Nokea
A 4-year-old child presents to the clinic with a history of persistent dry cough and wheezing. What is the nurse’s primary concern?
- A. Allergic reaction
- B. Asthma exacerbation
- C. Respiratory infection
- D. Acute bronchiolitis
Correct Answer: B
Rationale: Wheezing and persistent dry cough are hallmark symptoms of asthma exacerbation, which is the nurse's primary concern.
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The most common indication of heart transplantation in the neonate is
- A. Hypoplastic left heart syndrome
- B. Hypoplastic right heart syndrome
- C. Severe Ebstein's anomaly
- D. Dilated cardiomyopathy
Correct Answer: A
Rationale: Hypoplastic left heart syndrome is the most common indication for heart transplantation in neonates.
When caring for a client with nephrotic syndrome, which assessment is most important for the nurse to obtain?
- A. Daily weight
- B. Vital signs
- C. Level of consciousness
- D. Bowel sounds
Correct Answer: A
Rationale: Daily weight is crucial in monitoring fluid balance in clients with nephrotic syndrome, as they are prone to edema.
An older adult man recently diagnosed with chronic obstructive pulmonary disease (COPD) is admitted with shortness of breath. The nurse observes the client sitting upright and leaning over the bedside table, using accessory muscles to assist in breathing. What action should the nurse take?
- A. Assist the client to a high Fowler's position in bed
- B. Observe the client for the presence of a barrel chest
- C. Prepare to transfer the client to a critical care unit
- D. Instruct the client in pursed lip breathing techniques
Correct Answer: D
Rationale: Pursed lip breathing helps reduce dyspnea and improves oxygenation in clients with COPD.
A 5-month-old previously well infant is found to have a loud holosystolic murmur (4/6) at the left sternal border. The first and second heart sounds are normal; there is no tachycardia, rumble, or gallop; and hepatomegaly is not noted. The child feeds well and has grown adequately. You suspect
- A. spontaneous closure is more common in muscular vs. membranous defects
- B. closure usually occurs in the first 2 years of life
- C. there is no risk of endocarditis
- D. pulmonary pressures are normal
Correct Answer: C
Rationale: Small VSDs still carry a risk of endocarditis despite being asymptomatic.
In bronchopulmonary dysplasia:
- A. Lung compliance is increased
- B. Bronchial reactivity is increased
- C. Lung function typically improves with age
- D. Hyperinflation is an associated finding
Correct Answer: D
Rationale: Hyperinflation is a common finding in bronchopulmonary dysplasia due to lung damage and the need for prolonged mechanical ventilation.