Nokea
Which of the following statements is incorrect regarding shock?
- A. In cardiogenic shock systemic vascular resistance is high
- B. In hypovolemic shock pulmonary capillary wedge pressure is reduced
- C. In distributive shock central venous pressure is increased
- D. In hypovolemic shock mean arterial pressure is normal
Correct Answer: D
Rationale: In hypovolemic shock
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Systolic murmur in which among the following conditions does not increase in intensity in the cardiac cycle after a premature ventricular contraction?
- A. Valvular aortic stenosis
- B. Hypertrophic obstructive cardiomyopathy
- C. Valvular pulmonic stenosis
- D. Mitral valve prolapse
Correct Answer: D
Rationale: Mitral valve prolapse does not typically increase in intensity after a premature ventricular contraction.
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.
An 8-year-old from the former Soviet Union is brought to your office because of a heart murmur and dusty blue skin. He has marked clubbing of his fingers and toes, and his hematocrit is 70%. He has a grade 4/6 holosystolic murmur. His chest x-ray reveals a normal pulmonary blood flow as well as a right-sided aortic arch. What is the likely diagnosis?
- A. total anomalous venous return
- B. tetralogy of Fallot
- C. Eisenmenger syndrome
- D. transposition of the great vessels
Correct Answer: C
Rationale: Eisenmenger syndrome involves reversal of shunt direction due to long-standing pulmonary hypertension, explaining the cyanosis and clubbing.
The following are true of umbilical hernia:
- A. It is more common in Caucasian than Blacks
- B. It is commonly associated with hypothyroidism
- C. It must be operated on by two years of age
- D. It becomes obstructed in 2% of cases
Correct Answer: D
Rationale: Umbilical hernias can become obstructed in about 2% of cases. They are more common in Blacks and are not typically associated with hypothyroidism.
Prior to the patient being given medication, he becomes hypotensive, mottled, and cold. His heart rate is 240. The next therapeutic step should be
- A. digoxin
- B. synchronized DC cardioversion
- C. lidocaine
- D. defibrillation
Correct Answer: B
Rationale: Synchronized DC cardioversion is indicated for unstable tachycardia unresponsive to pharmacological agents.