A characteristic sign of hypercalcaemia is:
- A. Trousseau's sign
- B. Chvostek's sign
- C. Homan's sign
- D. Kussmaul's sign
Correct Answer: A
Rationale: Trousseau's sign, which involves muscle spasms when a blood pressure cuff is inflated, is a common indicator of hypocalcemia, not hypercalcemia.
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The following are features of encephalitis:
- A. Herpes simplex encephalitis has a reasonably good prognosis
- B. Varicella zoster virus encephalitis is predominantly 'cerebellar'
- C. Mumps encephalitis can cause unilateral nerve deafness
- D. Herpes simplex encephalitis predominantly affects the temporal lobe
Correct Answer: D
Rationale: Herpes simplex encephalitis primarily affects the temporal lobe. Prognosis is poor, and varicella zoster encephalitis is not predominantly cerebellar. Mumps encephalitis can cause deafness.
While assisting a female client to the toilet, the client begins to have a seizure and the nurse eases her to the floor. The nurse calls for help and monitors the client until the seizing stops. Which intervention should the nurse implement first?
- A. Document details of the seizure activity
- B. Observe for lacerations to the tongue
- C. Observe for prolonged periods of apnea
- D. Evaluate for evidence of incontinence
Correct Answer: C
Rationale: Observing for prolonged periods of apnea is critical to ensure the client's airway remains patent and to prevent hypoxia.
A client with a liver abscess undergoes surgical evacuation and drainage of the abscess. Which laboratory value is most important for the nurse to monitor following the procedure?
- A. Serum creatinine
- B. Blood urea nitrogen (BUN)
- C. White blood cell count
- D. Serum glucose
Correct Answer: C
Rationale: Monitoring WBC is essential to assess for infection or signs of abscess recurrence after the procedure.
Which of the following is false regarding right ventricle?
- A. It has fine and regular trabeculations
- B. Septal attachment of AV valve is more apical
- C. Moderator band is present
- D. Trabecular septomarginalis is present
Correct Answer: A
Rationale: The right ventricle typically has coarse trabeculations, not fine and regular ones.
A father asks why his child with tetralogy of Fallot seems to favor a squatting position. What is the nurse’s best response?
- A. Squatting increases the return of venous blood back to the heart.
- B. Squatting decreases arterial blood flow away from the heart.
- C. Squatting is a common resting position when a child is tachycardic.
- D. Squatting increases the workload of the heart.
Correct Answer: A
Rationale: The squatting position allows the child to breathe more easily because systemic venous return is increased.
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