Nokea
A 3-year-old child diagnosed with congestive heart failure is receiving maintenance doses of digoxin and furosemide (Lasix). She is rubbing her eyes when she is looking at the lights in the room and her heart rate is 65 beats per minute. The nurse expects which laboratory finding?
- A. Hypokalemia
- B. Hypomagnesemia
- C. Hypocalcemia
- D. Hypophosphatemia
Correct Answer: A
Rationale: Hypokalemia is a common side effect of furosemide, a diuretic, and can exacerbate digoxin toxicity, which may present with symptoms such as visual disturbances and bradycardia.
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A client with ulcerative colitis is admitted to the medical unit during an acute exacerbation. The nurse should instruct the unlicensed assistive personnel (UAP) to report which finding related to the client's bowel movements?
- A. Hard pellets of stool
- B. Clay-colored stool
- C. Stool with fatty streaks
- D. Blood in the stool
Correct Answer: D
Rationale: Blood in the stool is a common finding during an acute exacerbation of ulcerative colitis, which is an inflammatory condition of the colon.
Increased left ventricular end diastolic volume is seen in:
- A. Mitral regurgitation
- B. Congestive cardiomyopathy
- C. Hypertrophic obstructive cardiomyopathy
- D. Aortic stenosis
Correct Answer: A
Rationale: Mitral regurgitation leads to increased left ventricular end-diastolic volume due to backflow of blood into the left atrium.
Which is best described as the inability of the heart to pump an adequate amount of blood to the systemic circulation at normal filling pressures?
- A. Pulmonary congestion
- B. Congenital heart defect
- C. Heart failure
- D. Systemic venous congestion
Correct Answer: C
Rationale: The definition of heart failure is the inability of the heart to pump an adequate amount of blood to the systemic circulation at normal filling pressures to meet the body’s metabolic demands. Pulmonary congestion is an excessive accumulation of fluid in the lungs. Congenital heart defect is a malformation of the heart present at birth. Systemic venous congestion is an excessive accumulation of fluid in the systemic vasculature.
The nurse is monitoring an infant with a congenital heart disease closely for signs of heart failure. Which early sign should the nurse be most concerned about?
- A. Pallor
- B. Cough
- C. Tachycardia
- D. Slow and shallow breathing
Correct Answer: C
Rationale: Tachycardia is an early sign of heart failure in infants because the heart attempts to compensate for decreased cardiac output by increasing the heart rate.
Polycythaemia:
- A. Is a common cause of jaundice in the newborn
- B. Is significant if haematocrit > 65% on a capillary sample
- C. May cause apnoeas
- D. Exchange transfusion is the treatment of choice in symptomatic cases
Correct Answer: B
Rationale: Polycythaemia is considered significant if the haematocrit exceeds 65% on a capillary sample, as it can lead to hyperviscosity and related complications.