Nokea
You are meeting parents of a 1.5-year-old boy who has suboptimal growth. He has been delivered prematurely at the gestational age of 32 weeks. Examination reveals a healthy child with growth parameters below normal for age. You reassure the parents that their child will catch his normal growth with time. Of the following, the growth parameter that should be corrected at this age is
- A. weight
- B. height
- C. body mass index
- D. head circumference
Correct Answer: A
Rationale: Premature infants often experience suboptimal weight gain initially due to their early birth. However, they tend to 'catch up' in weight over time as they mature, making weight the most relevant parameter to correct.
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Which of the ff factors predisposes a client to the development of TB?
- A. Exposure to toxic gases
- B. Congenital abnormalities
- C. Obstruction by tumor
- D. Malnutrition
Correct Answer: D
Rationale: Malnutrition predisposes a client to the development of Tuberculosis (TB) because a lack of proper nutrition weakens the immune system, making the individual more susceptible to infections such as TB. Adequate nutrition is essential for maintaining a healthy immune system that can effectively fight off pathogens. Malnourished individuals are less able to mount a strong immune response, thus increasing their vulnerability to contracting TB and experiencing more severe symptoms and complications from the disease.
A 10-month-old child can do all the following EXCEPT
- A. says mama or dada
- B. follows one-step command without gesture
- C. points to objects or real first word
- D. speaks inhibition word 'no'
Correct Answer: D
Rationale: Speaking inhibition words like 'no' typically occurs later.
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.
The nurse is caring for a client in acute addisonian crisis. Which laboratory data would the nurse expect to find?
- A. Hyperkalemia
- B. Hypernatremia
- C. Reduced blood urea nitrogen (BUN)
- D. Hyperglycemia
Correct Answer: A
Rationale: In acute Addisonian crisis, the adrenal glands do not produce enough cortisol and aldosterone, leading to a decrease in blood volume and blood pressure. This can cause hyperkalemia (high potassium levels) due to the lack of aldosterone, which normally helps regulate potassium excretion from the body. Additionally, clients in Addisonian crisis may experience hyponatremia (low sodium levels) rather than hypernatremia. Reduced blood urea nitrogen (BUN) and hyperglycemia would not be typical findings in acute Addisonian crisis.
What is the best initial action for the nurse to take?
- A. Try to have the client breathe slower or
- B. Give O2 via nasal cannula into the paper bag
- C. Administer sodium bicarbonate
- D. Monitor the client's fluid balance
Correct Answer: A
Rationale: The best initial action for the nurse to take when a client is experiencing hyperventilation is to try to have the client breathe slower. This is because hyperventilation is often caused by rapid, shallow breathing and slowing down the breathing pattern can help restore normal gas exchange and alleviate symptoms. Providing oxygen via a nasal cannula or administering sodium bicarbonate would not directly address the underlying issue of hyperventilation. Monitoring fluid balance is important for overall assessment but not the priority when dealing with acute respiratory distress due to hyperventilation.