What is the earliest age at which a satisfactory radial pulse can be taken in children?
- A. 1 year
- B. 2 years
- C. 3 years
- D. 6 years
Correct Answer: A
Rationale: A satisfactory radial pulse can be taken in children as young as 1 year old. The radial pulse is commonly checked in the wrist and is a valuable indicator of cardiac function. Children as young as 1 year old can have a palpable radial pulse, allowing healthcare providers to assess their heart rate and rhythm. It is important to be gentle when palpating a pulse in young children to avoid causing discomfort or distress.
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Which of the following instructions would Nurse Courtney include in a teaching plan that focuses on initial prevention for Sheri who is diagnosed with rheumatic fever?
- A. Treating streptococcal throat infections with an antibiotic
- B. Giving penicillin to patients with rheumatic fever
- C. Using corticosteroid to reduce inflammation
- D. Providing an antibiotic before dental work
Correct Answer: A
Rationale: The most appropriate instruction in a teaching plan focusing on initial prevention for Sheri, who is diagnosed with rheumatic fever, would be treating streptococcal throat infections with an antibiotic (Choice A). Rheumatic fever is often preceded by a group A streptococcal infection, such as strep throat. Prompt treatment of streptococcal infections with antibiotics can help prevent the development of rheumatic fever and its complications. Therefore, this instruction emphasizes the importance of treating the initial infection to prevent the occurrence of rheumatic fever in individuals like Sheri who are at risk. Choices B, C, and D are not specific to the initial prevention of rheumatic fever but may be more related to the management or treatment of established cases.
To return a patient with hyponatremia to normal sodium levels, it is safer to restrict fluid intake than to administer sodium:
- A. In patients who are unconscious
- B. In patients who show neurologic
- C. To prevent fluid overload symptoms
- D. To prevent dehydration
Correct Answer: C
Rationale: It is safer to restrict fluid intake rather than administer sodium to return a patient with hyponatremia to normal sodium levels to prevent fluid overload symptoms. Restoring normal sodium levels in patients with hyponatremia requires caution to prevent rapid correction which can lead to osmotic demyelination syndrome. By restricting fluid intake, the dilutional effect on sodium levels can be reduced, aiding in a safer and more controlled correction of hyponatremia without causing fluid overload. Administering sodium can lead to rapid changes in sodium levels, increasing the risk of complications.
A 3-year-old child from a suburban community presents with vomiting, diarrhea, and blurred vision. Physical examination reveals an afebrile child with pinpoint pupils, salivation, and muscular fasciculations. The child's lawn was treated yesterday for insects. Which of the following tests will establish the correct diagnosis?
- A. Blood-lead level
- B. 24-hour urine mercury level
- C. Plasma cholinesterase level
- D. Urine malathion level
Correct Answer: C
Rationale: The symptoms suggest organophosphate poisoning, which can be confirmed by measuring plasma cholinesterase levels, as organophosphates inhibit this enzyme.
Why are rectal temperatures not recommended in the newborn?
- A. They are inaccurate.
- B. They do not reflect core body temperature.
- C. They can cause perforation of rectal mucosa.
- D. They take too long to obtain an accurate reading.
Correct Answer: C
Rationale: Rectal temperatures are not recommended in newborns because they can potentially cause perforation of the rectal mucosa. Newborns have fragile, delicate tissues in the rectal area, and the insertion of a rectal thermometer may lead to injury or damage to the mucosal lining. It is important to exercise caution and use alternative methods for taking temperatures in newborns to avoid any harm or discomfort.
Which of the ff should qualify as an abnormal result in a Romberg test?
- A. Hypotension
- B. Swaying, losing balance, or arm drifting
- C. Sneezing and wheezing
- D. Excessive cerumen in the outer ear
Correct Answer: B
Rationale: During a Romberg test, the individual is asked to stand with feet together, arms at sides, and eyes closed. The tester then observes for swaying, losing balance, or arm drifting, which are signs of a positive Romberg test, indicating a potential issue with proprioception or vestibular function. Hypotension (choice A) refers to low blood pressure and is not directly assessed during a Romberg test. Sneezing and wheezing (choice C) are unrelated symptoms. Excessive cerumen in the outer ear (choice D) does not affect the results of a Romberg test focused on balance and proprioception.