Nokea
Three days after a female client with multiple sclerosis (MS) is admitted to the hospital with a severe urinary tract infection, she reports experiencing double vision. Which intervention should the nurse implement?
- A. Patch one eye and then the other every few hours
- B. Encourage bedrest until the diplopia is resolved
- C. Instruct the client to limit intake of oral fluids
- D. Administer artificial tear drops to both eyes
Correct Answer: A
Rationale: Patching each eye helps alleviate double vision caused by MS-related vision impairment.
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A child with rheumatic fever begins involuntary, purposeless movements of her limbs. What does the nurse recognize that this indicates?
- A. Seizure activity
- B. Hypoxia
- C. Sydenham’s chorea
- D. Decreasing level of consciousness
Correct Answer: C
Rationale: As the effects of rheumatic fever affect the central nervous system, the child may develop Sydenham’s chorea, manifested by involuntary, purposeless movements of the limbs.
Causes of hypertension in a child include:
- A. Long-standing vesico-ureteric reflux
- B. Cushing's syndrome
- C. Addison's disease
- D. Turner's syndrome
Correct Answer: B
Rationale: Cushing's syndrome, characterized by excessive cortisol levels, is a known cause of secondary hypertension in children.
Which explanation regarding cardiac catheterization is appropriate for a preschool child?
- A. Postural drainage will be performed every 4 to 6 hours after the test.
- B. It is necessary to be completely “asleep†during the test.
- C. The test is short, usually taking less than 1 hour.
- D. When the procedure is done, you will have to keep your leg straight for at least 4 hours.
Correct Answer: D
Rationale: The child’s leg will have to be maintained in a straight position for approximately 4 hours. Younger children can be held in the parent’s lap with the leg maintained in the correct position. Postural drainage will not be performed unless the child has corresponding pulmonary problems. The child should be sedated to lie still, but being completely asleep is not necessary. The test will vary in length of time from start to finish.
A nurse assesses clients on a medical-surgical unit. Which client should the nurse identify as having the greatest risk for cardiovascular disease?
- A. An 86-year-old man with a history of asthma
- B. A 32-year-old Asian-American man with colorectal cancer
- C. A 45-year-old American Indian woman with diabetes mellitus
- D. A 53-year-old postmenopausal woman who is on hormone therapy
Correct Answer: C
Rationale: Diabetes mellitus is a significant risk factor for cardiovascular disease, and the 45-year-old American Indian woman with diabetes mellitus has the highest risk among the options provided.
In urgent situations of supraventricular tachycardia (SVT) when symptoms of severe heart failure have already occurred, the initial management is
- A. adenosine by rapid intravenous push
- B. DC cardioversion
- C. verapamil
- D. digoxin
Correct Answer: B
Rationale: DC cardioversion is the preferred initial management in hemodynamically unstable SVT.