Nokea
A nurse is teaching nursing students the physiology of congenital heart defects. Which defect results in decreased pulmonary blood flow?
- A. Atrial septal defect
- B. Tetralogy of Fallot
- C. Ventricular septal defect
- D. Patent ductus arteriosus
Correct Answer: B
Rationale: Tetralogy of Fallot results in decreased blood flow to the lungs. The pulmonic stenosis increases the pressure in the right ventricle, causing the blood to go from right to left across the ventricular septal defect. Atrial and ventricular septal defects and patent ductus arteriosus result in increased pulmonary blood flow.
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After the nurse provides dietary restrictions to the parents of a child with celiac disease, which statement by the parents indicates effective teaching?
- A. “Well follow these instructions until our child’s symptoms disappear.â€
- B. “Our child must maintain these dietary restrictions until adulthood.â€
- C. “Our child must maintain these dietary restrictions lifelong.â€
- D. “We’ll follow these instructions until our child has completely grown and developed.â€
Correct Answer: C
Rationale: Celiac disease requires lifelong adherence to a gluten-free diet to prevent symptoms and complications.
In the treatment of asthma, inhaled corticosteroids:
- A. Relieve acute symptoms
- B. Prevent long-term symptoms
- C. Cause airway constriction
- D. Are contraindicated in pregnancy
Correct Answer: B
Rationale: Inhaled corticosteroids are used in asthma management to prevent inflammation and control long-term symptoms, though they do not relieve acute attacks.
Regarding cafe-au-lait spots:
- A. They can be normal findings
- B. They are found in tuberous sclerosis
- C. When present in a child, > 4 spots each > 0.5 cm, is diagnostic of neurofibromatosis type II
- D. Typical appearance in neurofibromatosis is of a smooth border
Correct Answer: A
Rationale: Cafe-au-lait spots can be a normal variant and do not always indicate an underlying pathology.
An older client is admitted after falling while walking. The left leg is externally rotated and shorter than the right leg, and the client is having severe pain and tingling in the left foot. The nurse is unable to palpate the left pedal pulses. Which action is most important for the nurse to implement?
- A. Use a doppler to assess bilateral pedal pulses
- B. Administer pain medication to relieve discomfort.
- C. Position the client’s left leg in a neutral position to reduce pain.
- D. Immobilize the left leg to prevent further injury.
Correct Answer: A
Rationale: Assessing pedal pulses with a doppler is critical to evaluate circulation and detect potential vascular compromise in the affected limb.
As part of the treatment for heart failure, the child takes the diuretic furosemide (Lasix). As part of teaching home care, the nurse encourages the family to give the child foods such as bananas, oranges, and leafy vegetables. These foods are recommended because they are high in which nutrient?
- A. Chlorides
- B. Potassium
- C. Sodium
- D. Vitamins
Correct Answer: B
Rationale: Diuretics that work on the proximal and distal renal tubules contribute to increased losses of potassium. The child’s diet should be supplemented with this electrolyte. With this type of diuretic, potassium must be monitored and supplemented as needed.