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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.
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Radiotherapy is an effective modality of treatment in variable pediatric solid tumors. Of the following, the LEAST responsive tumor to radiotherapy is
- A. rhabdomyosarcoma
- B. neuroblastoma
- C. nephroblastoma
- D. osteosarcoma
Correct Answer: D
Rationale: Osteosarcoma is relatively radioresistant compared to other listed tumors.
An 8-day-old is admitted with vomiting and dehydration. His HR is 170, RR is 44, BP is 85/52, and T is 99°F. The parents ask if these vital signs are normal. Which is the best response?
- A. The BP is elevated.
- B. The temperature is elevated.
- C. The heart rate is elevated; normal for a neonate is 90-160 bpm.
- D. The respiratory rate is elevated.
Correct Answer: C
Rationale: A neonatal heart rate of 170 is above the normal range (90-160 bpm), which is concerning for dehydration.
A child is diagnosed with Wilms' tumor. During assessment, the nurse in charge expects to detect:
- A. Gross hematuria
- B. Dysuria
- C. Nausea and vomiting
- D. An abdominal mass
Correct Answer: D
Rationale: In a child with Wilms' tumor, the nurse would expect to detect an abdominal mass upon assessment. Wilms' tumor, also known as nephroblastoma, is a type of kidney cancer that commonly presents as a firm, non-tender abdominal mass. This mass may be felt upon palpation of the abdomen. Gross hematuria (A) is not a typical finding associated with Wilms' tumor. Dysuria (B) is the term used to describe painful or difficult urination and is not a characteristic symptom of Wilms' tumor. Nausea and vomiting (C) are also not commonly associated with Wilms' tumor, unless the tumor is causing obstruction or compression of nearby structures in the abdomen.
A client with serum glucose level of 618mg/dl is admitted to the facility. He's awake and oriented, has hot dry skin, and has the following vital signs: temperature of 100.6F (38.1C), heart rate of 116 beats/min, and blood pressure of 108/70mHg. Based on these assessment findings, which nursing diagnosis take highest priority?
- A. Deficient volume related to osmotic diuresis
- B. Decreased cardiac output related to elevated heart rate
- C. Imbalanced nutrition: Less than body requirements related to insulin deficiency
- D. Ineffective thermoregulation related to dehydration
Correct Answer: A
Rationale: The client's serum glucose level of 618mg/dl is indicative of severe hyperglycemia, likely due to uncontrolled diabetes mellitus. The client's presentation with hot dry skin, elevated heart rate, and low blood pressure suggests dehydration as a result of osmotic diuresis, which occurs in an attempt to excrete excess glucose. With an elevated heart rate and low blood pressure, it is essential to address the deficient volume to prevent further complications such as hypovolemic shock. Rehydration and fluid replacement are crucial interventions to help restore the client's fluid balance and prevent hemodynamic instability. Addressing the deficient volume related to osmotic diuresis should take the highest priority in this case.
Which blood gas analyses are most indicative of respiratory acidosis?
- A. pH = 7.22, PCO2 = 55 mmHg, HCO3 = 30 mEq/L.
- B. pH = 7.28, PCO2 = 45 mmHg, HCO3 = 15 mEq/L.
- C. pH = 7.34, PCO2 = 35 mmHg, HCO3 = 25 mEq/L.
- D. pH = 7.40, PCO2 = 25 mmHg, HCO3 = 30 mEq/L.
Correct Answer: A
Rationale: Respiratory acidosis is indicated by a low pH and elevated PCO2, as seen in option A.