A cardiac catheterization of a client with heart disease indicates the following blockages: 95% proximal left anterior descending (LAD), 99% proximal circumflex, and ? % proximal right coronary artery (RCA). The client later asks the nurse 'what does all this mean for me?' What information should the nurse provide?
- A. Blood supply to the heart is diminished by atherosclerotic lesions, which necessitate lifestyle changes.
- B. Blood vessels supplying the pumping chamber have blockages indicating a past heart attack.
- C. Three main arteries have major blockages, with only 1 to 5% of blood flow getting through to the heart muscle.
- D. The heart is not receiving enough blood, so there is a risk of heart failure and fluid retention.
Correct Answer: C
Rationale: This explanation provides a clear understanding of the severity of the blockages and the implications for the client's heart function.
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Regarding resuscitation of a three-year old with asystole:
- A. Hypoxia is the commonest cause
- B. It commonly leads to ventricular fibrillation
- C. Intracardiac adrenaline is an absolute indication
- D. IV calcium gluconate is the first line of therapy
Correct Answer: A
Rationale: Hypoxia is the most common cause of asystole in children, emphasizing the importance of oxygenation during resuscitation.
What are THREE long-term complications in repaired Tetralogy of Fallot?
- A. Arrhythmia
- B. Pulmonary valve insufficiency
- C. Sudden Death
- D. Recurrent PS
Correct Answer: D
Rationale: Patients with repaired Tetralogy of Fallot are at risk of long-term complications such as recurrent pulmonary stenosis, arrhythmias, and valve insufficiencies.
The ECG in left ventricular hypertrophy and shows a superior QRS axis (between -90' and 0')
- A. tricuspid atresia
- B. Ebstein anomaly
- C. pulmonary atresia
- D. tetralogy of Fallot
Correct Answer: D
Rationale: Left ventricular hypertrophy with a superior QRS axis is characteristic of tetralogy of Fallot.
Inability to do which of the following in a 20-month child is cause for concern?
- A. Speak in clear two to three word phrases
- B. Walk unaided
- C. Kick a ball
- D. Build a tower of 8 blocks
Correct Answer: B
Rationale: Inability to walk unaided by 20 months is a red flag for developmental delay. Other skills are more variable and less concerning if delayed.
The following drugs are given by subcutaneous route:
- A. Human GH
- B. Insulin
- C. Human erythropoietin
- D. Hepatitis B vaccine
Correct Answer: A
Rationale: The correct answer is A because human growth hormone (GH) is commonly administered subcutaneously. The other options (b-e) are also given subcutaneously, but GH is the most relevant in this context.