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 is a combination of four structural defects in the heart. These include pulmonic stenosis (narrowing of the pulmonary valve or artery), ventricular septal defect (hole in the wall that separates the two lower chambers of the heart), overriding aorta (aorta positioned directly over the ventricular septal defect), and right ventricular hypertrophy (enlargement of the right ventricle due to increased workload). Therefore, the correct combination of defects that constitute tetralogy of Fallot is pulmonic stenosis, ventricular septal defect, overriding aorta, and right ventricular hypertrophy, which is option A.
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Small round blue cell tumors refer to all the following EXCEPT
- A. non-Hodgkin lymphoma
- B. osteosarcoma
- C. Ewing sarcoma
- D. rhabdomyosarcoma
Correct Answer: B
Rationale: Osteosarcoma does not typically fall under the category of small round blue cell tumors.
In a client who has human immunodeficiency virus (HIV) infection, CD4+ levels are measured to determine the:
- A. Presence of opportunistic infections
- B. Extent of immune system damage
- C. Level of the viral load
- D. Resistance to antigens
Correct Answer: B
Rationale: CD4+ T cells are a type of white blood cell that plays an essential role in coordinating the immune system's response to infections. In individuals with HIV infection, the virus specifically targets and destroys CD4+ T cells. Therefore, measuring CD4+ levels provides valuable information about the extent of damage to the immune system caused by HIV. Monitoring CD4+ levels helps in assessing the progression of the disease and determining when to initiate antiretroviral therapy to prevent opportunistic infections. Additionally, CD4+ levels are used to determine the prognosis and guide treatment decisions in individuals with HIV.
A 2-year-old male child has an asymptomatic right flank mass discovered incidentally by the mother while bathing. Suspicion of Wilms tumor is raised. Of the following, the LEAST likely investigation to be performed in this child is
- A. plain abdominal radiography
- B. computerized tomography (CT) scan of the abdomen
- C. CT scan of the chest
- D. biopsy of the mass
Correct Answer: D
Rationale: Biopsy is generally avoided in suspected Wilms tumor to prevent upstaging the disease.
The clue to need help by age of 24 months, if the child
- A. speech is not understood by familiar listeners
- B. speech is not understood by unfamiliar listeners
- C. has not begun to ask questions (using where, what, why)
- D. is not using short sentences (e.g., 'Daddy went bye-bye')
Correct Answer: D
Rationale: By 24 months, children should begin using short sentences.
A client has an abnormal result on a Papanicolaou test. After admitting that she read her chart while the nurse was out of the room, the client asks what dysplasia means. Which definition should the nurse provide?
- A. Presence of completely undifferentiated tumor cells that don't resemble cells of the tissues of their origin
- B. Increase in the number of normal cells in a normal arrangement in a tissue or an organ
- C. Replacement of one type of fully differentiated cell by another in tissues where the second type normally isn't found
- D. Alteration in the size, shape, and organization of differentiated cells
Correct Answer: D
Rationale: Dysplasia refers to an alteration in the size, shape, and organization of differentiated cells. It indicates abnormal changes in the cells that can be a precursor to cancer. In the context of a Papanicolaou test, the presence of dysplasia may suggest abnormal cell growth in the cervix, which can potentially develop into cervical cancer if left untreated. It is important for the client to follow up with healthcare providers for further evaluation and management if dysplasia is detected.