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Treatment for congestive heart failure (CHF) in an infant began 3 days ago and has included digoxin and furosemide. The child no longer has retractions, lungs are clear, and HR is 96 beats per minute while sleeping. The nurse is confident that the child has diuresed successfully and has good renal perfusion when the nurse notes the child's urine output is:
- A. 0.5 cc/kg/hr
- B. 1 cc/kg/hr
- C. 30 cc/hr
- D. 1 oz/hr
Correct Answer: B
Rationale: Normal pediatric urine output is approximately 1 cc/kg/hr.
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Features of severe folate deficiency include:
- A. Steatorrhoea
- B. Glossitis
- C. Leucoerythroblastic picture
- D. Increased total iron binding capacity
Correct Answer: B
Rationale: Glossitis, or inflammation of the tongue, is a common feature of folate deficiency due to its role in cell division and growth.
Features differentiating renal tubular acidosis type II from type I include:
- A. Increased anion gap
- B. Nephrocalcinosis
- C. Urinary pH can be lowered < 5.5 in ammonium chloride loading test in type I
- D. Aminoaciduria
Correct Answer: C
Rationale: In type I renal tubular acidosis, urinary pH can be lowered below 5.5 during an ammonium chloride loading test, unlike in type II.
A cardiac catheterization of a client with heart disease indicates the following blockages: 95% proximal left anterior descending (LAD), 99% proximal circumflex, and ? % proximal right coronary artery (RCA). The client later asks the nurse 'what does all this mean for me?' What information should the nurse provide?
- A. Blood supply to the heart is diminished by atherosclerotic lesions, which necessitate lifestyle changes.
- B. Blood vessels supplying the pumping chamber have blockages indicating a past heart attack.
- C. Three main arteries have major blockages, with only 1 to 5% of blood flow getting through to the heart muscle.
- D. The heart is not receiving enough blood, so there is a risk of heart failure and fluid retention.
Correct Answer: C
Rationale: This explanation provides a clear understanding of the severity of the blockages and the implications for the client's heart function.
The following conditions are associated with hyperammonaemia:
- A. Reye syndrome
- B. Citrullinaemia
- C. Methylmalonic acidaemia
- D. Homocystinuria
Correct Answer: A
Rationale: Reye syndrome is associated with hyperammonaemia due to liver dysfunction and impaired urea cycle function, leading to ammonia accumulation.
Causes of pancytopenia and splenomegaly include:
- A. Low-grade non-Hodgkin's lymphoma
- B. Gaucher's disease
- C. Alcoholic cirrhosis
- D. BI2 deficiency
Correct Answer: B
Rationale: Gaucher's disease, a lysosomal storage disorder, can cause pancytopenia and splenomegaly due to bone marrow infiltration and hypersplenism.