Nokea
Of the following, the MOST common clinical sign of coarctation of the aorta in older children is
- A. cardiac enlargement
- B. notching of the inferior border of the ribs
- C. a systolic ejection click or thrill in the suprasternal notch
- D. differential blood pressure: arms > legs
Correct Answer: B
Rationale: Notching of the ribs due to collateral circulation is a classic sign of coarctation of the aorta.
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Usual indications for an exchange transfusion in a child with sickle cell disease include:
- A. Painful vaso-occlusive crisis
- B. Splenic sequestration crisis
- C. Acute chest syndrome
- D. Dactylitis
Correct Answer: C
Rationale: Acute chest syndrome, a severe complication of sickle cell disease, often requires exchange transfusion to reduce the proportion of sickle hemoglobin and improve oxygenation.
In Wilson's disease:
- A. There is an association with high caeruloplasmin levels
- B. Hepatic copper deposition is pathognomonic
- C. There is increased urinary excretion of copper
- D. There are copper deposits on the cornea
Correct Answer: D
Rationale: Copper deposits on the cornea (Kayser-Fleischer rings) are a hallmark of Wilson's disease, a genetic disorder leading to copper accumulation in tissues.
A hospitalized client with chemotherapy-induced stomatitis complains of mouth pain. What is the best initial nursing action?
- A. Encourage frequent mouth care
- B. Cleanse the tongue and mouth with glycerin swabs
- C. Obtain a soft diet for the client
- D. Administer a topical analgesic per PRN protocol.
Correct Answer: D
Rationale: Administering a topical analgesic provides immediate pain relief, allowing the client to tolerate mouth care and other interventions.
Causes of uveitis include:
- A. Diabetes
- B. Behçet's disease
- C. Ankylosing spondylitis
- D. Rheumatic fever
Correct Answer: B
Rationale: Behçet's disease, a systemic vasculitis, is a known cause of uveitis, an inflammation of the uvea in the eye.
A 3-year-old child diagnosed with congestive heart failure is receiving maintenance doses of digoxin and furosemide (Lasix). She is rubbing her eyes when she is looking at the lights in the room and her heart rate is 65 beats per minute. The nurse expects which laboratory finding?
- A. Hypokalemia
- B. Hypomagnesemia
- C. Hypocalcemia
- D. Hypophosphatemia
Correct Answer: A
Rationale: Hypokalemia is a common side effect of furosemide, a diuretic, and can exacerbate digoxin toxicity, which may present with symptoms such as visual disturbances and bradycardia.