Maternity and Pediatric Nursing 4th Edition Test Bank

Maternity and Pediatric Nursing 4th Edition Test Bank Related

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The nurse is examining 12-month-old Amy, who was brought to the clinic for persistent diaper rash. The nurse finds perianal inflammation with satellite lesions that cross the inguinal folds. What is most likely the cause of the diaper rash?

  • A. Impetigo
  • B. Candida albicans
  • C. Urine and feces
  • D. Infrequent diapering
Correct Answer: B

Rationale: The presentation of perianal inflammation with satellite lesions that cross the inguinal folds is highly suggestive of a Candida albicans (yeast) diaper rash. Yeast diaper rash is characterized by redness, swollenness, and usually involves the skin folds. The warm, moist environment created by a diaper provides an ideal setting for Candida albicans to grow and cause a rash. The presence of satellite lesions that cross the inguinal folds further supports the diagnosis of a yeast infection rather than other causes like impetigo, irritation from urine and feces, or infrequent diapering. Treatment for yeast diaper rash typically involves antifungal creams or ointments.

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Discharge care planning has begun for a seriously injured patient who is Asian. The patient's parents have refused routine home health visits. The pediatric nurse understands the family may:

  • A. believe that health outcomes are predetermined.
  • B. feel health is a personal responsibility and maintenance of family reputation is paramount.
  • C. regard health as a family responsibility, seeking outside aid only when resources are exhausted.
  • D. none of the above.
Correct Answer: C

Rationale: In some cultures, families may prefer to handle health matters internally, viewing outside assistance as a last resort.

Mr. Kawasaki, a 23-year old industrial worker, was burned severely in an industrial accident. He has second degree burns on his right leg and arm, and on his left leg. He has third degree burns on his left arm. The triage nurse, using the rule of nines, estimates the extent of burn as:

  • A. 18%
  • B. 45%
  • C. 36%
  • D. 54%
Correct Answer: C

Rationale: The rule of nines is a method used to quickly estimate the extent of burns on a patient's body. According to the rule of nines, each area of the body is assigned a percentage that represents its proportional size compared to the total body surface area. In adults, the body is divided into areas of 9% or multiples of 9%.

A patient has end-stage dilated cardiomyopathy. He comes to the emergency department with dyspnea. He says he went to bed and awoke with a feeling of suffocation. He says it was frightening. Which of the ff. responses by the nurse is most appropriate?

  • A. "You must have been dreaming."
  • B. "Reclining decreases the heart's ability to pump blood." c."Sleeping increases heart rate, which increases the body's need for oxygen."
  • C. "Reclining increases fluid returning to the heart, which builds up fluid in the lungs."
Correct Answer: C

Rationale: The most appropriate response by the nurse is option C, "Reclining increases fluid returning to the heart, which builds up fluid in the lungs." In a patient with end-stage dilated cardiomyopathy, reclining position can lead to increased fluid return to the heart due to the failing pump function. This can result in fluid backing up in the lungs, causing symptoms such as dyspnea or feeling of suffocation. By explaining this mechanism to the patient, the nurse can provide valuable information about the condition and the reason for the distressing symptoms experienced by the patient. It also highlights the importance of proper positioning to alleviate symptoms and improve the patient's comfort.

While bathing an 82 y.o. man hospitalized with pneumonia, a nurse notes an ulcerated area on his penis. What action should the nurse take first?

  • A. Report the ulcer to the admitting care provider.
  • B. Teach the man about STD prevention.
  • C. Ask the man if he has a history of syphilis.
  • D. Clean the ulcer; reporting is not necessary because an STD is unlikely in a man this age.
Correct Answer: A

Rationale: The nurse should report the ulcer to the admitting care provider as the first action. An ulcerated area on the penis in an older adult may be indicative of various serious conditions, such as sexually transmitted infections (STIs) or skin breakdown. It is important for the healthcare provider to assess the ulcer, determine the cause, and initiate appropriate treatment. Reporting the finding promptly ensures timely intervention and appropriate management of the patient's condition. This initial action takes priority over teaching about STD prevention or inquiring about the patient's history of syphilis. Cleaning the ulcer without proper assessment and diagnosis by a healthcare provider can potentially worsen the patient's condition.

Which of the following types of translocation of childhood AML that typically associated with granulocytic sarcoma mass?

  • A. inv(16)
  • B. t(8;21)
  • C. t(6;9)
  • D. inv(3)
Correct Answer: A

Rationale: The inv(16) translocation is strongly associated with granulocytic sarcoma in AML.

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