Nokea
How will a ventricular septal defect affect blood flow?
- A. Blood will shunt left to right, causing increased pulmonary flow and no cyanosis.
- B. Blood will shunt right to left, causing decreased pulmonary flow and cyanosis.
- C. No shunting occurs due to high pressure in the left ventricle.
- D. Increased pressure in the left atrium hinders the circulation of oxygenated blood in the circulating volume.
Correct Answer: A
Rationale: A ventricular septal defect allows blood to shunt left to right, leading to increased pulmonary flow. This results in oxygenated blood mixing with deoxygenated blood, causing no cyanosis as the mixed blood is still oxygenated. The shunting from left to right overloads the pulmonary circulation, leading to increased pulmonary flow. Choice B is incorrect because blood does not shunt right to left in a ventricular septal defect. Choice C is incorrect as shunting does occur due to the pressure differences between the ventricles. Choice D is incorrect because the defect affects the ventricles, not the atrium, and does not hinder the circulation of oxygenated blood in the circulating volume.
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An infant with congestive heart failure is receiving diuretic therapy. A nurse is closely monitoring the intake and output. The nurse uses which most appropriate method to assess the urine output?
- A. Weighing the diapers
- B. Inserting a Foley catheter
- C. Comparing intake with output
- D. Measuring the amount of water added to formula
Correct Answer: A
Rationale: Weighing the diapers is the most appropriate method to assess urine output in infants. Diapers will absorb and retain urine, providing a measurable indicator of urine output without invasive procedures. This method is non-invasive, simple, and convenient for monitoring urine output, especially in infants who may not be able to use other urine output measurement techniques. Inserting a Foley catheter is invasive and not indicated for routine urine output monitoring in infants. Comparing intake with output does not directly measure urine output. Measuring the amount of water added to formula does not provide an accurate assessment of urine output.
Where is the most appropriate location to perform a procedure on a preschooler?
- A. Perform the procedure in the child's hospital bed.
- B. Perform the procedure in the treatment room.
- C. Allow the child to decide when the procedure will be performed.
- D. Ask the parents to help restrain the child so the procedure can be performed.
Correct Answer: B
Rationale: When performing a procedure on a preschooler, it is most appropriate to do so in the treatment room. This setting is specifically designed to provide a suitable environment with necessary equipment and resources to ensure the procedure is carried out safely and efficiently. It helps minimize distractions and provides a controlled environment for healthcare providers to focus on the child's needs. Choices A, C, and D are incorrect because performing the procedure in the child's hospital bed may lack the necessary resources and equipment, allowing the child to decide when the procedure will be performed may not be feasible due to medical necessity and urgency, and asking parents to help restrain the child is not ideal as it may not provide a professional and controlled setting for the procedure.
A 2-year-old client is admitted for an acute asthma episode. The hospital provides family-centered care. In explaining the program to the parents, the nurse would explain that the parents are:
- A. Required to implement all personal hygiene care for their child.
- B. Encouraged to be as involved with the child's care as they are comfortable being.
- C. Requested to administer all oral medications.
- D. Expected to be present at the child's bedside.
Correct Answer: B
Rationale: Family-centered care involves encouraging parents to actively participate in their child's care based on their comfort level. This approach promotes collaboration between healthcare providers and families, enhancing the quality of care and ensuring the family's involvement in decision-making. Choice A is incorrect because parents are encouraged to participate, not required to implement all personal hygiene care. Choice C is incorrect as it implies a specific action rather than the broader concept of involvement. Choice D is incorrect as it focuses solely on physical presence rather than active participation in care.
What comment made by a parent of a 1-month-old would alert the nurse about the presence of a congenital heart defect?
- A. He is always hungry.
- B. He tires out during feedings.
- C. He is fussy for several hours every day.
- D. He sleeps all the time.
Correct Answer: B
Rationale: Observing a 1-month-old tiring out during feedings should alert the nurse to the possibility of a congenital heart defect. This symptom may indicate that the infant is expending excess energy to compensate for a heart issue, leading to fatigue during feeding. Choices A, C, and D do not directly relate to a congenital heart defect. Being always hungry, fussy, or sleeping a lot are not specific signs of a congenital heart defect in a 1-month-old.
Beta-adrenergic agonists such as Salbutamol are given to Reggie, a child with asthma. Such drugs are administered primarily to do which of the following?
- A. Dilate the bronchioles
- B. Reduce secondary infections
- C. Decrease postnasal drip
- D. Reduce airway inflammation
Correct Answer: A
Rationale: Beta-adrenergic agonists like Salbutamol are used to dilate the bronchioles in asthma patients. This action helps in relieving bronchospasms and improving airflow to the lungs, making breathing easier for the individual. While reducing inflammation is an essential part of asthma management, beta-adrenergic agonists primarily work by relaxing the smooth muscles around the airways, leading to bronchodilation. Choices B, C, and D are incorrect because beta-adrenergic agonists are not primarily used to reduce secondary infections, decrease postnasal drip, or directly reduce airway inflammation in asthma patients.