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What are FIVE immediate management steps for an infant with Tetralogy of Fallot presenting with saturations of 60%?
- A. Knees to chest
- B. Calm baby
- C. Oxygen
- D. Beta-blocker
Correct Answer: A
Rationale: The knees-to-chest position helps increase systemic vascular resistance, improving oxygen saturation in a tetralogy of Fallot crisis.
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Increased fetal haemoglobin is seen in:
- A. Haemoglobin H disease
- B. β-thalassaemia major
- C. Fanconi's anaemia
- D. Pyruvate kinase deficiency
Correct Answer: B
Rationale: Increased fetal haemoglobin (HbF) is a compensatory mechanism in β-thalassaemia major to counteract the reduced production of adult haemoglobin (HbA).
The most common coronary artery anomaly in Tetralogy of Fallot is
- A. Left anterior descending artery from right aortic sinus
- B. Single coronary artery from right aortic sinus
- C. Single coronary artery from left aortic sinus
- D. Left circumflex coronary artery from right aortic sinus
Correct Answer: A
Rationale: The most common coronary artery anomaly in Tetralogy of Fallot is the left anterior descending artery arising from the right aortic sinus.
During a home visit, the nurse assesses the skin of a client with eczema who reports that an exacerbation of symptoms has occurred during the last week. Which information is most useful in determining the possible cause of the symptoms?
- A. An old friend with eczema came for a visit
- B. Recently received an influenza immunization
- C. A grandson and his new dog recently visited
- D. Corticosteroid cream was applied to eczema
Correct Answer: C
Rationale: Exposure to new allergens, such as a pet, can trigger eczema flare-ups.
Nystagmus can be a presenting sign in:
- A. Partial albinism
- B. Retinopathy of prematurity
- C. Acute vestibulitis
- D. Medulloblastoma
Correct Answer: D
Rationale: Medulloblastoma, a type of brain tumor, can present with nystagmus due to its impact on the cerebellum and brainstem.
A nurse assists a male client with Parkinson's disease (PD) to ambulate in the hallway. The client appears to 'freeze' and then carefully lifts one leg and steps forward. He tells the nurse that he is pretending to step over a crack on the floor. How should the nurse respond?
- A. Re-orient the client to his present location and circumstances
- B. Confirm that this is an effective technique to help with ambulation
- C. Assist the client to a carpeted area where he can walk more easily
- D. Plan to assess the client's cognition after returning to his room
Correct Answer: B
Rationale: Pretending to step over a crack is a known technique that can help clients with PD overcome freezing episodes.