Which of the following measures will not help correct the patient's condition
- A. Offer large amount of oral fluid intake to replace fluid lost
- B. Give enteral or parenteral fluid
- C. Frequent oral care
- D. Give small volumes of fluid at frequent interval
Correct Answer: C
Rationale: Frequent oral care is important for overall oral health and cleanliness, but it will not directly help correct the patient's fluid imbalance. The patient's condition likely requires direct fluid replacement to address the fluid loss and restore balance. A, B, and D are focused on fluid replacement strategies which are more crucial in correcting the patient's condition. Offering a large amount of oral fluid intake to replace lost fluids, giving enteral or parenteral fluid, and giving small volumes of fluid at frequent intervals are all appropriate measures that can help correct the patient's condition by addressing the underlying fluid imbalance.
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Which intervention is appropriate for the nurse caring for a client in severe pain receiving a continuous I.V. infusion of morphine?
- A. Assisting with a naloxone challenge test before therapy begins
- B. Discontinuing the drug immediately if signs of dependence appear
- C. Changing the administration route to P.O. if the client can tolerate fluids
- D. Obtaining baseline vital signs before administering the first dose
Correct Answer: D
Rationale: Obtaining baseline vital signs before administering the first dose is appropriate for the nurse caring for a client in severe pain receiving a continuous I.V. infusion of morphine. Monitoring vital signs, including blood pressure, heart rate, respiratory rate, and oxygen saturation, is essential to assess the client's response to opioid therapy. Baseline vital signs provide a comparison for evaluating changes in the client's physical status and help identify any adverse effects or complications related to morphine administration. This proactive approach allows the nurse to detect and address any abnormalities promptly, ensuring the client's safety and optimal pain management.
What is oral candidiasis (thrush) in the newborn?
- A. Bacterial infection that is life threatening in the neonatal period
- B. Bacterial infection of mucous membranes that responds readily to treatment
- C. Yeastlike fungal infection of mucous membranes that is relatively common
- D. Benign disorder that is transmitted from mother to newborn during the birth process only
Correct Answer: C
Rationale: Oral candidiasis, also known as thrush, is a yeastlike fungal infection of the mucous membranes in the mouth. It is relatively common in newborns, as their immune systems are still developing and can be easily affected by the overgrowth of Candida fungi. Thrush can present as white patches or plaques on the tongue, gums, or inner cheeks. It is important to treat oral thrush to prevent any discomfort for the newborn and potential complications such as difficulty feeding or spreading of the infection.
A narcotic analgesic is ordered for postoperative pain. Why are narcotics given in low doses to the laryngectomy patient?
- A. They depress the respiratory rate and cough reflex.
- B. They increase respiratory tract secretions.
- C. They have a tendency to cause stomal edema.
- D. They can cause addiction.
Correct Answer: A
Rationale: Narcotic analgesics, when given in high doses, can depress the respiratory rate and cough reflex in patients. Laryngectomy patients have had their larynx removed and may already have compromised respiratory function. Therefore, giving narcotics in low doses helps to minimize the risk of further respiratory depression in these patients. It is important to closely monitor respiratory status when administering narcotics to laryngectomy patients to prevent potential complications.
A 2-mo-old male infant has a left flank mass discovered incidentally by the mother; radiological imaging reveals a left renal mass. Of the following, the MOST likely diagnosis is
- A. nephroblastoma
- B. neuroblastoma
- C. mesoblastic nephroma
- D. clear cell sarcoma
Correct Answer: A
Rationale: Nephroblastoma (Wilms tumor) is the most common renal malignancy in infants.
The neurologist tests the 4th and 6th cranial nerves together by having a patient do which of the following?
- A. Turn his head to the right and left
- B. Say "ahhh"
- C. Identify whispering in his ears
- D. Follow his finger with his eyes
Correct Answer: D
Rationale: The neurologist tests the 4th and 6th cranial nerves together by having a patient follow his finger with his eyes. The 4th cranial nerve (trochlear nerve) innervates the superior oblique muscle, which primarily moves the eye downward and outward. The 6th cranial nerve (abducens nerve) innervates the lateral rectus muscle, which primarily moves the eye laterally. Testing these cranial nerves simultaneously by asking the patient to follow the neurologist's finger helps assess the coordination and function of both of these nerves, which are important for eye movement control.