Nokea
You are the nurse in charge on a pediatric unit. A child with sickle cell disease, in splenic sequestration crisis, is being admitted. You should assign this child to a
- A. Semiprivate room.
- B. Reverse-isolation room.
- C. Contact-isolation room.
- D. Private room.
Correct Answer: D
Rationale: Correct Answer: D - Private room
Rationale:
1. In splenic sequestration crisis, there is a risk of sudden severe anemia and hypovolemic shock.
2. Isolation is not necessary as it's not a contagious condition.
3. A private room allows close monitoring, privacy, and individualized care.
4. A semiprivate room (A) may lead to exposure to infections.
5. Reverse-isolation (B) is for immunocompromised patients.
6. Contact-isolation (C) is for contagious diseases, not applicable here.
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Scientific studies have indicated that there is a higher percentage of allergies in babies fed formula containing cow's milk than in breast-fed babies. Which statement represents a valid inference made from these studies?
- A. Milk from cows causes allergic reactions in all infants.
- B. Breast feeding prevents all allergies from occurring.
- C. There is no relationship between drinking cow's milk and having allergies.
- D. Breast milk most likely contains fewer substances that trigger allergies.
Correct Answer: D
Rationale: Rationale for Answer D:
1. Scientific studies show higher allergies in cow's milk-fed babies.
2. Breast milk is the alternative in this scenario.
3. Breast milk is generally considered hypoallergenic.
4. Breast milk contains fewer potential allergens.
5. Thus, breast milk most likely contains fewer allergy triggers.
Summary:
A: Overgeneralization, not all infants react to cow's milk.
B: Absolute statement, breast milk is not 100% effective against all allergies.
C: Contradicts scientific findings, relationship exists between cow's milk and allergies.
Patient with AML on induction chemo. Which finding requires rapid action?
- A. Serum potassium 7.8 mEq/L
- B. Urine output 400 mL less than intake
- C. Inflammation of oral mucosa
- D. Ecchymoses on trunk
Correct Answer: A
Rationale: The correct answer is A: Serum potassium 7.8 mEq/L. A high serum potassium level (hyperkalemia) can lead to life-threatening cardiac arrhythmias. Rapid action is necessary to prevent cardiac complications. Urine output slightly less than intake (choice B), oral mucosa inflammation (choice C), and ecchymoses on trunk (choice D) are important but do not require immediate action to prevent fatal consequences like hyperkalemia.
This drug can potentiate the effect of prostacyclins to antagonize platelet stickiness and therefore decreases platelet adhesion to thrombogenic surfaces.
- A. Sulfinpyrazone
- B. Dipyridamole
- C. Ticlopidine
- D. Clopidogrel
Correct Answer: B
Rationale: The correct answer is B: Dipyridamole. Dipyridamole works by inhibiting the enzyme phosphodiesterase, leading to an increase in cyclic adenosine monophosphate (cAMP) levels. This increase in cAMP levels potentiates the effect of prostacyclins, which inhibit platelet stickiness and decrease platelet adhesion to thrombogenic surfaces.
Rationale:
A: Sulfinpyrazone is a uricosuric agent, not a platelet anti-aggregant.
C: Ticlopidine and D: Clopidogrel are both antiplatelet agents but work by different mechanisms (ADP receptor antagonists). They do not potentiate prostacyclins and do not directly affect cAMP levels.
The mother asks the nurse if her child's iron deficiency anemia is related to the child's frequent infections. The nurse responds based on the understanding of which of the following?
- A. Little is known about iron-deficiency anemia and its relationship to infection in children.
- B. Children with iron deficiency anemia are more susceptible to infection than are other children.
- C. Children with iron-deficiency anemia are less susceptible to infection than are other children.
- D. Children with iron-deficient anemia are equally as susceptible to infection as are other children.
Correct Answer: B
Rationale: The correct answer is B: Children with iron deficiency anemia are more susceptible to infection than are other children. Iron is crucial for the immune system to function optimally. In iron deficiency anemia, the body lacks enough iron to produce hemoglobin, which can impair the immune response, making individuals more prone to infections. Therefore, children with iron deficiency anemia are indeed more susceptible to infections.
Explanation of other choices:
A: Little is known about iron-deficiency anemia and its relationship to infection in children - This is incorrect as there is a clear understanding of the link between iron deficiency anemia and susceptibility to infections.
C: Children with iron-deficiency anemia are less susceptible to infection than are other children - This is incorrect as iron deficiency impairs the immune response, making individuals more susceptible to infections.
D: Children with iron-deficient anemia are equally as susceptible to infection as are other children - This is incorrect as iron deficiency compromises the immune system, leading to increased susceptibility to
Laboratory Studies: Red Cell Indices: Evaluation of RBC saturation with Hb, 32-36%
- A. MCV
- B. MCH
- C. MCHC
- D. RDW
Correct Answer: C
Rationale: The correct answer is C: MCHC. MCHC stands for Mean Corpuscular Hemoglobin Concentration, which is a measure of the average concentration of hemoglobin in a given volume of packed red blood cells. In this case, a saturation of 32-36% indicates the concentration of hemoglobin in the red blood cells. MCV (Mean Corpuscular Volume) measures the average volume of a red blood cell, MCH (Mean Corpuscular Hemoglobin) measures the average amount of hemoglobin in a red blood cell, and RDW (Red Cell Distribution Width) measures the variation in red blood cell size. These parameters do not directly indicate the saturation of hemoglobin in red blood cells, making them incorrect choices for this scenario.