Nokea
Which should the nurse anticipate in the newborn whose mother used cocaine during pregnancy?
- A. Seizures
- B. Hyperglycemia
- C. Cardiac and respiratory problems
- D. Neurobehavioral depression or excitability
Correct Answer: C
Rationale: When a newborn's mother uses cocaine during pregnancy, the baby may experience cardiac and respiratory problems. Cocaine can negatively impact the development of the baby's cardiovascular system, potentially leading to issues such as abnormal heart rhythms, increased blood pressure, and even heart attacks in severe cases. Additionally, cocaine can also affect the respiratory system, putting the newborn at risk of breathing difficulties or even respiratory distress. Therefore, it is crucial for the nurse to anticipate these potential complications and provide appropriate monitoring and care to address any cardiac and respiratory issues that may arise in a newborn exposed to cocaine in utero.
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For most children with enuresis, the only test recommended is
- A. blood sugar
- B. serum electrolytes
- C. urinalysis
- D. abdominal sonography
Correct Answer: C
Rationale: Urinalysis is the standard initial test for evaluating enuresis to rule out urinary tract infections or other conditions.
A healthy, stable, preterm newborn will soon be discharged. The nurse should recommend which position for sleep?
- A. Prone
- B. Supine
- C. Side lying
- D. Position of comfort
Correct Answer: B
Rationale: The nurse should recommend placing the healthy, stable, preterm newborn in the supine position for sleep. This is the current recommendation to reduce the risk of sudden infant death syndrome (SIDS) per the American Academy of Pediatrics. Placing the infant on their back to sleep helps ensure an open airway and reduces the risk of suffocation or SIDS. It is important to adhere to safe sleep practices to promote the infant's well-being and reduce the risk of sleep-related incidents.
20-year old Mr. Ang fell off from his horse, and sustained a lft hip fracture. Buck's extension traction is applied. The following statements are true about Buck's extension traction except:
- A. used as a temporary measure in adults to control muscle spasm and pain
- B. applied by orthopedic surgeon under aseptic conditions using wires and pins
- C. The pulling force is transmitted to the musculoskeletal structures
- D. used definitively to treat fractures in children
Correct Answer: D
Rationale: Buck's extension traction is typically used as a temporary measure in adults to control muscle spasm and pain while awaiting definitive treatment, such as surgery. It is applied by an orthopedic surgeon under aseptic conditions using wires and pins, through which the pulling force is transmitted to the musculoskeletal structures of the patient. However, Buck's extension traction is not used definitively to treat fractures in children; other treatment modalities are often preferred for pediatric fractures.
Which patient should be monitored most closely for dehydration?
- A. The 50-year-old with an ileostomy
- B. The 72-year-old with diabetes mellitus
- C. The 19-year-old with chronic asthma
- D. The 28-year-old with a broken femur
Correct Answer: A
Rationale: A patient with an ileostomy has an increased risk of dehydration because the ileostomy bypasses a significant portion of the small intestine where most of the water absorption occurs. As a result, the patient is more likely to experience fluid and electrolyte imbalances, leading to dehydration. It is important to monitor this patient closely for signs and symptoms of dehydration, such as decreased urine output, dry mouth, dark-colored urine, weakness, dizziness, and confusion, and take appropriate measures to ensure adequate hydration.
A 2-year-old child presents with a peeling, erythematous rash on the hands and feet. The mother reports that he has become ill tempered and refuses to walk about, preferring to lie in bed. Physical examination reveals an irritable, pale child with photophobia. Temperature is 98.5°F, heart rate is 80/minute, and respiratory rate is 23/minute. Tremor of the tongue is evident. Further history and follow-up evaluation reveal that the child's elder brothers have been playing with liquid mercury. Which is the most likely diagnosis?
- A. Measles
- B. Fifth disease
- C. Kawasaki disease
- D. Acrodynia
Correct Answer: D
Rationale: Acrodynia, also known as pink disease, is caused by chronic mercury exposure. The symptoms described, including the rash, irritability, photophobia, and tremor, are consistent with mercury poisoning.