A nurse is assessing a newborn who has a coarctation of the aorta. Which of the following should the nurse recognize as a clinical manifestation of coarctation of the aorta?
Increased blood pressure in the arms with decreased blood pressure in the legs
Increased blood pressure in both the arms and the legs
Decreased blood pressure in both the arms and the legs
Decreased blood pressure in the arms with increased blood pressure in the legs
The Correct Answer is A
Choice A Reason:
In coarctation of the aorta, the narrowing of the aorta typically occurs after the arteries that supply the upper body branch off. This results in higher blood pressure in the arms and lower blood pressure in the legs. The difference in blood pressure between the upper and lower extremities is a key diagnostic indicator of this condition.
Choice B Reason:
Increased blood pressure in both the arms and the legs is not characteristic of coarctation of the aorta. This condition specifically causes a disparity in blood pressure between the upper and lower parts of the body due to the narrowing of the aorta.
Choice C Reason:
Decreased blood pressure in both the arms and the legs is not a typical manifestation of coarctation of the aorta. The condition usually leads to increased blood pressure in the upper body and decreased blood pressure in the lower body.
Choice D Reason:
Decreased blood pressure in the arms with increased blood pressure in the legs is the opposite of what is seen in coarctation of the aorta. The narrowing of the aorta causes higher pressure in the upper body and lower pressure in the lower body.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason:
Suctioning the mouth with an oral suction tube is not recommended postoperatively for cleft palate repair. This procedure can disrupt the surgical site and cause bleeding or damage to the repair. Instead, gentle cleaning methods should be used to maintain oral hygiene.
Choice B Reason:
Feeding the infant with a spoon for 48 hours is not appropriate. Postoperative care for cleft palate repair typically involves using a specialized bottle or syringe to avoid disrupting the surgical site. Feeding with a spoon can cause trauma to the delicate tissues and should be avoided.
Choice C Reason:
Applying and releasing elbow restraints every hour is crucial to prevent the infant from touching or putting objects in their mouth, which could damage the surgical repair. The restraints should be checked and adjusted regularly to ensure they are not too tight and to allow for movement and comfort.
Choice D Reason:
Keeping the infant supine is not specifically required for postoperative care following cleft palate repair. The infant can be positioned in a way that is comfortable and safe, as long as it does not interfere with the surgical site. Elevating the head slightly can help reduce swelling and promote drainage.
Correct Answer is B
Explanation
Choice A Reason:
Tricuspid atresia is a congenital heart defect where the tricuspid valve is missing or abnormally developed, blocking blood flow from the right atrium to the right ventricle. This condition does not increase pulmonary blood flow; instead, it limits the amount of blood that reaches the lungs, often leading to cyanosis and requiring surgical intervention.
Choice B Reason:
Tetralogy of Fallot is a complex congenital heart defect that includes four anatomical abnormalities: ventricular septal defect (VSD), pulmonary stenosis, right ventricular hypertrophy, and an overriding aorta. This defect results in decreased pulmonary blood flow and causes cyanosis due to the mixing of oxygen-poor and oxygen-rich blood.
Choice C Reason:
Patent ductus arteriosus (PDA) is a condition where the ductus arteriosus, a fetal blood vessel, fails to close after birth. This results in increased pulmonary blood flow as blood from the aorta is shunted into the pulmonary artery, leading to symptoms such as rapid breathing, poor feeding, and failure to thrive. PDA can cause significant complications if not treated, including pulmonary hypertension and heart failure.
Choice D Reason:
Coarctation of the aorta is a narrowing of the aorta, which restricts blood flow to the lower part of the body8. This condition does not increase pulmonary blood flow; instead, it causes high blood pressure in the upper body and low blood pressure in the lower body9. It requires surgical or catheter-based intervention to correct the narrowing and restore normal blood flow.
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