Nokea
All of the following are true regarding intussusception in children, except
- A. It is more common in boys than girls
- B. Adeno virus C has been implicated
- C. Urgent barium meal follow-through is the investigation of choice
- D. Postoperative intussusception is commonly ileoileal
Correct Answer: C
Rationale: Urgent barium meal follow-through is not the investigation of choice for intussusception; ultrasound is preferred for diagnosis.
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ECG
- A. Bifid P waves in large VSD
- B. Complete Ht block in cyanotic attacks of fallots
- C. RBBB in Ebstein anomaly
- D. Right axis deviation in tricuspid atresia
Correct Answer: C
Rationale: In Ebstein's anomaly, right bundle branch block (RBBB) is commonly seen on ECG.
A previously well 3½-month-old presents with poor feeding, diaphoresis during feeding, and poor growth. Vital signs reveal respirations of 70, pulse of 175, and blood pressure of 90/65 mm Hg in the upper and lower extremities. The cardiac examination reveals a palpable parasternal lift and a systolic thrill. A grade 4 holosystolic murmur and a mid-diastolic rumble are noted. The chest radiograph reveals cardiomegaly. The most likely diagnosis is
- A. cardiomyopathy
- B. myocarditis
- C. VSD
- D. coarctation of the aorta
Correct Answer: C
Rationale: The presentation suggests a large ventricular septal defect (VSD) causing significant left-to-right shunting and heart failure.
An older adult man recently diagnosed with chronic obstructive pulmonary disease (COPD) is admitted with shortness of breath. The nurse observes the client sitting upright and leaning over the bedside table, using accessory muscles to assist in breathing. What action should the nurse take?
- A. Assist the client to a high Fowler's position in bed
- B. Observe the client for the presence of a barrel chest
- C. Prepare to transfer the client to a critical care unit
- D. Instruct the client in pursed lip breathing techniques
Correct Answer: D
Rationale: Pursed lip breathing helps reduce dyspnea and improves oxygenation in clients with COPD.
An older female client with long term type 2 diabetes mellitus (DM) is seen in the clinic for a routine health assessment. To determine if the client is experiencing any long-term complication of DM, which assessments should the nurse obtain?
- A. Serum creatinine and blood urea nitrogen (BUN)
- B. Sensation in feet and legs
- C. Skin condition of lower extremities
- D. Visual acuity
Correct Answer: B
Rationale: These assessments are crucial for detecting complications such as neuropathy, nephropathy, and retinopathy.
Indications for an exchange transfusion include:
- A. ABO incompatibility
- B. Acute chest syndrome
- C. Sepsis
- D. Polycythaemia
Correct Answer: A
Rationale: Exchange transfusion is indicated in conditions like ABO incompatibility to prevent severe hemolytic disease in newborns. Acute chest syndrome sepsis polycythaemia and sickle nephropathy are not typical indications for exchange transfusion.