Nokea
Which are appropriate actions to manage a hospitalized child with hemophilia? (Select all that apply).
- A. Administer Factor VII for bleeding crises
- B. Administer platelets for bleeding crises
- C. Avoid unnecessary skin punctures
- D. Administer Ibuprofen for complaints of discomfort
Correct Answer: A,C
Rationale: The correct answers are A and C. Administering Factor VII helps in managing bleeding crises in hemophiliac patients. Factor VII aids in clotting, essential for stopping bleeding. Avoiding unnecessary skin punctures reduces the risk of bleeding episodes in hemophilia patients. Platelets (B) and Ibuprofen (D) are not appropriate for managing hemophilia. Platelets do not address the underlying clotting factor deficiency in hemophilia, and Ibuprofen can worsen bleeding due to its antiplatelet effects.
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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 home health nurse is caring for a child who has lyme disease. Which of the following is an appropriate action for the nurse to take
- A. Ensure the state health department has been notified
- B. Administer antitoxin
- C. Educate the family to avoid sharing personal belongings
- D. Assess for skin necrosis
Correct Answer: B
Rationale: The correct answer is B: Administer antitoxin. Lyme disease is caused by a bacterium, not a toxin, so administering antitoxin is not appropriate. Option A is incorrect because notifying the state health department is not a direct action for the nurse to take in caring for the child. Option C is incorrect as educating the family to avoid sharing personal belongings is a preventive measure but not a direct action for the child's care. Option D is incorrect as skin necrosis is not a typical manifestation of Lyme disease. Administering appropriate antibiotics to treat the bacterial infection is the most appropriate action for the nurse to take in caring for the child with Lyme disease.
The nurse is providing education to parents of a toddler that will receive an iron supplement to treat iron deficiency anaemia. Which statement indicates the parents need further teaching?
- A. It's important to rinse my baby's mouth out with water immediately after giving her the iron
- B. We need to store the iron in a safe place because an accidental overdose can be toxic to the baby
- C. If we notice dark green stools, we should immediately notify the doctor.
- D. A good way to prevent iron deficiency anaemia is to limit the baby's milk consumption to 32 ounces per day.
Correct Answer: C
Rationale: The correct answer is C. If parents notice dark green stools after giving iron supplements, it is actually a common and harmless side effect due to the iron's color. They do not need to immediately notify the doctor unless there are other concerning symptoms. Rinsing the baby's mouth after giving iron (A) is important to prevent staining. Storing iron safely (B) is crucial to prevent accidental ingestion. Limiting milk consumption (D) is recommended as excessive milk can hinder iron absorption.
When instructing the parents of a toddler with iron deficiency anemia about the importance of increasing iron in the toddler's diet, which of the following foods should the nurse instruct the parents to include in the toddler's diet?
- A. Pasta
- B. Vitamin D milk
- C. Dried fruits
- D. Green leafy vegetables
Correct Answer: C
Rationale: The correct answer is C: Dried fruits. Dried fruits are a good source of iron, which is essential for treating iron deficiency anemia in toddlers. They provide a concentrated amount of iron in a small serving size, making them convenient for toddlers. Pasta (A) does not contain significant amounts of iron. Vitamin D milk (B) is important for bone health but does not provide a substantial amount of iron. Green leafy vegetables (D) are a good source of iron, but they may be harder for toddlers to eat compared to dried fruits.
The expected finding of Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) include:
- A. Low urine output & increased levels of antidiuretic hormone
- B. Low urine output & decreased levels of antidiuretic hormone
- C. Increased urine output & decreased levels of antidiuretic hormone
- D. Increased urine output & increased levels of antidiuretic hormone
Correct Answer: A
Rationale: The correct answer is A: Low urine output & increased levels of antidiuretic hormone. In SIADH, there is an excessive release of antidiuretic hormone (ADH), leading to water retention and dilutional hyponatremia. This results in low urine output as the body retains water. Increased levels of ADH cause the kidneys to reabsorb more water, further contributing to low urine output. The other choices are incorrect because in SIADH, urine output is typically low, and ADH levels are elevated due to the dysregulation of the feedback mechanism that controls ADH release. Increased urine output and decreased levels of ADH (choice C) would be more indicative of diabetes insipidus, a condition characterized by decreased ADH production or kidney insensitivity to ADH.