Nokea
A 14-year-old child was recently diagnosed with hypertrophic cardiomyopathy. During a follow-up appointment, the mother asks the nurse, "How will this affect my child's ability to play football in the fall?" How should the nurse respond?
- A. "This shouldn't affect his ability to play football."
- B. "Children with cardiomyopathy should not play football."
- C. "He could participate in flag football but not tackle football."
- D. "This may actually make him a better, stronger football player."
Correct Answer: B
Rationale: Children diagnosed with hypertrophic cardiomyopathy should not participate in competitive sports such as football due to the potential risk of sudden cardiac events. Physical activity and sports with lower intensity may be allowed, but organized competitive sports with high intensity (such as football) are generally contraindicated. It is important for the health care team to prioritize the child's safety and well-being over sports participation in cases of cardiomyopathy. The nurse should communicate this information to the mother to help her understand the importance of limiting the child's physical activities to reduce the risk of complications related to hypertrophic cardiomyopathy.
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A client is prescribed enalapril (Vasotec) for treatment of heart failure. Which adverse effect should the nurse assess for following the initial administration of this drug?
- A. Jaundice
- B. Ototoxicity
- C. Low blood pressure
- D. Blurred vision
Correct Answer: C
Rationale: Enalapril is an angiotensin-converting enzyme (ACE) inhibitor commonly used in the treatment of heart failure. One of the potential adverse effects of ACE inhibitors, including enalapril, is hypotension or low blood pressure. This is especially a concern following the initial administration of the drug, as it can cause a significant drop in blood pressure. Nurses should assess the patient for signs and symptoms of hypotension, such as dizziness, light-headedness, weakness, or fainting, after starting enalapril therapy. Monitoring blood pressure regularly and educating the patient about the possibility of low blood pressure is important to ensure patient safety and optimal outcomes.
After being diagnosed with polycystic kidney disease, an adult patient asks if current children are at risk for developing the disorder. How should the nurse respond?
- A. The adult form of this disorder is rare and should not affect grown children
- B. The children should undergo genetic testing and screening for evidence of the disease
- C. Because the condition was just diagnosed, there is no risk of passing the condition on to any children
- D. The children would have developed symptoms of the disorder in utero or shortly after birth if they had inherited the defective gene
Correct Answer: B
Rationale: Polycystic kidney disease (PKD) is a genetic disorder that can be inherited by children if one or both parents have the gene mutation responsible for the condition. In cases where a parent has been diagnosed with PKD, their children are at risk of inheriting the faulty gene. As such, it is recommended for the children to undergo genetic testing and screening to identify any evidence of the disease early on. By identifying the gene mutation in the children, appropriate monitoring and management can be initiated, potentially leading to better outcomes and quality of life for the affected individuals. Therefore, genetic testing and screening are crucial in cases where there is a known genetic component to a disorder like PKD.
The nurse is assessing a client who is in the third trimester of pregnancy. Which finding would require immediate intervention by the nurse?
- A. Blood pressure of 142/92 mmHg
- B. Pulse of 92 beats per minute
- C. Respiratory rate of 24 per minute
- D. Weight gain of 16 oz per week
Correct Answer: A
Rationale: A blood pressure of 142/92 mmHg in a client in the third trimester of pregnancy is elevated and could indicate the development of preeclampsia, a serious hypertensive disorder that can have adverse effects on both the mother and the fetus. Preeclampsia is characterized by high blood pressure accompanied by signs of organ damage, such as proteinuria and changes in other laboratory values. Immediate intervention is required in this situation, as preeclampsia can lead to complications such as seizures (eclampsia), stroke, and placental abruption. It is essential for the nurse to further assess the client and notify the healthcare provider promptly for appropriate management.
A client with sepsis has a temperature of 40°C. Which dysrhythmia is most likely to occur in this client?
- A. Bradydysrhythmia
- B. Tachydysrhythmia
- C. Wolff-Parkinson-White dysrhythmia
- D. Long QT dysrhythmia
Correct Answer: B
Rationale: A client with sepsis and a temperature of 40°C is likely experiencing a systemic inflammatory response, which can lead to a variety of dysrhythmias. In this case, the client is more likely to develop a tachydysrhythmia (fast heart rate) due to the body's response to the infection. Sepsis can result in an increase in heart rate as the body tries to maintain adequate perfusion to vital organs in response to the inflammatory process. Tachydysrhythmias such as supraventricular tachycardia or atrial fibrillation are commonly observed in septic patients with high fevers.
What is the most accurate tool for assessing and diagnosing venous thrombosis?
- A. Ascending contrast venography
- B. Duplex venous ultrasonography
- C. Magnetic resonance imaging
- D. Plethysmography
Correct Answer: B
Rationale: Duplex venous ultrasonography is the most accurate tool for assessing and diagnosing venous thrombosis. It is a non-invasive imaging technique that combines Doppler flow studies with conventional ultrasonography. This allows for the visualization of blood flow in the veins and identification of any blood clots or obstructions. Duplex venous ultrasonography is highly sensitive and specific for detecting deep vein thrombosis (DVT) in the lower extremities, making it the preferred imaging modality for diagnosing venous thrombosis. Other imaging modalities like ascending contrast venography, magnetic resonance imaging, and plethysmography are less commonly used due to their disadvantages compared to duplex venous ultrasonography such as invasiveness, cost, and lower accuracy.