Nokea
During a routine well child exam on a 5-year-old child, a grade II/VI, harsh, late systolic ejection murmur at the upper left sternal border that transmits to both lung fields is auscultated. The child has normal growth and development. What will the nurse practitioner suspect?
- A. Aortic stenosis (AS)
- B. Patent ductus arteriosus (PDA)
- C. Pulmonic stenosis
- D. Tricuspid atresia
Correct Answer: C
Rationale: Pulmonic stenosis may be asymptomatic with a murmur as described above.
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Avascular necrosis of the femoral head is associated with:
- A. Sickle cell trait
- B. Nephrotic syndrome
- C. Cushing's syndrome
- D. Hypothyroidism
Correct Answer: C
Rationale: Cushing's syndrome is associated with avascular necrosis due to steroid use. Sickle cell trait, nephrotic syndrome, and hypothyroidism are not directly linked.
Regarding malaria:
- A. Plasmodium ovale has an exoerythrocytic cycle
- B. Plasmodium malariae does not occur after 5 years of primary illness
- C. Chloroquine is useful for prophylaxis of falciparum malaria in all areas of the world
- D. Primaquine is used to eradicate falciparum malaria
Correct Answer: A
Rationale: Plasmodium ovale has both an exoerythrocytic (liver) and erythrocytic (blood) cycle, which is a characteristic of this species of malaria parasite.
What is the primary nursing intervention to prevent bacterial endocarditis?
- A. Institute measures to prevent dental procedures.
- B. Counsel parents of high-risk children about prophylactic antibiotics.
- C. Observe children for complications, such as embolism and heart failure.
- D. Encourage restricted mobility in susceptible children.
Correct Answer: B
Rationale: The objective of nursing care is to counsel the parents of high-risk children about both the need for prophylactic antibiotics for dental procedures and the necessity of maintaining excellent oral health. The child’s dentist should be aware of the child’s cardiac condition. Dental procedures should be done to maintain a high level of oral health. Prophylactic antibiotics are necessary. Children should be observed for complications such as embolism and heart failure and restricted mobility should be encouraged in susceptible children, but maintaining good oral health and prophylactic antibiotics is important.
The nurse is evaluating a male client’s understanding of diet teaching about the DASH (Dietary Approaches to Stop Hypertension) eating plan. Which behavior indicates that the client is adhering to the eating plan?
- A. Uses only lactose-free dairy products
- B. Enjoys fat free yogurt as an occasional snack food
- C. No longer includes grains in his daily diet
- D. Carefully cleans and peels all fresh fruit and vegetables
Correct Answer: D
Rationale: Cleaning and peeling fruits and vegetables is consistent with the DASH plan, which promotes a high intake of fresh produce.
A male client who had abdominal surgery 5 days ago, and hospitalized because of a surgical wound infection, tells the nurse that he feels like his insides just spilled out when he coughed. What action should the nurse take first?
- A. Notify the healthcare provider
- B. Assure the client that such feelings occur with wound infections
- C. Visualize the abdominal incision
- D. Obtain sterile towels soaked in saline
Correct Answer: C
Rationale: Visualizing the incision helps determine if dehiscence or evisceration has occurred, which requires immediate intervention.