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.
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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.
Shone complex consist of the following EXCEPT
- A. coarctation of the aorta
- B. subvalvar aortic stenosis
- C. valvar aortic stenosis
- D. pulmonic stenosis
Correct Answer: D
Rationale: Pulmonic stenosis is not part of Shone complex.
The wife of a client with Parkinson's disease expresses concern because her husband has lost so much weight. Which teaching is best for the nurse to provide?
- A. Invite friends over regularly to share in meal times
- B. Encourage the client to drink clear liquids between meals
- C. Coach the client to make an intentional effort to swallow
- D. Talk to the healthcare provider about prescribing an appetite stimulant
Correct Answer: A
Rationale: Social interaction during meals can improve appetite and intake in clients with Parkinson's disease.
The aminoacid used in the treatment of hyperammonemia due to certain urea cycle disorders is
- A. Leucine
- B. Valine
- C. Arginine
- D. Isoleucine
Correct Answer: C
Rationale: Arginine is used in the treatment of hyperammonemia due to urea cycle disorders, as it helps in the detoxification of ammonia.
The most common cardiac anomaly associated with Coarctation of aorta is
- A. Bicuspid aortic valve
- B. Subaortic ventricular septal defect
- C. Atrial septal defect
- D. Supramitral ring
Correct Answer: A
Rationale: Bicuspid aortic valve is the most common cardiac anomaly associated with coarctation of the aorta.