Nokea
Which medication is most likely included in post-operative care of a child with repair of bladder exstrophy?
- A. Lasix
- B. Mannitol
- C. Meperidine
- D. Oxybutynin
Correct Answer: D
Rationale: Oxybutynin helps control bladder spasms and improves comfort after urinary reconstructive surgery.
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Mr. Garcia, a 41-year old chronic alcohol drinker is admitted to the hospital after vomiting bright red blood. He was diagnosed to have a bleeding gastric ulcer and suddenly develops sudden sharp pain in the midepigastric region with a rigid boardlike abdomen. This likely indicates:
- A. development of intestinal
- B. inflammation of the esophagus
- C. perforation of the ulcer
- D. development of additional ulcers
Correct Answer: C
Rationale: The sudden sharp pain in the midepigastric region with a rigid boardlike abdomen in a patient with a bleeding gastric ulcer, especially in the setting of chronic alcohol use, is indicative of a perforation of the ulcer. Perforation occurs when the ulcer penetrates through the wall of the stomach or duodenum, leading to the leakage of gastric contents into the peritoneal cavity. This results in peritonitis, causing severe abdominal pain and rigidity. Perforation of the ulcer is a surgical emergency requiring immediate intervention to repair the perforation, control the infection, and prevent further complications like sepsis. It is a life-threatening condition that necessitates prompt diagnosis and management.
Poor prognostic factors in Hodgkin lymphoma include all the following EXCEPT
- A. age of more than 15 year at the time of diagnosis
- B. stage IV disease
- C. manifested by positron emission tomography (PET) scan positivity
- D. presence of bulky mediastinal mass
Correct Answer: A
Rationale: Older age is generally considered a poor prognostic factor, but not necessarily worse than other listed options.
when a female carrier of hemophilia marries a male who is free of the disease, the risk to their off spring for each pregnancy is what:
- A. all female children will be carriers of hemophilia
- B. half the male children will have the hemophilia
- C. all male children will have the disease
- D. half the female children will have hemophilia 125
Correct Answer: B
Rationale: Hemophilia is an X-linked recessive genetic disorder, meaning it is carried on the X chromosome. Females have two X chromosomes, while males have one X and one Y chromosome. In this scenario, the female carrier has one X chromosome with the hemophilia gene and one normal X chromosome. When she has children, she has a 50% chance of passing on the X chromosome with the hemophilia gene to her sons. Therefore, half the male children will inherit hemophilia, while half will not. Daughters, on the other hand, have a 50% chance of inheriting the X chromosome with the hemophilia gene but since it is a recessive disorder, they will be carriers of hemophilia rather than having the disease itself.
The nurse is having difficulty communicating with a hospitalized 6-year-old child. What technique might be most helpful?
- A. Suggest that the child keep a diary.
- B. Suggest that the parent read fairy tales to the child.
- C. Ask the parent if the child is always uncommunicative.
- D. Ask the child to draw a picture.
Correct Answer: D
Rationale: Asking the child to draw a picture can be the most helpful technique in this situation because it allows the child to express themselves visually, especially when verbal communication may be challenging. Drawing can serve as a form of communication that the child may find more comfortable and engaging. It provides the child with a non-verbal way to express their thoughts, feelings, and experiences, which can help the nurse better understand the child's perspective and potentially build a connection with them. Additionally, examining the child's drawings can provide valuable insights into their emotional state and concerns, facilitating more effective care and support.
What is the risk of not treating congenital hypothyroidism within the first 3 months following birth?
- A. To ensure normal growth
- B. To prevent cognitive impairment
- C. To prevent mental retardation
- D. All of the above
Correct Answer: D
Rationale: Congenital hypothyroidism is a condition where a newborn baby is born with an underactive thyroid gland. If left untreated within the first 3 months following birth, it can lead to serious consequences such as stunted growth, cognitive impairment, and mental retardation.