Prior to the patient being given medication, he becomes hypotensive, mottled, and cold. His heart rate is 240. The next therapeutic step should be
- A. digoxin
- B. synchronized DC cardioversion
- C. lidocaine
- D. defibrillation
Correct Answer: B
Rationale: Synchronized DC cardioversion is indicated for unstable tachycardia unresponsive to pharmacological agents.
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Which of the following is an example of ductus dependent systemic circulation?
- A. Severe Ebstein's anomaly
- B. Pulmonary atresia
- C. Tricuspid atresia
- D. Interruption of aortic arch
Correct Answer: D
Rationale: Interruption of aortic arch is ductus dependent as it relies on the ductus arteriosus for systemic blood flow.
Afterload reducers are not indicated in children with heart failure secondary to
- A. cardiomyopathy
- B. severe mitral insufficiency
- C. aortic stenosis
- D. ventricular septal defect
Correct Answer: C
Rationale: Afterload reducers are contraindicated in conditions where forward flow is already compromised, such as aortic stenosis.
The nurse is collecting information from a client with chronic pancreatitis who reports persistent gnawing abdominal pain. To help the client manage the pain, which assessment data is most important for the nurse to obtain?
- A. Eating patterns and dietary intake
- B. Level and amount of physical activity
- C. Color and consistency of feces
- D. Presence and activity of bowel sounds
Correct Answer: A
Rationale: Eating patterns can affect the pain and inflammation in chronic pancreatitis, making this data crucial.
Histochemical staining used for diagnosing Hirschsprung's disease is
- A. Acetyl choline esterase
- B. Dopamine
- C. Glutamate
- D. Chromogranin and synaptophysin
Correct Answer: A
Rationale: Acetylcholine esterase staining is used to diagnose Hirschsprung's disease by identifying the absence of ganglion cells.
Which of the following is least considered to be a normal variant in newborns?
- A. Milia
- B. Neonatal pustular melanosis
- C. Dermal melanocytosis
- D. Infantile acropustulosis
Correct Answer: D
Rationale: Infantile acropustulosis is not considered a normal variant in newborns; it is a rare condition characterized by recurrent pustular eruptions.
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