Nokea
Depending on the frequency and severity of hypercyanotic attacks in tetralogy of Fallot, all the following procedures are true EXCEPT
- A. placement of the infant in the knee-chest position
- B. administration of oxygen
- C. injection of morphine subcutaneously
- D. rapid correction with intravenous sodium bicarbonate
Correct Answer: D
Rationale: Intravenous sodium bicarbonate is not typically used for hypercyanotic attacks.
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Features predisposing to NEC (necrotising enterocolitis) in the neonatal period include:
- A. Short fixation
- B. Asphyxia
- C. Umbilical artery catheter
- D. Maternal Crohn's disease
Correct Answer: B
Rationale: Asphyxia is a known risk factor for necrotizing enterocolitis (NEC) due to its effect on intestinal blood flow, leading to bowel ischemia and increased risk of bacterial translocation.
Nurse Victoria is teaching the parents of a school-age child. Which teaching topic should take priority?
- A. Prevent accidents
- B. Keeping a night light on to allay fears
- C. Explaining normalcy of fears about body integrity
- D. Encouraging the child to dress without help
Correct Answer: A
Rationale: Accident prevention is a priority for school-age children as they become more independent and engage in activities that may pose risks.
Which physiological changes occur as a result of hypoxemia in congestive heart failure (CHF)?
- A. Polycythemia and clubbing
- B. Anemia and barrel chest
- C. Increased white blood cells and low platelets
- D. Elevated erythrocyte sedimentation rate and peripheral edema
Correct Answer: A
Rationale: Hypoxemia stimulates erythropoiesis, causing polycythemia, which along with chronic hypoxemia can lead to digital clubbing.
Which explanation regarding cardiac catheterization is appropriate for a preschool child?
- A. Postural drainage will be performed every 4 to 6 hours after the test.
- B. It is necessary to be completely “asleep†during the test.
- C. The test is short, usually taking less than 1 hour.
- D. When the procedure is done, you will have to keep your leg straight for at least 4 hours.
Correct Answer: D
Rationale: The child’s leg will have to be maintained in a straight position for approximately 4 hours. Younger children can be held in the parent’s lap with the leg maintained in the correct position. Postural drainage will not be performed unless the child has corresponding pulmonary problems. The child should be sedated to lie still, but being completely asleep is not necessary. The test will vary in length of time from start to finish.
Deafness can develop due to:
- A. Unconjugated hyperbilirubinaemia in the newborn
- B. Pneumococcal meningitis
- C. Alport syndrome
- D. Cleft palate
Correct Answer: B
Rationale: Pneumococcal meningitis is a known cause of sensorineural hearing loss due to inflammation and damage to the cochlea.