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The nurse caring for an adolescent patient with a diagnosis of goiter knows that goiter is most often caused by?
- A. Kawasaki's disease
- B. Takayasu Disease
- C. Matsuzaki Disease
- D. Hashimoto Disease
Correct Answer: D
Rationale: The correct answer is D: Hashimoto Disease. Goiter is most commonly caused by Hashimoto Disease, which is an autoimmune condition where the body attacks the thyroid gland, leading to inflammation and enlargement of the gland. This results in the development of a goiter. Kawasaki's disease (A), Takayasu Disease (B), and Matsuzaki Disease (C) are not typically associated with the development of goiter. A summary of why the other choices are incorrect: A is a systemic vasculitis, B is a type of vasculitis involving the aorta and its main branches, and C is a fictional disease.
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A home health nurse is caring for a child who has lyme disease. Which of the following is an appropriate action for the nurse to take
- A. Ensure the state health department has been notified
- B. Administer antitoxin
- C. Educate the family to avoid sharing personal belongings
- D. Assess for skin necrosis
Correct Answer: B
Rationale: The correct answer is B: Administer antitoxin. Lyme disease is caused by a bacterium, not a toxin, so administering antitoxin is not appropriate. Option A is incorrect because notifying the state health department is not a direct action for the nurse to take in caring for the child. Option C is incorrect as educating the family to avoid sharing personal belongings is a preventive measure but not a direct action for the child's care. Option D is incorrect as skin necrosis is not a typical manifestation of Lyme disease. Administering appropriate antibiotics to treat the bacterial infection is the most appropriate action for the nurse to take in caring for the child with Lyme disease.
Your patient has just returned from the OR following an arterial septal defect repair. You are reviewing your orders and question the fluid rate ordered. Your patient is 6 years old and weighs 50 pounds. Select the appropriate hourly maintenance fluid rate for your patient.
- A. 63 ml/hr
- B. 64 ml/hr
- C. 65 ml/hr
- D. 107 ml/hr
Correct Answer: A
Rationale: The appropriate hourly maintenance fluid rate for a 6-year-old patient weighing 50 pounds can be calculated using the Holliday-Segar method, which recommends 100 ml/kg/day for the first 10 kg of body weight, 50 ml/kg/day for the next 10 kg, and 20 ml/kg/day for each additional kg. Converting the patient's weight from pounds to kg (50 lbs / 2.2 = 22.73 kg), the calculation would be:
100 ml x 10 kg + 50 ml x 10 kg + 20 ml x 2.73 kg = 1000 ml + 500 ml + 54.6 ml = 1554.6 ml/day
To convert this to an hourly rate, divide by 24 hours: 1554.6 ml/day / 24 hours = 64.775 ml/hr, which rounds down to 63 ml/hr (Option A).
The other choices are incorrect because
Ringworm, frequently found in school children, is caused by which of the following?
- A. Virus
- B. Fungus
- C. Allergic reaction
- D. Bacterial infection
Correct Answer: B
Rationale: Ringworm is caused by a fungus, specifically dermatophytes that infect the skin, hair, or nails. Fungi thrive in warm, moist environments, making schools a common place for transmission. Viruses, allergic reactions, and bacterial infections do not cause ringworm. Ringworm is a fungal infection, not a result of an allergic reaction or bacterial infection.
A 16-year-old with a chronic illness has recently become rebellious and is taking risks such as missing doses of his medication. What is the best explanation for this behavior?
- A. The child needs more discipline
- B. The child needs more socialization with peers
- C. The child is exhibiting normal adolescent behavior
- D. The child is demonstrating a need for more parental control
Correct Answer: C
Rationale: The correct answer is C. The child is exhibiting normal adolescent behavior. Adolescence is a period of identity formation, autonomy-seeking, and risk-taking. It is common for teenagers to rebel against authority figures, including parents and healthcare providers, as they strive for independence and self-discovery. This rebellious behavior, such as missing medication doses, can be a way for the teenager to assert control over their own life and make their own decisions. It is crucial for healthcare providers to recognize this normal developmental stage and approach the situation with understanding and support rather than punitive measures.
Other choices are incorrect because:
A: The child needing more discipline implies that the behavior is solely due to a lack of control or structure, which overlooks the developmental aspect of adolescence.
B: While socialization with peers is important, it may not address the underlying reasons for the rebellious behavior.
D: Imposing more parental control may exacerbate the rebellion and hinder the adolescent's autonomy development.
A six-year-old is scheduled for a cardiac catheterization. Preoperative teaching should be:
- A. Directed to the parents because the patient is too young to understand
- B. Detailed regarding the actual procedure so the patient will know what to expect
- C. Completed several days prior to the procedure so the patient will be prepared
- D. Adapted to the patient's development level
Correct Answer: D
Rationale: The correct answer is D because preoperative teaching for a six-year-old undergoing cardiac catheterization should be adapted to the patient's development level. This is crucial as it ensures the information is communicated in a way that the child can comprehend and reduces anxiety. Providing information at the appropriate developmental stage helps the child feel more prepared and less fearful. Choice A is incorrect as children as young as six can understand basic concepts with appropriate communication techniques. Choice B may overwhelm the child with unnecessary details. Choice C is incorrect because waiting too long to provide information may increase anxiety.