Nokea
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.
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All the following are signs of coarctation of the aorta EXCEPT
- A. femoral pulses are weak or absent
- B. bounding pulses of the arms
- C. blood pressure in the legs is lower than that in the arms
- D. precordial impulse and heart sounds are usually normal
Correct Answer: B
Rationale: In coarctation of the aorta, femoral pulses are delayed or absent, not bounding.
Polycythaemia:
- A. Is a common cause of jaundice in the newborn
- B. Is significant if haematocrit > 65% on a capillary sample
- C. May cause apnoeas
- D. Exchange transfusion is the treatment of choice in symptomatic cases
Correct Answer: B
Rationale: Polycythaemia is considered significant if the haematocrit exceeds 65% on a capillary sample, as it can lead to hyperviscosity and related complications.
Which clinical manifestation should the nurse expect to see as shock progresses in a child and becomes decompensated shock?
- A. Thirst
- B. Irritability
- C. Apprehension
- D. Confusion and somnolence
Correct Answer: D
Rationale: Confusion and somnolence are beginning signs of decompensated shock. Thirst, irritability, and apprehension are signs of compensated shock.
What is the primary nursing intervention to prevent bacterial endocarditis?
- A. Institute measures to prevent dental procedures.
- B. Counsel parents of high-risk children about prophylactic antibiotics.
- C. Observe children for complications, such as embolism and heart failure.
- D. Encourage restricted mobility in susceptible children.
Correct Answer: B
Rationale: The objective of nursing care is to counsel the parents of high-risk children about both the need for prophylactic antibiotics for dental procedures and the necessity of maintaining excellent oral health. The child’s dentist should be aware of the child’s cardiac condition. Dental procedures should be done to maintain a high level of oral health. Prophylactic antibiotics are necessary. Children should be observed for complications such as embolism and heart failure and restricted mobility should be encouraged in susceptible children, but maintaining good oral health and prophylactic antibiotics is important.
Causes of a dilated renal pelvis in a foetal scan include:
- A. Normal variant
- B. Vesico-ureteric reflux
- C. Pelvi-ureteric junction obstruction
- D. Multicystic kidney
Correct Answer: A
Rationale: A dilated renal pelvis can be a normal variant in a foetal scan, often resolving spontaneously without intervention.