Nokea
A nurse is preparing to administer an angiotensin-converting enzyme (ACE) inhibitor. Which drug should the nurse administer?
- A. Captopril (Capoten)
- B. Furosemide (Lasix)
- C. Spironolactone (Aldactone)
- D. Chlorothiazide (Diuril)
Correct Answer: A
Rationale: Captopril is an ACE inhibitor. Furosemide is a loop diuretic. Spironolactone blocks the action of aldosterone. Chlorothiazide works on the distal tubules.
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Regarding fluid and electrolyte homeostasis in a child:
- A. Normal maintenance requirement in a child weighing 20 kg is 1.5 litre/day
- B. A fluid deficit of 50ml/kg produces a body weight loss of 10%
- C. Hypotension is a useful sign ,which indicates moderate dehydration
- D. Normal maintenance needs of sodium are 5-6mmol/kg/day
Correct Answer: B
Rationale: A fluid deficit of 50ml/kg producing a 10% body weight loss is a well-established clinical guideline for assessing dehydration in children. Hypotension is a late sign of severe dehydration, not moderate dehydration.
A child with rheumatic fever begins involuntary, purposeless movements of her limbs. What does the nurse recognize that this indicates?
- A. Seizure activity
- B. Hypoxia
- C. Sydenham’s chorea
- D. Decreasing level of consciousness
Correct Answer: C
Rationale: As the effects of rheumatic fever affect the central nervous system, the child may develop Sydenham’s chorea, manifested by involuntary, purposeless movements of the limbs.
During a home visit, the nurse assesses the skin of a client with eczema who reports that an exacerbation of symptoms has occurred during the last week. Which information is most useful in determining the possible cause of the symptoms?
- A. An old friend with eczema came for a visit
- B. Recently received an influenza immunization
- C. A grandson and his new dog recently visited
- D. Corticosteroid cream was applied to eczema
Correct Answer: C
Rationale: Exposure to new allergens, such as a pet, can trigger eczema flare-ups.
In the most common type of CAR:
- A. There is deficient 11-hydroxylase
- B. Hypertension is a feature
- C. There is an associated gene defect
- D. Transmission is autosomal dominant
Correct Answer: B
Rationale: Hypertension is a feature of congenital adrenal hyperplasia (CAH) caused by deficiencies in enzymes involved in steroidogenesis, including 11-hydroxylase.
The nurse is caring for a child with a diagnosis of Kawasaki disease. The child’s parent asks the nurse, “How does Kawasaki disease affect my child’s heart and blood vessels?†On what understanding is the nurse’s response based?
- A. Inflammation weakens blood vessels, leading to aneurysm.
- B. Increased lipid levels lead to the development of atherosclerosis.
- C. Untreated disease causes mitral valve stenosis.
- D. Altered blood flow increases cardiac workload with resulting heart failure.
Correct Answer: A
Rationale: Inflammation of vessels weakens the walls of the vessels and often results in aneurysm.