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When assessing a client with a disorder of the hematopoietic or the lymphatic, why is it important for the nurse to obtain a dietary history?
- A. Compromised nutrition interferes with the production of blood cells and hemoglobin
- B. Diet consisting of excessive fat interferes with the production of blood cells and haemoglobin
- C. Inconsistent dieting interferes with the production of blood cells and haemoglobin
- D. Diet consisting of excessive iron and protein elements interferes with the production of blood cells and haemoglobin
Correct Answer: A
Rationale: When assessing a client with a disorder of the hematopoietic or lymphatic system, obtaining a dietary history is important because compromised nutrition can interfere with the production of blood cells and hemoglobin. Hematopoiesis, the process of blood cell formation, requires adequate nutrition to support the production of red and white blood cells, as well as platelets. Nutrient deficiencies, such as iron, vitamin B12, and folate, can lead to anemia, which affects the oxygen-carrying capacity of red blood cells. Therefore, understanding the client's dietary intake can help the nurse identify any potential deficiencies or excessive intake that may be impacting hematopoiesis.
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Which symptoms should the nurse expect to observe during the physical assessment of an adolescent girl with severe weight loss and disrupted metabolism associated with anorexia nervosa?
- A. Dysmenorrhea and oliguria
- B. Tachycardia and tachypnea
- C. Heat intolerance and increased blood pressure
- D. Lowered body temperature and brittle nails
Correct Answer: B
Rationale: An adolescent girl with severe weight loss and disrupted metabolism associated with anorexia nervosa is likely to exhibit tachycardia (rapid heart rate) and tachypnea (rapid breathing). These symptoms are common manifestations of the body's response to malnutrition and starvation. Tachycardia occurs as a compensatory mechanism to maintain an adequate supply of oxygen to vital organs, while tachypnea helps to eliminate excess carbon dioxide due to metabolic imbalances. It is essential for the nurse to recognize these signs during the physical assessment as they indicate the severity of the condition and the need for immediate intervention to prevent further complications. Dysmenorrhea and oliguria, heat intolerance and increased blood pressure, and lowered body temperature and brittle nails are not typically associated with the physical manifestations of anorexia nervosa.
You are meeting with parents of a 12-year-old girl who recently diagnosed with papillary thyroid carcinoma (PTC). The statement that should be included in your discussion is
- A. PTC has a grim overall prognosis
- B. FTC do not require radioactive iodine therapy
- C. supraphysiologic levothyroxine therapy is required during long-term follow-up
- D. calcitonin/carcinogenic antigen monitoring is required during the course of treatment
Correct Answer: C
Rationale: Levothyroxine suppression therapy is standard in differentiated thyroid cancer.
An infant experienced an apparent life-threatening event (ALTE) and is being placed on home apnea monitoring. Parents have understood the instructions for use of a home apnea monitor when they state?
- A. "We can adjust the monitor to eliminate false alarms."
- B. "We should sleep in the same bed as our monitored infant."
- C. "We will check the monitor several times a day to be sure the alarm is working."
- D. "We will place the monitor in the crib with our infant."
Correct Answer: C
Rationale: The correct statement indicating understanding of the instructions for use of a home apnea monitor is "We will check the monitor several times a day to be sure the alarm is working." This is important because regular monitoring of the device's functioning ensures that it is able to detect any potential apnea episodes or abnormalities in the infant's breathing patterns. Checking the monitor several times a day helps in maintaining the safety and effectiveness of the monitor in alerting the parents to any potential issues with the infant's breathing. The other options are incorrect: A is incorrect because adjusting the monitor to eliminate false alarms can compromise its accuracy, B is incorrect as the infant should sleep in a separate safe sleep environment to reduce the risk of SIDS, and D is incorrect as the monitor should be placed near the infant's crib but not directly in it for safety reasons.
In teaching a female client who is HIV positive about pregnancy, the nurse would know more teaching is necessary when the client says:
- A. "The baby can get the virus from my placenta."
- B. "I'm planning on starting on birth control pills."
- C. "Not everyone who has the virus gives birth to a baby who has the virus."
- D. "I'll need to have a C-section if I become pregnant and have a baby."
Correct Answer: A
Rationale: Option A indicates a misunderstanding about HIV transmission during pregnancy. In reality, with proper medical care and management during pregnancy and delivery, the risk of transmitting HIV from mother to baby can be significantly reduced but not completely eliminated. The virus can be passed from mother to baby during pregnancy, childbirth, or breastfeeding, but it is not directly from the placenta. This misconception highlights the need for further education and clarification on the modes of HIV transmission from mother to child during pregnancy and delivery. Options B, C, and D all demonstrate understanding and appropriate planning related to HIV and pregnancy.
The nurse is teaching nursing students about shock that occurs in children. What is one of the most frequent causes of hypovolemic shock in children?
- A. Sepsis
- B. Blood loss
- C. Anaphylaxis
- D. Congenital heart disease
Correct Answer: B
Rationale: One of the most frequent causes of hypovolemic shock in children is blood loss. Children are at risk for blood loss due to trauma, surgical procedures, gastrointestinal bleeding, or other conditions that result in significant blood volume reduction. Blood loss leads to a decrease in circulating blood volume, which in turn reduces tissue perfusion and oxygen delivery to vital organs. This results in hypovolemic shock, where the heart is unable to pump sufficient blood to meet the body's needs, leading to organ dysfunction and potentially life-threatening complications. Therefore, recognizing and addressing blood loss promptly is essential in managing hypovolemic shock in children.