What is one reason why patients with CHD are more likely to have rejection post-transplant than those with cardiomyopathy?
- A. Sensitized recipients with panel reactive antibody (PRA)
- B. Absence of systemic disease
- C. History of good compliance
- D. None of the above
Correct Answer: A
Rationale: Patients with congenital heart disease (CHD) are often sensitized due to prior surgeries and blood transfusions, leading to a higher risk of rejection post-transplant.
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A male client with diabetes mellitus (DM) is transferred from the hospital to a rehabilitation facility following treatment for a stroke with resulting right hemiplegia. He tells the nurse that his feet are always uncomfortably cool at night, preventing him from falling asleep. Which action should the nurse implement.
- A. Provide a warming pad (Aqua-pad or K-pad) to feet
- B. Medicate the client with a prescribed sedative
- C. Use a bed cradle to hold the covers off the feet
- D. Place warm blankets next to the client's feet
Correct Answer: D
Rationale: Warm blankets can help improve circulation and provide comfort without the risk of burns associated with heating pads.
The healthcare provider prescribes epoetin alfa (Procrit) 8,200 units subcutaneously for a client with chronic kidney disease (CKD). The 2 ml multidose vial is labeled, 'Each 1 ml of solution contains 10,000 units of epoetin alfa.' How many ml should the nurse administer?
- A. 0.8
- B. 8
- D. 1
Correct Answer: A
Rationale: To calculate the dose, the nurse must divide the prescribed dose (8,200 units) by the concentration (10,000 units per ml). 8,200 ÷ 10,000 = 0.82 ml, rounded to 0.8 ml.
A wide splitting of S2 during expiration is auscultated in a 2-week-old infant.
- A. Atrial septal defect (ASD)
- B. Coarctation of the aorta (COA)
- C. Patent ductus arteriosis (PDA)
- D. Ventricular septal defect (VSD)
Correct Answer: A
Rationale: A wide splitting of S2 without becoming a single sound on expiration may indicate increased pulmonary flow, typical of atrial septal defect.
An 18-months old infant weighing 10 kg develops an acute anaphylactic reaction with bronchospasm towards antibiotic injection. What is the most appropriate initial treatment?
- A. Inj. Hydrocortisone 100 mg IV stat
- B. Inj. Epinephrine 0.1 mg IV / IM stat
- C. Inj. Epinephrine 0.01 mg IV/IM stat
- D. Nebulization Salbutamol + oxygen
Correct Answer: C
Rationale: The most appropriate initial treatment for anaphylaxis in a child is intramuscular epinephrine at a dose of 0.01 mg/kg, which is 0.1 mg for a 10 kg child.
Recognised features of myotonic dystrophy include:
- A. Phenomenon of anticipation
- B. Muscle pain
- C. Diplopia
- D. Cardiomyopathy
Correct Answer: A
Rationale: The phenomenon of anticipation, where symptoms become more severe or appear at an earlier age as the disorder is passed through generations, is a recognized feature of myotonic dystrophy.