Nokea
While caring for a client with Amyotrophic Lateral Sclerosis (ALS), the nurse performs a neurological assessment every four hours. Which assessment finding warrants immediate intervention by the nurse?
- A. Inappropriate laughter
- B. Increasing anxiety
- C. Weakened cough effort
- D. Asymmetrical weakness
Correct Answer: C
Rationale: A weakened cough effort can lead to respiratory complications, which are life-threatening in ALS patients.
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The severity of symptoms of Ebstein anomaly and the degree of cyanosis are high and depend on the extent of
- A. displacement of the tricuspid valve
- B. cardiac dysrhythmias
- C. atrial right-to-left shunt
- D. pulmonary vascular resistance
Correct Answer: A
Rationale: Displacement of the tricuspid valve is a key determinant of symptom severity in Ebstein anomaly.
Emergency management of acute asthma includes:
- A. Arterial blood gas
- B. Nebulised steroids
- C. Intravenous theophylline
- D. Nebulised ~-antagonists
Correct Answer: D
Rationale: Nebulised beta-antagonists are a key part of the emergency management of acute asthma. Arterial blood gas, nebulised steroids, and intravenous theophylline are also used but are not the first line.
X-linked conditions include:
- A. Duchenne muscular dystrophy
- B. Hypophosphataemic rickets
- C. Huntington's chorea
- D. Phenylketonuria
Correct Answer: A
Rationale: Duchenne muscular dystrophy is an X-linked recessive disorder caused by mutations in the dystrophin gene.
The following are true of vitamin K:
- A. It is a water-soluble vitamin
- B. It is found mainly in red meat
- C. After infancy most is synthesised by the gut flora
- D. Low levels after birth may lead to intracerebral haemorrhage
Correct Answer: C
Rationale: Vitamin K is synthesized by gut flora after infancy. It is a fat-soluble vitamin, and low levels after birth can lead to hemorrhagic disease of the newborn.
The patient most probably has
- A. severe aortic stenosis
- B. patent ductus arteriosus
- C. Williams syndrome
- D. none of the above
Correct Answer: A
Rationale: The clinical features suggest severe aortic stenosis with left ventricular hypertrophy.