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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Causes of a dilated renal pelvis in a foetal scan include:
- A. Normal variant
- B. Vesico-ureteric reflux
- C. Pelvi-ureteric junction obstruction
- D. Multicystic kidney
Correct Answer: A
Rationale: A dilated renal pelvis can be a normal variant in a foetal scan, often resolving spontaneously without intervention.
A client with stage IV bone cancer is admitted to the hospital for pain control. The client verbalizes continuous, severe pain of 8 on a 1 to 10 scale. Which intervention should the nurse implement?
- A. Administer opioid and non-opioid medication simultaneously
- B. Administer only opioid medication as prescribed.
- C. Encourage the client to practice relaxation techniques
- D. Delay medication administration until reassessment.
Correct Answer: A
Rationale: Combining opioid and non-opioid medications provides more effective pain relief for severe cancer-related pain.
The nurse reviews the laboratory results of a client during an annual physical examination and identifies a positive guaiac test of stool. Which additional serum laboratory test result should the nurse review?
- A. Glucose
- B. Platelet count
- C. White blood cell count
- D. Amylase
Correct Answer: B
Rationale: A positive guaiac test indicates gastrointestinal bleeding. A platelet count is essential to assess for thrombocytopenia, which could contribute to bleeding.
These causes often cause secretory diarrhoea except:
- A. Lactose intolerance
- B. E. coli infection
- C. Congenital chloridorrhoea
- D. Blind loop syndrome
Correct Answer: A
Rationale: The correct answer is A because lactose intolerance causes osmotic diarrhoea, not secretory diarrhoea. The other options (b-e) are causes of secretory diarrhoea.
Avascular necrosis of the femoral head is associated with:
- A. Sickle cell trait
- B. Nephrotic syndrome
- C. Cushing's syndrome
- D. Hypothyroidism
Correct Answer: C
Rationale: Cushing's syndrome is associated with avascular necrosis due to steroid use. Sickle cell trait, nephrotic syndrome, and hypothyroidism are not directly linked.