Nokea
Which is the best position for an 8-year-old who has returned after an appendectomy for a ruptured appendix?
- A. Right side-lying.
- B. Semi-Fowler.
- C. Prone.
- D. Left side-lying.
Correct Answer: A
Rationale: Right side-lying promotes drainage of the peritoneal cavity and enhances comfort after surgery.
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A nurse has determined that a newborn's respiratory breathing is within a normal range. How should the nurse document this finding?
- A. Irregular, abdominal, 30 to 60 breaths/min
- B. Regular, abdominal, 25 to 35 breaths/min
- C. Regular, noisy, 35 to 45 breaths/min
- D. Irregular, quiet, 45 to 55 breaths/min
Correct Answer: B
Rationale: A newborn with normal respiratory breathing would typically exhibit regular breathing patterns, with abdominal movements indicating effective diaphragmatic breathing. The normal respiratory rate for a newborn is considered to be 25 to 35 breaths per minute. Therefore, documenting the newborn's respiratory breathing as "Regular, abdominal, 25 to 35 breaths/min" would accurately represent a normal finding.
Neuroblastoma can be associated with paraneoplastic syndromes. All the following features are paraneoplastic EXCEPT
- A. uncontrollable jerking movements
- B. cerebellar ataxia and increased body coordination
- C. unilateral ptosis, myosis, and anhidrosis
- D. profound secretory diarrhea
Correct Answer: B
Rationale: Increased body coordination is not a typical feature of neuroblastoma-associated paraneoplastic syndromes.
Which of the ff. does the nurse understand usually precedes rheumatic fever?
- A. A viral infection
- B. A beta-hemolytic streptococcal
- C. A fungal infection infection c.A staphylococcal infection
Correct Answer: B
Rationale: Rheumatic fever is an inflammatory disease that can develop as a complication of untreated or inadequately treated infections caused by group A beta-hemolytic streptococci. These bacterial infections are usually in the form of strep throat or scarlet fever. Rheumatic fever typically occurs 2-4 weeks after a streptococcal infection. The body's immune response to the streptococcal infection can lead to an autoimmune reaction, resulting in rheumatic fever. It is important to promptly diagnose and treat streptococcal infections to prevent the development of rheumatic fever.
Although most relapses in children with Wilms tumor occur early (within 2 yr of diagnosis) and have a favorable outcome, about 15% suffer relapse. Relapse includes all the following EXCEPT
- A. low stage (I/II) at diagnosis
- B. no prior radiotherapy
- C. anaplastic histology
- D. more than 12 mo from nephrectomy
Correct Answer: C
Rationale: Anaplastic histology is associated with a poorer prognosis and is not typically associated with favorable relapse outcomes.
A complete blood count is commonly performed before a client goes into surgery. What does this test seek to identify?
- A. Potential hepatic dysfunction indicated by decreased blood urea nitrogen (BUN) and creatinine levels
- B. Low levels of urine constituents normally excreted in the urine
- C. Abnormally low hematocrit (HCT) and hemoglobin (Hb) levels
- D. Electrolyte imbalance that could affect the blood's ability to coagulate properly
Correct Answer: C
Rationale: A complete blood count (CBC) is a common blood test that provides important information about the types and numbers of cells in the blood, such as red blood cells, white blood cells, and platelets. The primary purpose of performing a CBC before surgery is to identify any abnormalities in the blood that could affect the patient's ability to undergo the surgical procedure safely. Abnormally low hematocrit (HCT) and hemoglobin (Hb) levels indicated by a CBC may suggest anemia, which could impact the patient's ability to tolerate surgery and anesthesia. Anemia can result in decreased oxygen delivery to tissues and organs, leading to potential complications during surgery. Therefore, identifying low HCT and Hb levels through a CBC allows healthcare providers to take appropriate measures to address and manage the condition before proceeding with surgery.