Nokea
The nurse is conducting a staff in-service on congenital heart defects. Which structural defect constitutes tetralogy of Fallot?
- A. Pulmonic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy
- B. Aortic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy
- C. Aortic stenosis, atrial septal defect, overriding aorta, left ventricular hypertrophy
- D. Pulmonic stenosis, ventricular septal defect, aortic hypertrophy, left ventricular hypertrophy
Correct Answer: A
Rationale: Tetralogy of Fallot has these four characteristics: pulmonic stenosis, ventricular septal defect, overriding aorta, and right ventricular hypertrophy. There is pulmonic stenosis but not atrial stenosis in tetralogy of Fallot. Right ventricular hypertrophy, not left ventricular hypertrophy, is present in tetralogy of Fallot. Tetralogy of Fallot has right ventricular hypertrophy, not left ventricular hypertrophy, and an atrial septal defect, not aortic hypertrophy.
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Acute laryngotracheobronchitis in children:
- A. Needs to be treated by broad-spectrum antibiotics
- B. Humidified oxygen by tent needs to be administered in infancy
- C. Dexamethasone is known to shorten the duration of illness
- D. Adrenaline by nebuliser is absolutely contraindicated
Correct Answer: C
Rationale: Dexamethasone, a corticosteroid, is known to reduce inflammation and shorten the duration of illness in acute laryngotracheobronchitis (croup).
An 18-month-old with a myelomeningocele is undergoing a cardiac catheterization. The mother expresses concern about the use of dye in the procedure. The child does not have any allergies. In addition to an iodine allergy, which other allergy should the nurse bring to the attention of the catheterization staff?
- A. Soy
- B. Latex
- C. Penicillin
- D. Dairy
Correct Answer: B
Rationale: Children with spina bifida (myelomeningocele) are often allergic to latex; catheter balloons and other materials may contain latex.
A client who took a camping vacation two weeks ago in a county with a tropical climate comes to the clinic describing vague symptoms and diarrhea for the past week. Which finding is most important for the nurse report to the healthcare provider?
- A. Weakness and fatigue
- B. Intestinal cramping
- C. Weight loss
- D. Jaundiced sclera
Correct Answer: D
Rationale: Jaundiced sclera indicates possible liver involvement, which could be due to a tropical disease such as hepatitis or leptospirosis.
During a home visit, the nurse assesses the skin of a client with eczema who reports that an exacerbation of symptoms has occurred during the last week. Which information is most useful in determining the possible cause of the symptoms?
- A. An old friend with eczema came for a visit
- B. Recently received an influenza immunization
- C. A grandson and his new dog recently visited
- D. Corticosteroid cream was applied to eczema
Correct Answer: C
Rationale: Exposure to new allergens, such as a pet, can trigger eczema flare-ups.
A client tells the nurse that her biopsy results indicate that the cancer cells are well-differentiated. How should the nurse respond?
- A. Ask the client if the healthcare provider has given her any information about the classification of her cancer
- B. Tell the client that well-differentiated cancer cells usually have a poor prognosis.
- C. Reassure the client that the cancer is not serious.
- D. Encourage the client to seek a second opinion for confirmation of the diagnosis.
Correct Answer: A
Rationale: Well-differentiated cancer cells typically indicate a slower-growing tumor. Clarifying the client's understanding ensures accurate communication and emotional support.