Nokea
Which may be given to high-risk children after exposure to chickenpox to prevent varicella?
- A. Acyclovir (Zovirax)
- B. Varicella globulin
- C. Diphenhydramine hydrochloride (Benadryl)
- D. VCZ immune globulin (VariZIG)
Correct Answer: D
Rationale: VCZ immune globulin (VariZIG) is given to high-risk children after exposure to chickenpox to prevent varicella. VariZIG contains antibodies against the varicella-zoster virus, providing passive immunity to the child. This can help reduce the severity of the infection or prevent it altogether in high-risk individuals. Acyclovir (Zovirax) is an antiviral medication used to treat varicella infections but is not typically used for prevention post-exposure. Varicella globulin is not a treatment for varicella. Diphenhydramine hydrochloride (Benadryl) is an antihistamine and is not used for preventing varicella post-exposure.
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To whom is RhIG (RhoGAM) administered to prevent Rh isoimmunization?
- A. Rh-negative women who deliver an Rh-positive newborn
- B. Rh-positive women who deliver an Rh-negative newborn
- C. Rh-negative newborns whose mothers are Rh positive
- D. Rh-positive fathers before conception of second newborn when first newborn was Rh positive
Correct Answer: A
Rationale: RhIG (RhoGAM) is administered to Rh-negative women who deliver an Rh-positive newborn to prevent Rh isoimmunization. Rh isoimmunization can occur when an Rh-negative mother is exposed to Rh-positive fetal blood during childbirth, leading to the production of antibodies against Rh antigen. RhIG works by binding to and destroying any fetal Rh-positive red blood cells that have entered the mother's circulation, preventing her immune system from mounting an immune response and producing antibodies. This helps to protect subsequent pregnancies from complications related to Rh isoimmunization. Therefore, RhIG administration is crucial in preventing sensitization and ensuring the health of future pregnancies in Rh-negative women who deliver an Rh-positive newborn.
Which of the following IV solutions is hypertonic?
- A. Normal saline
- B. 0.45% NaCl
- C. 5% dextrose in 0.9% NaCl
- D. 0.225% NaCl
Correct Answer: C
Rationale: A hypertonic solution has a higher concentration of solutes compared to the intracellular fluid. In this case, 5% dextrose in 0.9% NaCl is hypertonic because it has a higher osmolarity due to the combined effect of dextrose and sodium chloride. The dextrose contributes to the hypertonicity, making the overall solution more concentrated than the intracellular fluid.
How does the nurse assess a child's capillary refill time?
- A. Inspecting the chest
- B. Auscultating the heart
- C. Palpating the apical pulse
- D. Palpating the skin to produce a slight blanching
Correct Answer: D
Rationale: Capillary refill time is a clinical assessment used to evaluate peripheral perfusion. To perform this assessment on a child, the nurse would gently press on the child's nail bed or skin, causing the area to momentarily blanch (turn white) as blood is temporarily forced out of the capillaries. Once pressure is released, the nurse observes and times how quickly the color returns to normal. A normal capillary refill time in a child is less than 2 seconds. This method helps the nurse determine if the child's peripheral circulation is adequate. Inspecting the chest (choice A), auscultating the heart (choice B), and palpating the apical pulse (choice C) are not appropriate methods for assessing capillary refill time.
Nurse Raymond is giving instructions to an elderly client on diabetic foot care. Which teaching is not part of foot care?
- A. wear comfortable shoes that fit well and protect your feet
- B. trim your toenails straight across and file edges with emery board
- C. wash your feet in hot water to keep feet soft
- D. wear shoes at the beach or on hot pavement
Correct Answer: C
Rationale: Washing your feet in hot water is not recommended for diabetic foot care as it can increase the risk of burns and skin damage due to reduced sensitivity and circulation in the feet. Instead, it is advised to wash your feet in warm water, not hot, and to thoroughly dry them, especially in between the toes, to prevent fungal infections.
When the patient's signature is witnessed by the nurse on the surgical consent, which of the following does the nurse's signature indicate?
- A. The nurse obtained informed consent.
- B. The nurse provided informed consent.
- C. The nurse answered all surgical procedure questions.
- D. The nurse verified that the patient signed the consent.
Correct Answer: D
Rationale: The nurse's signature on the surgical consent form indicates that the nurse has verified and confirmed that the patient has signed the consent form. This step is crucial to ensure that the patient has voluntarily given their consent for the surgical procedure. It does not mean that the nurse obtained or provided informed consent, answered all surgical procedure questions, or made decisions on behalf of the patient. The nurse's role is to act as a witness to the patient's signature on the consent form to acknowledge that the patient has agreed to the procedure and signed the document.