Nokea
Which clinical manifestation would be seen in a child with chronic renal failure?
- A. Hypotension
- B. Massive hematuria
- C. Hypokalemia
- D. Unpleasant "uremic" breath odor
Correct Answer: D
Rationale: Chronic renal failure is characterized by the buildup of waste products and toxins in the blood due to kidney dysfunction. One common clinical manifestation in children with chronic renal failure is the development of an unpleasant "uremic" breath odor. This odor is often described as a fishy or ammonia-like smell and is a result of the accumulation of urea in the blood, which is normally filtered out by the kidneys. Other common clinical manifestations of chronic renal failure in children may include hypertension, fluid retention, electrolyte abnormalities (such as hyperkalemia rather than hypokalemia), anemia, growth failure, and bone abnormalities.
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A post-TURP patient experiences dribbling following removal of his catheter. Which action should the nurse take?
- A. Have him restrict fluid intake to 1000 mL/day
- B. Teach him to perform Kegel's exercises 10 to 20 times per hour
- C. Reinsert the Foley catheter until he regains urinary control
- D. Reassure him that incontinence never lasts more than a few days
Correct Answer: B
Rationale: The best course of action for a post-TURP patient experiencing dribbling after catheter removal is to teach him to perform Kegel's exercises 10 to 20 times per hour. Kegel exercises help strengthen the pelvic floor muscles, which can improve urinary control and reduce dribbling. Restricting fluid intake is not recommended as it can lead to dehydration. Reinserting the Foley catheter is not ideal unless there are complications. Incontinence following TURP can take time to improve, so reassuring the patient that it never lasts more than a few days may give false expectations. Teaching Kegel exercises is the most appropriate intervention to address post-TURP dribbling.
Matthew, age 18 months, has just been admitted with croup. His parent is tearful and tells the nurse, "This is all my fault. I should have taken him to the doctor sooner so he wouldn't have to be here." Which is appropriate in the care plan for this parent who is experiencing guilt?
- A. Clarify misconception about the illness.
- B. Explain to the parent that the illness is not serious.
- C. Encourage the parent to maintain a sense of control.
- D. Assess further why the parent has excessive guilt feelings.
Correct Answer: A
Rationale: In this situation, it is important to clarify the parent's misconception about the illness. By providing information about croup, the nurse can help the parent understand that seeking medical care promptly is essential in managing the condition but that it is not solely the parent's fault. This can help alleviate the parent's guilt and provide reassurance that they are doing their best for their child. It is essential to provide education and support to empower the parent in caring for their child effectively.
A nurse is teaching a parent about introduction of solid foods into an infant's diet. Which should the nurse include in the teaching session? (Select all that apply.)
- A. Solid food introduction can be started at 2 months of age.
- B. Rice cereal is introduced first.
- C. Begin the introduction of solid foods by mixing with formula in the bottle.
- D. Introduce egg white in small quantities (1 tsp) toward the end of the first year.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
During chemotherapy for lymphocytic leukemia, a client develops abdominal pain, fever, and "horse barn" smelling diarrhea. It would be most important for the nurse to advise the physician to order:
- A. Enzyme-linked immunosuppressant assay
- B. Stool for Clostridium difficile test
- C. Flat palate X-ray of the abdomen
- D. Electrolyte panel and hemogram
Correct Answer: B
Rationale: The client's symptoms of abdominal pain, fever, and "horse barn" smelling diarrhea are concerning for Clostridium difficile infection, especially in the setting of receiving chemotherapy which can weaken the immune system. Clostridium difficile is a bacteria that can cause severe diarrhea and inflammation of the colon. Testing for Clostridium difficile in the stool is crucial for diagnosing the infection and guiding appropriate treatment. Therefore, advising the physician to order a stool test for Clostridium difficile would be the most important in this scenario to confirm the diagnosis and initiate appropriate management.
The nurse is helping parents achieve a more nutritionally adequate vegetarian diet for their child. Which is most likely lacking in their particular diet?
- A. Fat
- B. Protein
- C. Vitamins C and A
- D. Complete protein
Correct Answer: C
Rationale: A vegetarian diet can provide adequate amounts of protein, fat, and even complete protein if well-balanced. However, certain essential nutrients like vitamins C and A are more commonly found in higher concentrations in animal-based products. Therefore, in a vegetarian diet, particularly if not carefully planned, there may be a potential lack of these specific vitamins. It is important for the nurse to educate the parents on alternative plant-based sources of vitamins C and A to ensure their child's nutritional requirements are met.