Nokea
Features that would increase suspicion of cerebral palsy at age 9 months include:
- A. Presence of Moro reflex
- B. Abductor spasm
- C. Hand dominance
- D. Grasp reflex
Correct Answer: C
Rationale: Hand dominance at 9 months is a red flag for cerebral palsy. The persistence of primitive reflexes like the Moro and grasp reflexes can also be indicative.
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A previously well 3½-month-old presents with poor feeding, diaphoresis during feeding, and poor growth. Vital signs reveal respirations of 70, pulse of 175, and blood pressure of 90/65 mm Hg in the upper and lower extremities. The cardiac examination reveals a palpable parasternal lift and a systolic thrill. A grade 4 holosystolic murmur and a mid-diastolic rumble are noted. The chest radiograph reveals cardiomegaly. The most likely diagnosis is
- A. cardiomyopathy
- B. myocarditis
- C. VSD
- D. coarctation of the aorta
Correct Answer: C
Rationale: The presentation suggests a large ventricular septal defect (VSD) causing significant left-to-right shunting and heart failure.
The following drugs cause hypokalaemia:
- A. Commencement of digoxin for atrial fibrillation
- B. ACE (angiotensin converting enzyme) inhibitors
- C. Salbutamol for asthma
- D. Vitamin B1 for the treatment of pernicious anaemia
Correct Answer: C
Rationale: Salbutamol can cause hypokalaemia. Digoxin, ACE inhibitors, and vitamin B1 do not typically cause hypokalaemia.
Regarding a supracristal VSD, the following are true EXCEPT
- A. incidence is higher in Asian children
- B. complicated by aortic insufficiency in 50-90% of patients
- C. aortic insufficiency is most often not recognized until late in the lst decade of life
- D. murmur of a supracristal VSD is usually heard at the mid to upper left sternal border
Correct Answer: D
Rationale: Closure of asymptomatic supracristal VSDs at the time of diagnosis is not recommended.
A nurse assesses a client who is recovering after a left-sided cardiac catheterization. Which assessment finding requires immediate intervention?
- A. Urinary output less than intake
- B. Bruising at the insertion site
- C. Slurred speech and confusion
- D. Discomfort in the left leg
Correct Answer: C
Rationale: Slurred speech and confusion may indicate a neurological complication, such as a stroke, which requires immediate intervention.
The nurse is teaching the importance of an exercise regime that includes walking daily for a group of clients with asthma, chronic bronchitis, and emphysema at a pulmonary rehabilitation clinic. Which rationale should the nurse include when motivating the clients?
- A. Daily exercise and walking enhances cardiovascular fitness
- B. Exercise eliminates the need for bronchodilator medications.
- C. Walking daily reverses lung damage caused by chronic conditions.
- D. Physical activity increases mucus production to clear airways.
Correct Answer: A
Rationale: Regular exercise improves cardiovascular fitness, which can enhance overall respiratory function and quality of life in clients with chronic pulmonary conditions.