A nurse is providing care to a school-aged child with tetralogy of Fallot. The caregivers ask the nurse if there are any mental health concerns associated with this condition that they should be aware of. Which of the following statements made by the nurse is appropriate?
"Children with tetralogy of Fallot are at greater risk for developing psychiatric disorders. Please call the clinic if you have concerns about changes in their mood or behavior."
"Children with tetralogy of Fallot may experience more intense mood changes during their teenage years. However, they are not at risk for diagnosis of mental health conditions."
"Children with congenital heart defects, like tetralogy of Fallot, are not at risk for a mental health diagnosis. There is no need to be concerned about your child."
"Children with tetralogy of Fallot may be at greater risk of anxiety and depression, but there are no concerns regarding psychiatric disorders."
The Correct Answer is A
A. "Children with tetralogy of Fallot are at greater risk for developing psychiatric disorders. Please call the clinic if you have concerns about changes in their mood or behavior.": Children with congenital heart disease, including tetralogy of Fallot, have an increased risk of neurodevelopmental and mental-health problems; caregivers should monitor and report mood or behavior changes.
B. "Children with tetralogy of Fallot may experience more intense mood changes during their teenage years. However, they are not at risk for diagnosis of mental health conditions.": Adolescence can bring emotional changes, but saying there is no risk of diagnosable mental health conditions understates the documented increased risk in this population.
C. "Children with congenital heart defects, like tetralogy of Fallot, are not at risk for a mental health diagnosis. There is no need to be concerned about your child.": This statement downplays known associations between congenital heart disease and later neurodevelopmental/psychological issues and could delay needed assessment.
D. "Children with tetralogy of Fallot may be at greater risk of anxiety and depression, but there are no concerns regarding psychiatric disorders.": Anxiety and depression are psychiatric disorders; mentioning those symptoms while saying there are no psychiatric concerns is contradictory and may mislead caregivers.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. It is effective for up to 48 hours if positioned properly: A diaphragm should not be left in place for 48 hours; leaving it longer than 24 hours increases risk of infection and toxic shock syndrome.
B. Use of a spermicidal cream or jelly is not recommended: A spermicidal agent is recommended with diaphragm use to increase effectiveness; omission lowers contraceptive efficacy.
C. Leave in place for at least 6 hours after intercourse: The diaphragm should remain in place for a minimum of 6 hours after intercourse to ensure sperm are immobilized, but it should not be left longer than the recommended maximum (usually 24 hours).
D. Remove immediately after intercourse for douching: Removing the diaphragm immediately is not advised; douching after intercourse is discouraged because it can push sperm upward and reduce contraceptive effectiveness.
Correct Answer is B
Explanation
A. Reduced effectiveness of the sildenafil: Sildenafil’s effect is not the primary concern when combined with nitrates; the interaction is about additive vasodilation rather than sildenafil becoming ineffective.
B. Significant decrease in blood pressure: Combining sildenafil (a PDE-5 inhibitor) with nitrates causes marked vasodilation that can produce a dangerous drop in blood pressure (severe hypotension), which is why coadministration is contraindicated.
C. Significant increase in pulse rate: Although reflex tachycardia can occur with hypotension, the main clinically significant and consistently reported problem with sildenafil + nitrates is large decreases in blood pressure rather than a primary sustained pulse increase.
D. Increased risk of bleeding: There is no direct mechanism by which sildenafil combined with nitrates causes increased bleeding risk; the major safety issue is hypotension.
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