Nokea
A diagnosis of primary pulmonary hypertension of the newborn can be made if:
- A. Oxygen saturation in the hand is 80% and in the foot 67%
- B. A tachypnoeic baby has a saturation of 60%
- C. A baby with history of being covered in thick meconium at birth has PaO2 of 4kPa
- D. A septic baby is hypoxic in 100% oxygen
Correct Answer: A
Rationale: A significant difference in oxygen saturation between the upper and lower extremities (e.g., hand 80%, foot 67%) is indicative of persistent pulmonary hypertension of the newborn (PPHN).
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A nurse assesses a client 2 hours after a cardiac angiography via the left femoral artery. The nurse notes that the left pedal pulse is weak. Which action should the nurse take?
- A. Elevate the leg and apply a sandbag to the entrance site.
- B. Increase the flow rate of intravenous fluids.
- C. Assess the color and temperature of the left leg.
- D. Document the finding as the left pedal pulse of +1/4.
Correct Answer: C
Rationale: A weak pedal pulse after cardiac angiography may indicate compromised blood flow. Assessing the color and temperature of the leg helps determine if there is ischemia or other complications.
The most appropriate first-line treatment for status epilepticus in a child is:
- A. Diazepam
- B. Phenytoin
- C. Carbamazepine
- D. Valproate
Correct Answer: A
Rationale: Diazepam is commonly used as the first-line treatment in managing status epilepticus due to its fast-acting, long-lasting anticonvulsant effects.
A nurse assesses clients on a medical-surgical unit. Which client should the nurse identify as having the greatest risk for cardiovascular disease?
- A. An 86-year-old man with a history of asthma
- B. A 32-year-old Asian-American man with colorectal cancer
- C. A 45-year-old American Indian woman with diabetes mellitus
- D. A 53-year-old postmenopausal woman who is on hormone therapy
Correct Answer: C
Rationale: Diabetes mellitus is a significant risk factor for cardiovascular disease, and the 45-year-old American Indian woman with diabetes mellitus has the highest risk among the options provided.
Nurse Victoria is teaching the parents of a school-age child. Which teaching topic should take priority?
- A. Prevent accidents
- B. Keeping a night light on to allay fears
- C. Explaining normalcy of fears about body integrity
- D. Encouraging the child to dress without help
Correct Answer: A
Rationale: Accident prevention is a priority for school-age children as they become more independent and engage in activities that may pose risks.
Diamond Blackfan anemia is different from Transient Erythroblastopenia of Childhood as the former has
- A. Increased adenosine deaminase
- B. Mean corpuscular volume is decreased
- C. Female predominance
- D. Antecedent history of viral illness
Correct Answer: A
Rationale: Diamond Blackfan anemia is characterized by increased adenosine deaminase activity, unlike Transient Erythroblastopenia of Childhood.