Nokea
A 2 years old girl presents with blue discoloration of nails and lips. On examination she is cyanosed and clubbed, heart auscultation reveals a short systolic murmur at left upper sternal border. The most likely diagnosis is?
- A. VSD
- B. Tetralogy of Fallot
- C. Tricuspid atresia
- D. Trunchus arteriosus
Correct Answer: B
Rationale: Tetralogy of Fallot typically causes cyanosis, clubbing, and a systolic murmur due to right-to-left shunting.
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The nurse is conducting discharge teaching about signs and symptoms of heart failure to parents of an infant with a repaired tetralogy of Fallot. Which signs and symptoms should the nurse include? (Select all that apply.)
- A. Warm flushed extremities
- B. Weight loss
- C. Decreased urinary output
- D. Sweating (inappropriate)
Correct Answer: C
Rationale: C. Decreased urinary output: This can be a sign of fluid retention, which is a common symptom of heart failure. Infants with heart failure may have decreased urine output as the body tries to retain fluid to help compensate for the heart's decreased ability to pump effectively.
Small round blue cell tumors refer to all the following EXCEPT
- A. non-Hodgkin lymphoma
- B. osteosarcoma
- C. Ewing sarcoma
- D. rhabdomyosarcoma
Correct Answer: B
Rationale: Osteosarcoma does not typically fall under the category of small round blue cell tumors.
Minda, a 65-year old female has been admitted with a left hemisphere stroke. Which behavioral change would the nurse expect to find upon assessment?
- A. impulsive, unsafe activity
- B. motor deficits on the right eye
- C. motor deficits on the left side of the body
- D. error in word choices
Correct Answer: D
Rationale: A left hemisphere stroke typically affects the right side of the body due to the way the brain controls motor functions. Since the left hemisphere is also responsible for language and speech processing, patients with a left hemisphere stroke commonly exhibit errors in word choices, difficulty speaking or understanding language, aphasia, and other language-related impairments. This is known as Broca's aphasia or expressive aphasia. Therefore, the nurse would expect to find errors in word choices as a behavioral change in a patient like Minda with a left hemisphere stroke.
A client suspected of having colorectal cancer will require which diagnostic study to confirm the diagnosis?
- A. Stool hematest
- B. Abdominal computed tomography (CT)
- C. Carcinoembryonic antigen (CEA) scan
- D. Sigmoidoscopy
Correct Answer: D
Rationale: Sigmoidoscopy is a diagnostic study that allows direct visualization of the lower part of the colon and rectum using a flexible tube with a camera at its end, called a sigmoidoscope. This procedure enables the healthcare provider to visually inspect the lining of the colon and rectum, identify any abnormal growths, such as tumors or polyps, and obtain tissue samples for biopsy if necessary. In the case of suspected colorectal cancer, sigmoidoscopy is crucial for confirming the diagnosis by directly visualizing any cancerous lesions or abnormal tissue changes in the colon and rectum. Other diagnostic tests, such as stool hematest, abdominal CT, and CEA scan, may aid in the evaluation and staging of colorectal cancer but are not as effective in confirming the diagnosis as sigmoidoscopy. Thus, sigmoidoscopy is the preferred diagnostic study for definitively diagnosing colorectal cancer in a client suspected of having the disease.
Which of the ff. actions would the nurse include in the plan of care to reduce the symptoms of the patient who has vertigo?
- A. Avoid noises
- B. Encourage fluid intake
- C. Avoid sudden movements
- D. Administer analgesics
Correct Answer: C
Rationale: Vertigo is a sensation of spinning or dizziness that can be caused by issues in the inner ear. One of the key strategies in managing vertigo is to avoid sudden movements that can trigger or worsen the symptoms. Sudden movements can disrupt the balance mechanisms in the inner ear and further exacerbate the feeling of dizziness and spinning. By advising the patient to avoid sudden movements, the nurse can help reduce the intensity and frequency of vertigo episodes, promoting greater comfort and quality of life for the patient.