Nokea
A nurse cares for a client who has an 80% blockage of the right coronary artery (RCA) and is scheduled for bypass surgery. Which intervention should the nurse be prepared to implement while this client waits for surgery?
- A. Administration of IV furosemide (Lasix)
- B. Initiation of an external pacemaker
- C. Assistance with endotracheal intubation
- D. Placement of central venous access
Correct Answer: B
Rationale: An 80% blockage of the RCA can lead to bradycardia or heart block. An external pacemaker may be needed to maintain adequate heart rate and cardiac output.
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Isovolumic contraction phase of ventricular systole occurs during which of the following phases of central venous pressure, approximately
- A. From nadir of y descent to peak of a wave
- B. From peak of a wave to trough of x wave
- C. From trough of x wave to peak of c wave
- D. From peak of c wave to trough of x' descent
Correct Answer: C
Rationale: Isovolumic contraction occurs from the trough of the x wave to the peak of the c wave.
Causes of short stature include:
- A. Steroids at a dose of> 2 mg/kg for 4 weeks
- B. Osteogenesis imperfecta
- C. Hypochondroplasia
- D. Morquio syndrome
Correct Answer: A
Rationale: The correct answer is A because prolonged high-dose steroid use can cause growth suppression and short stature. The other options (b-e) are genetic or metabolic conditions that can also cause short stature.
While looking through the chart of an infant with a congenital heart defect (CHD) of decreased pulmonary blood flow, the nurse would expect which laboratory finding?
- A. Decreased platelet count
- B. Decreased ferritin level
- C. Respiratory alkalosis
- D. Polycythemia
Correct Answer: D
Rationale: Polycythemia is often seen in infants with congenital heart defects that cause decreased pulmonary blood flow, as the body produces more red blood cells to compensate for low oxygen levels.
Insulin-like growth factor-l (IGF-I):
- A. Increases during pubertal growth spurt
- B. Is a single polypeptide chain
- C. Is produced in pancreas
- D. Is secreted in a pulsatile manner
Correct Answer: A
Rationale: IGF-I levels rise significantly during the pubertal growth spurt, contributing to rapid growth and development.
SVT in children differ from physiologic sinus tachycardia by all the following EXCEPT
- A. sudden onset and termination
- B. persistent ventricular rate of >180 bpm
- C. fixed RR interval on ECG
- D. evident change in heart rate with activity
Correct Answer: D
Rationale: Physiologic sinus tachycardia can show changes in heart rate with activity, unlike SVT which has a fixed rate.