Nokea
The following statements are true of bronchiolitis:
- A. Up to 50% of patients continue to wheeze after recovery
- B. The typical pathogen is para-influenza virus
- C. Corticosteroid therapy is beneficial
- D. Tachypnoea is invariable
Correct Answer: A
Rationale: Wheezing after bronchiolitis is common. The typical pathogen is respiratory syncytial virus, not para-influenza. Corticosteroids are not routinely beneficial, and tachypnoea is common but not invariable.
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Regarding hand innervation:
- A. Median nerve supplies all thenar muscles except adductor pollicis
- B. The sensory supply to the dorsal surface of the medial two digits is via the radial nerve
- C. In ulnar nerve damage at the elbow there is sensory loss over the medial aspect of forearm proximal to the wrist
- D. Radial nerve provides the sensory innervation to the terminal areas of the dorsal surfaces of the lateral three digits
Correct Answer: A
Rationale: The median nerve innervates most thenar muscles, except for the adductor pollicis, which is supplied by the ulnar nerve.
What does the surgical closure of the ductus arteriosus do?
- A. Stop the loss of unoxygenated blood to the systemic circulation
- B. Decrease the edema in legs and feet
- C. Increase the oxygenation of blood
- D. Prevent the return of oxygenated blood to the lungs
Correct Answer: D
Rationale: The ductus arteriosus allows blood to flow from the higher-pressure aorta to the lower-pressure pulmonary artery, causing a right-to-left shunt. If this is surgically closed, no additional oxygenated blood (from the aorta) will return to the lungs through the pulmonary artery. The aorta carries oxygenated blood to the systemic circulation. Because of the higher pressure in the aorta, blood is shunted into the pulmonary artery and the pulmonary circulation. Edema in the legs and feet is usually a sign of heart failure. This repair would not directly affect the edema. Increasing the oxygenation of blood would not interfere with the return of oxygenated blood to the lungs.
On examination, a nurse hears a murmur at the left sternal border (LSB) in a child with diarrhea and fever. The parent asks why the pediatrician never mentioned the murmur. The nurse explains:
- A. The pediatrician is not a cardiologist.
- B. Murmurs are difficult to detect, especially in children.
- C. The fever increased the intensity of the murmur.
- D. We need to refer the child to an interventional cardiologist.
Correct Answer: C
Rationale: The increased cardiac output associated with fever can accentuate a heart murmur, making it more noticeable.
Recognised features in Ehlers-Danlos syndrome include:
- A. Mutation in fibrillin gene
- B. Short stature
- C. Keratoconus
- D. Easy scarring
Correct Answer: D
Rationale: Easy scarring: Ehlers-Danlos syndrome is characterized by hyperelastic skin and joint hypermobility, with easy scarring and tissue fragility being common features.
The wife of a client with Parkinson's disease expresses concern because her husband has lost so much weight. Which teaching is best for the nurse to provide?
- A. Invite friends over regularly to share in meal times
- B. Encourage the client to drink clear liquids between meals
- C. Coach the client to make an intentional effort to swallow
- D. Talk to the healthcare provider about prescribing an appetite stimulant
Correct Answer: A
Rationale: Social interaction during meals can improve appetite and intake in clients with Parkinson's disease.