Nokea
Which of the ff. nursing interventions will help prevent complications in the patient with Bell's Palsy?
- A. Megavitamin therapy
- B. Application of ice to the affected area
- C. Elastic bandages
- D. Lubricating eye drops
Correct Answer: D
Rationale: Bell's Palsy is a condition that affects the facial nerve, leading to weakness or paralysis of the facial muscles. One common complication of Bell's Palsy is the inability to fully close the affected eye, which can result in corneal exposure and dryness. Lubricating eye drops help prevent dryness and protect the cornea from damage due to inadequate eye closure. Using lubricating eye drops regularly can help maintain the eye's moisture and prevent potential complications such as corneal abrasions and infections, which are common in patients with Bell's Palsy. Megavitamin therapy, application of ice, and elastic bandages are not typically indicated for preventing complications in patients with Bell's Palsy.
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An infant with bladder exstrophy has had a continent urinary reservoir placed. Which discharge instruction should be included?
- A. Allow your child to sleep on the abdomen for comfort.
- B. Avoid contact with latex-containing surfaces (e.g., playgrounds with rubber) to prevent allergic reactions.
- C. Encourage a varied diet to prevent allergies.
- D. Provide brightly colored objects to stimulate development.
Correct Answer: B
Rationale: Children with urologic malformations are prone to latex allergies; parents should be advised to avoid latex exposure.
An adult has been treated for pulmonary tuberculosis and is being discharged home with his wife and two young children. His wife asks how TB is passed from one person to another so she can prevent anyone from catching it. How should the nurse respond?
- A. You should wear gloves when handling his linen and bedding
- B. You should keep the windows and doors closed so as not to spread the droplets
- C. He must be careful to cough into a handkerchief that is washed in hot water or discarded
- D. Make sure to boil all water before drinking or using it
Correct Answer: C
Rationale: Tuberculosis is primarily spread through the air when an infected person coughs, sneezes, speaks, or sings, releasing bacteria-containing droplets into the air. Therefore, it is important for the individual with TB to cover their mouth and nose when coughing or sneezing to prevent the spread of the bacteria. By coughing into a disposable tissue or a handkerchief that can be washed in hot water, the risk of spreading the infection to others is significantly reduced. This measure helps minimize the transmission of the disease within the household and community.
Which of the following is disease process characterized by a chronic progressive inflammation of the sacroiliac and costovertebral joints and adjacent soft tissue?
- A. Rheumatoid arthritis
- B. Scoliosis
- C. Kyphosis
- D. Ankylosing spondylitis
Correct Answer: D
Rationale: Ankylosing spondylitis is a chronic inflammatory disease primarily affecting the sacroiliac joints and the spine. It leads to progressive inflammation of the sacroiliac and costovertebral joints, which can cause pain, stiffness, and eventually lead to fusion of the affected joints. This condition is also characterized by inflammation of other joints, tendons, and ligaments, as well as extra-articular manifestations such as uveitis and cardiac involvement. Ankylosing spondylitis is more common in young males and is associated with the presence of the HLA-B27 genetic marker. It is important to diagnose and manage ankylosing spondylitis early to help prevent complications and improve quality of life for affected individuals.
A worried mother of a 4-year-old boy describing attacks of inconsolable crying episodes. The MOST appropriate action is
- A. reassures her that this is a normal phenomenon of temper tantrum
- B. seek more history regarding other skills and developmental domains
- C. refer her to pediatric psychiatry
- D. investigate social issues of the family
Correct Answer: A
Rationale: Temper tantrums are common at this age and often do not indicate pathology.
A child with a poor nutritional status and weight loss is at risk for a negative nitrogen balance. To help diagnose this problem, the nurse in charge anticipates that the doctor will order which laboratory test?
- A. Total iron-binding capacity
- B. Hemoglobin
- C. Total protein
- D. Serum transferrin
Correct Answer: C
Rationale: Total protein is a laboratory test that is commonly ordered to assess the nutritional status of an individual. In the case of a child with poor nutritional status and weight loss, assessing the total protein levels can help in diagnosing a negative nitrogen balance. Total protein levels may decrease in individuals with inadequate protein intake, malnutrition, or negative nitrogen balance. Monitoring total protein levels can provide valuable information about the child's nutritional status and help guide further interventions to improve their overall health and well-being.