Nokea
Distal renal tubular acidosis:
- A. Is characterised by hypokalaemia
- B. May be primary or secondary
- C. Presents with growth failure in infancy
- D. Urinary pH is usually < 5
Correct Answer: B
Rationale: Distal renal tubular acidosis (RTA) can be either primary (inherited) or secondary (acquired due to other conditions), affecting acid excretion in the distal tubule.
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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.
Dome and dart P wave in lead V1 in electrocardiogram is suggestive of which of the following?
- A. Dextrocardia
- B. Left atrial ectopic rhythm
- C. Biatrial enlargement
- D. Mitral stenosis
Correct Answer: C
Rationale: The dome and dart P wave morphology is characteristic of biatrial enlargement, often seen in conditions like mitral stenosis and atrial fibrillation.
The mother of Gian, a preschooler with spina bifida tells the nurse that her daughter sneezes and gets a rash when playing with brightly colored balloons, and that she recently had an allergic reaction after eating kiwifruit and bananas. The nurse would suspect that the child may have an allergy to:
- A. Bananas
- B. Latex
- C. Kiwifruit
- D. Color dyes
Correct Answer: B
Rationale: Latex allergy is common in children with spina bifida and can cause cross-reactivity with certain fruits like bananas and kiwifruit.
The nurse is talking to a parent of an infant with heart failure about feeding the infant. Which statement about feeding the child is correct?
- A. “You may need to increase the caloric density of your infant’s formula.â€
- B. “You should feed your baby every 2 hours.â€
- C. “You may need to increase the amount of formula your infant eats with each feeding.â€
- D. “You should place a nasal oxygen cannula on your infant during and after each feeding.â€
Correct Answer: A
Rationale: The metabolic rate of infants with heart failure is greater because of poor cardiac function and increased heart and respiratory rates. Their caloric needs are greater than those of the average infants, yet their ability to take in the calories is diminished by their fatigue. Infants with heart failure should be fed every 3 hours; a 2-hour schedule does not allow for enough rest, and a 4-hour schedule is too long. Fluids must be carefully monitored because of the heart failure. Infants do not require supplemental oxygen with feedings.
Which should the nurse consider when preparing a school-age child and the family for heart surgery?
- A. Unfamiliar equipment should not be shown.
- B. Let the child hear the sounds of an ECG monitor.
- C. Avoid mentioning postoperative discomfort and interventions.
- D. Explain that an endotracheal tube will not be needed if the surgery goes well.
Correct Answer: B
Rationale: The child and family should be exposed to the sights and sounds of the intensive care unit (ICU). All positive, nonfrightening aspects of the environment are emphasized. The child should be shown unfamiliar equipment and its use demonstrated on a doll. Carefully prepare the child for the postoperative experience, including intravenous (IV) lines, incision, and endotracheal tube.