Nokea
Which of the following guidekines does not observe surgical asepisi in the operating room?
- A. sterile articles may touch other sterile articles or surface and remain sterile
- B. gowns of surgical team are considered sterile in front from the chest down to the bottom of the gown
- C. whenever a sterile barrier is breached, the area must be considered contaminated
- D. sterile drapes are used to create a sterile field
Correct Answer: A
Rationale: This statement is incorrect and does not observe surgical asepsis in the operating room. In surgical asepsis, it is crucial that sterile articles do not touch other sterile articles or surfaces to prevent contamination. Any contact between sterile items or surfaces can lead to the transfer of microorganisms, compromising the sterility of the environment. Maintaining a sterile field is essential to prevent surgical site infections and ensure the safety of the patient undergoing the procedure.
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The Foley Family is caring for their youngest child, Justin, who is suffering from tetralogy of Fallot. Which of the following are defects associated with this congenital heart condition?
- A. Aorta exits from the right ventricle, pulmonary artery exits from the left ventricle, and two noncommunicating circulations
- B. Ventricular septal defect, overriding aorta, pulmonic stenosis (PS), and right ventricular hypertrophy
- C. Coarctation of aorta, aortic valve stenosis, mitral valve stenosis, and patent ductus arteriosus
- D. Tricuspid valve atresia, atrial septal defect, ventricular septal defect, and hypoplastic right ventricle
Correct Answer: B
Rationale: Tetralogy of Fallot is a congenital heart condition characterized by four specific defects:
Sudden infant death syndrome (SIDS) is one of the most common causes of death in infants. At what age is the diagnosis of SIDS most likely?
- A. At 1 to 2 years of age
- B. At I week to 1 year of age, peaking at 2 to 4 months
- C. At 6 months to 1 year of age, peaking at 10 months
- D. At 6 to 8 weeks of age
Correct Answer: B
Rationale: Sudden infant death syndrome (SIDS) is most likely to occur between the ages of 1 week to 1 year, with the highest risk period being between 2 to 4 months of age. While SIDS can occur up to the age of 1 year, the peak incidence is during the first 6 months of life. It is important to follow safe sleep practices, such as placing infants on their backs to sleep, to reduce the risk of SIDS during this vulnerable period.
While caring for a critically ill child, the nurse observes that respirations are gradually increasing in rate and depth, with periods of apnea. What pattern of respiration will the nurse document?
- A. Dyspnea
- B. Tachypnea
- C. Cheyne-Stokes respirations
- D. Seesaw (paradoxic) respirations
Correct Answer: C
Rationale: Cheyne-Stokes respirations are characterized by alternating periods of deep, rapid breathing followed by periods of apnea. This cyclic pattern of respiration is often seen in critically ill patients and can be a sign of serious neurological or cardiac dysfunction. The nurse should document Cheyne-Stokes respirations when observing this specific breathing pattern in the child described in the scenario.
A patient has allergic rhinitis. In planning care for the patient, the nurse understands that if the patient does not remain compliant with the treatment regimen, the patient is at risk for developing which of the following?
- A. Sinusitis
- B. Lymphadenopathy
- C. Anaphylaxis
- D. Angioedema
Correct Answer: A
Rationale: Allergic rhinitis is characterized by inflammation of the nasal passages due to exposure to allergens. If a patient with allergic rhinitis does not remain compliant with the treatment regimen, such as taking antihistamines or using nasal corticosteroids, it can lead to chronic inflammation and congestion of the nasal passages. Over time, this chronic inflammation can predispose the patient to developing complications such as sinusitis, which is the inflammation of the sinuses. Sinusitis can result in symptoms such as facial pain, pressure, nasal congestion, and fever. Therefore, non-compliance with treatment in allergic rhinitis can increase the risk of developing sinusitis as a complication.
A preschool child is scheduled for an echocardiogram. Parents ask the nurse whether they can hold the child during the procedure. The nurse should answer with which response?
- A. "You will be able to hold your child during the procedure."
- B. "Your child can be active during the procedure, but can't sit in your lap."
- C. "Your child must lie quietly; sometimes a mild sedative is administered before the procedure."
- D. "The procedure is invasive so your child will be restrained during the echocardiogram."
Correct Answer: A
Rationale: The correct response is that "You will be able to hold your child during the procedure." It is common for parents to be allowed to hold their child during an echocardiogram to provide comfort and reassurance. This can help the child stay calm and cooperative during the procedure. Holding the child can also create a familiar and secure environment, making it easier for the healthcare provider to perform the echocardiogram successfully.