Nokea
The primary care pediatric nurse practitioner is performing a well child examination on a school-age child who had complete repair of a tetralogy of Fallot (TOF) defect in infancy. What is important in this child's health maintenance regime?
- A. Cardiology clearance for sports participation
- B. Restriction of physical activity to avoid pulmonary complications
- C. Sub-acute bacterial endocarditis prophylaxis precautions
- D. Teaching about management of hypercyanotic episodes
Correct Answer: A
Rationale: Children who have had TOF repair must be cleared by cardiology before participation in sports.
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A client with carcinoma of the lung is complaining of weakness and has a serum sodium level of 117 mEq/L. Which nursing problem should the nurse include in this client's plan of care?
- A. Altered urinary elimination
- B. Impaired gas exchange
- C. Fluid volume excess
- D. Decreased cardiac output
Correct Answer: C
Rationale: Hyponatremia (low sodium level) is often associated with fluid volume excess in clients with lung carcinoma.
Complement C3 levels are decreased in:
- A. Systemic lupus erythematoses
- B. Henoch-Schoenlein purpura
- C. Haemolytic uraemic syndrome
- D. Type II membrano-proliferative glomerulonephritis
Correct Answer: A
Rationale: Decreased C3 levels are characteristic of systemic lupus erythematosus due to immune complex deposition and complement consumption.
All of the following reduces intensity of first heart sound (S1) except
- A. Mechanical ventilation
- B. Calcific mitral stenosis
- C. Short PR interval
- D. LV dysfunction
Correct Answer: B
Rationale: Calcific mitral stenosis typically increases the intensity of the first heart sound (S1).
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.
The child becomes unresponsive. The most likely underlying lesion is
- A. cardiomyopathy
- B. anomalous coronary artery
- C. tetralogy of Fallot
- D. constipation
Correct Answer: C
Rationale: Tetralogy of Fallot can cause hypoxic spells leading to unresponsiveness.