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The nurse is caring for a 5-year-old child with impetigo contagiosa. The parents ask the nurse what will happen to their child's skin after the infection has subsided and healed. Which answer should the nurse give?
- A. There will be no scarring.
- B. There may be some pigmented spots.
- C. It is likely there will be some slightly depressed scars.
- D. There will be some atrophic white scars.
Correct Answer: A
Rationale: Impetigo contagiosa typically does not leave scarring once it has subsided and healed. This skin infection primarily affects the superficial layers of the skin and does not cause damage deep enough to result in scarring. While there may be some temporary pigmented spots or mild changes in skin color after the infection resolves, scarring is not a common outcome of impetigo contagiosa in most cases. Thus, the nurse should reassure the parents that their child's skin is not likely to have any scarring after the infection has healed.
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A total thyroidectomy is ordered following discovery of a cold nodule. In this case of hyperthyroidism versus malignancy, the nurse anticipates that the patient will have:
- A. A complete thyroidectomy also
- B. a partial thyroidectomy (approximately one-half of the thyroid is removed)
- C. a partial thyroidectomy (approximately five-sixths of the thyroid is removed)
- D. administration of thyroid medication
Correct Answer: A
Rationale: A total thyroidectomy is the removal of the entire thyroid gland. In the case of a cold nodule, which may indicate malignancy, a total thyroidectomy is usually performed to ensure complete removal of the potentially cancerous tissue. Hyperthyroidism, on the other hand, can often be managed with medication or a partial thyroidectomy, depending on the underlying condition. In this scenario, the presence of a cold nodule suggests a higher likelihood of malignancy, hence the need for a total thyroidectomy.
Which of the following is an intraoperative outcome for a patient undergoing an inguinal hernia repair?
- A. Verbalizes fears
- B. Demonstrates leg exercises
- C. Maintains skin integrity
- D. Explains deep breathing exercises
Correct Answer: C
Rationale: Intraoperative outcomes refer to the immediate goals and conditions that are assessed during a surgical procedure. Maintaining skin integrity is a crucial intraoperative outcome for a patient undergoing an inguinal hernia repair surgery. This outcome focuses on ensuring that the patient's skin remains intact, without any damage or breakdown during the surgical procedure. It involves proper positioning of the patient, adequate support to vulnerable areas, and meticulous monitoring of the skin throughout the surgery to prevent any pressure injuries or skin trauma. Other outcomes listed, such as verbalizing fears, demonstrating leg exercises, and explaining breathing exercises, are more pertinent to preoperative or postoperative care rather than intraoperative outcomes.
Which is the most reliable method for monitoring fluid balance?
- A. Daily intake and output
- B. Vital signs
- C. Daily weight
- D. Skin turgor
Correct Answer: A
Rationale: Monitoring daily intake and output is the most reliable method for assessing fluid balance in a patient. By accurately measuring the amount of fluids taken in through foods, drinks, and IV fluids, as well as the amount of fluids eliminated through urine, stool, vomit, and other means, healthcare providers can closely track the body's fluid balance. Discrepancies between intake and output can indicate potential issues such as dehydration or fluid overload. This method provides quantitative data that can guide appropriate interventions and treatment adjustments to maintain the patient's fluid balance within normal limits. While vital signs, daily weight, and skin turgor are also important indicators of fluid status, they may not always provide as specific or accurate information as the direct measurement of intake and output.
Children with ALL who carry poor outcome include all the following EXCEPT
- A. age younger than 1 year and older than 10 year
- B. T-cell immunophenotype
- C. hyperdiploidy chromosomal abnormality
- D. initial leukocyte count of > 50,000
Correct Answer: C
Rationale: Hyperdiploidy is generally associated with a favorable prognosis in ALL, unlike other listed factors.
The parents of a 4-month-old infant tell the nurse that they are getting a microwave oven and will be able to heat the baby's formula faster. What should the nurse recommend?
- A. Never heat a bottle in a microwave oven.
- B. Heat only 10 ounces or more.
- C. Always leave bottle top uncovered to allow heat to escape.
- D. Shake bottle vigorously for at least 30 seconds after heating.
Correct Answer: A
Rationale: The nurse should recommend never heating a bottle in a microwave oven. Microwaves do not heat liquids evenly, and there is a risk of creating hot spots in the formula, which can burn the baby's mouth and throat. It is safer to heat the formula by placing the bottle in warm water or using a bottle warmer to ensure uniform heating throughout.