To reduce the risk for pulmonary complications for a client with Amyotrophic Lateral Sclerosis (ALS), what interventions should the nurse implement?
- A. Initiate passive range of motion exercises
- B. Establish a regular bladder routine
- C. Teach the client breathing exercises
- D. Perform chest physiotherapy
Correct Answer: C
Rationale: Breathing exercises, chest physiotherapy, and use of an incentive spirometer can help reduce the risk of pulmonary complications in ALS by improving lung function.
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Coarctation of aorta is:
- A. Commonly associated with Turner's syndrome
- B. Inherited as autosomal dominant
- C. Associated with intracranial aneurysms
- D. Excluded from the diagnosis in the presence of femoral pulses
Correct Answer: A
Rationale: Coarctation of the aorta is commonly associated with Turner's syndrome, a chromosomal condition affecting females.
The nurse is preparing to administer a dose of digoxin (Lanoxin) to a child in heart failure (HF). Which is a beneficial effect of administering digoxin (Lanoxin)?
- A. It decreases edema.
- B. It decreases cardiac output.
- C. It increases heart size.
- D. It increases venous pressure.
Correct Answer: A
Rationale: Digoxin has a rapid onset and is useful for increasing cardiac output, decreasing venous pressure, and, as a result, decreasing edema. Cardiac output is increased by digoxin. Heart size and venous pressure are decreased by digoxin.
Maltese crosses' are identified in the urinary sediments in
- A. Niemann Pick disease
- B. Gaucher disease
- C. Krabbe's disease
- D. Fabry disease
Correct Answer: D
Rationale: Fabry disease is characterized by the presence of 'Maltese crosses' in urinary sediments due to glycosphingolipid accumulation.
What should the school nurse recommend when encouraging a heart-healthy diet for a child with high cholesterol?
- A. A fat intake reduction of 5-10% of total calories
- B. A fat intake reduction of 10-15% of total calories
- C. A fat intake reduction of 15-20% of total calories
- D. A fat intake reduction of 25-35% of total calories
Correct Answer: D
Rationale: For a child with increased cholesterol, a fat reduction of 25-35% of total calories with less than 75 saturated fat and less than 200 mg of cholesterol per day is advised.
A client who was discharged 8 months ago with cirrhosis and ascites is admitted with anorexia and recent hemoptysis. The client is drowsy but responds to verbal stimuli. The nurse programs a blood pressure monitor to take readings every 15 minutes,. Which assessment should the nurse implement first?
- A. Evaluate distal capillary refill for delayed perfusion
- B. Check the extremities for bruising and petechiae
- C. Examine the pretibial regions for pitting edema
- D. Palpate the abdomen for tenderness and rigidity
Correct Answer: D
Rationale: Palpating the abdomen helps assess for complications such as peritonitis or worsening ascites.