What does the nurse explain that a ventricular septal defect will allow?
- A. Blood to shunt left to right, causing increased pulmonary flow and no cyanosis
- B. Blood to shunt right to left, causing decreased pulmonary flow and cyanosis
- C. No shunting because of high pressure in the left ventricle
- D. Increased pressure in the left atrium, impeding circulation of oxygenated blood in the circulating volume
Correct Answer: A
Rationale: Pulmonary blood flow is increased when a ventricular septal defect exists. The blood shifts from left to right because of the higher pressure in the left ventricle. This particular shift does not cause cyanosis.
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These causes often cause secretory diarrhoea except:
- A. Lactose intolerance
- B. E. coli infection
- C. Congenital chloridorrhoea
- D. Blind loop syndrome
Correct Answer: A
Rationale: The correct answer is A because lactose intolerance causes osmotic diarrhoea, not secretory diarrhoea. The other options (b-e) are causes of secretory diarrhoea.
Sodium valproate is used in all types of seizures except:
- A. Absences
- B. Infantile spasms
- C. Generalised clonic seizures
- D. Myoclonic type
Correct Answer: B
Rationale: Infantile spasms: Sodium valproate is not the first-line treatment for infantile spasms. Vigabatrin is preferred due to its effectiveness in this condition.
In congenital hypertrophic pyloric stenosis:
- A. Conjugated hyperbilirubinaemia may be seen
- B. Hypokalaemia is due to vomiting
- C. Blood pH is high and urinary pH is low
- D. First-born males are commonly affected
Correct Answer: B
Rationale: Hypokalaemia in congenital hypertrophic pyloric stenosis is typically due to the loss of potassium through vomiting.
The nurse is completing the preoperative assessment of a client who is scheduled for a laparoscopic cholecystectomy under general anesthesia. Which finding warrants notification of the healthcare provider prior to proceeding with the scheduled procedure?
- A. Light yellow coloring of the client's skin and eyes
- B. The client's blood pressure reading is 184/88 mm Hg.
- C. The client vomits 20 ml of clear yellowish fluid
- D. The IV insertion site is red, swollen, and leaking IV fluid
Correct Answer: B
Rationale: High blood pressure increases the risk of complications during surgery and needs to be addressed before proceeding.
HLA B27 positivity is least common in
- A. Ankylosing spondylosis
- B. Juvenile psoriatic arthritis
- C. Inflammatory bowel disease
- D. Reactive arthritis
Correct Answer: C
Rationale: HLA B27 positivity is least common in inflammatory bowel disease compared to the other conditions listed.
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