Nokea
Which explanation regarding cardiac catheterization is appropriate for a preschool child?
- A. Postural drainage will be performed every 4 to 6 hours after the test.
- B. It is necessary to be completely "asleep" during the test.
- C. The test is short, usually taking less than 1 hour.
- D. When the procedure is done, you will have to keep your leg straight for at least 4 hours.
Correct Answer: C
Rationale: For a preschool child, the appropriate explanation about cardiac catheterization would be that the test is short, usually taking less than 1 hour. This explanation is suitable for a preschool child because it provides a simple and clear understanding of what to expect during the procedure. Preschool-aged children have limited attention spans and may become anxious about medical procedures, so providing a concise and reassuring explanation can help alleviate their fears. Additionally, knowing that the test will not take a long time can help the child feel more at ease about the procedure.
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Which of the following procedures does the nurse understand is used to correct otosclerosis?
- A. Myringotomy
- B. Mastoidectomy
- C. Myringoplasty
- D. Stapedectomy
Correct Answer: D
Rationale: Otosclerosis is a condition characterized by abnormal bone growth in the middle ear, particularly around the stapes bone. A stapedectomy is a surgical procedure performed to correct otosclerosis by removing the stapes bone and replacing it with a prosthesis. This surgery aims to improve hearing by restoring the movement of the ossicles in the middle ear. Myringotomy is a procedure involving an incision in the eardrum to drain fluid, mastoidectomy involves the removal of infected mastoid air cells, and myringoplasty is the surgical repair of a perforated eardrum, none of which address the specific issue of otosclerosis.
The nurse is reviewing the medication history of a new preoperative patient who is nil by mouth (NPO). The nurse notes that the patient has been on long-term oral steroid therapy. The nurse understands that which of the following is the reason that steroids cannot be abruptly stopped?
- A. Higher steroid levels are needed during
- B. Malignant hypertension will occur.
- C. Respiratory failure will result.
- D. Malignant hyperthermia will result.
Correct Answer: A
Rationale: Steroids should not be abruptly stopped, especially in patients on long-term therapy, because higher steroid levels are needed during stress. Abruptly stopping steroids can lead to adrenal insufficiency and a life-threatening condition called adrenal crisis. Patients undergoing surgery or experiencing significant stress require higher doses of steroids to prevent adrenal crisis. It is important for healthcare providers to monitor and adjust steroid doses accordingly during stressful situations such as surgery.
A young couple of a 2-month-old baby girl with excessive crying seeks medical advice. The LEAST important advice is to
- A. master the situation in a relaxed manner
- B. adhere to precry cues
- C. change milk formula
- D. avoid sensory overstimulation
Correct Answer: C
Rationale: Changing the milk formula is less critical unless there is evidence of intolerance or allergy.
A 2-year-old child presents with a peeling, erythematous rash on the hands and feet. The mother reports that he has become ill tempered and refuses to walk about, preferring to lie in bed. Physical examination reveals an irritable, pale child with photophobia. Temperature is 98.5°F, heart rate is 80/minute, and respiratory rate is 23/minute. Tremor of the tongue is evident. Further history and follow-up evaluation reveal that the child's elder brothers have been playing with liquid mercury. Which is the most likely diagnosis?
- A. Measles
- B. Fifth disease
- C. Kawasaki disease
- D. Acrodynia
Correct Answer: D
Rationale: Acrodynia, also known as pink disease, is caused by chronic mercury exposure. The symptoms described, including the rash, irritability, photophobia, and tremor, are consistent with mercury poisoning.
The physical manifestations of fetal alcohol syndrome include:
- A. abnormal facial tissue, cleft lip, and cleft palate.
- B. hepatomegaly, hypotonia, and microphthalmia.
- C. microcephaly, short philtrum, and intrauterine growth restriction.
- D. hyperbilirubinemia, jaundice, and failure to thrive.
Correct Answer: C
Rationale: Fetal alcohol syndrome is characterized by microcephaly, a short philtrum, and intrauterine growth restriction, among other features.