Nokea
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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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.
A client tells the nurse that her biopsy results indicate that the cancer cells are well-differentiated. How should the nurse respond?
- A. Ask the client if the healthcare provider has given her any information about the classification of her cancer
- B. Tell the client that well-differentiated cancer cells usually have a poor prognosis.
- C. Reassure the client that the cancer is not serious.
- D. Encourage the client to seek a second opinion for confirmation of the diagnosis.
Correct Answer: A
Rationale: Well-differentiated cancer cells typically indicate a slower-growing tumor. Clarifying the client's understanding ensures accurate communication and emotional support.
Accepted maintenance treatment for chronic asthma includes the following:
- A. High-dose inhaled steroids and long-acting bronchodilators
- B. Montelucast
- C. Montelucast and inhaled steroids
- D. Long-acting ~2-agonists alone
Correct Answer: A
Rationale: The correct answer is A because high-dose inhaled steroids and long-acting bronchodilators are the mainstay of chronic asthma management. The other options (b-e) are less commonly used or not first-line.
A client who took a camping vacation two weeks ago in a county with a tropical climate comes to the clinic describing vague symptoms and diarrhea for the past week. Which finding is most important for the nurse report to the healthcare provider?
- A. Weakness and fatigue
- B. Intestinal cramping
- C. Weight loss
- D. Jaundiced sclera
Correct Answer: D
Rationale: Jaundiced sclera indicates possible liver involvement, which could be due to a tropical disease such as hepatitis or leptospirosis.
During a well baby examination of a 6-week-old infant, poor weight gain, acrocyanosis of the hands and feet, and a respiratory rate of 60 breaths per minute are noted. Oxygen saturation on room air is 93%. What is the correct action?
- A. Follow-up in 1 week to assess the infant's weight.
- B. Order a chest radiograph and an electrocardiogram.
- C. Reassure the parents that the exam is within normal limits.
- D. Refer the infant to a pediatric cardiologist.
Correct Answer: D
Rationale: Infants with oxygen saturation less than 95% and those with poor feeding should be referred emergently to a cardiologist.