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An infant is experiencing dyspnea related to patent ductus arteriosus (PDA). What does the nurse understand regarding why dyspnea occurs?
- A. Blood is circulated through the lungs again, causing pulmonary circulatory congestion.
- B. Blood is shunted past the pulmonary circulation, causing pulmonary hypoxia.
- C. Blood is shunted past cardiac arteries, causing myocardial hypoxia.
- D. Blood is circulated through the ductus from the pulmonary artery to the aorta, bypassing the left side of the heart.
Correct Answer: A
Rationale: When PDA is present, oxygenated blood recycles through the lungs, overburdening the pulmonary circulation.
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The following syndromes are caused by chromosomal abnormalities:
- A. Cri-du-chat syndrome
- B. Kearns-Sayre syndrome
- C. Marfan's syndrome
- D. Turner's syndrome
Correct Answer: D
Rationale: Turner's syndrome: Turner's syndrome is caused by a monosomy of the X chromosome, characterized by short stature, infertility, and heart defects.
While assessing a newborn with respiratory distress, the nurse auscultates a machine-like heart murmur. Other findings are a wide pulse pressure, periods of apnea, increased PaCO2, and decreased PO2. The nurse suspects that the newborn has:
- A. Pulmonary hypertension
- B. Patent ductus arteriosus (PDA)
- C. Ventricular septal defect (VSD)
- D. Bronchopulmonary dysplasia
Correct Answer: B
Rationale: A machine-like murmur is the hallmark of a PDA.
An adult client is admitted with flank pain and is diagnosed with acute pyelonephritis. What is the priority nursing action?
- A. Auscultate for presence of bowel sounds.
- B. Monitor hemoglobin and hematocrit
- C. Encourage turning and deep breathing
- D. Administer IV antibiotics as prescribed.
Correct Answer: D
Rationale: Administering IV antibiotics promptly is critical to treat the infection and prevent complications in acute pyelonephritis.
The following procedures may abort an attack of SVT EXCEPT
- A. placing of the face in ice water
- B. straining
- C. breath holding
- D. standing on head
Correct Answer: D
Rationale: Standing on the head is not a practical or effective method to terminate SVT.
A harsh, blowing grade IV/VI murmur is auscultated in a 6-month-old infant. What will the nurse practitioner do next?
- A. Get a complete blood count to rule out severe anemia.
- B. Obtain an electrocardiogram to assess for arrhythmia.
- C. Order a chest radiograph to evaluate for cardiomegaly.
- D. Refer to a pediatric cardiologist for further evaluation.
Correct Answer: D
Rationale: A harsh, blowing murmur is suspicious for pathology, so a cardiology referral is warranted.