Nokea
Exposure to which illness should be a cause to discontinue therapy and substitute dipyridamole (Persantine) in a child receiving aspirin therapy for Kawasaki disease (KD)?
- A. Chickenpox or influenza
- B. E. coli or staphylococcus
- C. Mumps or streptococcus A
- D. Streptococcus A or staphylococcus
Correct Answer: A
Rationale: Both chickenpox and influenza are viral; during these illnesses, aspirin (a salicylate) is typically discontinued due to the risk of Reye syndrome.
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In childhood asthma:
- A. Over 90% of patients show exercise-induced bronchoconstriction
- B. Hypercapnia is the first physiological disturbance in status asthmaticus
- C. Infants are unresponsive to bronchodilators
- D. Spontaneous cure occurs before adolescence
Correct Answer: D
Rationale: Spontaneous cure before adolescence is a recognized phenomenon in childhood asthma, though not all cases resolve. Other options are incorrect: exercise-induced bronchoconstriction is common but not universal, hypercapnia occurs late in status asthmaticus, and infants do respond to bronchodilators.
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.
The treatment of choice for the lesion of the neonate is
- A. digoxin
- B. propranolol (Inderal)
- C. surgical shunt
- D. balloon valvuloplasty
Correct Answer: D
Rationale: Balloon valvuloplasty can relieve pulmonary stenosis and improve symptoms in Tetralogy of Fallot.
A nurse cares for a client who has an 80% blockage of the right coronary artery (RCA) and is scheduled for bypass surgery. Which intervention should the nurse be prepared to implement while this client waits for surgery?
- A. Administration of IV furosemide (Lasix)
- B. Initiation of an external pacemaker
- C. Assistance with endotracheal intubation
- D. Placement of central venous access
Correct Answer: B
Rationale: An 80% blockage of the RCA can lead to bradycardia or heart block. An external pacemaker may be needed to maintain adequate heart rate and cardiac output.
A health care provider has prescribed oxygen as needed for an infant with heart failure. In which situation should the nurse administer the oxygen?
- A. During sleep
- B. When changing the infant’s diapers
- C. When the mother is holding the infant
- D. When drawing blood for electrolyte level testing
Correct Answer: A
Rationale: Administering oxygen during sleep can help ensure the infant maintains adequate oxygenation, especially since infants with heart failure may have compromised respiratory function.