Nokea
The mother of a 14-year old who had a below-the-knee amputation for osteosarcoma tells the nurse that her child is angry and blaming her for allowing the amputation to occur. Which response is best for the nurse to provide?
- A. I will ask the HCP for a psychiatric consult for your child'
- B. This type of acting out behavior is normal for adolescents'
- C. It is important to focus on your child's needs at this difficult time'
- D. A reaction of anger is your child's attempt to cope with this loss'
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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The heart rate for a 3-year-old with a congenital heart defect has steadily decreased over the last few hours, now it's 76 bpm, the previous reading 4 hours ago was 110 bpm. Which additional finding should be reported immediately to a healthcare provider?
- A. Oxygen saturation 94%.
- B. RR of 25 breaths/minute.
- C. Urine output 20 mL/hr.
- D. BP 70/40.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A 16-year-old female student with a history of asthma controlled with both an oral antihistamine and an albuterol (Proventil) metered-dose inhaler (MDI) comes to the school nurse. The student complains that she cannot sleep at night, feels shaky and her heart feels like it is 'beating a mile a minute.' Which information is most important for the nurse to obtain?
- A. When she last took the antihistamine.
- B. When her last asthma attack occurred.
- C. Duration of most asthma attacks.
- D. How often the MDI is used daily.
Correct Answer: D
Rationale: The most important information for the nurse to obtain in this scenario is how often the MDI is used daily. This is crucial to assess if the symptoms the student is experiencing, such as insomnia, shakiness, and tachycardia, could be related to overuse of the inhaler. Overuse of albuterol can lead to side effects like tremors, palpitations, and difficulty sleeping, so understanding the frequency of MDI use is key in determining a potential cause for the student's symptoms.
A child diagnosed with Kawasaki disease is brought to the clinic. The mother reports that her child is irritable, refuses to eat, and has skin peeling on both hands and feet. Which intervention should the nurse instruct the mother to implement first?
- A. Place the child in a quiet environment
- B. Make a list of foods that the child likes
- C. Encourage the parents to rest when possible
- D. Apply lotion to hands and feet
Correct Answer: A
Rationale: Creating a quiet environment is the priority intervention as it helps reduce irritability and stress in children with Kawasaki disease. This intervention can promote a soothing atmosphere for the child, which may help in managing their symptoms effectively. Once the child is in a peaceful setting, further interventions such as addressing nutritional needs or skincare can be addressed.
The heart rate for a 3-year-old with a congenital heart defect has steadily decreased over the last few hours; it is now 76 bpm, whereas the previous reading 4 hours ago was 110 bpm. Which additional finding should be reported immediately to a healthcare provider?
- A. Oxygen saturation of 94%.
- B. Respiratory rate of 25 breaths/minute.
- C. Urine output of 20 mL/hr.
- D. Blood pressure of 70/40.
Correct Answer: D
Rationale: A significant drop in heart rate and blood pressure should be reported immediately as it may indicate worsening of the congenital heart defect. A decrease in blood pressure to 70/40 is a critical finding that suggests potential cardiovascular compromise and requires urgent attention to prevent further deterioration.
The nurse is conducting an admission assessment of an 11-month-old infant with CHF who is scheduled for repair of restenosis of coarction of the aorta that was repaired 4 days after birth. Findings include blood pressure higher in the arms than the lower extremities, pounding brachial pulses, and slightly palpable femoral pulses. What pathophysiologic mechanisms support these findings?
- A. The aortic semilunar valve obstructs blood flow into the systemic circulation
- B. The lumen of the aorta reduces the volume of the blood flow to the lower extremities
- C. The pulmonic valve prevents adequate blood volume into the pulmonary circulation
- D. An opening in the atrial septum causes a murmur due to a turbulent left to right shunt
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.