Nokea
Which among the following is not a feature of low flow - low gradient severe aortic stenosis with preserved left ventricular function?
- A. Mean trans aortic pressure gradient < 40 mm Hg
- B. Aortic valve area < 1 cm²
- C. Stroke volume > 35 ml/m²
- D. Left ventricular ejection fraction > 50%
Correct Answer: C
Rationale: Stroke volume is typically reduced, not increased, in low flow - low gradient severe aortic stenosis.
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How would the nurse caring for an infant with congestive heart failure (CHF) modify feeding techniques to adapt for the child's weakness and fatigue? (Select all that apply.)
- A. Feeding more frequently with smaller feedings
- B. Using a soft nipple with enlarged holes
- C. Holding and cuddling the child during feeding
- D. Substituting glucose water for formula
Correct Answer: A
Rationale: Infants with CHF fatigue easily. Feeding can be given more frequently in smaller amounts through a soft, large-holed nipple. Formulas with a denser caloric content can be offered. The child may be encouraged to nurse if he or she is held.
In the treatment of hypothyroidism in children:
- A. Levodopa is the treatment of choice
- B. Levothyroxine should be used
- C. Triiodothyronine is the first line treatment
- D. Carbimazole is indicated
Correct Answer: B
Rationale: Levothyroxine is the treatment of choice for hypothyroidism, as it replaces the deficient thyroid hormone and helps normalize metabolic functions.
A nurse cares for a client who has advanced cardiac disease and states, I am having trouble sleeping at night. How should the nurse respond?
- A. I will consult the provider to prescribe a sleep study to determine the problem.
- B. You become hypoxic while sleeping; oxygen therapy via nasal cannula will help.
- C. A continuous positive airway pressure, or CPAP, breathing mask will help you breathe at night.
- D. Use pillows to elevate your head and chest while you are sleeping.
Correct Answer: D
Rationale: Elevating the head and chest can reduce fluid accumulation in the lungs, improving breathing and sleep quality in clients with advanced cardiac disease.
An emergency room nurse obtains the health history of a client. Which statement by the client should alert the nurse to the occurrence of heart failure?
- A. I get short of breath when I climb stairs.
- B. I see halos floating around my head.
- C. I have trouble remembering things.
- D. I have lost weight over the past month.
Correct Answer: A
Rationale: Shortness of breath, especially during exertion, is a classic symptom of heart failure due to the heart's inability to pump blood effectively.
Which instruction should the nurse include in the discharge teaching for a client who has gastroesophageal reflux?
- A. Teach the client to elevate the head of the bed on blocks
- B. Remind the client to avoid high-fiber foods
- C. Encourage the client to lie down and rest after meals
- D. Instruct the client to use antacids only as a last resort
Correct Answer: A
Rationale: Elevating the head of the bed on blocks helps reduce reflux of stomach acid into the esophagus, improving symptoms of gastroesophageal reflux disease.