Alice, 4, shows delays in reaching milestones like sitting and walking. Chetic testing confirms the SMN1 gene deletion characteristic of Spinal Muscular Atrophy. A pulmonary function test shows reduced FVC.

Which piece of equipment would most benefit Alice at this stage?

Cough assist machine

Orthopedic shoes

A manually operated wheelchair

High-frequency chest wall oscillation device

Answer and Explanation

The Correct Answer is A

A.   A cough assist machine can help Alice clear secretions from her airways, reducing the risk of respiratory complications associated with spinal muscular atrophy.

B.   Orthopedic shoes may help with support and stability but do not directly address Alice's respiratory needs.
C.   While a wheelchair may be necessary for mobility, it does not address Alice's respiratory needs.
D.   High-frequency chest wall oscillation devices are used to help clear mucus from the airways but may not be as appropriate for Alice's age and condition as a cough assist machine.

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Correct Answer is D

Explanation

A. There's no indication of a bacterial infection, so antibiotics are not warranted.

B. A biopsy may be considered if the diagnosis is uncertain, but it's not the first-line action.
C. Tretinoin is typically used for conditions like acne or photoaging, not for eczematous lesions.
D. Corticosteroid creams are commonly used to reduce inflammation and itching associated with eczema, making this the most appropriate action.

A. To avoid fluid overload. B. To prevent mannitol crystallization. C. To avoid hyperglycemia. D. To maintain electrolyte balance. E. Grace, 67: Chronic sinusitis not responding to medications

Correct Answer is B

Explanation

A. Mannitol is an osmotic diuretic used to reduce intracranial pressure. While maintaining an appropriate infusion rate helps prevent fluid overload, it's not the primary reason for the slow infusion rate.
B. Mannitol can crystallize at lower temperatures or higher concentrations, leading to occlusion of the IV line. Maintaining a slow infusion rate reduces the risk of crystallization.
C. Mannitol itself does not typically cause hyperglycemia. Its primary concern regarding infusion is related to crystallization rather than glucose metabolism.
D. Mannitol's impact on electrolyte balance is more related to its osmotic diuretic effect rather than the infusion rate.

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Alice, 4, shows delays in reaching milestones like sitting and walking. Chetic testing confirms the SMN1 gene deletion characteristic of Spinal Muscular Atrophy. A pulmonary function test shows reduced FVC. Which piece of equipment would most benefit Alice at this stage?

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Sarah, a 30-year-old with a family history of eczema, presents with a scaly, erythematous plaque on her right cheek. Blood tests reveal normal inflammatory markers. What should the nurse do?

Correct Answer is D

Explanation

Lisa, a 29-year-old woman, is diagnosed with a subdural hematoma and is on an IV drip of mannitol at 50 mL/hr. Why is it crucial to maintain this slow infusion rate?

Correct Answer is B

Explanation

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Alice, 4, shows delays in reaching milestones like sitting and walking. Chetic testing confirms the SMN1 gene deletion characteristic of Spinal Muscular Atrophy. A pulmonary function test shows reduced FVC.

Which piece of equipment would most benefit Alice at this stage?