Nokea
A child with a known history of asthma is admitted to the hospital with a respiratory infection. Which action is the nurse's priority?
- A. Administer a nebulizer treatment as ordered.
- B. Perform chest physiotherapy.
- C. Monitor oxygen saturation levels closely.
- D. Educate the parents about infection prevention.
Correct Answer: A
Rationale: The priority in asthma management is ensuring the airways are open, which is best achieved by administering a nebulizer treatment as ordered.
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Pulsus paradoxus is associated with
- A. pericarditis
- B. endocarditis
- C. rheumatic fever
- D. myocarditis
Correct Answer: A
Rationale: Pulsus paradoxus is commonly associated with pericardial diseases such as constrictive pericarditis.
In D-transposition of the great vessels, accounts for =5% of all congenital heart disease. In this anomaly, the following are true EXCEPT
- A. the pulmonary artery is anterior and to the left of the aorta
- B. pulmonary veins return to the left atrium
- C. connections between the atria and ventricles are normal
- D. aorta is posterior and to the right of the pulmonary artery
Correct Answer: A
Rationale: The pulmonary artery is anterior and to the left of the aorta in normal anatomy.
A child diagnosed with congestive heart failure (CHF) is receiving maintenance doses of digoxin and furosemide. She is rubbing her eyes when looking at the lights in the room, and her HR is 70 beats per minute. The nurse expects which laboratory finding?
- A. Hypokalemia
- B. Hypomagnesemia
- C. Hypocalcemia
- D. Hypophosphatemia
Correct Answer: A
Rationale: The child's eye rubbing may indicate seeing halos (a sign of digoxin toxicity), and the slow HR supports this. Furosemide can cause hypokalemia, increasing the risk for digoxin toxicity.
A 9-month-old infant has a grade III/VI, harsh, rumbling, continuous murmur in the left infraclavicular fossa and pulmonic area. A chest radiograph reveals cardiac enlargement. The primary care pediatric nurse practitioner will refer the infant to a pediatric cardiologist and prepare the parents for which intervention to repair this defect?
- A. Cardiopulmonary bypass surgery
- B. Coil insertion in the catheterization laboratory
- C. Indomethacin administration
- D. Observation for spontaneous closure
Correct Answer: B
Rationale: This murmur is characteristic of a PDA and, because of cardiac enlargement, represents a larger shunt, requiring repair. Infants older than 8 months may have a coil or plug inserted into the shunt in the cardiac catheterization laboratory.
A client with type 2 diabetes mellitus (DM) is admitted to the hospital for uncontrolled DM. Insulin therapy is initiated with an initial dose of Humulin N insulin at 0800. At 1600, the client complains of diaphoresis, rapid heartbeat, and feeling shaky. What should the nurse do first?
- A. Determine the client's current glucose level
- B. Administer 10 units of fast-acting insulin.
- C. Offer the client a snack with high protein.
- D. Increase the IV infusion rate of normal saline.
Correct Answer: A
Rationale: The symptoms suggest hypoglycemia. Checking the glucose level confirms the diagnosis and guides appropriate treatment.