Nokea
What does the nurse understand regarding why dyspnea occurs?
- A. Blood is circulated through the lungs again, causing pulmonary circulatory congestion.
- B. Blood is shunted past the pulmonary circulation, causing pulmonary hypoxia.
- C. Blood is shunted past cardiac arteries, causing myocardial hypoxia.
- D. Blood is circulated through the ductus from the pulmonary artery to the aorta, bypassing the left side of the heart.
Correct Answer: A
Rationale: In patent ductus arteriosus, oxygenated blood recycles through the lungs, causing pulmonary congestion and dyspnea.
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Which assessment would lead the nurse to suspect that a newborn infant has a ventricular septal defect?
- A. A loud, harsh murmur with a systolic thrill
- B. Cyanosis when crying
- C. Blood pressure higher in the arms than in the legs
- D. A machinery-like murmur
Correct Answer: A
Rationale: A loud, harsh murmur with a systolic thrill is a hallmark sign of a ventricular septal defect in newborns.
Which is the most appropriate nursing action related to the administration of digoxin (Lanoxin) to an infant?
- A. Counting the apical rate for 30 seconds before administering the medication
- B. Withholding a dose if the apical heart rate is less than 100 beats/minute
- C. Repeating a dose if the child vomits within 30 minutes of the previous dose
- D. Checking respiratory rate and blood pressure before each dose
Correct Answer: B
Rationale: Withholding digoxin if the infant's heart rate is below 100 beats/minute prevents potential toxicity and ensures safety.
What risk factors does the nurse mention when providing education on this diagnosis to the patient and his family?
- A. Heredity
- B. Stress
- C. Congenital defect
- D. Obesity
- E. Poor diet
Correct Answer: A,B,D,E
Rationale: Primary hypertension is influenced by heredity, stress, obesity, and poor diet, but not congenital defects.
What finding would the nurse expect when measuring blood pressure on all four extremities of a child with coarctation of the aorta?
- A. Blood pressure higher on the right side
- B. Blood pressure higher on the left side
- C. Blood pressure lower in the arms than in the legs
- D. Blood pressure lower in the legs than in the arms
Correct Answer: D
Rationale: Coarctation of the aorta causes higher blood pressure in the arms due to obstruction distal to the defect, resulting in lower pressure in the legs.
Which combination of symptoms, in conjunction with this finding, would confirm a diagnosis of rheumatic fever?
- A. Subcutaneous nodules and fever
- B. Painful, tender joints, and carditis
- C. Erythema marginatum and arthralgia
- D. Chorea and elevated sedimentation rate
Correct Answer: B
Rationale: Painful, tender joints and carditis, along with an elevated ASO titer, meet the major Jones criteria for diagnosing rheumatic fever.