Nokea
To decrease the likelihood of bradyarrhythmias in children during endotracheal intubation, succinylcholine(Anectine) is used with which of the following agents?
- A. Epinephrine (Adrenalin)
- B. Isoproterenol (Isuprel)
- C. Atropine sulfate
- D. Lidocaine hydrochloride (Xylocaine)
Correct Answer: C
Rationale: Succinylcholine administration can lead to bradycardia or bradyarrhythmias in children due to its depolarizing neuromuscular blockade effects. To counteract this detrimental effect and decrease the likelihood of bradyarrhythmias, atropine sulfate is commonly used in conjunction with succinylcholine. Atropine, an anticholinergic agent, works by blocking the action of acetylcholine on muscarinic receptors, which helps prevent vagal-induced bradycardia. This approach is especially important in pediatric patients to maintain a stable heart rate and hemodynamic status during endotracheal intubation.
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is a Self - Limiting disease that affects of femoral head :
- A. Coxa
- B. JRA
- C. Rickets
- D. DDH
Correct Answer: C
Rationale: Rickets is a self-limiting disease that affects the growth plates in bones, including the femoral head. It is primarily caused by a deficiency in vitamin D, which is necessary for proper bone mineralization and growth. Rickets is more common in children and can lead to weakened bones, deformities, and growth disturbances. With proper treatment and supplementation, rickets can be reversed and often resolves once the underlying vitamin D deficiency is addressed.
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.
When should the nurse expect breastfeeding-associated jaundice to first appear in a normal newborn?
- A. 0 to 12 hours
- B. 12 to 24 hours
- C. 2 to 4 days
- D. 4 to 5 days
Correct Answer: C
Rationale: Breastfeeding-associated jaundice typically first appears in a normal newborn between 2 to 4 days after birth. This type of jaundice is usually mild and is caused by insufficient milk intake, leading to decreased bilirubin elimination. It is important for healthcare providers to monitor the baby's weight and ensure adequate feeding to prevent or address breastfeeding-associated jaundice.
What should nursing interventions to maintain a patent airway in a newborn include?
- A. Sleeping in the prone (on abdomen) position
- B. Wrapping neonate as snugly as possible
- C. Positioning neonate supine while sleeping
- D. Using bulb syringe to suction as needed, suctioning nose first, and then pharynx
Correct Answer: D
Rationale: Nursing interventions to maintain a patent airway in a newborn should prioritize safety and best practices. Positioning the neonate supine while sleeping is crucial to reduce the risk of sudden infant death syndrome (SIDS) and ensure proper airway alignment. Using a bulb syringe to suction as needed, with the correct technique of suctioning the nose first and then the pharynx, helps effectively remove secretions and keep the airway clear. This intervention promotes optimal respiratory function and reduces the risk of airway obstruction in newborns. Sleeping in the prone position is not recommended due to the increased risk of SIDS. Wrapping the neonate as snugly as possible can also pose risks of overheating and compromising the airway, making it an unsafe practice.
For a patient who is being discharged on digoxin, the nurse should include which of the ff. in an explanation to the patient on the signs and symptoms of digoxin toxicity?
- A. Poor appetite
- B. Halos around lights
- C. Constipation
- D. Tachycardia
Correct Answer: B
Rationale: Digoxin toxicity can manifest in various ways, but one common sign is the presence of visual disturbances such as seeing halos around lights. This is due to digoxin's effect on the optic nerve. Patients experiencing halos around lights should seek medical attention promptly as it may indicate a serious reaction to the medication. The other options (poor appetite, constipation, tachycardia) may occur with digoxin toxicity as well, but the visual disturbance of halos around lights is a classic and important sign to be aware of.