An adult woman with primary Raynaud phenomenon develops pallor and then cyanosis of her fingers. After warming her hands, the fingers turn red and the client reports a burning sensation. What action should the nurse take?
- A. Apply a cool compress to the affected fingers for 20 minutes
- B. Secure a pulse oximeter to monitor the client's oxygen saturation
- C. Report the finding to the healthcare provider as soon as possible
- D. Continue to monitor the fingers until color returns to normal
Correct Answer: D
Rationale: Monitoring is appropriate as the symptoms are consistent with Raynaud's phenomenon and should resolve with warming.
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In a cyanotic spell of TOF
- A. Systemic vascular resistance is reduced
- B. Murmur disappear
- C. PO2 is reduced
- D. Right to Left shunt is Increased
Correct Answer: D
Rationale: During a cyanotic spell in Tetralogy of Fallot, there is an increased right-to-left shunting through the ventricular septal defect.
The reason that the hematocrit is so high is
- A. chronic hypoxia
- B. it was taken in a low cardiac output state
- C. it was a peripheral finger stick
- D. embolic stroke
Correct Answer: A
Rationale: Chronic hypoxia leads to secondary polycythemia as a compensatory mechanism.
Diamond Blackfan anemia is different from Transient Erythroblastopenia of Childhood as the former has
- A. Increased adenosine deaminase
- B. Mean corpuscular volume is decreased
- C. Female predominance
- D. Antecedent history of viral illness
Correct Answer: A
Rationale: Diamond Blackfan anemia is characterized by increased adenosine deaminase activity, unlike Transient Erythroblastopenia of Childhood.
Of the following, the cyanotic cardiac lesion with decreased pulmonary blood flow is
- A. transposition of the great vessels
- B. single ventricle
- C. truncus arteriosus
- D. tricuspid atresia
Correct Answer: D
Rationale: Tricuspid atresia results in decreased pulmonary blood flow due to lack of right ventricular input.
Biochemical abnormalities in a chronic carrier of hepatitis B are:
- A. Raised AST
- B. Low serum albumin
- C. Raised gamma GT
- D. Raised transferrin
Correct Answer: A
Rationale: The correct answer is A because chronic hepatitis B carriers often have raised AST (aspartate aminotransferase) due to liver inflammation. The other options are less specific or not typically associated with chronic hepatitis B.
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