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When palpating the brachial, radial, and femoral pulses of a neonate, the nurse notes a difference in pulse amplitude between the femoral and radial pulses bilaterally. This difference suggests:
- A. Patent ductus arteriosus
- B. Coarctation of the aorta
- C. Diminished cardiac output
- D. Left to right shunting in the heart. 104 Practice Exam I
Correct Answer: B
Rationale: Coarctation of the aorta is a congenital heart defect in which there is a narrowing of the aorta leading to differential pulses in the upper and lower extremities. In neonates, this can manifest as weaker femoral pulses compared to radial pulses due to decreased blood flow to the lower body. This difference in pulse amplitude between the femoral and radial pulses bilaterally is a classic finding in coarctation of the aorta, making it the most likely cause in this scenario. Other conditions like patent ductus arteriosus, diminished cardiac output, or left to right shunting in the heart may not specifically present with this particular pulse amplitude difference.
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A patient visits her nurse practitioner (NP) after she has a cold for a week and is now experiencing a severe headache and fever. Her NP diagnoses a sinus infection. Which of the following additional symptoms is the patient likely to exhibit?
- A. Facial tenderness
- B. Photophobia
- C. Chest pain
- D. Ear drainage
Correct Answer: A
Rationale: Sinus infections, also known as sinusitis, are often characterized by symptoms such as congestion, facial pain or pressure, and nasal discharge. Facial tenderness over the affected sinuses, particularly when tapping on the area, is a common symptom associated with sinus infections due to the inflammation and buildup of mucus in the sinuses. This tenderness is often present in the cheeks, forehead, or around the eyes. The other symptoms mentioned in the choices (photophobia, chest pain, ear drainage) are less commonly associated with sinus infections compared to facial tenderness.
When assessing a female adolescent for scoliosis, what should the nurse ask the client to do?
- A. Bend forward at the waist with arms hanging freely.
- B. Lie flat on the floor and extend her legs straight from the trunk.
- C. Sit in a chair while lifting her feet and legs to a right angle with the trunk.
- D. Stand against a wall while pressing the length of her back against the wall.
Correct Answer: A
Rationale: When assessing a female adolescent for scoliosis, the nurse should ask the client to bend forward at the waist with arms hanging freely. This Adams forward bend test allows the nurse to evaluate the spine for any asymmetry, curvature, or rib hump that may indicate scoliosis. By observing the alignment of the spine while the client is in a forward bent position, the nurse can gather important information to determine if further evaluation or referral to a healthcare provider is necessary.
What is the mineral necessary for chemical clotting?
- A. Iron
- B. Potassium
- C. Sodium
- D. Calcium
Correct Answer: D
Rationale: Calcium is the mineral necessary for chemical clotting. When there is a cut or injury that causes bleeding, the body's clotting process is initiated to stop the bleeding. Calcium ions play a crucial role in several steps of the clotting cascade, helping to activate various clotting factors and promoting the formation of a stable blood clot. Without sufficient calcium, the blood would not be able to clot properly, leading to potential complications with excessive bleeding.
When the nurse interviews an adolescent, which is especially important?
- A. Focus the discussion on the peer group.
- B. Allow an opportunity to express feelings.
- C. Emphasize that confidentiality will always be maintained.
- D. Use the same type of language as the adolescent.
Correct Answer: B
Rationale: When the nurse interviews an adolescent, allowing an opportunity for the adolescent to express their feelings is especially important. Adolescents are at a stage in life where they are developing their own identity and dealing with a range of emotions. Providing a safe space for them to open up about their thoughts and feelings can help the nurse better understand and address their needs. This can also build a trustful relationship between the nurse and the adolescent, leading to more effective communication and care.
The nurse understands that for the parathyroid hormone to exert its effect, what must be present?
- A. Decreased phosphate level
- B. Functioning thyroid gland
- C. Adequate vitamin D level
- D. Increased calcium level
Correct Answer: D
Rationale: Parathyroid hormone (PTH) is released by the parathyroid glands in response to low calcium levels in the blood. Its primary function is to regulate calcium and phosphorus levels in the body. When calcium levels in the blood are low, PTH is released, leading to increased calcium levels by stimulating the release of calcium from the bones, increasing calcium absorption in the intestines, and promoting calcium reabsorption in the kidneys. Therefore, for PTH to exert its effect, increased calcium levels must be present.