Nokea
A client's telemetry monitor indicates ventricular fibrillation (VF). After delivering one counter shock, the nurse resumes chest compression. After another minute of compressions, the client's rhythm converts to supraventricular tachycardia (SVT) on the monitor. At this point, what is the priority intervention for the nurse?
- A. Prepare for transcutaneous pacing
- B. Deliver another defibrillator shock
- C. Administer IV Epinephrine per ACLS protocol
- D. Give IV dose of adenosine rapidly over 1-2 seconds
Correct Answer: D
Rationale: SVT can be treated by rapidly administering adenosine to restore normal sinus rhythm.
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Pulmonary venous hypertension is a feature of
- A. Large ostium secundum defect with left to right shunt
- B. large ventricular septal defect with left to right shunt
- C. large pulmonary arteriovenous malformation
- D. Tricuspid atresia with restrictive atrial septal defect
Correct Answer: B
Rationale: Pulmonary venous hypertension is a feature of large ventricular septal defect with left to right shunt.
The school nurse has been following a child who frequently complains of dizziness and headache. Today, she is brought in after fainting in the cafeteria following a nosebleed. Her BP is 122/85, and her radial pulses are bounding. The nurse suspects she has:
- A. Transposition of the great vessels
- B. Coarctation of the aorta (COA)
- C. Aortic stenosis (AS)
- D. Pulmonic stenosis (PS)
Correct Answer: B
Rationale: In older children, COA can cause elevated blood pressure, headache, fainting, and bounding radial pulses.
Croup:
- A. Is a disease
- B. Is commonly caused by parainfluenza viruses
- C. Most cases are managed with nebulised adrenaline
- D. Inhaled steroids are reported to be of benefit
Correct Answer: B
Rationale: Croup is most commonly caused by parainfluenza viruses, which lead to inflammation of the larynx and trachea.
While assessing a newborn with respiratory distress, the nurse auscultates a machine-like heart murmur. Other findings are a wide pulse pressure, periods of apnea, increased PaCO2, and decreased PO2. The nurse suspects that the newborn has:
- A. Pulmonary hypertension
- B. Patent ductus arteriosus (PDA)
- C. Ventricular septal defect (VSD)
- D. Bronchopulmonary dysplasia
Correct Answer: B
Rationale: A machine-like murmur is the hallmark of a PDA.
Hypoglycemia in an infant is defined as whole blood glucose level less than
- A. 40 mg/dl
- B. 50 mg/dl
- C. 60 mg/dl
- D. 80 mg/dl
Correct Answer: A
Rationale: Hypoglycemia in infants is defined as a whole blood glucose level less than 40 mg/dl, as this threshold is critical for brain function.