Nokea
Obstructed total anomalous pulmonary venous return (TAPVR) is a pediatric surgical emergency because
- A. therapy is usually not effective
- B. severe pulmonary congestion
- C. left atrium may be small
- D. left ventricle may be small
Correct Answer: B
Rationale: Obstructed TAPVR requires immediate surgical intervention due to severe pulmonary congestion.
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A toddler who has been hospitalized for vomiting due to gastroenteritis is sleeping and difficult to wake up. Assessment reveals: HR: 220 beats per minute (regular) Respiratory rate: 30 per minute BP: 84/52 Capillary refill: 3 seconds Which dysrhythmia does the nurse suspect in this child?
- A. Rapid pulmonary flutter
- B. Sinus bradycardia
- C. Rapid atrial fibrillation
- D. Supraventricular tachycardia (SVT)
Correct Answer: D
Rationale: SVT is typically above 200 beats per minute and can result from dehydration; the rapid rate causes low cardiac output (CO), resulting in low BP and prolonged capillary refill.
A male client with diabetes mellitus (DM) is transferred from the hospital to a rehabilitation facility following treatment for a stroke with resulting right hemiplegia. He tells the nurse that his feet are always uncomfortably cool at night, preventing him from falling asleep. Which action should the nurse implement.
- A. Provide a warming pad (Aqua-pad or K-pad) to feet
- B. Medicate the client with a prescribed sedative
- C. Use a bed cradle to hold the covers off the feet
- D. Place warm blankets next to the client's feet
Correct Answer: D
Rationale: Warm blankets can help improve circulation and provide comfort without the risk of burns associated with heating pads.
The best test to confirm the diagnosis of tuberculosis is:
- A. Chest X-ray
- B. Sputum culture
- C. Skin test
- D. Blood culture
Correct Answer: B
Rationale: Sputum culture is the gold standard for diagnosing tuberculosis, as it can identify Mycobacterium tuberculosis bacteria in a sample.
Common causes of jaundice in a 12-hour-old neonate include:
- A. Glucose-6-phosphate dehydrogenase deficiency
- B. Rhesus isoimmunisation
- C. Crigler-Najjar syndrome type II
- D. Choledochal cyst
Correct Answer: B
Rationale: Rhesus isoimmunisation can cause severe hemolysis in neonates, leading to early-onset jaundice within the first 12 hours of life.
Sheena, tells the nurse that she wants to begin toilet training her 22-month-old child. The most important factor for the nurse to stress to the mother is:
- A. Developmental readiness of the child
- B. Consistency in approach
- C. The mother’s positive attitude
- D. Developmental level of the child’s peers
Correct Answer: A
Rationale: Developmental readiness is crucial for successful toilet training, as forcing it before the child is ready can lead to resistance and setbacks.