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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Recurrent pneumonia is defined in children as having a frequency of episodes more than or equal to
- A. 2 episodes in 6 months
- B. 2 episodes in one year
- C. 3 episodes ever without radiographic clearance
- D. 4 episodes ever with radiographic clearance
Correct Answer: A
Rationale: Recurrent pneumonia in children is defined as having 2 or more episodes in 6 months, indicating a pattern of frequent infections.
A client who is receiving chemotherapy is vomiting. Which nursing intervention should the nurse implement first?
- A. Teach the client about the importance of hydration
- B. Report the volume of emesis to the healthcare provider
- C. Administer ondansetron hydrochloride (Zofran)
- D. Encourage the client to limit the amount of movement
Correct Answer: C
Rationale: Administering ondansetron (Zofran) will help relieve the vomiting and prevent dehydration, addressing the immediate concern.
An asymptomatic 45-year old male with newly diagnosed atrial fibrillation and normal echo, refused cardioversion while suggested. The next optimal management strategy for him is
- A. Sedate and cardiovert against patient wishes
- B. Aspirin
- C. Anticoagulation
- D. Rate control
Correct Answer: D
Rationale: Rate control is the optimal management strategy for asymptomatic atrial fibrillation when cardioversion is refused.
A chest radiograph film is ordered for a child with suspected cardiac problems. The child’s parent asks the nurse, “What will the radiograph show about the heart?†What knowledge about the x-ray should the nurse include in the response to the parents?
- A. Bones of chest but not the heart
- B. Measurement of electrical potential generated from heart muscle
- C. Permanent record of heart size and configuration
- D. Computerized image of heart vessels and tissues
Correct Answer: C
Rationale: A chest radiograph will provide information on the heart size and pulmonary blood-flow patterns. It will provide a baseline for future comparisons. The heart will be visible, as well as the sternum and ribs. Electrocardiography (ECG) measures the electrical potential generated from heart muscle. Echocardiography will produce a computerized image of the heart vessels and tissues by using sound waves.
The parents of a child, age 6, who will begin school in the fall ask the nurse for anticipatory guidance. The nurse should explain that a child of this age:
- A. Still depends on the parents
- B. Rebels against scheduled activities
- C. Is highly sensitive to criticism
- D. Loves to tattle
Correct Answer: C
Rationale: A 6-year-old child is typically highly sensitive to criticism as they are developing self-esteem and are influenced by feedback from adults and peers.