Nokea
A client with carcinoma of the lung is complaining of weakness and has a serum sodium level of 117 mEq/L. Which nursing problem should the nurse include in this client's plan of care?
- A. Altered urinary elimination
- B. Impaired gas exchange
- C. Fluid volume excess
- D. Decreased cardiac output
Correct Answer: C
Rationale: Hyponatremia (low sodium level) is often associated with fluid volume excess in clients with lung carcinoma.
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In systemic mastocytosis:
- A. Areas of depigmentation occur
- B. Intermittent flushing is seen
- C. IgE levels are high
- D. Is relieved by aspirin
Correct Answer: B
Rationale: Intermittent flushing is a recognized symptom of systemic mastocytosis due to the release of histamine and other chemicals from mast cells.
Accepted maintenance treatment for chronic asthma includes the following:
- A. High-dose inhaled steroids and long-acting bronchodilators
- B. Montelucast
- C. Montelucast and inhaled steroids
- D. Long-acting ~2-agonists alone
Correct Answer: A
Rationale: The correct answer is A because high-dose inhaled steroids and long-acting bronchodilators are the mainstay of chronic asthma management. The other options (b-e) are less commonly used or not first-line.
The parents of a 3-month-old ask why their baby will not have an operation to correct a ventricular septal defect (VSD). The nurse's best response is:
- A. It is always helpful to get a second opinion about any serious condition like this.
- B. Your baby's defect is small and will likely close on its own by 1 year of age.
- C. It is common for physicians to wait until an infant develops respiratory distress before they do the surgery.
- D. With a small defect like this, they wait until the child is 10 years old to do the surgery.
Correct Answer: B
Rationale: Most small VSDs close spontaneously within the first year of life.
List FOUR other cardiac manifestations for Marfan’s syndrome, aside from aortopathy.
- A. Mitral valve prolapse/regurgitation
- B. Calcification of the mitral valve <40 years
- C. Dilation of pulmonary artery
- D. Dilation or dissection of ascending/descending aorta (<50 years old)
Correct Answer: A
Rationale: Marfan's syndrome may involve multiple cardiac complications including mitral valve prolapse and other structural heart abnormalities.
Which of the following statements is true regarding Glasgow coma scale (GCS) in children?
- A. The scale is validated as a prognostic scoring system in children and young infants
- B. Patients with GCS < or = 8 require aggressive management
- C. All patients with GCS < or = 5 should be intubated and mechanically ventilated
- D. It is useful in children to assess the neurological, circulatory and cardiac status
Correct Answer: B
Rationale: Patients with a GCS of 8 or less require aggressive management, as this indicates severe brain injury and potential airway compromise.