Nokea
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.
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In urgent situations of supraventricular tachycardia (SVT) when symptoms of severe heart failure have already occurred, the initial management is
- A. adenosine by rapid intravenous push
- B. DC cardioversion
- C. verapamil
- D. digoxin
Correct Answer: B
Rationale: DC cardioversion is the preferred initial management in hemodynamically unstable SVT.
The following statements are true regarding a screening test:
- A. Sensitivity indicates the proportion of true positives
- B. Specificity indicates the proportion of true negatives
- C. Sensitivity is inversely related to specificity
- D. Prevalence affects predictive value
Correct Answer: D
Rationale: Prevalence affects predictive value
The MOST common cause of pulmonary hypertension in pediatric patients is
- A. idiopathic pulmonary hypertension
- B. pulmonary venoocclusive disease
- C. left-sided valvular heart disease
- D. chronic obstructive pulmonary disease
Correct Answer: A
Rationale: Idiopathic pulmonary hypertension is a rare but recognized cause of pulmonary hypertension in children.
Accepted maintenance treatment for chronic asthma includes the following:
- A. High-dose inhaled steroids and long-acting bronchodilators
- B. Montelucast
- C. Montelucast and inhaled steroids
- D. Long-acting ~2-agonists alone
Correct Answer: A
Rationale: The correct answer is A because high-dose inhaled steroids and long-acting bronchodilators are the mainstay of chronic asthma management. The other options (b-e) are less commonly used or not first-line.
The nurse is talking to a parent of an infant with heart failure about feeding the infant. Which statement about feeding the child is correct?
- A. “You may need to increase the caloric density of your infant’s formula.â€
- B. “You should feed your baby every 2 hours.â€
- C. “You may need to increase the amount of formula your infant eats with each feeding.â€
- D. “You should place a nasal oxygen cannula on your infant during and after each feeding.â€
Correct Answer: A
Rationale: The metabolic rate of infants with heart failure is greater because of poor cardiac function and increased heart and respiratory rates. Their caloric needs are greater than those of the average infants, yet their ability to take in the calories is diminished by their fatigue. Infants with heart failure should be fed every 3 hours; a 2-hour schedule does not allow for enough rest, and a 4-hour schedule is too long. Fluids must be carefully monitored because of the heart failure. Infants do not require supplemental oxygen with feedings.