Nokea
Which of the following is a neurocutaneous syndrome without cutaneous manifestations?
- A. Sturge-Weber syndrome
- B. Tuberous sclerosis
- C. Ataxia telangiectasia
- D. Von Hippel-Lindau disease
Correct Answer: D
Rationale: Von Hippel-Lindau disease is a neurocutaneous syndrome that primarily affects internal organs and often lacks cutaneous manifestations.
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A previously well 3½-month-old presents with poor feeding, diaphoresis during feeding, and poor growth. Vital signs reveal respirations of 70, pulse of 175, and blood pressure of 90/65 mm Hg in the upper and lower extremities. The cardiac examination reveals a palpable parasternal lift and a systolic thrill. A grade 4 holosystolic murmur and a mid-diastolic rumble are noted. The chest radiograph reveals cardiomegaly. The most likely diagnosis is
- A. cardiomyopathy
- B. myocarditis
- C. VSD
- D. coarctation of the aorta
Correct Answer: C
Rationale: The presentation suggests a large ventricular septal defect (VSD) causing significant left-to-right shunting and heart failure.
The following cranial nerves carry pre-ganglionic parasympathetic nerves:
- A. Oculomotor nerve
- B. Trigeminal nerve
- C. Facial nerve
- D. Vagus nerve
Correct Answer: D
Rationale: The vagus nerve carries parasympathetic fibers. The oculomotor, trigeminal, and facial nerves do not.
Skin lesions characteristically associated with CNS problems:
- A. Dermatitis herpetiformis
- B. Vitiligo
- C. Strawberry angioma on face
- D. Axillary freckling
Correct Answer: D
Rationale: Axillary freckling
The nurse is finishing her shift on the pediatric unit. Because her shift is ending, which intervention takes top priority?
- A. Changing the linens on the clients’ beds
- B. Restocking the bedside supplies needed for a dressing change on the upcoming shift
- C. Documenting the care provided during her shift
- D. Emptying the trash cans in the assigned client room
Correct Answer: C
Rationale: Documenting care is a legal and professional responsibility that ensures continuity of care and accurate communication between shifts.
A nurse assesses an older adult client who has multiple chronic diseases. The client’s heart rate is 48 beats/min. Which action should the nurse take first?
- A. Document the finding in the chart.
- B. Initiate external pacing.
- C. Assess the client’s medications.
- D. Administer 1 mg of atropine.
Correct Answer: C
Rationale: A heart rate of 48 beats/min (bradycardia) in an older adult with multiple chronic diseases may be due to medication side effects. Assessing the client’s medications is the first step to determine if any drugs are contributing to the bradycardia.