Nokea
Systolic murmur in which among the following conditions does not increase in intensity in the cardiac cycle after a premature ventricular contraction?
- A. Valvular aortic stenosis
- B. Hypertrophic obstructive cardiomyopathy
- C. Valvular pulmonic stenosis
- D. Mitral valve prolapse
Correct Answer: D
Rationale: Mitral valve prolapse does not typically increase in intensity after a premature ventricular contraction.
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Obstructed total anomalous pulmonary venous return (TAPVR) is a pediatric surgical emergency because
- A. therapy is usually not effective
- B. severe pulmonary congestion
- C. left atrium may be small
- D. left ventricle may be small
Correct Answer: B
Rationale: Obstructed TAPVR requires immediate surgical intervention due to severe pulmonary congestion.
Elevated levels of CPK are seen in:
- A. Duchenne muscular dystrophy
- B. Dermatomyositis
- C. Spinal muscular atrophy
- D. Malignant hyperthermia
Correct Answer: A
Rationale: Duchenne muscular dystrophy: Elevated creatine phosphokinase (CPK) levels are a hallmark of Duchenne muscular dystrophy due to muscle damage and degeneration.
Which is an important nursing consideration when chest tubes will be removed from a child?
- A. Explain that it is not painful.
- B. Explain that only a Band-Aid will be needed.
- C. Administer analgesics before the procedure.
- D. Expect bright red drainage for several hours after removal.
Correct Answer: C
Rationale: It is appropriate to prepare the child for the removal of chest tubes with analgesics. Short-acting medications can be used that are administered through an existing IV line. A sharp, momentary pain is felt. This should not be misrepresented to the child. A petroleum gauze, air-tight dressing will be needed, but it is not a pain-free procedure. Little or no drainage should be found on removal.
When planning care for a client newly diagnosed with open angle glaucoma, the nurse identifies a priority nursing diagnosis of, 'visual sensory/perceptual alterations.' This diagnosis is based on which etiology?
- A. Limited eye movement
- B. Decreased peripheral vision
- C. Blurred distance vision
- D. Photosensitivity
Correct Answer: B
Rationale: Open angle glaucoma primarily affects peripheral vision, leading to visual sensory/perceptual alterations.
What is one reason why patients with CHD are more likely to have rejection post-transplant than those with cardiomyopathy?
- A. Sensitized recipients with panel reactive antibody (PRA)
- B. Absence of systemic disease
- C. History of good compliance
- D. None of the above
Correct Answer: A
Rationale: Patients with congenital heart disease (CHD) are often sensitized due to prior surgeries and blood transfusions, leading to a higher risk of rejection post-transplant.