Nokea
A parent brings a toddler, age 19 months, to the clinic for a regular check-up. When palpating the toddler’s fontanels, what should the nurse expects to find?
- A. Closed anterior fontanel and open posterior fontanel
- B. Open anterior and fontanel and closed posterior fontanel
- C. Closed anterior and posterior fontanels
- D. Open anterior and posterior fontanels
Correct Answer: C
Rationale: By 19 months, both the anterior and posterior fontanels should be closed as the skull bones have fused.
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Which of the following statements is true regarding alcohol septal ablation?
- A. Indicated when dynamic LV outflow gradient is more than 50 mm Hg at rest
- B. Targeted septal thickness less than 16 mm is a contraindication
- C. Usually preferred over surgical myomectomy
- D. Reduces risk of sudden death
Correct Answer: A
Rationale: Alcohol septal ablation is indicated when the dynamic LV outflow gradient is more than 50 mm Hg at rest.
After a transurethral resection of the prostate (TURP), a client has bloody urine output with large clots. The nurse implements the postoperative prescription to irrigate the indwelling catheter PRN to maintain the catheter's patency. Which action should the nurse implement?
- A. Clamp the catheter for 30 minutes prior to irrigating with saline
- B. Manually irrigate the catheter with sterile saline as prescribed
- C. Increase the client's oral fluid intake to flush out clots naturally
- D. Remove the catheter and notify the healthcare provider immediately
Correct Answer: A
Rationale: Clamping the catheter before irrigation prevents sudden fluid shifts and ensures that irrigation is performed effectively.
Treatment for congestive heart failure (CHF) in an infant began 3 days ago and has included digoxin and furosemide. The child no longer has retractions, lungs are clear, and HR is 96 beats per minute while sleeping. The nurse is confident that the child has diuresed successfully and has good renal perfusion when the nurse notes the child's urine output is:
- A. 0.5 cc/kg/hr
- B. 1 cc/kg/hr
- C. 30 cc/hr
- D. 1 oz/hr
Correct Answer: B
Rationale: Normal pediatric urine output is approximately 1 cc/kg/hr.
What does the nurse need to assess first when caring for a child with a suspected myocardial infarction?
- A. Blood pressure and heart rate
- B. Chest pain and anxiety levels
- C. Oxygen saturation and respiratory rate
- D. Electrocardiogram and heart sounds
Correct Answer: D
Rationale: The first priority in a suspected myocardial infarction is to assess the heart's electrical activity using an electrocardiogram and listen to heart sounds for any abnormality such as murmurs.
All the following conditions are associated with high volume pulse except
- A. Aorta to LV tunnel
- B. Coronary cameral fistula
- C. Neonatal Blalock Taussig shunt
- D. Hemitruncus
Correct Answer: C
Rationale: Neonatal Blalock Taussig shunt is not associated with a high volume pulse.