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Diagnostic signs of child abuse are:
- A. Sub-hyaloid bleeding
- B. Spiral fracture of a long bone
- C. Lacerated tongue
- D. Posterior rib fractures
Correct Answer: D
Rationale: Posterior rib fractures are highly suggestive of child abuse, as they are often caused by forceful squeezing or shaking.
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A male client in skeletal traction tells the nurse that he is frustrated because he needs help repositioning himself in bed. Which intervention should the nurse implement?
- A. Provide an overhead trapeze to the bed for the client to use
- B. Assist the client with repositioning every hour to prevent discomfort.
- C. Encourage the client to use a bedpan instead of getting up to the bathroom.
- D. Offer additional pain medication to help the client relax.
Correct Answer: A
Rationale: An overhead trapeze allows the client to reposition independently, promoting autonomy and reducing frustration.
The most common coronary artery anomaly in Tetralogy of Fallot is
- A. Left anterior descending artery from right aortic sinus
- B. Single coronary artery from right aortic sinus
- C. Single coronary artery from left aortic sinus
- D. Left circumflex coronary artery from right aortic sinus
Correct Answer: A
Rationale: The most common coronary artery anomaly in Tetralogy of Fallot is the left anterior descending artery arising from the right aortic sinus.
All of the following are true regarding proximal renal tubular acidosis, except
- A. Growth failure in the first few years of life is a characteristic presentation
- B. Urine pH cannot be reduced to < 5.5
- C. It is usually a component of Fanconi syndrome
- D. Non-anion gap metabolic acidosis is common
Correct Answer: D
Rationale: Proximal renal tubular acidosis is associated with a normal anion gap metabolic acidosis, not a non-anion gap metabolic acidosis.
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.
An older male client with long-standing lung disease is admitted to the medical unit for treatment of pulmonary infection. In assessing for signs of increasing hypoxia, which action should the nurse include? (select all that apply)
- A. Monitor dryness of mucous membranes
- B. Check for changes in mentation
- C. Observe color of skin and nailbeds
- D. Note appearance of jugular veins
Correct Answer: B
Rationale: Changes in mentation, skin color, and breathing patterns are key indicators of hypoxia in clients with lung disease.