Nokea
What should the nurse assess prior to administering digoxin? (Select all that apply.)
- A. Sclera
- B. Apical pulse rate
- C. Cough
- D. Liver function test
Correct Answer: B
Rationale: Because digoxin decreases the heart rate, the apical pulse should be assessed. If the HR is below 60 beats per minute, digoxin should not be administered.
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Which defect results in increased pulmonary blood flow?
- A. Pulmonic stenosis
- B. Tricuspid atresia
- C. Atrial septal defect
- D. Transposition of the great arteries
Correct Answer: C
Rationale: Atrial septal defect results in increased pulmonary blood flow. Blood flows from the left atrium (higher pressure) into the right atrium (lower pressure) and then to the lungs via the pulmonary artery. Pulmonic stenosis is an obstruction to blood flowing from the ventricles. Tricuspid atresia results in decreased pulmonary blood flow. Transposition of the great arteries results in mixed blood flow.
Paroxysmal hypercyanotic attacks (hypoxic, blue, or tet spells) are a particular problem during the lst 2 yr of life. They are characterized by
- A. early evening occurrence
- B. an increase in intensity of the systolic murmur
- C. unpredictable onset
- D. metabolic alkalosis
Correct Answer: A
Rationale: Unpredictable onset and metabolic alkalosis are common features of tet spells.
On assessment of a child admitted with a diagnosis of Kawasaki Disease, the nurse expects to note which clinical manifestation of the acute phase of the disease?
- A. Cracked lips
- B. Normal appearance
- C. Conjuntival hyperemia
- D. Desquamation of the skin
Correct Answer: C
Rationale: Conjunctival hyperemia is a common clinical manifestation during the acute phase of Kawasaki Disease, characterized by redness of the eyes without discharge.
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.
Histochemical staining used for diagnosing Hirschsprung's disease is
- A. Acetyl choline esterase
- B. Dopamine
- C. Glutamate
- D. Chromogranin and synaptophysin
Correct Answer: A
Rationale: Acetylcholine esterase staining is used to diagnose Hirschsprung's disease by identifying the absence of ganglion cells.