Nokea
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: The characteristic symptoms of coarctation of the aorta are a marked difference in blood pressure and pulses between the upper and lower extremities. Pressure is increased proximal to the defect and decreased distal to the coarctation.
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A nurse assesses an older adult client who is experiencing a myocardial infarction. Which clinical manifestation should the nurse expect?
- A. Excruciating pain on inspiration
- B. Left lateral chest wall pain
- C. Disorientation and confusion
- D. Numbness and tingling of the arm
Correct Answer: C
Rationale: Older adults may present with atypical symptoms of myocardial infarction, such as confusion or disorientation, rather than classic chest pain.
To reduce the risk for pulmonary complications for a client with Amyotrophic Lateral Sclerosis (ALS), what interventions should the nurse implement?
- A. Initiate passive range of motion exercises
- B. Establish a regular bladder routine
- C. Teach the client breathing exercises
- D. Perform chest physiotherapy
Correct Answer: C
Rationale: Breathing exercises, chest physiotherapy, and use of an incentive spirometer can help reduce the risk of pulmonary complications in ALS by improving lung function.
Common causes of jaundice in a 12-hour-old neonate include:
- A. Glucose-6-phosphate dehydrogenase deficiency
- B. Rhesus isoimmunisation
- C. Crigler-Najjar syndrome type II
- D. Choledochal cyst
Correct Answer: B
Rationale: Rhesus isoimmunisation can cause severe hemolysis in neonates, leading to early-onset jaundice within the first 12 hours of life.
The following are true of umbilical hernia:
- A. It is more common in Caucasian than Blacks
- B. It is commonly associated with hypothyroidism
- C. It must be operated on by two years of age
- D. It becomes obstructed in 2% of cases
Correct Answer: D
Rationale: Umbilical hernias can become obstructed in about 2% of cases. They are more common in Blacks and are not typically associated with hypothyroidism.
During play, a toddler with a history of tetralogy of Fallot (TOF) might assume which position?
- A. Sitting
- B. Supine
- C. Squatting
- D. Standing
Correct Answer: C
Rationale: Squatting naturally increases SVR by occluding venous return from the lower extremities, thereby increasing pulmonary blood flow.