Nokea
Regarding the genetics of CF:
- A. The commonest mutation in Caucasians is the ~F-580
- B. The affected protein is a transmembrane Na channel
- C. Accurate prenatal diagnosis is possible in all cases
- D. There are less than 10 mutations causing disease
Correct Answer: B
Rationale: the affected protein in cystic fibrosis (CF) is the cystic fibrosis transmembrane conductance regulator (CFTR), which is a chloride channel, not a sodium channel. The other options are incorrect: (a) The commonest mutation in Caucasians is ΔF508, not ~F-580. (b) Parents of an affected child are typically carriers and do not show symptoms. (c) Prenatal diagnosis is not possible in all cases due to the vast number of mutations. (d) There are over 2000 known mutations causing CF.
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The nurse reviews the laboratory results for a child with a suspected diagnosis of rheumatic fever. The nurse knows that which laboratory study would assist in confirming the diagnosis?
- A. Immunoglobulin
- B. Red blood cell count
- C. White blood cell count
- D. Anti-streptolysin O titer
Correct Answer: D
Rationale: The Anti-streptolysin O titer is used to confirm a diagnosis of rheumatic fever as it indicates a recent streptococcal infection, which is a precursor to rheumatic fever.
A patient with no structural heart disease: a wide QRS tachycardia of RBBB morphology at a rate of 160 bpm, QRS axis of (-) 40 degrees and AV dissociation was recorded during palpitation. What is the likely diagnosis?
- A. RV outflow ventricular tachycardia
- B. Posterior fascicular VT
- C. Anterior fascicular VT
- D. Antidromic AVRT
Correct Answer: A
Rationale: RV outflow ventricular tachycardia is the likely diagnosis given the RBBB morphology and QRS axis.
A male client with chronic kidney disease (CKD) is beginning his first hemodialysis 3 times per week. Which short-term goal is most important for the nurse to include in the plan of care for this client as he begins the series?
- A. Reports subjective symptoms during hemodialysis
- B. Documents his oral intake during dialysis treatments
- C. Demonstrates self-care of the arteriovenous (AV) Shunt
- D. Verbalizes understanding of the reasoning for dialysis
Correct Answer: D
Rationale: Verbalizing understanding is the most important short-term goal for the client beginning dialysis.
Ejection systolic murmur in outflow in a neonate is least likely to be due to
- A. Subaortic membrane
- B. Unicuspid aortic valve
- C. Bicuspid aortic valve
- D. Pulmonary stenosis
Correct Answer: A
Rationale: Subaortic membrane is least likely to cause an ejection systolic murmur in a neonate.
During a paracentesis, two liters of fluid are removed from the abdomen of a client with ascites. A drainage bag is placed, and 50 ml of clear, straw-colored fluid drains within the first hour. What action should the nurse implement?
- A. Palpate for abdominal distention
- B. Send fluid to the lab for analysis
- C. Continue to monitor the fluid output
- D. Clamp the drainage tube for 5 minutes
Correct Answer: C
Rationale: Monitoring fluid output is essential to assess for complications such as reaccumulation of fluid or bleeding.