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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The causes of elevated maternal serum AFP are:
- A. Trisomy 21
- B. Exomphalos
- C. Marfan syndrome
- D. Meningomyelocele
Correct Answer: D
Rationale: Elevated maternal serum alpha-fetoprotein (AFP) is associated with neural tube defects such as meningomyelocele, due to leakage of AFP into the amniotic fluid.
Parents of a 3-year-old child with congenital heart disease are afraid to let their child play with other children because of possible overexertion. The nurse’s reply should be based on which statement?
- A. The child needs opportunities to play with peers.
- B. The child needs to understand that peers’ activities are too strenuous.
- C. Parents can meet all of the child’s needs.
- D. Constant parental supervision is needed to avoid overexertion.
Correct Answer: A
Rationale: The child needs opportunities for social development. Children usually limit their activities if allowed to set their own pace. The child will limit activities as necessary. Parents must be encouraged to seek appropriate social activities for the child, especially before kindergarten. The child needs to have activities that foster independence. The child will be able to regulate activities.
Recognised causes of delayed speech include:
- A. Hypothyroidism
- B. PKU
- C. Cystinuria
- D. Twins
Correct Answer: A
Rationale: Hypothyroidism is a known cause of delayed speech. PKU and deafness can also cause speech delays, but cystinuria is not associated with speech delay.
The healthcare provider prescribes epoetin alfa (Procrit) 8,200 units subcutaneously for a client with chronic kidney disease (CKD). The 2 ml multidose vial is labeled, 'Each 1 ml of solution contains 10,000 units of epoetin alfa.' How many ml should the nurse administer?
- A. 0.8
- B. 8
- D. 1
Correct Answer: A
Rationale: To calculate the dose, the nurse must divide the prescribed dose (8,200 units) by the concentration (10,000 units per ml). 8,200 ÷ 10,000 = 0.82 ml, rounded to 0.8 ml.
Patients who have undergone surgery entailing the use of cardiopulmonary bypass should be watched carefully for
- A. epilepsy disabilities
- B. learning disabilities
- C. anemia
- D. arrhythmias
Correct Answer: D
Rationale: Arrhythmias are a common complication after cardiopulmonary bypass surgery.