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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A client uses triamcinolone (Kenalog), a corticosteroid ointment, to manage pruritus caused by a chronic skin rash. The client calls the clinic nurse to report increased erythema with purulent exudate at the site. Which action should the nurse implement?
- A. Schedule an appointment for the client to see the healthcare provider
- B. Advise the client to apply more corticosteroid cream
- C. Recommend using an antibiotic ointment.
- D. Instruct the client to stop using the medication for 24 hours.
Correct Answer: A
Rationale: Increased erythema and purulent exudate suggest infection. The client needs evaluation and possible treatment with antibiotics.
Pulmonary hypertension is a complication of:
- A. ASD
- B. Eisenmenger syndrome
- C. Tricuspid atresia
- D. Tricuspid regurgitation
Correct Answer: B
Rationale: Eisenmenger syndrome is a well-known cause of pulmonary hypertension. The other options (a-d) can also lead to pulmonary hypertension but are less specific.
The following criteria are indications for further investigation of premature ventricular contractions (PVCs) that could require suppressive therapy EXCEPT
- A. multiform PVCs
- B. disappear during exercise
- C. R-on-T phenomenon
- D. extreme frequency of beats
Correct Answer: B
Rationale: PVCs that disappear during exercise are less concerning and do not necessarily require suppressive therapy.
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.
The causative organisms for endocarditis in pediatric patients are
- A. enterococci
- B. group B streptococci
- C. viridans-type streptococci
- D. Pseudomonas aeruginosa
Correct Answer: C
Rationale: Viridans streptococci are the most common cause of endocarditis in pediatric patients.