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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Acetazolamide:
- A. Is used in the management of renal tubular acidosis
- B. Causes hypokalaemia
- C. Is usually given intravenously
- D. Inhibits the action of carbonic anhydrase
Correct Answer: D
Rationale: Inhibits the action of carbonic anhydrase: Acetazolamide works by inhibiting carbonic anhydrase, reducing the reabsorption of bicarbonate in the kidneys and helping with conditions like glaucoma, metabolic alkalosis, and altitude sickness.
Progressive spinal muscular atrophy of infancy presents with:
- A. Severe generalised weakness
- B. Fasciculations in the tongue
- C. Loss of spinothalamic tract function
- D. Spontaneous fibrillation on electromyography
Correct Answer: A
Rationale: Progressive spinal muscular atrophy presents with severe weakness and tongue fasciculations. Spinothalamic tract function is preserved, and electromyography shows fibrillation.
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.
Causes of hypertension in a child include:
- A. Long-standing vesico-ureteric reflux
- B. Cushing's syndrome
- C. Addison's disease
- D. Turner's syndrome
Correct Answer: B
Rationale: Cushing's syndrome, characterized by excessive cortisol levels, is a known cause of secondary hypertension in children.
Sudden death in an athlete immediately after forceful blunt trauma to the chest is most likely
- A. commotio cordis
- B. myocardial infarction
- C. lacerated coronary artery
- D. ruptured cardiac tendineae
Correct Answer: A
Rationale: Commotio cordis occurs due to sudden arrhythmias triggered by chest trauma during a vulnerable phase of the cardiac cycle.