Nokea
Which type of leukemia has been MOST likely developed in a 2-year-old child with Down syndrome in the neonatal period?
- A. ALL
- B. CML
- C. AML M1
- D. AML M6
Correct Answer: D
Rationale: Transient myeloproliferative disorder in neonates with Down syndrome can evolve into AML M6.
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Hemodynamic monitoring by means of a multilumen pulmonary artery catheter can provide detailed information about:
- A. Preload
- B. Afterload
- C. Cardiac output
- D. All of the above
Correct Answer: D
Rationale: A multilumen pulmonary artery catheter, also known as a Swan-Ganz catheter, is used for advanced hemodynamic monitoring. It is inserted through a central line and positioned in the pulmonary artery to provide detailed information about various hemodynamic parameters including preload, afterload, and cardiac output.
An adult had a total thyroidectomy. Which statement by the client demonstrates to the nurse an adequate understanding of long term care?
- A. "I will need to take replacement hormones for the rest of my life."
- B. " I should try to avoud stress and be alert for signs of recurrent hyperthyroidism."
- C. "Thank goodness, this is over! I will never have to worry about throid problems again."
- D. " I should increase my caloric intake to replace what I lost during the surgery."
Correct Answer: A
Rationale: An adult who had a total thyroidectomy will no longer be able to produce thyroid hormones naturally. Therefore, the client will need to take replacement hormones for the rest of their life to maintain normal bodily functions and prevent complications associated with hypothyroidism. This statement demonstrates an adequate understanding of the long-term care needed after a total thyroidectomy. The other options do not accurately reflect the necessary long-term care for someone who has undergone a total thyroidectomy.
The parents of a 3-month-old infant report that their infant sleeps supine (face up) but is often prone (face down) while awake. What knowledge should the nurse's response should be based?
- A. Unacceptable because of the risk of sudden infant death syndrome (SIDS)
- B. Unacceptable because it does not encourage achievement of developmental milestones
- C. Acceptable to encourage fine motor development
- D. Acceptable to encourage head control and turning over
Correct Answer: D
Rationale: The correct knowledge that the nurse's response should be based on is that it is acceptable to encourage head control and turning over. At 3 months of age, encouraging the infant to be prone while awake can help promote the development of head control, neck strength, and eventually facilitate the ability to turn over. This practice is considered safe and beneficial for infants within the appropriate age range, as long as the infant is supervised during the awake period. It is important to promote safe sleep practices for infants to reduce the risk of Sudden Infant Death Syndrome (SIDS), but allowing supervised tummy time for an awake infant is beneficial for their motor development.
The MOST appropriate age of a child who helps to undress; puts 3 words together (subject, verb, object); and handles spoon well is
- A. 15 months
- B. 18 months
- C. 24 months
- D. 30 months
Correct Answer: C
Rationale: These milestones are typically achieved around 24 months.
A nurse is assessing a child with an unrepaired ventricular septal defect. Which heart sound does the nurse expect to assess?
- A. Palpitations
- B. Wheeze
- C. Murmur
- D. Physiologic splitting
Correct Answer: C
Rationale: A ventricular septal defect (VSD) is a congenital heart defect characterized by a hole in the septum that separates the heart's two lower chambers (ventricles). When assessing a child with an unrepaired VSD, the nurse would expect to hear a murmur. The murmur is typically described as a harsh, holosystolic (pansystolic) murmur, best heard at the left lower sternal border. This murmur occurs due to the turbulent blood flow across the defect during systole. It is important for the nurse to recognize this characteristic murmur associated with a VSD to facilitate appropriate management and follow-up care for the child.