Nokea
A 3-year-old child is receiving dextrose 5% in water and half-normal saline solution at 100 ml/hour. Which sign or symptom suggests excessive I.V. fluid intake?
- A. Worsening dyspnea
- B. Gastric distension
- C. Nausea and vomiting
- D. Temperature of 102°F (38.9° C)
Correct Answer: A
Rationale: Worsening dyspnea may indicate fluid overload, leading to pulmonary edema and respiratory distress.
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Malignant mutation in hypertrophic cardiomyopathy is which of the following?
- A. Arg 403 Gln
- B. Gln 403 Arg
- C. Arg 304 Gln
- D. Gln 304 Arg
Correct Answer: A
Rationale: The Arg 403 Gln mutation is a known pathogenic mutation in hypertrophic cardiomyopathy, linked with a higher risk of sudden cardiac death.
After a hospitalization for Syndrome of Inappropriate Antidiuretic Hormone (SIADH), a client develops pontine myelinolysis. Which intervention should the nurse implement first?
- A. Reorient client to his room
- B. Place a patch on one eye
- C. Evaluate client's ability to swallow
- D. Perform range of motion exercises
Correct Answer: A
Rationale: Reorienting the client helps in managing confusion and disorientation, which are common in pontine myelinolysis.
Polysplenia (left isomerism) is characterized by
- A. right-sided stomach
- B. decreased pulmonary blood flow
- C. absent gallbladder
- D. howell-jolly bodies
Correct Answer: C
Rationale: Polysplenia is associated with left-sided structures and absent gallbladder.
A 5-year-old child has an elevated blood pressure during a well child exam. The primary care pediatric nurse practitioner notes mottling and pallor of the child's feet and lower legs and auscultates a systolic ejection murmur in the left infraclavicular region radiating to the child's back. The nurse practitioner will suspect which condition?
- A. Aortic stenosis (AS)
- B. Coarctation of the aorta (COA)
- C. Patent ductus arteriosus (PDA)
- D. Pulmonic stenosis
Correct Answer: B
Rationale: Coarctation of the aorta may not have symptoms until later childhood and may present as high blood pressure in the upper extremities and poor perfusion in the lower extremities.
False statements include:
- A. Curosurf is a natural surfactant
- B. Antenatal steroids are usually given as two oral doses of dexamethasone
- C. Increasing the rate on the ventilator raises the mean airway pressure
- D. CPAP is a common weaning tool in ventilated pre terms
Correct Answer: B
Rationale: The correct answer is B because antenatal steroids are typically given intramuscularly, not orally. The other options (a, c, d, e) are true statements.