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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In a client who has human immunodeficiency virus (HIV) infection, CD4+ levels are measured to determine the:
- A. Presence of opportunistic infections
- B. Extent of immune system damage
- C. Level of the viral load
- D. Resistance to antigens
Correct Answer: B
Rationale: CD4+ T cells are a type of white blood cell that plays an essential role in coordinating the immune system's response to infections. In individuals with HIV infection, the virus specifically targets and destroys CD4+ T cells. Therefore, measuring CD4+ levels provides valuable information about the extent of damage to the immune system caused by HIV. Monitoring CD4+ levels helps in assessing the progression of the disease and determining when to initiate antiretroviral therapy to prevent opportunistic infections. Additionally, CD4+ levels are used to determine the prognosis and guide treatment decisions in individuals with HIV.
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.
Which of the ff. actions would the nurse include in the plan of care to reduce the symptoms of the patient who has vertigo?
- A. Avoid noises
- B. Encourage fluid intake
- C. Avoid sudden movements
- D. Administer analgesics
Correct Answer: C
Rationale: Vertigo is a sensation of spinning or dizziness that can be caused by issues in the inner ear. One of the key strategies in managing vertigo is to avoid sudden movements that can trigger or worsen the symptoms. Sudden movements can disrupt the balance mechanisms in the inner ear and further exacerbate the feeling of dizziness and spinning. By advising the patient to avoid sudden movements, the nurse can help reduce the intensity and frequency of vertigo episodes, promoting greater comfort and quality of life for the patient.
Which is an objective of care for a 10-year-old child with minimal change nephrotic syndrome?
- A. Reduce blood pressure.
- B. Reduce excretion of urinary protein.
- C. Increase excretion of urinary protein.
- D. Increase ability of tissues to retain fluid.
Correct Answer: B
Rationale: The management goal for a child with minimal change nephrotic syndrome is to reduce the excretion of urinary protein. In this condition, there is an abnormal loss of protein in the urine due to damage in the glomeruli of the kidneys. Reducing the excretion of urinary protein helps prevent complications associated with protein loss, such as edema and hypoalbuminemia. While reducing blood pressure may be important in some cases, the primary focus for this specific condition is to address the protein leak in the urine. Increasing the excretion of urinary protein would worsen the condition, and increasing the ability of tissues to retain fluid is not the desired outcome in this context.
A 2 years old girl presents with blue discoloration of nails and lips. On examination she is cyanosed and clubbed, heart auscultation reveals a short systolic murmur at left upper sternal border. The most likely diagnosis is?
- A. VSD
- B. Tetralogy of Fallot
- C. Tricuspid atresia
- D. Trunchus arteriosus
Correct Answer: B
Rationale: Tetralogy of Fallot typically causes cyanosis, clubbing, and a systolic murmur due to right-to-left shunting.