Nokea
During play, a toddler with a history of tetralogy of Fallot (TOF) might assume which position?
- A. Sitting
- B. Supine
- C. Squatting
- D. Standing
Correct Answer: C
Rationale: Squatting naturally increases SVR by occluding venous return from the lower extremities, thereby increasing pulmonary blood flow.
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What finding would the nurse expect when measuring blood pressure on all four extremities of a child with coarctation of the aorta?
- A. Blood pressure higher on the right side
- B. Blood pressure higher on the left side
- C. Blood pressure lower in the arms than in the legs
- D. Blood pressure lower in the legs than in the arms
Correct Answer: D
Rationale: The characteristic symptoms of coarctation of the aorta are a marked difference in blood pressure and pulses between the upper and lower extremities. Pressure is increased proximal to the defect and decreased distal to the coarctation.
The nurse is assessing clients in an outpatient diabetic clinic. Which entry provides the best evidence that the client is adhering to the prescribed diabetic regimen?
- A. Hemoglobin A1C of 6.2%
- B. Fasting blood glucose of 130 mg/dL
- C. Positive urine ketones
- D. Self-reported daily blood glucose monitoring
Correct Answer: A
Rationale: A hemoglobin A1C of 6.2% indicates good glycemic control, reflecting adherence to the diabetic regimen.
What assessment(s) in a child with tetralogy of Fallot would indicate the child is experiencing a paroxysmal hypercyanotic episode? (Select all that apply.)
- A. Spontaneous cyanosis
- B. Dyspnea
- C. Weakness
- D. Dry cough
Correct Answer: C
Rationale: Indicators of a paroxysmal hypercyanotic episode or a tet episode are spontaneous cyanosis, dyspnea, weakness, and syncope.
Which among the following beta-blockers is not potent than propranolol (considering propranolol = 1)?
- A. Carvedilol
- B. Metoprolol
- C. Bisoprolol
- D. Labetalol
Correct Answer: D
Rationale: Labetalol has a lower beta-blocking potency compared to propranolol, especially considering it also has alpha-blocking activity.
Appropriate initial management steps in an acute anaphylactic reaction to a blood transfusion include:
- A. Nebulised steroids
- B. Oxygen
- C. Intravenous hydrocortisone
- D. Intravenous anti-H2 agent
Correct Answer: B
Rationale: Oxygen is a critical initial management step in anaphylaxis to ensure adequate oxygenation during the acute phase.