Nokea
A nurse assesses an older adult client who is experiencing a myocardial infarction. Which clinical manifestation should the nurse expect?
- A. Excruciating pain on inspiration
- B. Left lateral chest wall pain
- C. Disorientation and confusion
- D. Numbness and tingling of the arm
Correct Answer: C
Rationale: Older adults may present with atypical symptoms of myocardial infarction, such as confusion or disorientation, rather than classic chest pain.
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An infant aged 16 months was referred for assessment of suspected mental retardation. Which of the following findings is/are outside the normal range?
- A. He does not scribble spontaneously with pencil on paper
- B. He does not walk alone
- C. Ma' and 'Dada' are the only recognisable words
- D. He is unable to build a tower of four cubes
Correct Answer: B
Rationale: Not walking alone by 16 months is a concern. Scribbling, limited vocabulary, and building towers are less concerning at this age.
What percentage (%) of patients with rheumatic mitral valve disease has the echocardiographic diagnosis of tricuspid stenosis as a co-existing lesion?
- A. 10
- B. 20
- C. 30
- D. 40
Correct Answer: A
Rationale: Approximately 10% of patients with rheumatic mitral valve disease have tricuspid stenosis as a co-existing lesion.
Gingival hyperplasia is an adverse effect of therapy with:
- A. Phenytoin
- B. Cyclophosphamide
- C. Frusemide
- D. Carbamazepine
Correct Answer: A
Rationale: Phenytoin, an anticonvulsant medication, is well-known for causing gingival hyperplasia as a side effect.
Anthracycline (doxorubicin) on rare occasion causes acute inflammatory myocardial injury, but more classically results in dilated cardiomyopathy (DCM) in up to 30% of patients with a cumulative dose of doxorubicin exceeding
- A. 250 mg/m²
- B. 350 mg/m²
- C. 450 mg/m²
- D. 550 mg/m²
Correct Answer: D
Rationale: A cumulative dose of doxorubicin exceeding 550 mg/m² is associated with increased risk of dilated cardiomyopathy.
To reduce the risk for pulmonary complications for a client with Amyotrophic Lateral Sclerosis (ALS), what interventions should the nurse implement?
- A. Initiate passive range of motion exercises
- B. Establish a regular bladder routine
- C. Teach the client breathing exercises
- D. Perform chest physiotherapy
Correct Answer: C
Rationale: Breathing exercises, chest physiotherapy, and use of an incentive spirometer can help reduce the risk of pulmonary complications in ALS by improving lung function.