Nokea
Usual indications for an exchange transfusion in a child with sickle cell disease include:
- A. Painful vaso-occlusive crisis
- B. Splenic sequestration crisis
- C. Acute chest syndrome
- D. Dactylitis
Correct Answer: C
Rationale: Acute chest syndrome, a severe complication of sickle cell disease, often requires exchange transfusion to reduce the proportion of sickle hemoglobin and improve oxygenation.
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Which instruction should the nurse include in the discharge teaching for a client who has gastroesophageal reflux?
- A. Teach the client to elevate the head of the bed on blocks
- B. Remind the client to avoid high-fiber foods
- C. Encourage the client to lie down and rest after meals
- D. Instruct the client to use antacids only as a last resort
Correct Answer: A
Rationale: Elevating the head of the bed on blocks helps reduce reflux of stomach acid into the esophagus, improving symptoms of gastroesophageal reflux disease.
In 90% of cases of endocarditis, the causative agent is recovered from the first 2 blood cultures. Antimicrobial pretreatment of the patient reduces the yield of blood cultures to
- A. 10%
- B. 20%
- C. 30%
- D. 40%
Correct Answer: A
Rationale: Antimicrobial pretreatment can significantly reduce the yield of blood cultures, often to 10-20%.
A client is brought to the ED by ambulance in cardiac arrest with cardiopulmonary resuscitation (CPR) in progress. The client is intubated and is receiving 100% oxygen per self-inflating (ambu) bag. The nurse determines that the client is cyanotic, cold, and diaphoretic. Which assessment is most important for the nurse to obtain?
- A. Breath sounds over bilateral lung fields.
- B. Carotid pulsation during compressions
- C. Deep tendon reflexes
- D. Core body temperature
Correct Answer: A
Rationale: Assessing breath sounds ensures that the endotracheal tube is properly placed and that ventilation is effective, which is critical in a cardiac arrest situation.
Blau syndrome is associated with
- A. Amyloidosis
- B. Sarcoidosis
- C. Hemochromatosis
- D. Myeloma
Correct Answer: B
Rationale: Blau syndrome is associated with sarcoidosis
A female client who was involved in a motor vehicle collision is admitted with a fractured left femur which is immobilized using a fracture traction splint in preparation for an open reduction internal fixation (ORIF). The nurse determines that her distal pulses are diminished in the left foot. Which interventions should the nurse implement? (Select all that apply.)
- A. Offer ice chips and oral clear liquids
- B. Verify pedal pulses using a doppler pulse device
- C. Monitor left leg for pain, pallor, paresthesia, paralysis, pressure
- D. Evaluate the application of the splint to the left leg
Correct Answer: B
Rationale: These interventions assess and address potential vascular compromise, which is critical in a client with a fractured femur.