Nokea
The nurse is caring for a newborn with respiratory distress syndrome. The newborn has an endotracheal tube. Which statement describes nursing considerations related to suctioning?
- A. Suctioning should not be carried out routinely.
- B. Newborn should be in Trendelenburg position for suctioning.
- C. Routine suctioning, usually every 15 minutes, is necessary.
- D. Frequent suctioning is necessary to maintain patency of bronchi.
Correct Answer: A
Rationale: Suctioning should not be carried out routinely in a newborn with respiratory distress syndrome and an endotracheal tube. Routine, frequent suctioning can lead to airway trauma, damage to mucous membranes, and increased risk of infection. Suctioning should only be performed when there are clinical indications such as visible secretions or signs of respiratory distress. Each suctioning event should be carefully assessed and performed with gentle technique to minimize potential harm to the newborn's delicate airway.
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The neurologist tests the 4th and 6th cranial nerves together by having a patient do which of the following?
- A. Turn his head to the right and left
- B. Say "ahhh"
- C. Identify whispering in his ears
- D. Follow his finger with his eyes
Correct Answer: D
Rationale: The neurologist tests the 4th and 6th cranial nerves together by having a patient follow his finger with his eyes. The 4th cranial nerve (trochlear nerve) innervates the superior oblique muscle, which primarily moves the eye downward and outward. The 6th cranial nerve (abducens nerve) innervates the lateral rectus muscle, which primarily moves the eye laterally. Testing these cranial nerves simultaneously by asking the patient to follow the neurologist's finger helps assess the coordination and function of both of these nerves, which are important for eye movement control.
The MOST common cause of sleeping difficulty in the first 2 months of life is
- A. gastro-esophageal reflux
- B. colic
- C. formula intolerance
- D. developmentally self-resolving sleeping behavior
Correct Answer: B
Rationale: Colic is a frequent cause of sleep difficulties in young infants.
There are several risk factors with developing cancer. The following are risk factors of cancer, except:
- A. age
- B. ordinal petition In the family
- C. race
- D. lifestyle
Correct Answer: B
Rationale: Age, race, and lifestyle are all commonly recognized risk factors associated with the development of cancer. However, ordinal petition in the family is not a known or established risk factor for cancer. Family history of cancer (inheritance), on the other hand, is a significant risk factor for many types of cancer.
A client receiving ferrous sulfate (Fer-Iron) therapy to treat an iron deficiency reports taking an antacid frequently to relieve heart burn. Which nursing instruction should the nurse provide?
- A. "Take ferrous sulfate and the antacid together."
- B. "Take ferrous sulfate and the antacid at least 2 hours apart."
- C. "Avoid taking an antacid altogether."
- D. "Take ferrous sulfate and the antacid at least 1 hour apart."
Correct Answer: B
Rationale: Antacids can interfere with the absorption of iron from ferrous sulfate. Therefore, it is important to take these medications at least 2 hours apart to ensure proper absorption of the iron supplement. Taking them together can reduce the effectiveness of the ferrous sulfate therapy in treating the iron deficiency. It is not necessary to avoid taking an antacid altogether, but timing is crucial to optimize the benefits of both medications.
A 5-year old boy presents with afebrile generalized tonic-clonic seizure lasting for 5 minutes. Previously he was healthy and had no such problem. On examination there is no abnormality. Your plan of management should be:
- A. Start anticonvulsant therapy
- B. Request for an EEG and wait for its report
- C. Request for an EEG and start anticonvulsant therapy immediately
- D. Request for EEG and MRI brain
Correct Answer: C
Rationale: In a first-time generalized seizure, an immediate EEG and starting anticonvulsant therapy is prudent to prevent recurrence, especially if the EEG shows epileptiform activity.