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Which of the ff. medications might be ordered to help control symptoms of multiple sclerosis, and possibly induce a remission?
- A. Acyclovir
- B. Thyrotropin
- C. ACTH
- D. Benadryl
Correct Answer: C
Rationale: ACTH (Adrenocorticotropic hormone) might be ordered to help control symptoms of multiple sclerosis and possibly induce a remission. ACTH is sometimes used as a treatment option for multiple sclerosis due to its anti-inflammatory properties. It can help reduce inflammation in the central nervous system and, in some cases, lead to a decrease in symptoms and possibly induce a remission. However, it is important to note that ACTH is not commonly used as a first-line treatment for multiple sclerosis and is usually reserved for cases that are refractory to other medications.
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The nurse must assess a 10-month-old infant. The infant is sitting on the father's lap and appears to be afraid of the nurse and of what might happen next. Which initial action by the nurse would be most appropriate?
- A. Initiate a game of peek-a-boo.
- B. Ask father to place the infant on the examination table.
- C. Undress the infant while he is still sitting on his father's lap.
- D. Talk softly to the infant while taking him from his father.
Correct Answer: D
Rationale: Talking softly to the infant while taking him from his father would be the most appropriate initial action by the nurse in this situation. This approach allows the nurse to maintain communication with the infant to provide comfort and minimize fear or anxiety. By using a gentle tone and reassuring words, the nurse can help establish a sense of safety for the infant as he is transitioned from his father's lap to the examination table. This gradual and supportive approach is likely to facilitate a smoother assessment process and help build trust with the infant and the family.
Cystic fibrosis most often affects multiple systems of the body. The primary factor responsible for possible multiple clinical manifestations is which of the following?
- A. Hyperactivity of sweat glands
- B. Hypoactivity of parasympathetic nervous system
- C. Sweat chloride test >60 mEq/L
- D. Increased viscosity resulting in mucous gland secretions
Correct Answer: D
Rationale: Cystic fibrosis (CF) is an inherited genetic disorder caused by mutations in the CFTR gene, leading to the production of thick, sticky mucus. This increased viscosity affects various organs and systems in the body, causing multiple clinical manifestations. The abnormal secretions block the airways in the lungs, leading to recurrent lung infections, breathing difficulties, and ultimately respiratory failure. In the digestive system, the thick mucus blocks the pancreatic ducts, impairing the release of digestive enzymes, which can result in malabsorption and malnutrition. Additionally, the thick secretions can affect the liver, leading to complications like liver disease. Therefore, the primary factor responsible for the multiple clinical manifestations in cystic fibrosis is the increased viscosity of the mucous gland secretions, which impacts various systems in the body.
The nurse is aware that the following laboratory values support a diagnosis of pyelonephritis?
- A. Myoglobinuria
- B. Ketonuria
- C. Pyuria
- D. Low white blood cell (WBC) count
Correct Answer: C
Rationale: Pyelonephritis is a bacterial infection of the kidney. One of the key indicators of pyelonephritis is the presence of pyuria, which refers to white blood cells in the urine. White blood cells in the urine suggest inflammation and infection in the urinary tract, particularly in the kidneys. Therefore, the presence of pyuria supports a diagnosis of pyelonephritis. Myoglobinuria (choice A) is the presence of myoglobin in the urine and is associated with muscle breakdown, not specifically with pyelonephritis. Ketonuria (choice B) refers to the presence of ketones in the urine and may be seen in conditions such as diabetic ketoacidosis. A low white blood cell count (choice D) is not typically associated with pyelonephritis, as an infection would generally result in an elevated white blood cell count in response to the infection.
Which of the following assessment findings would suggest to the home health nurse that the patient is developing congestive heart failure?
- A. orthopnea
- B. fever
- C. weight loss
- D. calf pain A1 PASSERS TRAINING, RESEARCH, REVIEW & DEVELOPMENT COMPANY MEDICAL SURGICAL NURSING SET O
Correct Answer: A
Rationale: Orthopnea is a common symptom of congestive heart failure. It is defined as difficulty in breathing when lying flat, which improves when sitting up or standing. This occurs due to the redistribution of blood in the body when changing positions. As fluid accumulates in the lungs in congestive heart failure, lying down increases pressure on the chest and impairs breathing. Therefore, orthopnea is a significant assessment finding that would suggest to the home health nurse that the patient is developing congestive heart failure. Fever, weight loss, and calf pain are not typically associated with congestive heart failure.
The MOST appropriate answer to why infants cry in response to another infant's cry is
- A. an early sign of empathy development
- B. a sign of good hearing reflex
- C. a startle reflex
- D. an early sign of fear development
Correct Answer: A
Rationale: Empathy begins developing early, though rudimentary.