A child with coarctation of the aorta will have
The Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"A"}
Rationale for Correct Choices:
• Weak: Weak pedal pulses are typical because the narrowed aortic segment reduces blood flow to the lower extremities. This is a key clinical finding that often leads to suspicion of coarctation in children.
• Strong: Brachial pulses are typically strong or bounding because the narrowing occurs after the vessels to the upper body branch off, allowing normal or increased perfusion to the arms.
Rationale for Incorrect Choices:
• Absent: Completely absent pedal pulses are uncommon in coarctation of the aorta unless the narrowing is extremely severe or there is complete arterial obstruction. Most clients will have diminished but still palpable pedal pulses.
• Bounding: Bounding pedal pulses would indicate increased blood flow to the lower extremities, which is not seen in coarctation of the aorta. Instead, bounding pulses are usually found in the upper extremities in this condition.
• Weak: Weak brachial pulses would suggest reduced blood flow to the upper extremities, which is inconsistent with the anatomy of coarctation where the narrowing is distal to these branches.
• Thready: Thready pulses indicate low stroke volume or shock states, which are not characteristic of compensated coarctation. In coarctation, upper extremity pulses remain strong unless severe heart failure develops.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"A"}
Explanation
Rationale for Correct Choices:
• Cracked lips and strawberry tongue are hallmark mucocutaneous changes in Kawasaki disease, reflecting widespread inflammation of mucous membranes in the acute phase. These are often accompanied by conjunctival injection and rash.
• Aspirin and IV gamma globulin are the mainstay treatments for Kawasaki disease, reducing inflammation and significantly lowering the risk of coronary artery aneurysms when given early in the illness.
Rationale for Incorrect Choices:
• Petechiae and purpura rash are more commonly seen in platelet or clotting disorders such as idiopathic thrombocytopenic purpura or meningococcemia. Kawasaki disease typically presents with diffuse erythematous rash, not pinpoint hemorrhages.
• Polyarthritis may occur in the later stages of Kawasaki disease, but chorea is a neurological manifestation linked to rheumatic fever. This combination does not fit the acute presentation of Kawasaki disease.
• Corticosteroids and antibiotics are not first-line treatments for Kawasaki disease. Antibiotics are ineffective as the cause is not bacterial, and corticosteroids are generally reserved for IVIG-resistant cases.
• ACE inhibitors and NSAIDs are not standard therapy for Kawasaki disease. ACE inhibitors are used in hypertension or heart failure, and NSAIDs are not as effective as high-dose aspirin in reducing the acute inflammatory response in this condition.
Correct Answer is A
Explanation
Rationale:
A. Encourage peers to call and visit when the adolescent's condition allows: Social connections are vital for adolescents’ emotional well-being and identity development. Encouraging peer interaction helps reduce feelings of isolation and supports coping during hospitalization.
B. Ask the parents how the adolescent usually copes in new situations: While parents can provide useful information, involving the adolescent directly respects their growing autonomy and helps tailor interventions to their personal coping style.
C. Discourage questions and concerns about the effects of the illness on the adolescent's appearance: Adolescents are often highly concerned about body image. Discouraging these concerns can damage trust and hinder open communication.
D. Be sure the adolescent wears a hospital gown or pajamas throughout the hospitalization: Adolescents typically desire privacy and autonomy, including control over their clothing. Allowing them to wear their own clothes when possible promotes dignity and comfort.
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