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What information should the nurse include in the teaching plan of a client diagnosed with gastroesophageal reflux disease (GERD)?
- A. Sleep without pillows at night to maintain neck alignment.
- B. Adjust food intake to three full meals per day and no snacks.
- C. Minimize symptoms by wearing loose, comfortable clothing
- D. Avoid participation in any aerobic exercise programs
Correct Answer: C
Rationale: Loose clothing reduces pressure on the abdomen, which can help minimize GERD symptoms.
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Which of the following is an example of ductus dependent systemic circulation?
- A. Severe Ebstein's anomaly
- B. Pulmonary atresia
- C. Tricuspid atresia
- D. Interruption of aortic arch
Correct Answer: D
Rationale: Interruption of aortic arch is ductus dependent as it relies on the ductus arteriosus for systemic blood flow.
A child with rheumatic fever is being admitted to the pediatric floor. On admission assessment, the nurse should ask the parents which question to elicit assessment information specific to the development of rheumatic fever?
- A. “Has your child complained of back pain?â€
- B. “Has your child complained of headaches?â€
- C. “Has your child had any nausea or vomiting?â€
- D. “Did your child have a sore throat or fever within the last 2 months?â€
Correct Answer: D
Rationale: A history of sore throat or fever within the last 2 months is significant as rheumatic fever often follows a streptococcal infection such as strep throat.
The nurse is caring for an 8-year-old girl whose parents indicate she has developed spastic movements of her extremities and trunk, facial grimace, and speech disturbances. They state it seems worse when she is anxious and does not occur while sleeping. The nurse questions the parents about which recent illness?
- A. Kawasaki disease (KD)
- B. Strep throat
- C. Malignant hypertension
- D. Atrial fibrillation
Correct Answer: B
Rationale: Chorea (spastic movements, facial grimacing, and speech disturbances) can be a manifestation of rheumatic fever following streptococcal pharyngitis, with a higher incidence in females.
Evidence of increased pulmonary flow is associated with:
- A. Coarctation of the aorta
- B. Fallot's tetralogy
- C. Pneumocystis infection
- D. Ventricular septal defect
Correct Answer: D
Rationale: A ventricular septal defect (VSD) leads to increased pulmonary blood flow due to left-to-right shunting, resulting in pulmonary congestion.
Complications of long-term TPN administration are:
- A. Selenium deficiency
- B. Abnormal liver function tests
- C. Osteopaenia
- D. Renal failure
Correct Answer: A
Rationale: Selenium deficiency is a known complication of long-term total parenteral nutrition (TPN) due to inadequate trace element supplementation.