Nokea
A 5-year-old child who had a repair for transposition of the great arteries shortly after birth is growing normally and has been asymptomatic since the surgery. The primary care nurse practitioner notes mild shortness of breath with exertion and dizziness. What will the nurse practitioner do?
- A. Order an echocardiogram and chest radiograph.
- B. Perform pulmonary function testing.
- C. Reassure the parent that these symptoms are common.
- D. Refer the child to the cardiologist immediately.
Correct Answer: D
Rationale: Children with a history of transposition of the great arteries (d-TGA) who have a history of palpitations, syncope, or shortness of breath should be referred to a cardiologist.
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The nurse is caring for a child with acute glomerulonephritis. Which of the following would most likely indicate that the child’s condition is improving?
- A. Increased urine output with normal color and consistency
- B. Decrease in the blood pressure
- C. A reduction in protein levels in the urine
- D. A decrease in hematuria
Correct Answer: A
Rationale: Improved renal function is indicated by increased urine output and the return of urine to normal color and consistency.
An older client arrives at the outpatient eye surgery clinic for a right cataract extraction and lens implant. During the immediate postoperative period, which intervention should the nurse implement?
- A. Teach a family member to administer eye drops
- B. Encourage deep breathing and coughing exercises
- C. Provide an eye shield to be worn while sleeping
- D. Obtain vital signs every 2 hours during hospitalization
Correct Answer: C
Rationale: An eye shield protects the surgical site from accidental trauma during sleep, which is critical for postoperative healing.
An adult male client is admitted for Pneumocystis carinii pneumonia (PCP) secondary to AIDS. While hospitalized, he receives IV pentamidine isethionate therapy. In preparing this client for discharge, what important aspect regarding his medication therapy should the nurse explain?
- A. IV pentamidine may offer protection to other AIDS-related conditions, such as Kaposi's sarcoma
- B. It will be necessary to continue prophylactic doses of IV or aerosol pentamidine every month
- C. IV pentamidine will be given until oral pentamidine can be tolerated
- D. AZT (Azidothymidine) therapy must be stopped when IV or aerosol pentamidine is being used.
Correct Answer: B
Rationale: Prophylactic doses of pentamidine are necessary to prevent PCP recurrence and other AIDS-related infections.
Causes of hypogonadotropic hypogonadism are:
- A. Kallman's syndrome
- B. Testicular atrophy
- C. Klinefelter's syndrome
- D. Hypothalamic tumour
Correct Answer: A
Rationale: The correct answer is A because Kallman's syndrome is a well-known cause of hypogonadotropic hypogonadism. The other options (b-e) are either causes of hypergonadotropic hypogonadism or unrelated conditions.
Which patient could require feeding by gavage?
- A. Infant with congestive heart failure (CHF)
- B. Toddler with repair of transposition of the great vessels
- C. Toddler with Kawasaki disease (KD) in the acute phase
- D. School-age child with rheumatic fever (RF) and chorea
Correct Answer: B
Rationale: Feeding by gavage may be required if the child is unable to feed orally without increased cardiac demand, as might be seen after surgical repair of transposition of the great vessels.