Nokea
A nurse assesses a client who is recovering after a left-sided cardiac catheterization. Which assessment finding requires immediate intervention?
- A. Urinary output less than intake
- B. Bruising at the insertion site
- C. Slurred speech and confusion
- D. Discomfort in the left leg
Correct Answer: C
Rationale: Slurred speech and confusion may indicate a neurological complication, such as a stroke, which requires immediate intervention.
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In Wolff-Parkinson-White syndrome:
- A. The abnormal pathway is between the atrial and ventricular myocardium
- B. Wide QRS complexes occur more frequently than narrow QRS
- C. Narrow QRS complexes are regular
- D. Verapamil is the treatment of choice for atrial fibrillation
Correct Answer: B
Rationale: In Wolff-Parkinson-White syndrome, a wide QRS complex is often seen due to the presence of an accessory pathway that bypasses the normal conduction system.
The following statements are true:
- A. Unexplained vaginal discharge in a 3-year-old might be a sign of sexual abuse
- B. Spiral fracture of femur is always non-accidental
- C. Retinal bleeding in a 3-month-old unconscious baby is a sign of 'shaken baby' syndrome
- D. Bruises on the elbows and knees in a 4-year-old are suggestive of physical abuse
Correct Answer: C
Rationale: Retinal bleeding in a 3-month-old unconscious baby is a sign of 'shaken baby' syndrome: Retinal bleeding in infants, especially with other signs of physical abuse, is a key indicator of 'shaken baby' syndrome.
In bronchopulmonary dysplasia:
- A. Lung compliance is increased
- B. Bronchial reactivity is increased
- C. Lung function typically improves with age
- D. Hyperinflation is an associated finding
Correct Answer: D
Rationale: Hyperinflation is a common finding in bronchopulmonary dysplasia due to lung damage and the need for prolonged mechanical ventilation.
Ventricular tachycardia (VT) is defined as at least 3 premature ventricular contractions PVCs at >120 beats/min. Hemodynamically unstable patients with VT should be immediately treated with
- A. catheter ablation
- B. ICD implantation
- C. DC cardioversion
- D. amiodarone
Correct Answer: C
Rationale: DC cardioversion is the immediate treatment for hemodynamically unstable VT.
The definition of hypertension in children is
- A. average systolic blood pressure (SBP) and/or diastolic BP that is ≥95th percentile for age, sex, on ≥2 occasions
- B. average systolic blood pressure (SBP) and/or diastolic BP that is ≥95th percentile for age, sex, and height on ≥2 occasions
- C. average systolic blood pressure (SBP) and/or diastolic BP that is ≥95th percentile for age, sex, and height on ≥3 occasions
- D. average systolic blood pressure (SBP) and/or diastolic BP that is ≥90th percentile for age, sex, and height on ≥3 occasions
Correct Answer: C
Rationale: Hypertension in children is defined as BP ≥95th percentile for age, sex, and height on ≥3 occasions.