Nokea
Paroxysmal hypercyanotic attacks (hypoxic, blue, or tet spells) are a particular problem during the lst 2 yr of life. They are characterized by
- A. early evening occurrence
- B. an increase in intensity of the systolic murmur
- C. unpredictable onset
- D. metabolic alkalosis
Correct Answer: A
Rationale: Unpredictable onset and metabolic alkalosis are common features of tet spells.
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The following are causes of congestive heart failure and cardiomegaly during the newborn period but no murmur EXCEPT
- A. endocardial fibroelastosis
- B. asphyxia
- C. glycogen storage disease (Pompe disease)
- D. sepsis
Correct Answer: D
Rationale: Sepsis can cause heart failure and cardiomegaly but often presents with other systemic signs.
A 2-year-old child is being treated for lead poisoning. Which of the following findings indicates the need for further intervention?
- A. Increased urine output
- B. Decreased hemoglobin levels
- C. Weight gain
- D. Improved developmental milestones
Correct Answer: B
Rationale: Lead poisoning can cause anemia, so a decrease in hemoglobin levels would indicate that further intervention is necessary.
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.
A nurse assesses a client who is recovering from a myocardial infarction. The client’s pulmonary artery pressure reading is 25/12 mm Hg. Which action should the nurse take first?
- A. Compare the results with previous pulmonary artery pressure readings.
- B. Increase the intravenous fluid rate because these readings are low.
- C. Immediately notify the health care provider of the elevated pressures.
- D. Document the finding in the client’s chart as the only action.
Correct Answer: A
Rationale: Comparing the current pulmonary artery pressure readings with previous ones helps determine if the values are stable or changing, which guides further intervention.
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.