Nokea
The parents of a newborn with a strawberry hemangioma ask the nurse what the treatment will be. What information does the nurse need to include in the response?
- A. Excision of the lesion will be necessary.
- B. Injections of prednisone into the lesion will reduce it.
- C. No treatment is usually necessary because of the high rate of spontaneous involution.
- D. Pulsed dye laser treatments will be necessary immediately to prevent permanent disability.
Correct Answer: C
Rationale: The correct information the nurse should provide to the parents is that no treatment is usually necessary for a strawberry hemangioma because of the high rate of spontaneous involution. Strawberry hemangiomas are common vascular tumors in infants that typically appear in the first few weeks of life. They usually grow rapidly for the first several months and then begin to shrink and eventually disappear on their own. In most cases, the hemangioma resolves without the need for any intervention. Therefore, reassuring the parents that observation is the primary management approach is important, unless complications such as ulceration, bleeding, or obstruction occur.
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A 16-year-old, 165-pound patient reports consuming 20-40 325-mg capsules containing acetaminophen 1 hour ago. You should
- A. measure the plasma level and determine potential toxicity from the level on the nomogram
- B. wait until 4 hours after ingestion to measure the plasma level and do nothing else
- C. administer activated charcoal immediately and measure the plasma level of acetaminophen 4 hours after ingestion
- D. send the patient home because an ingestion of this magnitude is not toxic
Correct Answer: C
Rationale: Activated charcoal can help reduce absorption of acetaminophen, and plasma levels should be measured 4 hours post-ingestion to assess toxicity using the nomogram.
Tretinoin (Retin-A) is a topical agent commonly used to treat acne. Nursing considerations with this drug should include:
- A. teaching to avoid use of sunscreen agents.
- B. applying generously to the skin.
- C. explaining that medication should not be applied until at least 20 to 30 minutes after washing.
- D. explaining that erythema and peeling are indications of toxicity.
Correct Answer: C
Rationale: Nursing considerations with Tretinoin (Retin-A) should include explaining that the medication should not be applied until at least 20 to 30 minutes after washing. This wait time allows the skin to fully dry and reduces the risk of irritation. Applying the medication too soon after washing can increase the likelihood of skin irritation, dryness, and peeling. It is essential to follow this guideline to ensure the effectiveness of the treatment and minimize adverse effects on the skin.
A client with diabetes mellitus has a prescription for 5 U-100 regular insulin and 25 U of U-100 isophane insulin suspension (NPH) to be taken before breakfast. At about 4:30 p.m., the client experiences headache, sweating, tremor, pallor, and nervousness. What is the most probable cause of these signs and symptoms?
- A. Hyperglycemia
- B. Hyperuricemia
- C. Hypoglycemia
- D. Hypochondria
Correct Answer: C
Rationale: The signs and symptoms of headache, sweating, tremor, pallor, and nervousness described in the client suggest hypoglycemia, which is caused by low blood sugar levels. Insulin is a medication used to lower blood sugar levels in individuals with diabetes. In this case, the client has taken a combination of regular insulin and NPH insulin before breakfast, which could have led to a rapid drop in blood sugar levels by the afternoon causing the symptoms described. It is important to treat hypoglycemia promptly by giving the client a fast-acting carbohydrate source, such as glucose tablets or juice, to raise their blood sugar back to a safe level.
An adolescent patient with chronic asthma, who has been hospitalized several times during the winter with severe asthmatic exacerbations, confides, 'I wish I could stay here in the hospital because every time I go home, I get sick again!' What is the pediatric nurse's best response?
- A. Let's talk about preventing and managing your asthma on a daily basis at home.
- B. Why don't I speak with your parents about what they are doing at home to help control your asthma?
- C. We can arrange for you to stay in the hospital longer.
- D. none of the above.
Correct Answer: A
Rationale: Discussing strategies to manage asthma at home empowers the patient and addresses the root cause of recurrent exacerbations.
The child refusing to go to bed and remaining active is likely due to
- A. thyrotoxicosis
- B. ADHD
- C. primary sleep disorder
- D. limit-setting behavioral insomnia of childhood
Correct Answer: D
Rationale: Limit-setting insomnia involves resistance to bedtime routines.