Nokea
The parents of the child with juvenile rheumatoid arthritis (JRA) ask the nurse why the child cannot have aspirin. The parents further explain that they have heard that aspirin is used in the elderly for arthritis and the use of the patients. The nurse correctly explains that children with JRA are given different medications than adults with arthritis and explains that the toxic effects of aspirin include which manifestations?
- A. Constipation, weight gain, and fluid retention
- B. Ringing in the ears, nausea, and vomiting
- C. Anorexia, weight loss, and double vision
- D. Headache, dry mouth, and dental cavities
Correct Answer: B
Rationale: Aspirin in children can cause toxicity, including ringing in the ears (tinnitus), nausea, and vomiting, and is avoided due to the risk of Reye's syndrome, especially in children with viral infections.
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Thyrotoxicosis is pregnancy is treated with:
- A. Partial thyroidectomy in first trimester.
- B. Radioiodine ablation of thyroid gland.
- C. With neomercazole.
- D. Surgery on thyroid gland in 3rd trimester.
- E. With iodine drops and β-blockers.
Correct Answer: C
Rationale: Neomercazole (carbimazole) is used to treat thyrotoxicosis in pregnancy as it controls thyroid hormone production safely. Radioiodine is contraindicated and surgery is avoided unless absolutely necessary.
Which finding by the nurse strongly indicates that a child is experiencing hypokalemia?
- A. Full, bounding pulses
- B. Muscle weakness
- C. Elevated blood pressure
- D. Hyperactive bowel sounds
Correct Answer: B
Rationale: Hypokalemia causes muscle weakness due to impaired muscle contraction, a key manifestation resulting from low potassium levels affecting neuromuscular function.
A breastfeeding mother is being discharged with her 2-day-old,full-term newborn. The nurse recognizes that the mother understands how to determine if her newborn is getting enough breast milk when making which statement?
- A. “He should have at least three wet diapers tomorrow.”
- B. “He should have one stool per day during the next week.”
- C. “At his 1-week checkup,he should weigh an additional 8 ounces.”
- D. “He should nurse for 5 minutes on each breast to get enough milk.”
Correct Answer: A
Rationale: A 3-day-old should have at least three wet diapers indicating adequate intake. Breastfed infants stool 3–10 times daily lose 5–10% birth weight initially and nurse 10–20 minutes per breast.
What is the diameter of fetal skull that presents at vulva during normal labour:
- A. Suboccipitofrontal.
- B. Mentovertical.
- C. Suboccipitobregmatic.
- D. Occipitofrontal.
- E. Metoposterior.
Correct Answer: C
Rationale: In normal vertex presentation the suboccipitobregmatic diameter (9.5 cm) is the smallest and presents at the vulva during delivery. Other diameters are larger or associated with abnormal presentations.
Which clinical manifestation of the client's full-thickness burns would the nurse detect during an assessment?
- A. Moderate level of pain due to exposed nerve endings
- B. Eschar formation throughout the area of the burn
- C. The appearance of blister formation throughout the area of the burn
- D. Noted tissue destruction extending to the subcutaneous layer
Correct Answer: D
Rationale: Full-thickness burns involve destruction of all skin layers, including the subcutaneous layer, resulting in a leathery or charred appearance. Pain is minimal due to nerve destruction, and blisters are characteristic of partial-thickness burns.