Nokea
A toddler who has been hospitalized for vomiting due to gastroenteritis is sleeping and difficult to wake up. Assessment reveals vital signs of a regular heart rate of 230 beats per minute, respiratory rate of 30 per minute, BP of 84/52, and capillary refill time of 3 seconds. Which dysrhythmia does the nurse suspect in this child?
- A. Rapid atrial flutter
- B. Supraventricular tachycardia
- C. Sinus bradycardia
- D. Rapid atrial fibrillation
Correct Answer: B
Rationale: Supraventricular tachycardia is characterized by a very rapid heart rate, which can lead to decreased cardiac output and symptoms such as lethargy and difficulty waking, as seen in this toddler.
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A client with chronic kidney disease (CKD) arrives at the clinic reporting shortness of breath on exertion and extreme weakness. Vital signs are temperature 100.4°F (38°C), heart rate 110 beats/minute, respirations 28 breaths/minute, and blood pressure 175/98 mmHg. The client usually receives dialysis three times a week but missed the last treatment. STAT blood specimens are sent to the laboratory for analysis. Which laboratory results should the nurse report to the healthcare provider immediately?
- A. Potassium 6.5 mEq/L (mmol/L)
- B. Potassium 6 mEq/L (mmol/L)
- C. Potassium 0.5 mEq/L (mmol/L)
- D. Potassium 1.5 mEq/L (mmol/L)
Correct Answer: A
Rationale: Elevated potassium levels in CKD clients can lead to life-threatening arrhythmias, so this result needs immediate intervention.
A fair-skinned female client who is an avid runner is diagnosed with malignant melanoma, located on the lateral surface of the lower leg. After wide margin resection, the nurse provides discharge teaching. It is most important for the nurse to emphasize the need to observe for changes in which characteristic?
- A. Elasticity of the skin
- B. Appearance of any moles
- C. Muscle aches and pains
- D. Pigmentation of the skin
Correct Answer: B
Rationale: Monitoring for changes in moles is critical for early detection of new or recurrent melanoma, which is essential for timely intervention.
Duchenne muscular dystrophy:
- A. Has an association with malignant hyperpyrexia
- B. Is a reason for never running properly
- C. Is better diagnosed with muscle biopsy than gene probe
- D. Is associated with speech delay
Correct Answer: D
Rationale: Duchenne muscular dystrophy is associated with speech delay due to progressive muscle weakness, including facial muscles affecting speech.
The most common cardiac dysrhythmia in pediatrics is:
- A. Ventricular tachycardia
- B. Sinus bradycardia
- C. Supraventricular tachycardia
- D. First-degree heart block
Correct Answer: C
Rationale: SVT is the most common dysrhythmia in children.
Vitamin used in the treatment of transient tyrosinemia of newborn?
- A. Vitamin A
- B. Vitamin K
- C. Vitamin E
- D. Vitamin C
Correct Answer: D
Rationale: Vitamin C is used to treat transient tyrosinemia due to its role in tyrosine metabolism.