Nokea
The nurse understands that which of the ff. best describes the action of enalapril maleate (Vasotec)?
- A. It decreases levels of angiotensin II
- B. It dilates the arterioles and veins
- C. It adjusts the extracellular volume
- D. It decreases cardiac output
Correct Answer: A
Rationale: Enalapril maleate (Vasotec) is an angiotensin-converting enzyme (ACE) inhibitor. The main action of ACE inhibitors like enalapril is to decrease the levels of angiotensin II in the body. Angiotensin II is a potent vasoconstrictor that plays a role in regulating blood pressure, stimulating aldosterone secretion, and promoting sodium and water retention. By inhibiting the conversion of angiotensin I to angiotensin II, enalapril reduces vasoconstriction and aldosterone secretion, leading to vasodilation, decreased blood pressure, and ultimately decreased levels of angiotensin II. This mechanism allows for the dilation of arterioles and veins, reduction in cardiac afterload, and ultimately decreases the workload of the heart.
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The nurse is using the Centers for Disease Control and Prevention (CDC) growth chart for an African-American child. Which statement should the nurse consider?
- A. This growth chart should not be used.
- B. Growth patterns of African-American children are the same as for all other ethnic groups.
- C. A correction factor is necessary when the CDC growth chart is used for non- Caucasian ethnic groups.
- D. The CDC charts are accurate for US African-American children.
Correct Answer: C
Rationale: The correct statement for the nurse to consider is that a correction factor is necessary when the CDC growth chart is used for non-Caucasian ethnic groups. This is because the CDC growth charts were primarily developed using data from Caucasian children. Research has shown that children from different ethnic backgrounds may have differences in growth patterns compared to Caucasian children. Therefore, when using the CDC growth chart for African-American children or other ethnic groups, a correction factor may need to be applied to ensure accurate growth assessment and monitoring.
A child has a postoperative appendectomy incision covered by a dressing. The nurse has just completed a prescribed dressing change for this child. Which description is an accurate documentation of this procedure?
- A. Dressing change to appendectomy incision completed, child tolerated procedure well, parent present
- B. No complications noted during dressing change to appendectomy incision
- C. Appendectomy incision non-reddened, sutures intact, no drainage noted on old dressing, new dressing applied, procedure tolerated well by child
- D. No changes to appendectomy incisional area, dressing changed, child complained of pain during procedure, new dressing clean, dry and intact
Correct Answer: C
Rationale: Option C provides a thorough and accurate documentation of the dressing change procedure for the postoperative appendectomy incision. This documentation includes essential details such as the condition of the incision site (non-reddened, sutures intact, no drainage noted on old dressing), the action taken (new dressing applied), and the outcome (procedure tolerated well by the child). It covers all the necessary aspects of the dressing change procedure and clearly indicates the status of the incision site before and after the intervention. Options A, B, and D do not provide as comprehensive and detailed information about the dressing change procedure and its outcomes, making option C the most appropriate choice for accurate documentation.
The nurse is taking care of a 7-year-old child with a skin rash called a papule. Which clinical finding should the nurse expect to assess with this type of skin rash?
- A. A lesion that is elevated, palpable, firm, and circumscribed; less than 1 cm in diameter
- B. A lesion that is elevated, flat-topped, firm, rough, and superficial; greater than 1 cm in diameter
- C. An elevated lesion, firm, circumscribed, palpable; 1 to 2 cm in diameter
- D. An elevated lesion, circumscribed, filled with serous fluid; less than 1 cm in diameter
Correct Answer: A
Rationale: A papule is a small, solid, elevated skin lesion that is less than 1 cm in diameter. It is usually palpable, firm, circumscribed, and can be various colors. Papules do not contain any fluid or pus. In this case, the nurse should expect to assess an elevated lesion that is firm and circumscribed, measuring less than 1 cm in diameter. This description matches option A, making it the correct choice for a papule.
Decreasing level of consciousness is a symptom of which of the following physiological phenomena?
- A. Increased ICP
- B. Parasympathetic response
- C. Sympathetic response
- D. Increased cerebral blood flow
Correct Answer: A
Rationale: A decreasing level of consciousness is a symptom often associated with increased intracranial pressure (ICP). When the pressure inside the skull rises, it can compress and damage the brain, leading to a deterioration in consciousness. Common causes of increased ICP include traumatic brain injury, brain tumors, and infections. As ICP continues to rise, it can result in serious consequences such as brain herniation, which can be life-threatening if not promptly managed. Therefore, a decreasing level of consciousness should raise concerns about increased ICP and warrant immediate medical evaluation and intervention.
What is the care priority for a newborn with bladder exstrophy and a malformed pelvis?
- A. Change the diaper frequently and assess for skin breakdown.
- B. Keep the exposed bladder open in a warm, dry environment.
- C. Offer formula for growth and fluid management.
- D. Cluster care to allow the child uninterrupted sleep and strength for upcoming surgical repair.
Correct Answer: D
Rationale: Minimizing disturbances (clustering care) helps prevent infection and allows the infant to conserve energy before surgical repair.