Nokea
The nurse encourages a client with an immunologic disorder to eat a nutritionally balanced diet to promote optimal immunologic function. Autoimmunity has been linked to excessive ingestion of:
- A. Protein
- B. Vitamin A
- C. Fat
- D. Zinc
Correct Answer: C
Rationale: Excessive ingestion of fat has been linked to autoimmunity. A diet high in saturated and trans fats can lead to chronic inflammation and disrupt the balance of immune cells, potentially triggering autoimmune responses in the body. Conversely, a nutritionally balanced diet that includes healthy fats like omega-3 fatty acids from sources such as fish, nuts, and seeds can help support optimal immunologic function and reduce the risk of autoimmune disorders.
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Alveolar type of rhabdomyosarcoma accounts for approximately 1/3 of all cases of pediatric RMS and carries the poorest prognosis. Of the following, the MOST common site of involvement by alveolar type RMS is
- A. orbit
- B. middle ear
- C. extremities
- D. bladder
Correct Answer: C
Rationale: Extremities are the most common site for alveolar rhabdomyosarcoma.
Alex is taking carbamazepine (tegretol) for seizure disorder. He should be monitored for which of the following potential complications?
- A. adult respiratory distress syndrome
- B. elevated leves of phenytoin (Dilantin)
- C. diplopia
- D. leukocytosis
Correct Answer: B
Rationale: Carbamazepine is a known enzyme inducer, and it can increase the metabolism of other drugs, such as phenytoin (Dilantin). This can lead to lower levels of phenytoin in the blood and potentially reduce its effectiveness. Therefore, patients taking carbamazepine should be monitored for elevated levels of phenytoin to ensure optimal seizure control. Diplopia (double vision), leukocytosis, and adult respiratory distress syndrome are not typically associated with carbamazepine use.
A client with diabetes mellitus has a prescription for 5 U-100 regular insulin and 25 U of U-100 isophane insulin suspension (NPH) to be taken before breakfast. At about 4:30 p.m., the client experiences headache, sweating, tremor, pallor, and nervousness. What is the most probable cause of these signs and symptoms?
- A. Hyperglycemia
- B. Hyperuricemia
- C. Hypoglycemia
- D. Hypochondria
Correct Answer: C
Rationale: The signs and symptoms of headache, sweating, tremor, pallor, and nervousness described in the client suggest hypoglycemia, which is caused by low blood sugar levels. Insulin is a medication used to lower blood sugar levels in individuals with diabetes. In this case, the client has taken a combination of regular insulin and NPH insulin before breakfast, which could have led to a rapid drop in blood sugar levels by the afternoon causing the symptoms described. It is important to treat hypoglycemia promptly by giving the client a fast-acting carbohydrate source, such as glucose tablets or juice, to raise their blood sugar back to a safe level.
To prevent plagiocephaly, the nurse should teach parents to:
- A. place infant prone for 30 to 60 minutes per day.
- B. buy a soft mattress.
- C. allow infant to nap in the car safety seat.
- D. have infant sleep with the parents.
Correct Answer: A
Rationale: Placing the infant prone (on their stomach) for 30 to 60 minutes per day while they are awake is an effective way to prevent plagiocephaly, which is the flattening of the back or side of an infant's head. This practice helps to alleviate pressure on one particular area of the skull and promotes balanced head growth. It is important for parents to follow safe sleep guidelines and avoid having infants sleep on their stomachs, as this position is associated with an increased risk of sudden infant death syndrome (SIDS). Therefore, the recommended practice of placing the infant prone for short periods during supervised awake time helps prevent plagiocephaly without compromising the infant's safety during sleep.
For a 14-month-old whose cleft palate was repaired 12 hours ago, which should be included in the plan of care?
- A. Allow familiar comfort items (e.g., favorite stuffed animal) and a 'sippy' cup (avoid suction items).
- B. Once liquids are tolerated, encourage a bland diet (e.g., soup, Jell-O, saltine crackers).
- C. Administer scheduled pain medication rather than PRN only.
- D. Use a Yankauer suction catheter to decrease aspiration risk.
Correct Answer: A
Rationale: Providing comfort items and avoiding suction items helps reduce distress and supports healing.