Nokea
which of the following must be present in order for an infant with complete transposition of the great vessels to survive at birth?
- A. coarctation of aorta
- B. pulmonary stenosis
- C. patent ductus arteriosus
- D. mitral stenosis
Correct Answer: C
Rationale: In an infant with complete transposition of the great vessels, the survival at birth depends on the presence of a patent ductus arteriosus (PDA) to allow mixing of oxygenated and deoxygenated blood. In this condition, the aorta arises from the right ventricle and the pulmonary artery arises from the left ventricle, leading to separate circulatory pathways for oxygenated and deoxygenated blood. The survival of the infant is dependent on the remaining fetal shunts, such as a PDA, to maintain an adequate mixing of blood until corrective surgery can be performed. Therefore, the presence of a PDA is essential for the survival of an infant with complete transposition of the great vessels at birth.
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Discharge care planning has begun for a seriously injured patient who is Asian. The patient's parents have refused routine home health visits. The pediatric nurse understands the family may:
- A. believe that health outcomes are predetermined.
- B. feel health is a personal responsibility and maintenance of family reputation is paramount.
- C. regard health as a family responsibility, seeking outside aid only when resources are exhausted.
- D. none of the above.
Correct Answer: C
Rationale: In some cultures, families may prefer to handle health matters internally, viewing outside assistance as a last resort.
The nurse is observing a client receiving antiplatelet therapy for adverse reactions. Antiplatelet drugs most commonly produce which hypersensitivity reaction?
- A. Difficulty hearing
- B. Confusion
- C. Bronchospasm
- D. Agranulocytosis
Correct Answer: C
Rationale: Antiplatelet drugs most commonly produce bronchospasm as a hypersensitivity reaction. This adverse reaction occurs due to the release of bronchoconstrictive mediators, leading to narrowing of the airways and potentially causing respiratory distress. It is important for nurses to closely monitor clients receiving antiplatelet therapy for signs of bronchospasm, such as wheezing, shortness of breath, and chest tightness, and to intervene promptly to prevent further complications. Difficulty hearing, confusion, and agranulocytosis are not typically associated with antiplatelet therapy.
Which of the following dietary interventions prevents the precipitation of calcium renal stones?
- A. High fiber diet
- B. Increased protein intake
- C. High fluid intake
- D. Intake of zinc
Correct Answer: C
Rationale: High fluid intake is the dietary intervention that prevents the precipitation of calcium renal stones. By increasing fluid intake, particularly water, the urine gets diluted, thus reducing the concentration of substances that can lead to the formation of kidney stones, including calcium. Drinking enough water can also help to flush out any potential stone-forming minerals or substances before they have a chance to crystallize and form stones in the kidney. It is recommended to have an adequate fluid intake of around 2 to 3 liters per day to reduce the risk of calcium stone formation in the kidneys. High fiber diet, increased protein intake, and intake of zinc do not directly prevent the precipitation of calcium renal stones as effectively as maintaining high fluid intake.
A febrile patient's fluid output is in excess of normal because of diaphoresis. The nurse should plan fluid replacement based on the knowledge that insensible losses in an afebrile person are normally not greater than:
- A. 300ml/24hr
- B. 900ml/24hr
- C. 600ml/24hr
- D. 1200ml/24hr
Correct Answer: C
Rationale: Insensible losses are the fluid losses that occur without the individual being aware of it, such as through breathing, sweating, and through the skin. In an afebrile person, insensible losses are normally around 600ml per 24 hours. This amount can vary depending on factors such as temperature, humidity, and individual metabolism. When a patient is febrile and experiencing diaphoresis (excessive sweating), the fluid output can increase significantly due to the body's attempts to cool itself down. It is important for the nurse to consider these increased fluid losses when planning fluid replacement for a febrile patient to prevent dehydration.
Which of the ff interventions is implemented for a client with empyema?
- A. Teach the client breathing exercises
- B. Offer assurance that empyema takes less time to resolve
- C. Recommend that the client eat a balanced but light diet
- D. Emphasize the completion of the entire course of drug therapy
Correct Answer: D
Rationale: Empyema is a serious infection that requires aggressive treatment with antibiotics. The client must complete the entire course of drug therapy as prescribed by the healthcare provider to ensure that the infection is completely eradicated. Failure to complete the full course of antibiotics can lead to antibiotic resistance and recurrence of the infection. It is crucial to emphasize to the client the importance of adhering to the prescribed treatment regimen to achieve a full recovery and prevent complications.