Nokea
Which of the following is an example of ductus dependent systemic circulation?
- A. Severe Ebstein's anomaly
- B. Pulmonary atresia
- C. Tricuspid atresia
- D. Interruption of aortic arch
Correct Answer: D
Rationale: Interruption of aortic arch is ductus dependent as it relies on the ductus arteriosus for systemic blood flow.
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Following surgical repair of the bladder, a female client is being discharged from the hospital to home with an indwelling urinary catheter. Which instruction is most important for the nurse to provide to this client?
- A. Avoid coiling the tubing and keep if free of kinks
- B. Cleanse the perineal area with soap and water twice daily
- C. Keep the drainage bag lower than the level of the bladder
- D. Drink 1,000 ml of fluids daily to irrigate catheter
Correct Answer: C
Rationale: Keeping the drainage bag lower than the bladder prevents backflow of urine, reducing the risk of infection.
Paroxysmal hypercyanotic attacks (hypoxic, blue, or tet spells) are a particular problem during the lst 2 yr of life. They are characterized by
- A. early evening occurrence
- B. an increase in intensity of the systolic murmur
- C. unpredictable onset
- D. metabolic alkalosis
Correct Answer: A
Rationale: Unpredictable onset and metabolic alkalosis are common features of tet spells.
All of the following are true regarding attention deficit hyperactivity disorder (ADHD), except
- A. Dopamine transporter gene (DAT1) and dopamine 4 receptor gene (DRD4) are implicated in the diagnosis
- B. Impaired fine motor movement and poor coordination are 'soft' but specific signs of ADHD
- C. Developmentally inappropriate behavior must commence before 7 years of age and present for at least 6 months
- D. Maternal lead exposure is associated with ADHD
Correct Answer: B
Rationale: Impaired fine motor movement and poor coordination are not specific signs of ADHD; they are nonspecific and can occur in other conditions.
Which is an important nursing consideration when chest tubes will be removed from a child?
- A. Explain that it is not painful.
- B. Explain that only a Band-Aid will be needed.
- C. Administer analgesics before the procedure.
- D. Expect bright red drainage for several hours after removal.
Correct Answer: C
Rationale: It is appropriate to prepare the child for the removal of chest tubes with analgesics. Short-acting medications can be used that are administered through an existing IV line. A sharp, momentary pain is felt. This should not be misrepresented to the child. A petroleum gauze, air-tight dressing will be needed, but it is not a pain-free procedure. Little or no drainage should be found on removal.
The following causes of short stature respond to growth hormone:
- A. Turner's syndrome
- B. Panhypopituitarism
- C. Achondroplasia
- D. Social deprivation
Correct Answer: A
Rationale: Turner's syndrome is a condition that responds to growth hormone therapy. Panhypopituitarism also responds, but Achondroplasia and social deprivation do not.