Nokea
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 nurse is caring for a newborn whose mother was taking methadone during her pregnancy, which of the following findings indicates the newborn is experiencing withdrawal?
- A. Bulging fontanels
- B. Acrocyanosis
- C. Bradycardia
- D. Hypertonicity
Correct Answer: D
Rationale: The correct answer is D: Hypertonicity. Newborns exposed to opioids in utero often exhibit symptoms of withdrawal, known as Neonatal Abstinence Syndrome (NAS). Hypertonicity, or increased muscle tone, is a common sign of NAS. This occurs due to the withdrawal effects of methadone on the central nervous system. Bulging fontanels (A) are not typically associated with NAS. Acrocyanosis (B) is a common finding in newborns and not specific to NAS. Bradycardia (C) refers to a slow heart rate and is not a typical sign of NAS.
A 3-year-old patient is taking therapeutic doses of Digoxin and Lasix for heart failure and has an order for daily labs to be drawn. What side effect of this drug combination would the nurse find most concerning?
- A. Hypernatremia
- B. Hypokalemia
- C. Hyponatremia
- D. Hyperkalemia
Correct Answer: B
Rationale: The correct answer is B: Hypokalemia. Digoxin and Lasix can both cause potassium loss, leading to hypokalemia. In this case, hypokalemia is concerning as it can increase the risk of Digoxin toxicity, resulting in life-threatening arrhythmias. Hypernatremia (A), hyponatremia (C), and hyperkalemia (D) are not common side effects of this drug combination and would not pose the same level of risk as hypokalemia.
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.
Congenital heart defects are classified as all of the following? (Select all that apply)
- A. Mixed defects
- B. Obstruction defects
- C. Decreased pulmonary blood flow
- D. Acquired defects
Correct Answer: A,B,C
Rationale: Congenital heart defects can be classified based on pathophysiology. A: Mixed defects involve combination of two types of abnormalities, B: Obstruction defects involve narrowing/blockage in blood flow, and C: Decreased pulmonary blood flow includes defects leading to decreased blood flow to lungs. D: Acquired defects result from external factors and not present at birth. E, F, G are not applicable as no information is provided. Thus, A, B, C are correct based on classification of congenital heart defects.
Which is the most accurate genetic explanation for a family with hemophilia?
- A. It is an X-linked recessive disorder
- B. It is an autosomal recessive disorder
- C. It is equally distributed among males and females
- D. It is a Y-linked dominant disorder
Correct Answer: A
Rationale: The correct answer is A: It is an X-linked recessive disorder. Hemophilia is caused by a mutation in genes located on the X chromosome. Males inherit the disorder from their mothers, as they only inherit one X chromosome. Females can be carriers if they inherit one mutated X chromosome. Autosomal recessive disorders (choice B) require both parents to pass on the mutated gene. Hemophilia is not equally distributed among males and females (choice C) because males are more likely to exhibit symptoms. Y-linked disorders (choice D) are inherited only by males and are passed from father to son.