Nokea
The procedure that has to be performed in order to shift thehigh pressure from the right ventricle to the left ventricle in Transposition of the Great Arteries (TGA) is:
- A. Rashkind Procedure
- B. Rastelli Procedure
- C. Pulmonary Artery Banding
- D. Jatene Procedure
Correct Answer: D
Rationale: The Jatene procedure is a surgical technique used to correct Transposition of the Great Arteries (TGA). In this procedure, the great arteries (aorta and pulmonary artery) are switched back to their correct positions. The aorta is connected to the left ventricle, and the pulmonary artery is connected to the right ventricle. This correction allows for oxygen-rich blood to flow from the left side of the heart to the body, and oxygen-poor blood to flow from the right side of the heart to the lungs for oxygenation. The Jatene procedure is preferred over other methods like the Rashkind procedure, Rastelli procedure, or pulmonary artery banding for this specific purpose of correcting the high-pressure circulation seen in TGA.
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A client with human immunodeficiency virus (HIV) undergoes intradermal anergy testing using Candida and mumps antigen. During the 3 days following the tests, there is no induration or evidence of reaction at the intradermal injection sites. The most accurate conclusion the nurse can make is:
- A. The client has no previous exposure to the antigens injected
- B. The results demonstrate the client has antibodies to the antigens
- C. The client is immunodeficient and won't have a skin response
- D. The client isn't allergic to the antigens and therefore doesn't react
Correct Answer: C
Rationale: A client with HIV undergoing intradermal anergy testing with Candida and mumps antigens is suspected to be immunodeficient, making them unable to mount a normal skin response to these antigens. In an immunodeficient individual, the immune system is weakened, leading to a lack of response when exposed to these antigens. A lack of induration or reaction in the 3 days following the test suggests that the client's immune system is not able to mount a normal response, indicating immunodeficiency. The absence of a reaction does not necessarily indicate lack of exposure (Option A), presence of antibodies (Option B), or the absence of allergies (Option D), but rather points to a compromised immune system in an individual with HIV.
A client is being treated for acute pyelonephritis and will undergo laboratory tests. These tests are expected to help determine the clients BUN, creatinine, and serum electrolyte levels. Why should the nurse evaluate these test results?
- A. To determine the severity of the disorder
- B. To identify signs of fluid retention
- C. To determine the location of discomfort
- D. To determine clients response to therapy
Correct Answer: A
Rationale: Evaluating the client's BUN, creatinine, and serum electrolyte levels when being treated for acute pyelonephritis is crucial in determining the severity of the disorder. BUN and creatinine levels are indicators of renal function, where elevated levels may suggest impaired kidney function due to inflammation in the kidneys from pyelonephritis. Abnormal electrolyte levels, such as potassium and sodium, may also reflect the impact of the infection on renal function. Therefore, monitoring these test results helps healthcare providers assess how well the kidneys are functioning and the severity of the pyelonephritis to guide appropriate treatment decisions.
The nurse has just started assessing a young child who is febrile and appears very ill. There is hyperextension of the child's head (opisthotonos) with pain on flexion. Which is the most appropriate action?
- A. Refer for immediate medical evaluation.
- B. Continue assessment to determine cause of neck pain.
- C. Ask parent when neck was injured.
- D. Record "head lag" on assessment record, and continue assessment of child.
Correct Answer: A
Rationale: Referring the child for immediate medical evaluation is the most appropriate action in this scenario. The symptoms described, including hyperextension of the head (opisthotonos) with pain on flexion, are concerning for meningitis, a serious infection that can rapidly progress and lead to serious complications if not treated promptly. Seeking immediate medical intervention is crucial to assess and manage the child's condition effectively. Continuing with the assessment or asking about a neck injury is not recommended as the priority is to address the potential medical emergency. Recording the "head lag" without taking immediate action could delay necessary medical treatment.
A patient who was walking in the woods disturbed a beehive, was stung, and was taken to the emergency department immediately due to allergies to bee stings. Which of the ff. symptoms would the nurse expect to see upon admission of this patient? i.Pallor around the sting bites iv. Retinal hemorrhage ii.Numbness and tingling in the extremities v. Tachycardia iii.Respiratory stridor vi. Dyspnea
- A. 1, 2, 2004
- B. 3, 5, 2006
- C. 2, 3, 2004
- D. 4, 5, 2006
Correct Answer: B
Rationale: The nurse would expect to see respiratory stridor (iii), tachycardia (v), and dyspnea (vi) upon admission of the patient who was stung by a bee, particularly if the patient has allergies to bee stings. These symptoms are indicative of an allergic reaction, which can progress to anaphylaxis in severe cases. Symptoms such as pallor around the sting bites (i), retinal hemorrhage (iv), and numbness and tingling in the extremities (ii) are not typically associated with an allergic reaction to a bee sting.
Obstruction of the airway in the patient with asthma is caused by all of the following except:
- A. thick mucus.
- B. swelling of bronchial membranes.
- C. destruction of the alveolar wall.
- D. contraction of muscles surrounding the bronchi
Correct Answer: C
Rationale: Obstruction of the airway in a patient with asthma is primarily caused by inflammation and narrowing of the airways due to a combination of factors such as thick mucus, swelling of bronchial membranes, and contraction of muscles surrounding the bronchi. Destruction of the alveolar wall is not a direct cause of airway obstruction in asthma patients; alveolar wall destruction is typically associated with conditions like emphysema. In asthma, the primary mechanisms contributing to airway obstruction are related to inflammation, mucus production, and bronchoconstriction.