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Question 1 of 5.

The family member of a child scheduled for heart surgery states, 'I just don't understand this open-heart or closed-heart business. I'm so confused! Can you help me understand it?' The nurse explains that patent ductus arteriosus repair is:

A. Open-heart surgery. The child will be placed on a heart-lung machine while the surgery is being performed.

B. Closed-heart surgery. It does not require that the child be placed on the heart-lung machine while the surgery is being performed.

C. A pediatric version of the coronary artery bypass graft surgery performed on adults. It is an open-heart surgery.

D. A pediatric version of percutaneous transluminal coronary angioplasty performed on adults. It is a closed-heart surgery.

Explanation: Patent ductus arteriosus repair is a closed-heart procedure. The client is not placed on a heart-lung machine. Patent ductus arteriosus is a ductus arteriosus that does not close shortly after birth but remains patent. Repair is a closed-heart procedure involving ligation of the patent ductus arteriosus. Coronary artery bypass graft surgery is an open-heart surgical procedure in which blocked coronary arteries are bypassed using vessel grafts. Percutaneous transluminal coronary angioplasty is a closed-heart procedure that improves coronary blood flow by increasing the lumen size of narrowed vessels.

Question 2 of 5.

A client tells the nurse that she takes St. John's wort (hypericum perforatum) three times a day for mild depression. The nurse should tell the client that:

A. St. John's wort seldom relieves depression.

B. She should avoid eating aged cheese.

C. Skin reactions increase with the use of sunscreen.

D. The herbal is safe to use with other antidepressants.

Explanation: St. John's wort increases photosensitivity, so sunscreen use may paradoxically increase skin reactions; clients should be cautioned about sun exposure.

Question 3 of 5.

An adolescent client hospitalized with anorexia nervosa is described by her parents as 'the perfect child.' When planning care for the client, the nurse should:

A. Allow her to choose what foods she will eat

B. Provide activities to foster her self-identity

C. Encourage her to participate in morning exercise

D. Provide a private room near the nurse's station

Explanation: Anorexia nervosa is often linked to issues of control and identity; activities fostering self-identity help address underlying psychological factors.

Question 4 of 5.

The mother of a child with chickenpox wants to know if there is a medication that will shorten the course of the illness. Which medication is sometimes used to speed healing of the lesions and shorten the duration of fever and itching?

A. Zovirax (acyclovir)

B. Varivax (varicella vaccine)

C. VZIG (varicella-zoster immune globulin)

D. Periactin (cyproheptadine)

Explanation: Acyclovir (Zovirax) is an antiviral that can reduce the severity and duration of chickenpox symptoms, including lesions, fever, and itching.

Question 5 of 5.

The physician has ordered an IV bolus of Solu-Medrol (methylprednisolone sodium succinate) in normal saline for a client admitted with a spinal cord injury. Solu-Medrol has been shown to be effective in:

A. Preventing spasticity associated with cord injury

B. Decreasing the need for mechanical ventilation

C. Improving motor and sensory functioning

D. Treating post injury urinary tract infections

Explanation: High-dose methylprednisolone within 8 hours of spinal cord injury can improve motor and sensory outcomes by reducing inflammation and edema.

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