When planning care for a client newly diagnosed with open angle glaucoma, the nurse identifies a priority nursing diagnosis of, 'visual sensory/perceptual alterations.' This diagnosis is based on which etiology?
- A. Limited eye movement
- B. Decreased peripheral vision
- C. Blurred distance vision
- D. Photosensitivity
Correct Answer: B
Rationale: Open angle glaucoma primarily affects peripheral vision, leading to visual sensory/perceptual alterations.
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Short stature due to growth hormone deficiency:
- A. Is characteristically manifest in infancy
- B. May be secondary to irradiation to the skull
- C. Can be part of congenital hypopituitarism
- D. Is easily corrected
Correct Answer: B
Rationale: Growth hormone deficiency can result from cranial irradiation, which may damage the pituitary gland and impair hormone production.
Duchenne muscular dystrophy:
- A. Has an association with malignant hyperpyrexia
- B. Is a reason for never running properly
- C. Is better diagnosed with muscle biopsy than gene probe
- D. Is associated with speech delay
Correct Answer: D
Rationale: Duchenne muscular dystrophy is associated with speech delay due to progressive muscle weakness, including facial muscles affecting speech.
22q11 deletion is commonly associated with all except
- A. Tetralogy of Fallot
- B. Truncus arteriosus
- C. Interrupted aortic arch
- D. D-Transposition of great arteries
Correct Answer: D
Rationale: 22q11 deletion is not commonly associated with D-Transposition of great arteries.
During play, a toddler with a history of tetralogy of Fallot (TOF) might assume which position?
- A. Sitting
- B. Supine
- C. Squatting
- D. Standing
Correct Answer: C
Rationale: Squatting naturally increases SVR by occluding venous return from the lower extremities, thereby increasing pulmonary blood flow.
One of the following is a characteristic physical finding in patients with an ASD
- A. a right precordial bulge
- B. a fixed splitting of the second heart sound
- C. a systolic ejection heart murmur
- D. a short, mild left mid-diastolic murmur
Correct Answer: B
Rationale: Fixed splitting of the second heart sound is a hallmark of an atrial septal defect.