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When caring for a patient with Syndrome of inappropriate Antidiuretic Hormone Secretion (SIADH), the nurse would expect her patient to exhibit the following clinical signs and symptoms (Select all that apply):
- A. Fluid retention
- B. Hypotonicity
- C. Anorexia
- D. Frequent urination
Correct Answer: A,B,C
Rationale: Step-by-step rationale:
A: Fluid retention - In SIADH, there is excessive ADH secretion leading to water retention and dilutional hyponatremia.
B: Hypotonicity - Due to water retention, serum osmolality decreases leading to hypotonicity.
C: Anorexia - SIADH can cause nausea, vomiting, and anorexia due to hyponatremia and cerebral edema.
Incorrect choices:
D: Frequent urination - SIADH causes water retention, leading to decreased urine output, not frequent urination.
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A nurse is caring for a school-age child who is 2 hr postoperative following a cardiac catheterization. The nurse observes blood on the child's dressing. Which of the following actions should the nurse take?
- A. Apply intermittent pressure 2.5 cm (1 in) below the percutaneous skin site.
- B. Apply continuous pressure 2.5 cm (1 in) above the percutaneous skin site.
- C. Apply continuous pressure 2.5 cm (1 in) below the percutaneous skin site.
- D. Apply intermittent pressure 2.5 cm (1 in) above the percutaneous skin site.
Correct Answer: C
Rationale: Correct Answer: C
Rationale: Applying continuous pressure 2.5 cm below the percutaneous skin site will help control bleeding by promoting clot formation at the catheter insertion site. This pressure point is closer to the source of bleeding, ensuring better hemostasis and preventing further complications.
Summary:
A: Applying intermittent pressure below the site is incorrect as continuous pressure is more effective in achieving hemostasis.
B: Applying continuous pressure above the site is incorrect as it does not target the bleeding source directly.
D: Applying intermittent pressure above the site is incorrect as continuous pressure is preferred for controlling bleeding.
E, F, G: No information provided.
Anorexia nervosa may best be described as:
- A. Occurring most frequently in adolescent males
- B. Occurring most frequently in adolescents from lower socioeconomic groups
- C. Resulting from a posterior pituitary disorder
- D. Resulting in severe weight loss in the absence of obvious physical causes
Correct Answer: D
Rationale: Anorexia nervosa is characterized by severe weight loss due to restrictive eating behaviors and distorted body image. Choice D is correct as it accurately describes the hallmark symptom of anorexia. Choices A and B are incorrect because anorexia nervosa is more common in adolescent females and does not discriminate based on socioeconomic status. Choice C is incorrect as anorexia nervosa is primarily a psychological disorder, not a pituitary disorder.
A 14-year-old was brought to the school nurse's office due to a reported suicide threat. Which one of the following findings puts the patient at the greatest risk for suicide completion?
- A. History of suicide attempt
- B. History of drug and alcohol use
- C. History of divorced parents
- D. Bisexual orientation
Correct Answer: A
Rationale: The correct answer is A: History of suicide attempt. This finding puts the patient at the greatest risk for suicide completion because individuals with a history of suicide attempts are more likely to attempt suicide again. This indicates underlying mental health issues and distress, increasing the risk of completing suicide. Choice B is incorrect as drug and alcohol use is a risk factor but not as strong as a previous suicide attempt. Choices C and D are not direct risk factors for suicide completion.
A complication of hemophilia is:
- A. Mucositis
- B. Hemoarthritis
- C. Thrombocytopenia
- D. Acute Chest Syndrome
Correct Answer: B
Rationale: The correct answer is B: Hemoarthritis. Hemophilia is a bleeding disorder where blood does not clot properly. Hemoarthritis is a common complication, characterized by bleeding into joints leading to pain, swelling, and limited range of motion. Mucositis (A) is inflammation of mucous membranes, not specific to hemophilia. Thrombocytopenia (C) is a low platelet count, not directly related to hemophilia. Acute Chest Syndrome (D) is a complication of sickle cell disease, not hemophilia.
Solumedrol 1.5mg/kg is ordered for a child weighing 74.8 pounds. Solumedrol is available as 125mg/2ml. How many ml must the nurse administer?
- A. 0.62ml
- B. 0.062ml
- C. 0.82ml
- D. 0.082ml
Correct Answer: C
Rationale: To calculate the dose of Solumedrol, first convert the child's weight to kg: 74.8 lbs / 2.2 = 34 kg. Then, calculate the dose: 1.5 mg/kg * 34 kg = 51 mg. Next, determine how many ml is needed: 51 mg / 125 mg/ml = 0.408 ml, which is rounded up to 0.82 ml. Choice A is incorrect because it is too low. Choice B is incorrect as it is much lower than the calculated dose. Choice D is incorrect as it is also too low.