Nokea
The parents of a 3-month-old ask why their baby will not have an operation to correct a ventricular septal defect (VSD). The nurse's best response is:
- A. It is always helpful to get a second opinion about any serious condition like this.
- B. Your baby's defect is small and will likely close on its own by 1 year of age.
- C. It is common for physicians to wait until an infant develops respiratory distress before they do the surgery.
- D. With a small defect like this, they wait until the child is 10 years old to do the surgery.
Correct Answer: B
Rationale: Most small VSDs close spontaneously within the first year of life.
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Displacement of apex to anterior axillary line
- A. TOF
- B. Truncus arteriosus
- C. Hypoplastic left heart syndrome
- D. TAPVD
Correct Answer: B
Rationale: Truncus arteriosus typically shows displacement of the apex to the anterior axillary line.
Regarding idiopathic thrombocytopenic purpura (ITP):
- A. The more severe the disease
- B. the faster is the recovery to therapy
- C. Alloimmunisation occurs due to fetomaternal incompatibility
- D. Splenomegaly is a recognised feature
Correct Answer: C
Rationale: ITP is characterized by low platelet counts due to immune-mediated destruction. Splenomegaly is a recognized feature but the other options are incorrect. Recovery is not necessarily faster with more severe disease alloimmunisation is not a feature of ITP and not all children with platelet counts below 50 000 require hospitalization. IV immunoglobulin is not indicated in all cases.
A client with Guillain-Barre syndrome has paralysis of all extremities and requires mechanical ventilation. The nurse observes that the client is not blinking. Which action should the nurse implement?
- A. Protect cornea with lubricant and eye shields
- B. Administer artificial tears every hour.
- C. Encourage the client to blink every 10 minutes.
- D. Keep the client's eyes closed with adhesive tape.
Correct Answer: A
Rationale: Lack of blinking increases the risk of corneal damage. Lubricants and eye shields prevent dryness and injury to the cornea.
A male client with bilateral carpal tunnel syndrome reports to the nurse that the pain and tingling he is experiencing worsens at night. What client teaching should the nurse provide?
- A. Elevate the hands on two pillows at night
- B. Notify the healthcare provider as soon as possible
- C. Wear braces as both wrists during the night
- D. Apply cold compresses for 30 minutes before bedtime
Correct Answer: C
Rationale: Wearing wrist braces during the night helps prevent exacerbation of carpal tunnel syndrome symptoms.
Which assessment indicates that the parent of a 7-year-old is following the prescribed treatment for congestive heart failure (CHF)?
- A. HR of 56 beats per minute
- B. Elevated red blood cell count
- C. 50th percentile height and weight for age
- D. Urine output of 0.5 cc/kg/hr
Correct Answer: C
Rationale: Normal growth (50th percentile) indicates good nutrition and overall health, suggesting that CHF is well controlled.