Nokea
The nurse is preparing an adolescent for discharge after a cardiac catheterization. Which statement by the adolescent would indicate a need for further teaching?
- A. “I should avoid tub baths but may shower.â€
- B. “I have to stay on strict bed rest for 3 days.â€
- C. “I should remove the pressure dressing the day after the procedure.â€
- D. “I may attend school but should avoid exercise for several days.â€
Correct Answer: B
Rationale: The child does not need to be on strict bed rest for 3 days. Showers are recommended; children should avoid a tub bath. The pressure dressing is removed the day after the catheterization and replaced by an adhesive bandage to keep the area clean. Strenuous activity must be avoided for several days, but the child can return to school.
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Clubbing is found in:
- A. Crohn's disease
- B. Bronchiectasis
- C. Rheumatic fever
- D. Infective endocarditis
Correct Answer: B
Rationale: Clubbing is commonly associated with chronic respiratory conditions such as bronchiectasis, due to chronic hypoxia and inflammation.
A chest radiograph film is ordered for a child with suspected cardiac problems. The child’s parent asks the nurse, “What will the radiograph show about the heart?†What knowledge about the x-ray should the nurse include in the response to the parents?
- A. Bones of chest but not the heart
- B. Measurement of electrical potential generated from heart muscle
- C. Permanent record of heart size and configuration
- D. Computerized image of heart vessels and tissues
Correct Answer: C
Rationale: A chest radiograph will provide information on the heart size and pulmonary blood-flow patterns. It will provide a baseline for future comparisons. The heart will be visible, as well as the sternum and ribs. Electrocardiography (ECG) measures the electrical potential generated from heart muscle. Echocardiography will produce a computerized image of the heart vessels and tissues by using sound waves.
The most common cause of bacterial meningitis in children under 5 years is:
- A. Neisseria meningitidis
- B. Haemophilus influenzae
- C. Streptococcus pneumoniae
- D. Listeria monocytogenes
Correct Answer: C
Rationale: Streptococcus pneumoniae is the leading cause of bacterial meningitis in children under 5 years, especially in those who are not immunized.
All of the following are conditions with combined cellular and antibody immunodeficiency, except
- A. Ataxia telangiectasia
- B. Reticular dysgenesis
- C. Common variable immunodeficiency
- D. Severe combined immunodeficiency
Correct Answer: C
Rationale: Common variable immunodeficiency (CVID) is primarily an antibody deficiency, not a combined immunodeficiency.
A child has third-degree burns of the hands, face, and chest. Which nursing diagnosis takes priority?
- A. Ineffective airway clearance related to edema
- B. Disturbed body image related to physical appearance
- C. Impaired urinary elimination related to fluid loss
- D. Risk for infection related to epidermal disruption
Correct Answer: A
Rationale: Airway clearance is the top priority in burn patients, especially with facial burns, as swelling can obstruct the airway.