Nokea
Congenital heart defects have traditionally been divided into acyanotic or cyanotic defects. Based on the nurse's knowledge of congenital heart defects, this system in clinical practice is
- A. helpful because it explains the hemodynamics involved
- B. helpful because children with cyanotic defects are easily identified
- C. problematic because cyanosis is rarely present in children
- D. problematic because children with acyanotic heart defects may develop cyanosis
Correct Answer: D
Rationale: The classification system of congenital heart defects into acyanotic or cyanotic defects is problematic because children with acyanotic heart defects may develop cyanosis, complicating the differentiation. Cyanosis can occur in some acyanotic defects due to various reasons such as right-to-left shunting or decreased pulmonary blood flow, making the classification based solely on cyanosis misleading. Choice A is incorrect because while the classification may involve hemodynamics, the main issue lies in the potential for acyanotic defects to develop cyanosis. Choice B is incorrect as the ease of identifying children with cyanotic defects does not address the main problem with the classification system. Choice C is also incorrect as the presence of cyanosis is not the only factor determining the classification's validity.
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A healthcare professional is teaching parents about why most children should be immunized against varicella (chickenpox) and why some receiving specific medications should not. Which medication should be included in the discussion?
- A. Insulin
- B. Steroids
- C. Antibiotics
- D. Anticonvulsants
Correct Answer: B
Rationale: The correct answer is B: Steroids. Children receiving steroids should not receive the varicella vaccine as it can increase the risk of severe infection due to the immunosuppressive effects of steroids. Insulin (Choice A), antibiotics (Choice C), and anticonvulsants (Choice D) do not interact with the varicella vaccine in the same way as steroids, and therefore, they are not contraindicated.
What is a common finding that the nurse can identify in most children with symptomatic cardiac malformations?
- A. Mental retardation
- B. Inherited genetic factors
- C. Delayed physical growth
- D. Clubbing of the fingertips
Correct Answer: C
Rationale: Delayed physical growth is a common finding in most children with symptomatic cardiac malformations. This occurs due to inadequate oxygenation and nutrient supply to tissues as a result of the cardiac defect. Mental retardation (Choice A) is not typically associated with cardiac malformations unless there are complications affecting brain function. Inherited genetic factors (Choice B) may contribute to the development of cardiac malformations but are not a direct common finding in affected children. Clubbing of the fingertips (Choice D) is more commonly associated with chronic respiratory or cardiac conditions, not specifically cardiac malformations in children.
At 2 years of age, a child is readmitted to the hospital for additional surgery. What is the most important factor in preparing the toddler for this experience?
- A. Meeting the child's wishes
- B. Previous hospitalization experience
- C. Preventing the child from staying with strangers
- D. Ensuring ongoing parental affection
Correct Answer: B
Rationale: The most important factor in preparing a toddler for additional surgery is their previous hospitalization experience. This familiarity with the hospital setting and procedures can help reduce anxiety and fear in the child. Choice A, meeting the child's wishes, may not always align with what is medically necessary or safe for the child. Choice C, preventing the child from staying with strangers, is important for general comfort but may not directly address the child's preparation for surgery. Choice D, ensuring ongoing parental affection, is crucial for emotional support but may not have the same impact as the child's previous hospitalization experience in preparing them for the surgery.
A child with a diagnosis of celiac disease is being discharged. What dietary instructions should the nurse provide?
- A. Avoid dairy products
- B. Avoid gluten
- C. Avoid high-fat foods
- D. Avoid foods high in sugar
Correct Answer: B
Rationale: The correct answer is to 'Avoid gluten.' Celiac disease is an autoimmune disorder triggered by gluten consumption, a protein found in wheat, barley, and rye. By avoiding gluten-containing foods, individuals with celiac disease can prevent damage to their small intestine and manage their symptoms effectively. Choice A, 'Avoid dairy products,' is incorrect as dairy is not directly related to celiac disease. Choice C, 'Avoid high-fat foods,' and Choice D, 'Avoid foods high in sugar,' are incorrect as they are not primary dietary concerns in managing celiac disease. The main focus should be on eliminating gluten sources from the diet.
The healthcare provider is caring for an infant with suspected pyloric stenosis. Which clinical manifestation would indicate pyloric stenosis?
- A. abdominal rigidity and pain on palpation
- B. rounded abdomen and hypoactive bowel sounds
- C. visible peristalsis and weight loss
- D. distention of lower abdomen and constipation
Correct Answer: C
Rationale: Visible peristalsis and weight loss are classic clinical manifestations of pyloric stenosis. Visible peristalsis refers to the wave-like movements in the abdomen caused by the stomach trying to empty into the intestines due to the obstruction at the pylorus. Weight loss is often seen due to inadequate feeding and vomiting associated with this condition. Choices A, B, and D are not typical of pyloric stenosis. Abdominal rigidity and pain on palpation are more indicative of conditions like peritonitis. A rounded abdomen and hypoactive bowel sounds are more suggestive of conditions like constipation or bowel obstruction. Distention of the lower abdomen and constipation are not specific to pyloric stenosis and may be seen in various gastrointestinal issues.