Nokea
Which blood gas analyses are most indicative of respiratory acidosis?
- A. pH = 7.22, PCO2 = 55 mmHg, HCO3 = 30 mEq/L.
- B. pH = 7.28, PCO2 = 45 mmHg, HCO3 = 15 mEq/L.
- C. pH = 7.34, PCO2 = 35 mmHg, HCO3 = 25 mEq/L.
- D. pH = 7.40, PCO2 = 25 mmHg, HCO3 = 30 mEq/L.
Correct Answer: A
Rationale: Respiratory acidosis is indicated by a low pH and elevated PCO2, as seen in option A.
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Vitamin A supplementation may be recommended for the young child who has which disease?
- A. Mumps
- B. Rubella
- C. Measles (rubeola)
- D. Erythema infectiosum
Correct Answer: C
Rationale: Vitamin A supplementation may be recommended for children with measles (rubeola) due to the disease's association with vitamin A deficiency. Measles can lead to reduced levels of vitamin A in the body, which can result in increased severity of symptoms, complications, and even death. Supplementing with vitamin A during and after a measles infection helps reduce the risk of complications and mortality, particularly in young children under the age of 5 in areas where vitamin A deficiency is common. Therefore, providing vitamin A supplementation to children with measles is an important intervention to support their recovery and improve outcomes.
Mr. Chua has developed liver cirrhosis. Nurse Bea expects alteration in which laboratory values?
- A. carbon dioxide level
- B. prothrombin time
- C. gastric pH
- D. white blood cell count
Correct Answer: B
Rationale: Liver cirrhosis affects the liver's ability to produce proteins that are important for blood clotting, including prothrombin. Therefore, in a patient with liver cirrhosis, Nurse Bea would expect an alteration in the prothrombin time, which measures the time it takes for the blood to clot. A prolonged prothrombin time indicates impaired blood clotting function, which is commonly seen in patients with liver disease such as cirrhosis. It is an important laboratory value to monitor in patients with liver cirrhosis to assess their risk of bleeding complications.
The nurse is caring for a 3-week-old preterm newborn born at 29 weeks of gestation. While taking vital signs and changing the newborn's diaper, the nurse observes the newborn's color is pink but slightly mottled, arms and legs are limp and extended, hiccups are present, and heart rate is regular and rapid. The nurse should recognize these behaviors as manifestations of:
- A. stress.
- B. subtle seizures.
- C. preterm behavior.
- D. onset of respiratory distress.
Correct Answer: C
Rationale: The behaviors described, such as slightly mottled skin, limp and extended extremities, hiccups, and a rapid but regular heart rate, are typical of preterm newborn behavior. Preterm infants often exhibit these characteristics due to their immature neurological and physiological systems. The mottled skin may be due to the immature vascular system, while the limp and extended extremities are common in preterm newborns as they have less muscle tone compared to full-term infants. Hiccups are also common in newborns, including preterm infants, and are generally not a cause for concern. The rapid heart rate is typical in newborns, particularly in the immediate postnatal period. Therefore, in this scenario, these behaviors are most likely related to the preterm status of the newborn rather than indicating stress, seizures, or respiratory distress.
Where do the lesions of atopic dermatitis (eczema) most commonly occur in the infant? (Select all that apply.)
- A. Cheeks
- B. Buttocks
- C. Extensor surfaces of arms and legs
- D. Back
Correct Answer: A
Rationale: In infants with atopic dermatitis (eczema), the lesions most commonly occur on the cheeks (option A) and the extensor surfaces of the arms and legs (option C). The cheeks are a common site of involvement due to increased exposure to irritants and saliva from drooling. The extensor surfaces of the arms and legs are also frequently affected due to scratching and rubbing against clothing. While atopic dermatitis can occur in other areas such as the buttocks, back, and trunk, the cheeks and extensor surfaces are the most common locations in infants.
The nurse is caring for a newborn receiving an exchange transfusion for hemolytic disease. Assessment of the newborn reveals slight respiratory distress and tachycardia. Which should the nurse's first action be?
- A. Notify practitioner.
- B. Stop the transfusion.
- C. Administer calcium gluconate.
- D. Monitor vital signs electronically.
Correct Answer: B
Rationale: Slight respiratory distress and tachycardia in a newborn during an exchange transfusion may indicate a possible transfusion reaction or overload. The first action the nurse should take is to stop the transfusion to prevent any further complications and assess the newborn's condition. After stopping the transfusion, the nurse can then take appropriate steps such as notifying the practitioner, administering medications, or providing supportive care as needed.