The parents are speaking with the nurse to help clarify their understanding of the care of their baby.

Choose the most likely options for the information missing from the statement(s) by selecting from the lists of options provided.

The nurse educates the parents that the infant will likely be started on
dropdown
to try to medically close the patent ductus arteriosus. If this is unsuccessful, the nurse informs the parents that a(n)
dropdown
will likely be performed.

Answer and Explanation

The Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"A"}

When managing a patent ductus arteriosus (PDA), the clinical goal is to facilitate the closure of the ductus to prevent long-term complications such as pulmonary hypertension and heart failure. In preterm infants, the first line of management is often pharmacological, targeting the prostaglandin levels that keep the vessel open. If the vessel remains hemodynamically significant despite medical therapy, invasive interventions are considered to mechanically seal the shunt.

Rationale for correct answers:

Indomethacin (and sometimes Ibuprofen) is a nonsteroidal anti-inflammatory drug (NSAID) that acts as a prostaglandin inhibitor. Since prostaglandins are responsible for maintaining the patency of the ductus arteriosus in utero, inhibiting them often triggers the constriction and closure of the ductal smooth muscle.
Coil ligation: If medication fails, mechanical closure is required. Coil ligation (or surgical ligation/clipping) involves placing a tiny metal coil or a clip to physically block the abnormal blood flow between the aorta and the pulmonary artery. This is often done via a minimally invasive cardiac catheterization.

Rationale for incorrect answers:

Propranolol is a beta-blocker used for arrhythmias or hypertension, not ductal closure. This medication decreases heart rate and contractility. It has no effect on the prostaglandin-mediated closure of the ductus arteriosus.

Furosemide is a diuretic used to manage the symptoms of pulmonary congestion (fluid in the lungs) caused by the PDA, but it does not cause the ductus itself to close.

Balloon valvuloplasty is used to open narrowed heart valves (like in pulmonary stenosis), not to close an open vessel.
Septal patch repair is used to close holes in the wall between heart chambers (like an atrial septal defect or ventricular septal defect), which is a different anatomical issue than a PDA.

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Free Nursing Study Resources

Correct Answer is D

Explanation

Gastric bypass procedures involve creating a small gastric pouch and bypassing a significant portion of the small intestine. This anatomical alteration significantly reduces the stomach's holding capacity and alters nutrient absorption. Effective postoperative management focuses on preventing dumping syndrome, a condition where hyperosmolar chyme enters the jejunum too rapidly, causing systemic symptoms.

Rationale:

A. While reducing fats and gas-forming foods can prevent gastrointestinal distress, it is not the most critical instructional priority. These dietary modifications focus on comfort and minor flatulence rather than the fundamental structural limitations of the new stomach. They are secondary to volume and timing constraints.

B. Mastication is essential to prevent stomal obstruction and facilitate easier digestion within the smaller pouch. While important for safety and preventing esophageal discomfort, it does not address the systemic risks associated with rapid gastric emptying or the volume-related complications of the bypass.

C. Instructing a client to sip fluids with meals is actually contraindicated because it can cause the gastric pouch to empty too quickly. Fluids should be consumed between meals to avoid the rapid transit of food, which triggers vasomotor symptoms like tachycardia, sweating, and severe abdominal cramping.

D. Consuming 6 small, volume-controlled meals is the most important instruction to ensure nutritional adequacy while preventing pouch distension. This strategy minimizes the risk of dumping syndrome by regulating the osmotic load entering the small intestine. Maintaining a strict schedule prevents overeating and promotes stable blood glucose.

A. "My friend smoked cigarettes during the hike." B. "I should have taken an extra dose of fluticasone- salmeterol." C. "I should have eaten a snack halfway through the hike." D. "I should have taken some allergy medications before going on the hike." E. "I have been very stressed out lately and should work on stress management."

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"A"}}

Explanation

Brief introduction:

Asthma management relies heavily on the client’s ability to identify and mitigate triggers that cause airway inflammation and bronchospasm. Common triggers include environmental allergens (pollen, dust), chemical irritants (tobacco smoke), physical factors (exercise, cold air), and physiological stressors (viral infections, emotional stress). Proper education also involves distinguishing between rescue medications, used for acute symptoms, and maintenance medications, which are used daily for long-term control.

Rationale:

Secondhand smoke: Tobacco smoke is a well-documented primary irritant and asthma trigger that causes immediate airway constriction.
Extra maintenance dose: Fluticasone/Salmeterol is a controller medication, not a rescue medication. Taking extra doses during an acute attack does not provide rapid bronchodilation and reflects a misunderstanding of medication roles.
Snacking: While nutrition is important for general health, food intake (unless a specific food allergy exists) is not a direct trigger for asthma exacerbations.
Allergy medications: Since the exacerbation occurred during a hike (likely exposure to pollen/environmental allergens), using antihistamines or allergy prophylaxis is a valid strategy for trigger management.
Stress management: Emotional stress and high anxiety are physiological triggers that can induce or worsen bronchospasm in many asthma patients.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client who underwent an uncomplicated gastric bypass surgery is having difficulty with diet management. Which dietary instruction is most important for the nurse to explain to the client?

Correct Answer is D

Explanation

Patient data The nurse begins client education and asks the client what potential asthma triggers may have been involved in her recent exacerbation. For each statement click to specify if the client has an understanding or no understanding of asthma triggers. Each row must have one option selected.

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"A"}}

Explanation

A middle-aged female client is concerned about gaining 10 lb (4.5 kg) over the last 3 months. Which information in the health history should the nurse use to explain the recent weight gain? Select all that apply.

The nurse is developing a plan of care for a client with cardiovascular disease who reports chest pain on exertion. Which outcome should the nurse include in the plan of care for this client?

A client is admitted with hypotension, tachycardia, low urine output, and dry mucous membranes after severe vomiting and diarrhea. Laboratory results indicate dehydration. Which hormone-driven response(s) should the nurse expect? Select all that apply.

A toddler who weighs 6.5 kg receives a prescription for medication with a dose of 0.5 mg/kg/day PO in equal doses every 12 hours. How many mg should the nurse administer with each dose? (Enter numerical value. If rounding is required, round to the nearest tenth.)

A client recently diagnosed with Hodgkin's disease undergoes biopsy of cervical lymph nodes under local anesthesia. Which intervention is most important to include in this client's plan of care?

The nurse is considering priorities for the client's care. Drag from Word Choices to complete the sentence. The nurse knows that the priority concepts for nursing care management of the newborn with a patent ductus arteriosus are to dropdownanddropdown

The nurse is providing education to a client who experiences recurrent levels of moderate anxiety to situations and perceived stress. In addition to information about prescribed medication and administration, which instruction should the nurse include in the teaching?

A college student presents with fatigue, sore throat, and swollen cervical lymph nodes. Laboratory tests were positive for Epstein- Barr viral capsid antigen (VCA) IgM, but negative for Epstein-Barr viral capsid antigen (VCA) IgG. Which statement describes the client's current infection status?