Nokea
In homo cystinuria:
- A. Homocysteine accumulates just proximal to the enzyme defect
- B. Osteoporosis is a recognised feature
- C. Oral contraceptive pills with oestrogens are contraindicated
- D. Dislocation of lens is a feature
Correct Answer: D
Rationale: Dislocation of the lens is a well-documented feature of homocystinuria due to the accumulation of homocysteine, which affects connective tissue.
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A client with a liver abscess undergoes surgical evacuation and drainage of the abscess. Which laboratory value is most important for the nurse to monitor following the procedure?
- A. Serum creatinine
- B. Blood urea nitrogen (BUN)
- C. White blood cell count
- D. Serum glucose
Correct Answer: C
Rationale: Monitoring WBC is essential to assess for infection or signs of abscess recurrence after the procedure.
The nurse is preparing a client for discharge who was recently diagnosed with Addison's disease. Which instruction is most important for the nurse to include in the client's discharge teaching plan?
- A. Use a walker when weakness occurs
- B. Avoid extreme environmental temperatures
- C. Increase daily intake of sodium in diet
- D. Take prescribed cortisone accurately
Correct Answer: D
Rationale: Taking prescribed cortisone accurately is crucial for managing Addison's disease and preventing an adrenal crisis.
The following investigations are not needed in a 3-year old on TPN for the past 3 weeks:
- A. Serum selenium
- B. Serum manganese
- C. Serum iron
- D. Serum calcium
Correct Answer: C
Rationale: The correct answer is C because serum iron is not typically monitored in children on total parenteral nutrition (TPN). The other options (a, b, d, e) are commonly monitored to prevent deficiencies or toxicities.
On examination, a nurse hears a murmur at the left sternal border (LSB) in a child with diarrhea and fever. The parent asks why the pediatrician never mentioned the murmur. The nurse explains:
- A. The pediatrician is not a cardiologist.
- B. Murmurs are difficult to detect, especially in children.
- C. The fever increased the intensity of the murmur.
- D. We need to refer the child to an interventional cardiologist.
Correct Answer: C
Rationale: The increased cardiac output associated with fever can accentuate a heart murmur, making it more noticeable.
Which occurs in septic shock?
- A. Hypothermia
- B. Increased cardiac output
- C. Vasoconstriction
- D. Angioneurotic edema
Correct Answer: B
Rationale: Increased cardiac output, which results in warm, flushed skin, is one of the manifestations of septic shock. Fever and chills are characteristic of septic shock. Vasodilation is more common than vasoconstriction. Angioneurotic edema occurs as a manifestation in anaphylactic shock.