Nokea
All the following are correct about left ventricular assist device implantation, except
- A. LA pressure is reduced more than RA pressure
- B. A PFO/small ASD is created following LVAD implantation for decompressing LA
- C. Right to left shunting at atrial level can produce systemic desaturation
- D. RV failure is a bad prognostic marker
Correct Answer: B
Rationale: A PFO/small ASD is not typically created following LVAD implantation.
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An 8-month-old infant has a hypercyanotic spell while blood is being drawn. What is the priority nursing action?
- A. Assess for neurologic defects
- B. Place the child in the knee-chest position
- C. Begin cardiopulmonary resuscitation
- D. Prepare family for imminent death
Correct Answer: B
Rationale: The first action is to place the infant in the knee-chest position. Blow-by oxygen may be indicated. Neurologic defects are unlikely. The child should be assessed for airway, breathing, and circulation. Often, calming the child and administering oxygen and morphine can alleviate the hypercyanotic spell.
Regarding iron deficiency anemia, which of the following is true?
- A. Ferritin levels are elevated
- B. Red blood cell count is usually normal
- C. Hemoglobin is usually decreased
- D. Serum iron levels are elevated
Correct Answer: C
Rationale: In iron deficiency anemia, hemoglobin levels are usually decreased due to insufficient iron for red blood cell production.
While looking through the chart of an infant with a congenital heart defect (CHD) of decreased pulmonary blood flow, the nurse would expect which laboratory finding?
- A. Decreased platelet count
- B. Polycythemia
- C. Decreased ferritin level
- D. Shift to the left
Correct Answer: B
Rationale: Chronic hypoxemia in CHD leads to polycythemia as a compensatory mechanism.
A chest radiograph film is ordered for a child with suspected cardiac problems. The child’s parent asks the nurse, “What will the radiograph show about the heart?†What knowledge about the x-ray should the nurse include in the response to the parents?
- A. Bones of chest but not the heart
- B. Measurement of electrical potential generated from heart muscle
- C. Permanent record of heart size and configuration
- D. Computerized image of heart vessels and tissues
Correct Answer: C
Rationale: A chest radiograph will provide information on the heart size and pulmonary blood-flow patterns. It will provide a baseline for future comparisons. The heart will be visible, as well as the sternum and ribs. Electrocardiography (ECG) measures the electrical potential generated from heart muscle. Echocardiography will produce a computerized image of the heart vessels and tissues by using sound waves.
In autism:
- A. Social interaction is normal
- B. Dopamine levels are reduced
- C. Genetic factors may play a role in aetiology
- D. Methylphenidate is used with benefit
Correct Answer: C
Rationale: Genetic factors may play a role in aetiology: Autism spectrum disorder (ASD) has a strong genetic component, with numerous genes contributing to its development, although environmental factors may also play a role.