What assessment(s) in a child with tetralogy of Fallot would indicate the child is experiencing a paroxysmal hypercyanotic episode? (Select all that apply.)
- A. Spontaneous cyanosis
- B. Dyspnea
- C. Weakness
- D. Dry cough
Correct Answer: C
Rationale: Indicators of a paroxysmal hypercyanotic episode or a tet episode are spontaneous cyanosis, dyspnea, weakness, and syncope.
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The following criteria are indications for further investigation of premature ventricular contractions (PVCs) that could require suppressive therapy EXCEPT
- A. multiform PVCs
- B. disappear during exercise
- C. R-on-T phenomenon
- D. extreme frequency of beats
Correct Answer: B
Rationale: PVCs that disappear during exercise are less concerning and do not necessarily require suppressive therapy.
A client with acute renal injury (AKI) who weighs 50 kg and has a potassium level of 6.7 mEq/L (6.7 mmol/l) is admitted to the hospital. Which prescribed medication should the nurse administer first?
- A. Sevelamer (RenaGel) one tablet PO.
- B. Epoetin alfa, recombinant (Epogen) 2,500 units SUBQ
- C. Sodium polystyrene (Kayexalate) 15 grams PO
- D. Calcium acetate (Phos-Lo) one tablet PO
Correct Answer: C
Rationale: Sodium polystyrene (Kayexalate) helps remove excess potassium, which is the priority concern in AKI with elevated potassium.
Complement system:
- A. Is activated by bacterial endotoxins by the classical pathway
- B. Reduced C3 and C4 are usual findings in acute glomerulonephritis
- C. Hereditary angioneurotic oedema is caused by deficiency of one of the components of the classical pathway of the system
- D. Is part of humoral immunity
Correct Answer: D
Rationale: The complement system is a key component of humoral immunity, playing a role in the immune response to pathogens.
Type I renal tubular acidosis:
- A. Only occurs in children
- B. Is caused by a failure of ammonium ion secretion
- C. Is associated with renal calcification
- D. Typically leads to hypovolaemia
Correct Answer: B
Rationale: Type I renal tubular acidosis is characterized by a failure in ammonium ion secretion, leading to a failure to acidify urine, which can result in metabolic acidosis.
What are FIVE indications for surgical intervention in infective endocarditis?
- A. Heart block
- B. Abscess
- C. Valve dysfunction causing heart failure
- D. Large mobile vegetation
Correct Answer: A
Rationale: These are typical indications for surgery when complications of infective endocarditis progress to life-threatening stages.
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