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Question 1 of 5.

Which statement is true regarding a patient with a Sengstaken-Blakemore tube?

A. The smaller balloon will provide direct pressure to control bleeding from the esophagus.

B. The tube has four lumens, one of which drains esophageal secretions.

C. The esophageal balloon should be inflated to a pressure between 30-35 mmHg.

D. Scissors should be kept at the patient's bedside.

Explanation: A Sengstaken-Blakemore tube is used for esophageal variceal bleeding. Scissors must be kept at the bedside to cut the tube in case of airway obstruction from balloon migration. The gastric balloon (not esophageal) controls bleeding the tube has three lumens and esophageal balloon pressure is typically 20-25 mmHg.

Question 2 of 5.

A diagnosis of multiple sclerosis is often delayed because of the varied symptoms experienced by those affected with the disease. Which symptom is most common in those with multiple sclerosis?

A. Resting tremors

B. Double vision

C. Flaccid paralysis

D. Pill-rolling tremors

Explanation: Double vision (diplopia) is a common early symptom of multiple sclerosis due to demyelination affecting the optic nerves or brainstem.

Question 3 of 5.

A child with Down syndrome has a developmental age of four years. According to the Denver Developmental Assessment, the four-year-old should be able to:

A. Draw a man in six parts

B. Give his first and last name

C. Dress without supervision

D. Define a list of words

Explanation: Per the Denver Developmental Screening Test, a four-year-old should be able to state their first and last name, a milestone achievable despite Down syndrome delays.

Question 4 of 5.

Parents of a toddler are dismayed when they learn that their child has Duchenne's muscular dystrophy. Which statement describes the inheritance pattern of the disorder?

A. An affected gene is located on one of the 21 pairs of autosomes.

B. The disorder is caused by an over-replication of the X chromosome in males.

C. The affected gene is located on the Y chromosome of the father.

D. The affected gene is located on the X chromosome of the mother.

Explanation: Duchenne's muscular dystrophy is an X-linked recessive disorder, with the affected gene on the mother's X chromosome, primarily affecting males.

Question 5 of 5.

The physician has ordered an infusion of Osmitrol (mannitol) for a client with increased intracranial pressure. Which finding indicates the direct effectiveness of the drug?

A. Increased pulse rate

B. Increased urinary output

C. Decreased diastolic blood pressure

D. Increased pupil size

Explanation: Mannitol is an osmotic diuretic that reduces intracranial pressure by increasing urinary output, drawing fluid from the brain.

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