When choosing a needle gauge for an intramuscular injection in a 12-year-old boy, which of the following gauges would you choose?
- A. 27 gauge
- B. 25 gauge
- C. 22 gauge
- D. 20 gauge
Correct Answer: C
Rationale: The correct answer is 22 gauge. A 22-gauge needle is recommended for school-age children, toddlers, and adolescents due to their muscle mass and tolerance. In infants, a smaller gauge (23-25) is preferred as their muscles are less developed and more sensitive. Choice A, 27 gauge, is too thin for an intramuscular injection in a 12-year-old boy. Choice B, 25 gauge, is more suitable for infants than for a 12-year-old. Choice D, 20 gauge, is too thick and not typically used for intramuscular injections in children.
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A patient's nurse taking a history notes complaints of SOB and weakness in the lower extremities. The patient has a history of hyperlipidemia and hypertension. Which of the following may be occurring?
- A. The patient may be developing CHF
- B. The patient may be having a MI
- C. The patient may be developing COPD
- D. The patient may be having an onset of PVD
Correct Answer: B
Rationale: In this scenario, the patient's symptoms of shortness of breath (SOB) and weakness in the lower extremities, along with a history of hyperlipidemia and hypertension, are suggestive of a myocardial infarction (MI). It is important to note that MI can present with a variety of symptoms, including those affecting the respiratory system and muscle weakness. Choices A, C, and D are incorrect because the patient's symptoms are more indicative of a myocardial infarction rather than congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), or peripheral vascular disease (PVD).
What happens if folic acid is administered to treat anemia without determining its underlying cause?
- A. Erythropoiesis is inhibited
- B. Excessive levels of folic acid might accumulate, causing toxicity
- C. The symptoms of pernicious anemia might be masked, delaying treatment
- D. Intrinsic factor is destroyed
Correct Answer: C
Rationale: When folic acid is given without determining the underlying cause of anemia, the symptoms of pernicious anemia may be masked, potentially delaying the correct treatment. Folic acid alone does not protect against the central nervous system changes seen in pernicious anemia, which are related to Vitamin B12 deficiency. Folic acid and Vitamin B12 are both crucial for cell growth and division. Administering folic acid without knowing the specific type of anemia could lead to a delay in addressing the root cause. Option A is incorrect because folic acid is essential for erythropoiesis, the production of red blood cells. Option B is incorrect as excessive folic acid can cause toxicity, but it is not the primary concern in this context. Option D is incorrect because folic acid treatment for anemia does not directly impact intrinsic factor, which is related to Vitamin B12 absorption.
A nurse reviewed the arterial blood gas reading of a 25-year-old male. The nurse should be able to conclude the patient is experiencing which of the following conditions?
- A. metabolic acidosis
- B. respiratory acidosis
- C. metabolic alkalosis
- D. respiratory alkalosis
Correct Answer: D
Rationale: The correct answer is respiratory alkalosis. In respiratory alkalosis, there is an elevated pH and low carbon dioxide levels (PaCO2 < 35 mmHg). In the given arterial blood gas reading, the patient's pH is 7.41 (within normal range), PaCO2 is 29 mmHg (below normal range), indicating respiratory alkalosis. The bicarbonate level is normal (25 mEq/l), ruling out metabolic acidosis or alkalosis. The low PaO2 (54 mmHg) may indicate hypoxemia, but it is not directly related to the acid-base disorder being assessed. Metabolic acidosis (choice A) is characterized by low pH and low bicarbonate levels, which are not present in this case. Respiratory acidosis (choice B) is indicated by low pH and high PaCO2 levels, which also do not match the provided data. Metabolic alkalosis (choice C) is defined by high pH and high bicarbonate levels, which are not seen in this scenario.
A client had a colostomy done one day ago. Which of the following is an abnormal finding when assessing the stoma?
- A. mild edema
- B. minimal bleeding
- C. rose color
- D. dark red color
Correct Answer: D
Rationale: A dark red color is an abnormal finding when assessing the stoma as it indicates inadequate blood supply, possibly due to ischemia. Mild edema, minimal bleeding, and a rose color are expected findings one day post colostomy surgery. Mild edema can be present due to tissue trauma and inflammation, minimal bleeding can occur initially, and a healthy stoma typically appears pink to red, known as a rose color, indicating good blood supply and tissue perfusion. Therefore, the dark red color is the abnormal finding in this scenario.
Which type of hepatitis is transmitted via the fecal-oral route?
- A. Hepatitis A
- B. Hepatitis B
- C. Hepatitis C
- D. Hepatitis D
Correct Answer: A
Rationale: Hepatitis A is the correct answer because it is transmitted via the fecal-oral route, often through contaminated food or water. Hepatitis B is transmitted through exposure to infectious blood, semen, and other body fluids, not through the fecal-oral route. Hepatitis C is transmitted through blood-to-blood contact, not via the fecal-oral route. Hepatitis D occurs only in individuals infected with Hepatitis B. Therefore, the correct choice for the type of hepatitis transmitted via the fecal-oral route is Hepatitis A.
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