Nokea
Which assessment would lead the nurse to suspect that a newborn infant has a ventricular septal defect?
- A. A loud, harsh murmur with a systolic thrill
- B. Cyanosis when crying
- C. Blood pressure higher in the arms than in the legs
- D. A machinery-like murmur
Correct Answer: A
Rationale: A loud, harsh murmur combined with a systolic thrill is characteristic of a ventricular septal defect.
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Respiratory pathogens in the immunosuppressed include:
- A. Staphylococcus aureus
- B. Legionella
- C. Pneumocystis carinii
- D. Chlamydia
Correct Answer: C
Rationale: Pneumocystis carinii: Pneumocystis carinii pneumonia is a life-threatening infection in immunocompromised patients, especially those with HIV/AIDS or undergoing immunosuppressive therapy.
A characteristic sign of hypercalcaemia is:
- A. Trousseau's sign
- B. Chvostek's sign
- C. Homan's sign
- D. Kussmaul's sign
Correct Answer: A
Rationale: Trousseau's sign, which involves muscle spasms when a blood pressure cuff is inflated, is a common indicator of hypocalcemia, not hypercalcemia.
A 1-day-old is noted to be cyanotic. Physical examination reveals a grade 2-3/6 systolic murmur and a single loud second heart sound. The chest radiograph reveals a normal-sized heart and decreased pulmonary vascular markings. The electrocardiogram (ECG) reveals left ventricular dominance. The next step in the management of this neonate is to administer
- A. sodium bicarbonate
- B. morphine
- C. prostaglandin E1
- D. digoxin
Correct Answer: C
Rationale: Prostaglandin E1 helps maintain ductal patency, which can improve circulation in conditions like transposition of the great arteries or other congenital heart defects causing cyanosis.
Membranous glomerulonephritis:
- A. Is typically associated with immune complex deposition
- B. Presents with nephritic syndrome
- C. Is associated with highly selective proteinuria
- D. Deposits of IgG on the glomerular membrane
Correct Answer: A
Rationale: Membranous glomerulonephritis is characterized by immune complex deposition, particularly IgG, on the glomerular basement membrane, leading to proteinuria.
The nurse is caring for a child after heart surgery. What should the nurse do if evidence of cardiac tamponade is found?
- A. Increase analgesia
- B. Apply warming blankets
- C. Immediately report this to physician
- D. Encourage child to cough, turn, and breathe deeply
Correct Answer: C
Rationale: If evidence is noted of cardiac tamponade, which is blood or fluid in the pericardial space constricting the heart, the physician is notified immediately of this life-threatening complication. Increasing analgesia may be done before the physician drains the fluid, but the physician must be notified. Warming blankets are not indicated at this time. Encouraging the child to cough, turn, and breathe deeply should be deferred till after the evaluation by the physician.