Nokea
All are true about genotype - phenotype correlation in Brugada syndrome, except
- A. SCN5A mutation is associated with short PR interval
- B. LTCC mutation is associated with short QT interval
- C. Yield of genetic testing is low (25%)
- D. No major therapeutic implication of genetic testing
Correct Answer: D
Rationale: There are therapeutic implications of genetic testing in Brugada syndrome.
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Ventricular tachycardia (VT) is defined as at least 3 premature ventricular contractions PVCs at >120 beats/min. Hemodynamically unstable patients with VT should be immediately treated with
- A. catheter ablation
- B. ICD implantation
- C. DC cardioversion
- D. amiodarone
Correct Answer: C
Rationale: DC cardioversion is the immediate treatment for hemodynamically unstable VT.
The following factors trigger renin secretion:
- A. Hyponatremia
- B. ACTH
- C. Hypovolemia
- D. ADH
Correct Answer: C
Rationale: Hypovolemia: Renin is secreted by the kidneys in response to low blood volume (hypovolemia), initiating the renin-angiotensin-aldosterone system to conserve sodium and increase blood pressure.
The nurse is caring for a school-age child who has had a cardiac catheterization. The child tells the nurse that the bandage is “too wet.†The nurse finds the bandage and bed soaked with blood. What is the priority nursing action?
- A. Notify physician
- B. Apply new bandage with more pressure
- C. Place the child in Trendelenburg position
- D. Apply direct pressure above catheterization site
Correct Answer: D
Rationale: If bleeding occurs, direct continuous pressure is applied 2.5 cm (1 inch) above the percutaneous skin site to localize pressure over the vessel puncture. Notifying a physician and applying a new bandage can be done after pressure is applied. The nurse can have someone else notify the physician while the pressure is being maintained. It is not a helpful intervention to place the girl in the Trendelenburg position. It would increase the drainage from the lower extremities.
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.
An adult female client is diagnosed with restless leg syndrome and is referred to the sleep clinic. The healthcare provider prescribes ferrous sulfate (Feosol) 325 mg PO daily. Which laboratory values should the nurse monitor?
- A. Serum electrolytes
- B. Neutrophils and eosinophils
- C. Serum iron and ferritin
- D. Platelet count and hematocrit
Correct Answer: C
Rationale: Serum iron and ferritin levels should be monitored because they are indicators of iron deficiency, which is a common cause of restless leg syndrome.