While looking through the chart of an infant with a congenital heart defect (CHD) of decreased pulmonary blood flow, the nurse would expect which laboratory finding?
- A. Decreased platelet count
- B. Polycythemia
- C. Decreased ferritin level
- D. Shift to the left
Correct Answer: B
Rationale: Chronic hypoxemia in CHD leads to polycythemia as a compensatory mechanism.
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A client who had a biliopancreatic diversion procedure (BDP) 3 months ago is admitted with severe dehydration. Which assessment finding warrants immediate intervention by the nurse?
- A. Strong foul-smelling flatus
- B. Gastroccult positive emesis
- C. Complaint of poor night vision
- D. Loose bowel movements
Correct Answer: B
Rationale: Gastroccult positive emesis indicates gastrointestinal bleeding, which requires immediate intervention to prevent further complications.
Avascular necrosis of the femoral head is associated with:
- A. Sickle cell trait
- B. Nephrotic syndrome
- C. Cushing's syndrome
- D. Hypothyroidism
Correct Answer: C
Rationale: Cushing's syndrome is associated with avascular necrosis due to steroid use. Sickle cell trait, nephrotic syndrome, and hypothyroidism are not directly linked.
What does the nurse need to assess first when caring for a child with a suspected myocardial infarction?
- A. Blood pressure and heart rate
- B. Chest pain and anxiety levels
- C. Oxygen saturation and respiratory rate
- D. Electrocardiogram and heart sounds
Correct Answer: D
Rationale: The first priority in a suspected myocardial infarction is to assess the heart's electrical activity using an electrocardiogram and listen to heart sounds for any abnormality such as murmurs.
HLA B27 positivity is least common in
- A. Ankylosing spondylosis
- B. Juvenile psoriatic arthritis
- C. Inflammatory bowel disease
- D. Reactive arthritis
Correct Answer: C
Rationale: HLA B27 positivity is least common in inflammatory bowel disease compared to the other conditions listed.
BP screenings to detect end-organ damage should be done routinely beginning at what age?
- A. Birth
- B. 3 years
- C. 8 years
- D. 13 years
Correct Answer: B
Rationale: The recommended age to establish a baseline blood pressure in a healthy child is around 3 years.
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