Nokea
An infant with congestive heart failure is receiving digoxin (Lanoxin). What does the nurse recognize as a sign of digoxin toxicity?
- A. Restlessness
- B. Decreased respiratory rate
- C. Increased urinary output
- D. Vomiting
Correct Answer: D
Rationale: Symptoms of digoxin toxicity include nausea, vomiting, anorexia, irregularity in pulse rate and rhythm, and a sudden change in pulse.
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Regarding hand innervation:
- A. Median nerve supplies all thenar muscles except adductor pollicis
- B. The sensory supply to the dorsal surface of the medial two digits is via the radial nerve
- C. In ulnar nerve damage at the elbow there is sensory loss over the medial aspect of forearm proximal to the wrist
- D. Radial nerve provides the sensory innervation to the terminal areas of the dorsal surfaces of the lateral three digits
Correct Answer: A
Rationale: The median nerve innervates most thenar muscles, except for the adductor pollicis, which is supplied by the ulnar nerve.
A 3-year-old child is receiving dextrose 5% in water and half-normal saline solution at 100 ml/hour. Which sign or symptom suggests excessive I.V. fluid intake?
- A. Worsening dyspnea
- B. Gastric distension
- C. Nausea and vomiting
- D. Temperature of 102°F (38.9° C)
Correct Answer: A
Rationale: Worsening dyspnea may indicate fluid overload, leading to pulmonary edema and respiratory distress.
Measuring serum potassium is essential in a child with confirmed hypertension because hyperkalemia may be seen in
- A. Liddle syndrome
- B. Gordon syndrome
- C. glucocorticoid remediable aldosteronism
- D. apparent mineralocorticoid excess
Correct Answer: D
Rationale: Hyperkalemia is not typically associated with Liddle syndrome, which causes hypokalemia.
The following are potent vasoconstrictors:
- A. Renin
- B. Angiotensin I
- C. Nitric oxide
- D. PGI2
Correct Answer: A
Rationale: Renin: Renin is a precursor enzyme in the RAAS that helps in converting angiotensinogen into angiotensin I, a potent vasoconstrictor.
The nurse is caring for a child with Kawasaki disease. A student nurse who is on the unit asks if there are medications to treat the disease. The nurse’s best response to the student nurse is:
- A. Immunogloulin G and ACE inhibitors
- B. Immunoglobulin and heparin
- C. Immunoglobulin G and aspirin
- D. Immunoglobulin and ibuprofen
Correct Answer: C
Rationale: The standard treatment for Kawasaki disease includes Immunoglobulin G and aspirin to reduce inflammation and prevent coronary artery complications.