In a cyanotic spell of TOF
- A. Systemic vascular resistance is reduced
- B. Murmur disappear
- C. PO2 is reduced
- D. Right to Left shunt is Increased
Correct Answer: D
Rationale: During a cyanotic spell in Tetralogy of Fallot, there is an increased right-to-left shunting through the ventricular septal defect.
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Diagnostic signs of child abuse are:
- A. Sub-hyaloid bleeding
- B. Spiral fracture of a long bone
- C. Lacerated tongue
- D. Posterior rib fractures
Correct Answer: D
Rationale: Posterior rib fractures are highly suggestive of child abuse, as they are often caused by forceful squeezing or shaking.
An infant who has been in foster care since birth requires a blood transfusion. Who is authorized to give written, informed consent for the procedure?
- A. The foster mother
- B. The social worker who placed the infant in the foster home
- C. The registered nurse caring for the infant
- D. The nurse-manager
Correct Answer: A
Rationale: The foster mother, as the primary caregiver, is typically authorized to provide consent for medical procedures.
During preoperative teaching for a male client scheduled for repair of an inguinal hernia, the client tells the nurse that he has had several surgeries and understands the need to perform coughing and deep breathing exercises after surgery. How should the nurse respond?
- A. Ask for a demonstration of these exercises
- B. Explain that coughing should be avoided
- C. Review the client’s previous surgical history
- D. Document the client's understanding of teaching
Correct Answer: A
Rationale: Asking for a demonstration ensures that the client understands the proper technique for coughing and deep breathing exercises.
What are FOUR possible causes of left axis deviation in a newborn with features of Trisomy 21?
- A. AVSD
- B. Tricuspid atresia
- C. Pulmonary atresia with intact ventricular septum
- D. Mechanical shift
Correct Answer: A
Rationale: AVSD is a common congenital heart defect associated with Trisomy 21 and can lead to left axis deviation seen on ECG.
In normal neonates:
- A. Extracellular fluid volume exceeds intracellular fluid volume
- B. In a term baby, plasma calcium levels exceed that of the mother
- C. Clamping the umbilical cord after cessation of cord pulsations increases the blood volume by 20% in the baby
- D. There are two arteries and one vein in the umbilical cord
Correct Answer: A
Rationale: In neonates, extracellular fluid volume is greater than intracellular fluid volume, reflecting the transition from intrauterine to extrauterine life.
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