Nokea
A nurse is caring for a client with Diabetes Insipidus (DI). Which data warrants the most immediate intervention by the nurse?
- A. Serum sodium of 185 mEq/L
- B. Urine output of 3000 mL per hour.
- C. Blood pressure of 90/60 mmHg.
- D. Potassium level of 4.5 mEq/L.
Correct Answer: A
Rationale: A serum sodium level of 185 mEq/L indicates severe hypernatremia, which is life-threatening and requires immediate intervention.
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Distal renal tubular acidosis:
- A. Is characterised by hypokalaemia
- B. May be primary or secondary
- C. Presents with growth failure in infancy
- D. Urinary pH is usually < 5
Correct Answer: B
Rationale: Distal renal tubular acidosis (RTA) can be either primary (inherited) or secondary (acquired due to other conditions), affecting acid excretion in the distal tubule.
In congenital hypertophic pulmonary stenosis
- A. Metabolic alkalosis occurs
- B. In some cases can be treated with non surgical methods
- C. During surgery tumor is removed
- D. Is a caus of conjugated hyperbilirubinaemia in neonate
Correct Answer: B
Rationale: Some cases of congenital hypertrophic pulmonary stenosis can be managed with non-surgical techniques like balloon valvuloplasty.
A grade II vibratory, mid-systolic murmur at the mid sternal border in a 4-year-old child that is louder when the child is supine is most likely which type of murmur?
- A. Pathologic murmur
- B. Pulmonary flow murmur
- C. Still's murmur
- D. Venous hum
Correct Answer: C
Rationale: A Still's murmur is characterized by a vibratory or musical low-grade sound, along the sternal border, which is louder when the child is supine or during inspiration.
Indications for surgical closure of a VSD include the following EXCEPT
- A. patients who cannot thrive
- B. patients whose symptoms cannot be controlled between 6 and 24 months
- C. patients with pulmonary vascular disease
- D. patients older than 2 years with a large VSD associated with a Qs ratio greater than 2:1
Correct Answer: C
Rationale: Surgical closure is not routinely indicated for all VSDs, especially if asymptomatic.
The treatment of choice for the lesion of the neonate is
- A. digoxin
- B. propranolol (Inderal)
- C. surgical shunt
- D. balloon valvuloplasty
Correct Answer: D
Rationale: Balloon valvuloplasty can relieve pulmonary stenosis and improve symptoms in Tetralogy of Fallot.