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.
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The following drugs may cause long Q-T syndromes (LQTS) EXCEPT
- A. trimethoprim/sulfamethoxazole
- B. erythromycin
- C. imipramine
- D. pentostam
Correct Answer: D
Rationale: Pentostam is not known to cause long Q-T syndromes.
A child aged 10 days has ambiguous genitalia:
- A. If a buccal smear is chromatin negative, there is a serious risk of an Addisonian crisis
- B. A raised urinary output of pregnanetriol would confirm a diagnosis of CAR
- C. The finding of the genotype 45 XO would reliably explain the anomaly
- D. If testicles were present in the 'labia', an acceptable explanation would be Klinefelter's syndrome
Correct Answer: B
Rationale: A raised urinary pregnanetriol indicates congenital adrenal hyperplasia (CAR). Chromatin-negative buccal smear suggests male genotype, and 45 XO is Turner syndrome, not related to ambiguous genitalia. Klinefelter's syndrome does not explain testicles in the labia.
Arrhythmia in Children
- A. Re entry Tachycardia is the commonest
- B. Adenosine decreases the force of cardiac contractility
- C. SVT can cause hydrops foetalis
- D. Valsalva maneuver can restore sinus rhythm
Correct Answer: A
Rationale: Re-entry tachycardia is the most common type of arrhythmia in children.
All the following are signs of coarctation of the aorta EXCEPT
- A. femoral pulses are weak or absent
- B. bounding pulses of the arms
- C. blood pressure in the legs is lower than that in the arms
- D. precordial impulse and heart sounds are usually normal
Correct Answer: B
Rationale: In coarctation of the aorta, femoral pulses are delayed or absent, not bounding.
An adult female with multiple sclerosis (MS) falls while walking to the bathroom. On transfer to the intensive care unit, she is confused and has had projectile vomiting twice. Which intervention should the nurse implement first?
- A. Determine client's last dose of corticosteroids
- B. Determine neurological baseline prior to the fall
- C. Administer a PRN IV antiemetic as prescribed
- D. Complete head to toe neurological assessment.
Correct Answer: D
Rationale: The symptoms suggest increased intracranial pressure or a neurological emergency. A thorough neurological assessment is necessary to identify the cause and guide further interventions.