Nokea
Which characteristic is representative of the newborn's gastrointestinal tract?
- A. Stomach capacity is approximately 90 ml.
- B. Peristaltic waves are relatively slow.
- C. Overproduction of pancreatic amylase occurs.
- D. Intestines are shorter in relation to body size.
Correct Answer: D
Rationale: The characteristic representative of the newborn's gastrointestinal tract is that the intestines are shorter in relation to the body size. This is because a newborn's gastrointestinal tract is still developing and adapting to the digestion and absorption of nutrients. The proportion of the intestines to the body size is smaller in newborns compared to adults. Over time, as the newborn grows and matures, the intestines will also lengthen and increase in capacity to efficiently process food and absorb nutrients.
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A client requires minor surgery for removal of a basal cell tumor. The anesthesiologist administers the anesthetic ketamine hydrochloride (Ketalar), 60g IV. After Ketamine administration, the nurse should monitor the client for:
- A. Muscle rigidity and spasms
- B. Hiccups
- C. Extrapyramidal reactions
- D. Respiratory depression
Correct Answer: A
Rationale: Ketamine hydrochloride (Ketalar) is a dissociative anesthetic that can cause muscle rigidity and spasms as a side effect. This is known as a dose-dependent reaction to ketamine administration. Monitoring for muscle rigidity and spasms is important to ensure the client's safety and to provide appropriate management if this adverse effect occurs. It is essential for the nurse to closely observe the client for any signs of muscle rigidity and spasms after the administration of ketamine.
The nurse is caring for a patient with HIV. Which of the following foods would the nurse teach the patient is safe to eat to reduce the risk of infection?
- A. Raw fruits
- B. Raw vegetables
- C. Cooked vegetables
- D. Caesar dressing
Correct Answer: C
Rationale: For a patient with HIV, it is important to reduce the risk of infection by avoiding potentially contaminated foods. Cooked vegetables are safer to eat compared to raw fruits and vegetables since cooking helps to kill harmful pathogens that can be present on raw produce. Caesar dressing, which typically contains raw eggs, should also be avoided as these can pose a risk of foodborne illness for individuals with compromised immune systems like those with HIV. Therefore, the nurse should teach the patient that cooked vegetables are a safer option for reducing the risk of infection.
7-year-old Damon has cystitis; which of the following would Nurse Elena expect when assessing the child?
- A. Dysuria
- B. Costovertebral tenderness
- C. Flank pain
- D. High fever
Correct Answer: A
Rationale: Cystitis is inflammation of the bladder, commonly caused by a bacterial infection. In children, symptoms of cystitis often include dysuria, which is painful or difficult urination. This symptom is frequently observed in children with cystitis. Costovertebral tenderness and flank pain are more indicative of kidney involvement (such as in pyelonephritis) rather than just bladder inflammation like in cystitis. High fever may also be present in severe cases of cystitis, but dysuria is the more specific and common symptom associated with this condition in children.
A client with Hashimoto's thyroiditis and a history of two myocardial infarctions and coronary artery disease is to receive levothyroxine (Synthroid). Because of the client's cardiac history, the nurse would expect that the client's initial dose for the thyroid replacement would be which of the following?
- A. 25 g/day, initially
- B. Delayed until after thyroid surgery
- C. 100 g/day, initially
- D. Initiated before thyroid surgery
Correct Answer: A
Rationale: In a client with a history of two myocardial infarctions and coronary artery disease, initiating levothyroxine therapy with a low starting dose of 25 mcg/day is recommended. Thyroid hormone replacement therapy can potentially worsen underlying cardiac conditions, so a cautious approach is necessary. The dose may be gradually titrated upwards based on thyroid function tests and the client's response. Delaying treatment until after thyroid surgery (option B) is not necessary in this scenario if the client requires thyroid hormone replacement. Initiating levothyroxine before thyroid surgery (option D) is not relevant to the given clinical situation. Starting with a higher dose of 100 mcg/day (option C) may pose a higher risk of cardiac complications in this client with a cardiac history.
Which clinical manifestation should the nurse expect to see as shock progresses in a child and becomes decompensated shock?
- A. Thirst
- B. Irritability
- C. Apprehension
- D. Confusion and somnolence
Correct Answer: D
Rationale: As shock progresses and becomes decompensated in a child, profound perfusion abnormalities lead to inadequate oxygen and nutrient delivery to the brain. This can result in altered mental status such as confusion and somnolence. As the body struggles to maintain adequate perfusion to vital organs, the brain may be one of the first organs to demonstrate signs of inadequate perfusion. Thirst, irritability, and apprehension are more commonly seen in the early stages of shock. Confusion and somnolence indicate a more severe and critical state of shock where the child's body is struggling to maintain adequate blood flow to vital organs, including the brain.