Nokea
Which is a clinical manifestation of the systemic venous congestion that can occur with heart failure?
- A. Tachypnea
- B. Tachycardia
- C. Peripheral edema
- D. Pale, cool extremities
Correct Answer: C
Rationale: Peripheral edema, especially periorbital edema, is a clinical manifestation of systemic venous congestion. Tachypnea is a manifestation of pulmonary congestion. Tachycardia and pale, cool extremities are clinical manifestations of impaired myocardial function.
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The following are potent vasoconstrictors:
- A. Renin
- B. Angiotensin I
- C. Nitric oxide
- D. PGI2
Correct Answer: A
Rationale: Renin: Renin is a precursor enzyme in the RAAS that helps in converting angiotensinogen into angiotensin I, a potent vasoconstrictor.
Common presenting features of myotonic dystrophy are:
- A. Floppy infant
- B. Corneal opacities
- C. Frontal baldness
- D. Macro-orchidism
Correct Answer: D
Rationale: Macro-orchidism: Myotonic dystrophy is characterized by muscle weakness and myotonia. Macro-orchidism (enlarged testes) is a distinctive feature, especially in male patients.
A 5-year-old child has an elevated blood pressure during a well child exam. The primary care pediatric nurse practitioner notes mottling and pallor of the child's feet and lower legs and auscultates a systolic ejection murmur in the left infraclavicular region radiating to the child's back. The nurse practitioner will suspect which condition?
- A. Aortic stenosis (AS)
- B. Coarctation of the aorta (COA)
- C. Patent ductus arteriosus (PDA)
- D. Pulmonic stenosis
Correct Answer: B
Rationale: Coarctation of the aorta may not have symptoms until later childhood and may present as high blood pressure in the upper extremities and poor perfusion in the lower extremities.
An adult client is admitted with diabetic ketoacidosis (DKA) and a urinary tract infection (UTI). Prescriptions for intravenous antibiotics and an insulin infusion are initiated. Which serum laboratory value warrants the most immediate intervention by the nurse?
- A. Glucose of 350 mg/dl
- B. White blood cell count of 15,000 mm3
- C. Blood PH of 7.30
- D. Potassium of 2.5 mEq/L
Correct Answer: D
Rationale: A potassium level of 2.5 mEq/L is dangerously low and must be corrected immediately to prevent cardiac arrhythmias.
A client who weighs 175 pounds is receiving IV bolus dose of heparin 80 units/kg. The heparin is available in a 2 ml vial, labeled 10,000 units/ml. How many ml should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.)
- A. 0.6
- C. 6
- D. 1
Correct Answer: A
Rationale: The calculation is based on the client's weight and the prescribed dosage of heparin.