Nokea
Indications for surgical closure of a VSD include the following EXCEPT
- A. patients who cannot thrive
- B. patients whose symptoms cannot be controlled between 6 and 24 months
- C. patients with pulmonary vascular disease
- D. patients older than 2 years with a large VSD associated with a Qs ratio greater than 2:1
Correct Answer: C
Rationale: Surgical closure is not routinely indicated for all VSDs, especially if asymptomatic.
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Regarding insulin administration in diabetics:
- A. Short-acting insulin reaches peak action in 4-6 hours after injection
- B. In a twice daily regimen involving Mixtard 30 or Humulin M3, the bedtime reading is an effect of the long-acting component
- C. A bedtime blood sugar level of 10 mmol/l is unacceptable
- D. Using the same site for injections is a common cause of increasing insulin dosage
Correct Answer: B
Rationale: The bedtime reading in a twice-daily regimen involving Mixtard 30 or Humulin M3 is influenced by the long-acting component, which has a prolonged effect.
Which is not useful to test brainstem death in suspected cervical spine injury?
- A. Pupillary light reflex
- B. Doll's-eyes reflex
- C. Corneal reflex
- D. Oculo-vestibular reflex
Correct Answer: B
Rationale: Doll's-eyes reflex is not used in suspected cervical spine injury due to the risk of further injury.
A client who is newly diagnosed with emphysema is being prepared for discharge. Which instruction is best for the nurse to provide the client to assist them with dyspnea self-management?
- A. Allow additional time to complete physical activities to reduce oxygen demand
- B. Practice inhaling through the nose and exhaling slowly through pursed lips
- C. Use a humidifier to increase home air quality humidity between 30-50%
- D. Strengthen abdominal muscles by alternating leg raises during exhalation
Correct Answer: B
Rationale: Pursed-lip breathing helps improve oxygenation and reduce dyspnea in clients with emphysema.
The following are transmitted as autosomal dominant traits:
- A. Congenital spherocytosis
- B. Vitamin D-resistant rickets
- C. CAH
- D. Hereditary haemorrhagic telangiectasia
Correct Answer: D
Rationale: Hereditary haemorrhagic telangiectasia is an autosomal dominant disorder. Congenital spherocytosis and Vitamin D-resistant rickets can also be autosomal dominant, but CAH (Congenital Adrenal Hyperplasia) is typically autosomal recessive.
All of the following are true regarding proximal renal tubular acidosis, except
- A. Growth failure in the first few years of life is a characteristic presentation
- B. Urine pH cannot be reduced to < 5.5
- C. It is usually a component of Fanconi syndrome
- D. Non-anion gap metabolic acidosis is common
Correct Answer: D
Rationale: Proximal renal tubular acidosis is associated with a normal anion gap metabolic acidosis, not a non-anion gap metabolic acidosis.