During a paracentesis, two liters of fluid are removed from the abdomen of a client with ascites. A drainage bag is placed, and 50 ml of clear, straw-colored fluid drains within the first hour. What action should the nurse implement?
- A. Palpate for abdominal distention
- B. Send fluid to the lab for analysis
- C. Continue to monitor the fluid output
- D. Clamp the drainage tube for 5 minutes
Correct Answer: C
Rationale: Monitoring fluid output is essential to assess for complications such as reaccumulation of fluid or bleeding.
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Right to left shunts include:
- A. Fallot's tetralogy
- B. Tricuspid atresia
- C. Eisenmenger complex
- D. Ductus arteriosus in the fetus
Correct Answer: A
Rationale: Fallot's tetralogy is a congenital heart defect that includes a right-to-left shunt, allowing deoxygenated blood to bypass the lungs.
The following antibodies are seen in the conditions mentioned:
- A. Anti-endomysial antibodies in coeliac disease
- B. Anti-insulin receptor antibodies in diabetes mellitus
- C. Anti-epidermal antibodies in vitiligo
- D. Anti-acetylcholine receptor antibodies in spinal muscular atrophy
Correct Answer: A
Rationale: Anti-endomysial antibodies are specifically associated with coeliac disease, making (a) the correct answer. The other options are incorrect as they describe antibodies associated with different conditions.
Frequent complications of Mycoplasma infection include:
- A. Thrombocytopenia
- B. Haemolytic anaemia
- C. Cardiac conduction defects
- D. Pleural effusion
Correct Answer: B
Rationale: Haemolytic anaemia: Mycoplasma infections, particularly with Mycoplasma pneumoniae, can lead to autoimmune haemolytic anaemia, where the body’s immune system destroys red blood cells.
A 4-year-old child has had fever, malaise, and vomiting and right-sided abdominal pain for 48 hours. The following are likely diagnoses:
- A. Acute pyelonephritis
- B. Shigella dysentery
- C. Ascaris lumbricoides infestation, if the child is living in the tropics
- D. Right sided tumour
Correct Answer: A
Rationale: Acute pyelonephritis is a common cause of fever, vomiting, and abdominal pain in children. Shigella dysentery typically causes diarrhea, and Ascaris infestation is rare in non-tropical regions. A right-sided tumour is unlikely without other signs.
Postoperative pulmonary hypertension can be managed with
- A. hyperventilation
- B. catecholamines
- C. nitroprusside
- D. phosphodiesterase inhibitors
Correct Answer: C
Rationale: Inhaled nitric oxide and phosphodiesterase inhibitors are commonly used to manage postoperative pulmonary hypertension.