Nokea
The nurse provides home care instructions to the parents of a child with heart failure regarding the procedure for administration of digoxin (Lanoxin). Which statement by the parent indicates a need for further instruction?
- A. “If my child vomits after the medication administration, I will repeat the dose.â€
- B. “I will not mix the medication with food.â€
- C. “I will take my child’s pulse before administering the medication.â€
- D. “If more than one dose is missed, I will call the provider.â€
Correct Answer: A
Rationale: Repeating the dose after vomiting can lead to digoxin toxicity, which is dangerous. The parent should be instructed to contact the healthcare provider if vomiting occurs after administration.
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A client with unstable asthma had an emergent cardiac catheterization. Which complication should the nurse monitor for in the initial 24 hours after the procedure?
- A. Thrombus formation
- B. Infection
- C. Bronchospasm
- D. Heart failure
Correct Answer: A
Rationale: After a cardiac catheterization, the nurse must monitor for thrombus formation as it is a common complication in the first 24 hours.
Indications for surgical closure of a VSD include the following EXCEPT
- A. patients who cannot thrive
- B. patients whose symptoms cannot be controlled between 6 and 24 months
- C. patients with pulmonary vascular disease
- D. patients older than 2 years with a large VSD associated with a Qs ratio greater than 2:1
Correct Answer: C
Rationale: Surgical closure is not routinely indicated for all VSDs, especially if asymptomatic.
Rett syndrome is characterised by:
- A. Social withdrawal
- B. Self-mutilation
- C. Macrocephaly
- D. Wringing hand movements
Correct Answer: D
Rationale: Wringing hand movements are a hallmark feature of Rett syndrome, a neurodevelopmental disorder primarily affecting females.
A client with acquired immunodeficiency syndrome (AIDS) has impaired gas exchange from a respiratory infection. Which assessment finding warrants immediate intervention by the nurse?
- A. Elevated temperature
- B. Generalized weakness
- C. Diminished lung sounds
- D. Pain when swallowing
Correct Answer: D
Rationale: Pain when swallowing could indicate an opportunistic infection such as candidiasis, which requires prompt treatment.
Mechanisms of dyspnea in left heart disease include all, except
- A. PVH and decreased lung compliance
- B. Respiratory muscle fatigue
- C. Elevated LV End diastolic pressure leads to decreased antegrade coronary blood flow
- D. Reverse 'Bernheim' effect
Correct Answer: C
Rationale: Elevated LV end-diastolic pressure does not typically lead to decreased antegrade coronary blood flow.