntary physiologic response to drug
- C. Culturally defined use of drugs for purposes other than accepted medical purposes
- D. Voluntary behavior based on psychosocial needs
Correct Answer: B
Rationale: Physical dependence in substance abuse refers to the body's physiological adaptation to a drug, leading to the development of withdrawal symptoms when the drug is abruptly stopped or reduced in dosage. This is different from addiction, which involves psychological dependence and compulsive drug-seeking behavior despite harmful consequences. Physical dependence is typically characterized by tolerance (needing higher doses to achieve the same effect) and withdrawal symptoms when the drug is stopped.
Of the following, the MOST likely cause of constipation is
- A. hypothyroidism
- B. Hirschsprung disease
- C. functional constipation
- D. celiac disease
Correct Answer: C
Rationale: Functional constipation is the most common cause of constipation in children, often due to diet or behavioral factors.
Laboratory studies indicate a client's blood pressure level is 185mg/dl. Two hours have passed since the client ate breakfast. Which test would yield the most occlusive diagnostic information about the client's glucose utilization?
- A. A fasting blood glucose test
- B. A test of serum glycosylated hemoglobin (HbA1c)
- C. A 6-hour glucose tolerance test
- D. A test for urine ketones
Correct Answer: C
Rationale: A 6-hour glucose tolerance test would yield the most occlusive diagnostic information about the client's glucose utilization in this case. The elevated blood pressure level of 185 mg/dL two hours after breakfast indicates poor glucose regulation. A glucose tolerance test involves monitoring the client's blood glucose levels over a period of time after ingesting a glucose solution. This test provides a comprehensive assessment of how the body processes glucose, revealing any abnormalities in glucose metabolism beyond fasting levels, such as postprandial (after-meal) glucose spikes and prolonged hyperglycemia. This can help identify conditions like insulin resistance, impaired glucose tolerance, or diabetes, which may not be evident from a fasting blood glucose test alone. Glycosylated hemoglobin (HbA1c) reflects average blood sugar levels over the past 2-3 months and would not provide immediate information about the client's current glucose metabolism. Urine ketones