Nokea
A 1-day-old is noted to be cyanotic. Physical examination reveals a grade 2-3/6 systolic murmur and a single loud second heart sound. The chest radiograph reveals a normal-sized heart and decreased pulmonary vascular markings. The electrocardiogram (ECG) reveals left ventricular dominance. The next step in the management of this neonate is to administer
- A. sodium bicarbonate
- B. morphine
- C. prostaglandin E1
- D. digoxin
Correct Answer: C
Rationale: Prostaglandin E1 helps maintain ductal patency, which can improve circulation in conditions like transposition of the great arteries or other congenital heart defects causing cyanosis.
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The following are features of encephalitis:
- A. Herpes simplex encephalitis has a reasonably good prognosis
- B. Varicella zoster virus encephalitis is predominantly 'cerebellar'
- C. Mumps encephalitis can cause unilateral nerve deafness
- D. Herpes simplex encephalitis predominantly affects the temporal lobe
Correct Answer: D
Rationale: Herpes simplex encephalitis primarily affects the temporal lobe. Prognosis is poor, and varicella zoster encephalitis is not predominantly cerebellar. Mumps encephalitis can cause deafness.
A client with a liver abscess undergoes surgical evacuation and drainage of the abscess. Which laboratory value is most important for the nurse to monitor following the procedure?
- A. Serum creatinine
- B. Blood urea nitrogen (BUN)
- C. White blood cell count
- D. Serum glucose
Correct Answer: C
Rationale: Monitoring WBC is essential to assess for infection or signs of abscess recurrence after the procedure.
Ice applied to the face has been ineffective in the patient. The treatment of choice is
- A. adenosine
- B. verapamil
- C. digoxin
- D. lidocaine
Correct Answer: A
Rationale: Adenosine is the first-line treatment for supraventricular tachycardia.
The following antibiotics interfere with bacterial translation:
- A. Penicillin
- B. Ceftriaxone
- C. Azithromycin
- D. Ciprofloxacin
Correct Answer: C
Rationale: Azithromycin, a macrolide antibiotic, inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit, thereby interfering with translation.
The nurse is teaching parents about signs of digoxin (Lanoxin) toxicity. Which is a common sign of digoxin toxicity?
- A. Seizures
- B. Vomiting
- C. Bradypnea
- D. Tachycardia
Correct Answer: B
Rationale: Vomiting is a common sign of digoxin toxicity. Seizures are not associated with digoxin toxicity. The child will have a slower heart rate, not respiratory rate. The heart rate will be slower, not faster.