Nokea
The nurse is caring for a child with cystic fibrosis. Which intervention is most important when the child is hospitalized with a respiratory infection?
- A. Administer prescribed antibiotics as soon as possible.
- B. Increase fluid intake to help thin mucus.
- C. Provide respiratory treatments and postural drainage.
- D. Encourage high-calorie, high-protein meals.
Correct Answer: C
Rationale: Respiratory treatments and postural drainage are critical to help clear mucus from the lungs in children with cystic fibrosis, especially during respiratory infections.
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A 6-month-old presents with tachycardia, tachypnea, and poor feeding for 3 months. Physical examination reveals a continuous machinery murmur and a wide pulse pressure with a prominent apical impulse. The most likely diagnosis is
- A. pulmonic stenosis
- B. aortic stenosis
- C. ventricular septal defect
- D. patent ductus arteriosus
Correct Answer: D
Rationale: Patent ductus arteriosus causes a continuous machinery murmur and wide pulse pressure.
How would the nurse caring for an infant with congestive heart failure (CHF) modify feeding techniques to adapt for the child's weakness and fatigue? (Select all that apply.)
- A. Feeding more frequently with smaller feedings
- B. Using a soft nipple with enlarged holes
- C. Holding and cuddling the child during feeding
- D. Substituting glucose water for formula
Correct Answer: A
Rationale: Infants with CHF fatigue easily. Feeding can be given more frequently in smaller amounts through a soft, large-holed nipple. Formulas with a denser caloric content can be offered. The child may be encouraged to nurse if he or she is held.
Which of the following has the highest proportion of etiology of congenital malformations?
- A. Maternal infections
- B. Maternal illness
- C. Environmental agents
- D. Monogenic inheritance
Correct Answer: D
Rationale: Monogenic inheritance accounts for the highest proportion of congenital malformations.
The initial treatment of choice for a symptomatic patient with isolated pulmonic stenosis is
- A. closed surgical blade valvotomy
- B. open surgical valvotomy
- C. balloon catheter valvuloplasty
- D. Blalock-Taussig shunt
Correct Answer: C
Rationale: Balloon catheter valvuloplasty is less invasive and effective for relieving pulmonic stenosis.
Which high level labs should the nurse explain can prevent cardiovascular disease?
- A. Cholesterol
- B. Triglycerides
- C. Low-density lipoproteins (LDLs)
- D. High-density lipoproteins (HDLs)
Correct Answer: D
Rationale: HDLs contain very low concentrations of triglycerides, relatively little cholesterol, and high levels of proteins. It is thought that HDLs protect against cardiovascular disease. Cholesterol, triglycerides, and LDLs are not protective against cardiovascular disease.