Nokea
Which statement by the parent of a child with sickle cell anemia indicates an understanding of the disease?
- A. The pain he has is due to the presence of too many red blood cells.
- B. He will be able to go snow skiing with his friends as long as he stays warm.
- C. He will need extra fluids in summer to prevent dehydration.
- D. There is very little chance that his brother will have sickle cell.
Correct Answer: C
Rationale: Sickle cell anemia increases dehydration risk due to impaired blood flow, especially in heat. Extra fluids in summer prevent crises. Pain is due to vaso-occlusion, not excess RBCs, and skiing poses risks.
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The nurse caring for a client in shock recognizes that the glomerular filtration rate of the kidneys will fail if the client's mean arterial pressure falls below which of the following levels?
- A. 140
- B. 120
- C. 100
- D. 80
Correct Answer: D
Rationale: A mean arterial pressure (MAP) below 80 mmHg compromises renal perfusion, leading to glomerular filtration failure. Higher MAPs (A, B, C) maintain adequate kidney function.
A first-trimester primigravida is diagnosed with anemia. The nurse should suspect that this anemia is a result of:
- A. Mother's increased blood volume
- B. Mother's decreased blood volume
- C. Fetal blood volume increase
- D. Increase in iron absorption
Correct Answer: A
Rationale: Increased maternal blood volume in the first trimester causes dilutional anemia due to a relative decrease in red blood cell concentration.
A 4-week-old infant is admitted to the emergency room in respiratory distress. Which of the following statements indicates the nurse's knowledge of the anatomy of the respiratory system in pediatric clients?
- A. The diameter of the trachea is much smaller in children than in adults.
- B. The tongue is proportionally smaller in children than in adults.
- C. The pediatric airway is more rigid than that of the adults.
- D. The length of the pediatric airway is longer in children than in adults.
Correct Answer: A
Rationale: The airway in children is much smaller than it is in adults. The diameter of the trachea in the newborn is 4 mm and that of the adult is 20 mm. A small change in the diameter of the airway can make a major difference in the pediatric client. The tongue is proportionally larger in children and fills most of the oral cavity, thereby decreasing air space. The entire pediatric airway is elastic. Elasticity diminishes with age, however. The distances between respiratory structures are shorter than that of adults, and therefore organisms are able to move more rapidly down the throat, leading to more extensive respiratory involvement.
Which finding is expected in the normal newborn?
- A. Epstein pearls
- B. Moro reflex
- C. Swan neck deformity
- D. Cracked pot sound
Correct Answer: B
Rationale: The Moro reflex, a startle response to sudden movement, is a normal finding in newborns, present until about 3-6 months. Epstein pearls are benign but not universal, and the others are abnormal.
The nurse is caring for a client with a history of peptic ulcer disease. Which medication should the nurse anticipate being prescribed?
- A. Omeprazole (Prilosec)
- B. Ibuprofen (Motrin)
- C. Cimetidine (Tagamet)
- D. Both A and C
Correct Answer: D
Rationale: Peptic ulcer disease is treated with proton pump inhibitors like omeprazole and H2 blockers like cimetidine to reduce acid production and promote healing. Ibuprofen, an NSAID, can worsen ulcers and is avoided.