Nokea
One of the following is a characteristic physical finding in patients with an ASD
- A. a right precordial bulge
- B. a fixed splitting of the second heart sound
- C. a systolic ejection heart murmur
- D. a short, mild left mid-diastolic murmur
Correct Answer: B
Rationale: Fixed splitting of the second heart sound is a hallmark of an atrial septal defect.
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An 8-year-old from the former Soviet Union is brought to your office because of a heart murmur and dusty blue skin. He has marked clubbing of his fingers and toes, and his hematocrit is 70%. He has a grade 4/6 holosystolic murmur. His chest x-ray reveals a normal pulmonary blood flow as well as a right-sided aortic arch. What is the likely diagnosis?
- A. total anomalous venous return
- B. tetralogy of Fallot
- C. Eisenmenger syndrome
- D. transposition of the great vessels
Correct Answer: C
Rationale: Eisenmenger syndrome involves reversal of shunt direction due to long-standing pulmonary hypertension, explaining the cyanosis and clubbing.
Possible causes of upper airway obstruction are:
- A. Inhaled foreign body in the main bronchus on the right side
- B. Epiglottitis
- C. Retropharyngeal abscess
- D. Viral croup
Correct Answer: B
Rationale: Epiglottitis is a serious condition that can cause acute upper airway obstruction due to swelling of the epiglottis.
An adult male client is admitted for Pneumocystis carinii pneumonia (PCP) secondary to AIDS. While hospitalized, he receives IV pentamidine isethionate therapy. In preparing this client for discharge, what important aspect regarding his medication therapy should the nurse explain?
- A. IV pentamidine may offer protection to other AIDS-related conditions, such as Kaposi's sarcoma
- B. It will be necessary to continue prophylactic doses of IV or aerosol pentamidine every month
- C. IV pentamidine will be given until oral pentamidine can be tolerated
- D. AZT (Azidothymidine) therapy must be stopped when IV or aerosol pentamidine is being used.
Correct Answer: B
Rationale: Prophylactic doses of pentamidine are necessary to prevent PCP recurrence and other AIDS-related infections.
A client with acute renal injury (AKI) who weighs 50 kg and has a potassium level of 6.7 mEq/L (6.7 mmol/l) is admitted to the hospital. Which prescribed medication should the nurse administer first?
- A. Sevelamer (RenaGel) one tablet PO.
- B. Epoetin alfa, recombinant (Epogen) 2,500 units SUBQ
- C. Sodium polystyrene (Kayexalate) 15 grams PO
- D. Calcium acetate (Phos-Lo) one tablet PO
Correct Answer: C
Rationale: Sodium polystyrene (Kayexalate) helps remove excess potassium, which is the priority concern in AKI with elevated potassium.
Pulmonary hypotension in a neonate associate with
- A. Diaphragmatic hernia
- B. Oxygen therapy
- C. Meconium aspiration
- D. Pneumothrax
Correct Answer: A
Rationale: Diaphragmatic hernia can lead to decreased lung expansion and pulmonary hypotension.